Brain injury frequently results in cognitive impairment, reducing an individual's ability to judge driving situations accurately. Rehabilitation professionals use clinical and on-road tests to determine whether an individual is safe to drive. The on-road tests are typically conducted under calm conditions and offer little information regarding an individual's response to real-life driving challenges. The lack of valid and reliable driving assessments leaves rehabilitation teams ill-equipped to recommend whether patients should be allowed to drive. Until recently, driving simulators were too expensive or unsophisticated for widespread clinical applications. Recent advances have improved performance and reduced costs. This STTR project will investigate whether STISIM, a low-cost PC-based driving simulator, can improve the driving assessment of individuals with cognitive impairment. We will develop two driving scenarios, one basic, one challenging, and pilot test them on 5 subjects with moderate cognitive impairments and 5 control subjects. Results from the simulator will be compared to results from an on-road driving evaluation and to standard predictions of driving capacity as judged by a battery of clinical paper-and-pencil assessments. Qualitative data gathered from subject exit interviews will also be used to assess simulator efficacy. A phase II project will validate the simulator in a comprehensive clinical study.
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