🎯 From Therapy to Traffic: Michigan Driving Rehab

Driving is a complex instrumental activity of daily living (IADL) that requires the integration of vision, cognition, perception, motor control, behavior, and executive functioning. When a medical condition, injury, or age related change affects any of these areas, driving safety and independence can be compromised. Driving rehabilitation in Michigan is a specialized service designed to evaluate driving ability, reduce risk, and support safe return to driving or transition to alternative transportation.

Individuals searching for driving rehab in Michigan, occupational therapy driving evaluations, or medical driving assessments are often navigating new diagnoses, post-injury recovery, or concerns raised by physicians or family members. Driving rehabilitation exists to provide clear answers and an evidence-based plan.

Why Someone Might Need Driving Rehabilitation

Referrals to driving rehabilitation often occur after a medical event, diagnosis, or functional change that may impact driving safety. In Michigan, referrals commonly come from physicians, neurologists, rehabilitation teams, case managers, and auto insurance carriers.

People may benefit from a driving evaluation after

• Traumatic brain injury or concussion

• Stroke or other neurological conditions such as Parkinson’s disease, multiple sclerosis, or epilepsy

• Spinal cord injury, limb loss, or complex orthopedic trauma

• Motor vehicle accident with lingering cognitive or physical impairments

• Developmental conditions such as autism or ADHD when driving readiness is unclear

• Visual changes affecting acuity or visual field under Michigan driving laws

• Progressive or age-related cognitive or physical changes

• Medication changes that affect alertness, reaction time, or judgment

  
  

The purpose is not to automatically remove driving privileges. The purpose is to determine fitness to drive, identify modifiable risks, and support safe, independent community mobility whenever possible.

What Is Driving Rehabilitation

Driving rehabilitation is a medically informed process that evaluates and trains drivers whose abilities may be affected by health conditions. It integrates clinical assessment with behind the wheel evaluation and may include adaptive equipment, compensatory strategies, or vehicle modifications.

Unlike a traditional driving school, driving rehabilitation addresses medical, cognitive, visual, perceptual, and physical factors that influence driving performance. It also involves collaboration with healthcare providers, case managers, driver licensing agencies, and mobility equipment dealers.

The Role of ADED and Why Credentials Matter

ADED stands for the Association for Driver Rehabilitation Specialists. It is the national professional organization that establishes practice standards, publishes evidence based guidelines, and credentials specialists in driver rehabilitation.

ADED develops and maintains:

• The Spectrum of Driver Services framework

• Recommended Practices for Driver Rehabilitation and Vehicle Modification

• Guidelines for determining fitness to drive

• Credentialing for Certified Driver Rehabilitation Specialists

• Continuing education and professional accountability

  
  

In Michigan, access to credentialed providers is limited. According to the ADED registry, there are currently (Feb 2026) only eight Certified Driver Rehabilitation Specialists listed statewide. This limited availability means waitlists are common and highlights the importance of working with programs that follow ADED standards and evidence-based practice.

Understanding the Spectrum of Driver Services

Not all driving concerns require the same level of service. ADED defines a Spectrum of Driver Services to ensure the right service is provided at the right time.

Community-Based Education

These programs are designed for healthy drivers without medical complications.

Examples include:

• Driver safety programs such as AARP or AAA

• Traditional driving schools

  
  

These services focus on rules of the road, skill refreshers, and licensing preparation. They do not evaluate medical or functional limitations.

Medically-Based Assessment Education and Referral

These services address drivers who may be medically at risk but do not yet require specialized driver rehabilitation. Referring providers may include occupational therapy practitioners, physicians, neuropsychologists, or other healthcare professionals.

Services include:

• Driver screening

• Clinical instrumental activities of daily living evaluation

• Assessment of vision, cognition, perception, behavior, and physical function

• Education on driving risk related to medical conditions

• Referral to driver rehabilitation or discussion of driving cessation when appropriate

The outcome is identification of risk and guidance on next steps.

Specialized Evaluation and Training Driver Rehabilitation

This is the highest level on the spectrum and is appropriate when medical complexity, safety concerns, or adaptive equipment needs are present.

Driver rehabilitation programs provide:

• Comprehensive clinical and behind the wheel evaluations

• Integration of medical findings with real world driving performance

• Recommendations regarding fitness to drive

• Training with compensatory strategies and adaptive equipment

• Vehicle modification recommendations

• Documentation for physicians, insurers, and driver licensing agencies

• Planning for alternative transportation when driving is not recommended

  
  

What Happens During a Comprehensive Driver Evaluation

A comprehensive driver evaluation typically includes:

1. Review of medical history and driving history

2. Clinical assessment of vision, cognition, perception, motor control, and behavior

3. Behind the wheel assessment using a standard route, home based route, or simulator when appropriate

4. Outcome summary

5. Individualized mobility plan

   
   

Not every client proceeds to on road testing. Clinical findings may indicate that on road assessment would be unsafe or unnecessary.

Credentials and Professional Designations in Driver Rehabilitation

Understanding credentials is critical when searching for a driving evaluation in Michigan.

Driver Rehabilitation Specialist (DRS)

A Driver Rehabilitation Specialist is a health professional with advanced training in driver evaluation and rehabilitation. DRS describes a role or scope of practice, not a formal certification.

Certified Driver Rehabilitation Specialist (CDRS)

A CDRS is a nationally recognized credential awarded by ADED. It requires documented education, supervised experience, successful completion of a national examination, and ongoing continuing education. CDRS is the highest credential specific to driver rehabilitation.

Michigan currently has a very limited number of CDRS providers, with only eight listed on the ADED registry statewide. This scarcity reinforces the need for early referrals and medically appropriate triage along the Spectrum of Driver Services.

Occupational Therapist with Specialty Certification in Driving and Community Mobility (SCDCM)

This advanced credential is awarded by the American Occupational Therapy Association and reflects specialization in driving and community mobility. Occupational therapists with this training frequently lead medically-based driving evaluations and driver rehabilitation programs. In 2026, this program was discontinued and now the only certifications nationally-recognized are through ADED, CDRS being the gold standard.

Levels of Driver Rehabilitation Programs

Driver rehabilitation programs vary based on complexity and equipment.

Basic Programs

• Use original equipment manufacturer vehicle controls

• Focus on evaluation, education, and training

• Require independent transfer into the driver seat

  
  

Low Tech Programs

• Include mechanical adaptive equipment such as hand controls or left foot accelerators

• Address seating, transfers, and positioning

• May modify secondary controls

  
  

High Tech Programs

• Include powered or electronic driving systems

• May involve ramps, lifts, or driving from a wheelchair

• Integrate computerized systems with vehicle electronics

  
  

The level of program is determined by client needs, not by quality of care.

The Ultimate Goal

Driving rehabilitation is about safety, independence, dignity, and access to community life. Outcomes may include unrestricted driving, restricted driving, additional training, vehicle modification, planned re-evaluation, or transition away from driving with a comprehensive mobility plan. The goal is always the same, to ensure the individual has safe, reliable, and meaningful access to their community.

*Fun Fact: Our owner, Quinn, is currently going through mentorship and training to receive her Driver Rehab Specialist (DRS) microcredential. This is the first step in training to become a Certified Driving Rehab Specialist (CDRS).

References

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

Association for Driver Rehabilitation Specialists. (2022). Recommended practices for driver rehabilitation and vehicle modification. ADED. https://www.aded.net/resources/Documents/Recommended%20Practices/2022%20RP%20Driver%20Rehab.pdf

Association for Driver Rehabilitation Specialists. (2022). Spectrum of driver services: Guidelines for determining fitness to drive. ADED. https://www.aded.net/driver-services

Carr, D. B., & Ott, B. R. (2010). The older driver with cognitive impairment: “You can’t test, but can they drive?” Journal of the American Geriatrics Society, 58(5), 983–986. https://doi.org/10.1111/j.1532-5415.2010.02808.x

Edwards, J. D., & Hoffmann, R. G. (2014). Driver rehabilitation and community mobility: Principles and practice. Plural Publishing.

Marottoli, R. A., & Richardson, E. D. (1998). Assessing driving performance in older persons: A framework for research and practice. The Journals of Gerontology: Series A, 53A(3), M235–M241. https://doi.org/10.1093/gerona/53A.3.M235

Michon, J. A. (1985). A critical view of driver behavior models: What do we know, what should we do? Human Behavior and Traffic Safety, 485–520.

Ott, B. R., Lopez, E. D. S., & Heindel, W. C. (2008). Attention and driving performance in older adults with cognitive impairment. Journal of Aging and Health, 20(6), 561–576. https://doi.org/10.1177/0898264308316768

Quillian, W. (2016). Driver evaluation and rehabilitation manual (4th ed.). Association for Driver Rehabilitation Specialists.

U.S. Department of Transportation, National Highway Traffic Safety Administration. (2017). Older driver safety and mobility. https://www.nhtsa.gov/road-safety/older-drivers

Wilde, G. J. S. (1994). Target risk: Dealing with the danger in everyday decisions (2nd ed.). PDE Publications.