Instrumental
Hi, I'm Carrie, a stroke survivor, and a member of BIND.
And I'm Kezia stroke, survivor and member of BIND as well. And today. Uh, we're going to be listening to. Uh, Brandon. Uh, about going back onto driving. That is something that we really find very important after a brain injury survivor, um, to be able to gain back our independence. So he is the owner of Driver Rehabilitation Program in North, Texas H and T Driver Rehabilitation Sppecialists, LLC. Which focuses on neural cognitive logic. I can't say the word. Right. That's.
Cool near- neurologically impaired population. Like us. Yeah, just like us. Um, so we're excited to have him here and having all of you listen to him and giving us more information on going back to drive. So welcome back, Brandon.
Thank you. Glad to be back.
Okay. So in the first episode we talked a lot about modifications and also, um, I can't say these words today, but anyway, we talked about going back to drive and today we just wanted to know more about, uh, the company that you're running and how does that help? Uh, survivors to go back and to be on the road.
Yeah, thanks for having me back again. Um, so we're occupational therapy based program. Uh, we do work under a doctor's order, just like you would, if you were getting a referral for Occupational Therapy. Okay. Anywhere. And really that covers us. Well, number one, it tells us that yes, these services or recommended, you know, we're not going to see somebody that's doesn't have a diagnosis. That's not what we do.
Um, And once we get that referral, uh, we do scheduling all that good stuff, but we start with an evaluation. We call it an OT driver evaluation. It's a comprehensive evaluation that could take up to four hours. Oh wow. We do come to your home. Uh, however, there is a fee associated with that. Where you can come to one of our two offices. We have office in McKinney and one in Flower Mound.
Um, so once we, you know, we kind of get your records, if you've had, you know, intensive therapy, We want those notes. Um, We'll schedule the appointment. During the appointment, we do the initial interview, kind of, you know, what you were doing before your brain injury. Kind of your recovery process and how you're functioning now. Uh, that's one last question is about ADL's and IDL's okay. Then we get into our testing. We have test your vision from, uh, uh, for multiple reasons.
Number one, vision is a big part of driving. And like we were talking about, you could have the left side neglect. You could have peripheral vision loss, which that's a controversial subject here in the state of Texas as well. We can talk about that later. Hemianoxia Um, That's where you have visual.
I get it. That's a new word for me. I haven't heard.
Yeah. Hemi- anoxia. Uh, and, uh, so we could talk about that later, but so we do the vision test and of course, we got to test your acuity. We also do some visual perceptual tests, like how the brain and the eyes work together. You know, these are tests that you've probably done before through your course of rehab. Uh, and then we get into the physical testing. So we, you know, we test your strength, your range of motion.
We do, uh, you know, kind of your, uh, reaction time for do we're reaction time behind the wheel. But, uh, really your strength range of motion. We asked about your spasticity. If you have high tone or flacid tone, do you have spasms? We get all that information. That's all important to driving. Uh, then we gets you behind the wheel. So as I, we in, uh, this children were talking earlier the clinical testing, that's what I would call the clinical testing.
Uh, because really it's a two part evaluation clinical and behind the wheel. So the clinical is important. You know, we do the cognitive testing, processing speed, executive functioning skills, you know, divided attention. We're looking at those domains. That's all good to get those scores in the clinic, but then we get you behind the wheel. Now the level that we test you behind the wheel depends on a multitude of things, you know? How long have you been driving? Are you a new driver?
Are you a returning driver? You have to have a valid driver's license or permit to be seen by our program. Uh, do you need adaptive equipment? So if I'm introducing adaptive equipment, you know, we're probably just going to stay in the parking lot. You know, I'm not going to introduce something and then get you out in the 45 mile per hour traffic. I don't know if you're doing great. I might. You know, I'm not opposed to it. Um, but we progressed that up as you're progressing.
So if you're doing great in the parking lot, You know, Hey, we get you in a 25 mile per hour traffic. We'll get you into a neighb, your neighborhood. And then we're just looking at basic maneuvers. You know, of course we have an instructor vehicle. We have, we have an instructor brake on the passenger side. So, and we're also trained to take over the vehicle.
If you're doing something unsafe, we hit the brake, put it in neutral, grabbed the steering wheel, get you over to the side of the road, figure out what's going on. Um, we're also certified driving instructors for the State of Texas. So we have that background. We have the occupational therapy background, and then of course we bring it all together with the driver rehab certification. Um, so we thought about this.
You know, Uh, and our association has thought about this Aided and they have, we take continuing education courses through them. So getting back to our evaluation, if things are going good, and we got you at 25 mile prior traffic, if they're going. You know, well, we'll keep progressing you up. Uh, now we get back to the office or your home, depending on the situation. And we talk about recommendations. We tell you how you did on the clinical testing, how you did a behind the wheel.
And then we provide recommendations. Recommendations can vary. So if you've had a brain injury and you've returned. Uh, you know, And you feel like, and we think that, Hey, you're doing great. You know, like you, you're doing awesome. Uh, we might just recommend that you retake the road test at DPS. And we'll help you with that process. Uh, if we think you need training. We're going to tell you, Hey, we think you need some training.
Uh, if we think you need equipment, we're going to say, we think you need equipment. This is equipment we use today. We might switch it depending on, you know, We. That's an ongoing process. Yes. Because we have different versions of this. Uh, you know, if we have, you know, of course, like we were talking about earlier, we have left side. Uh, accelerators left foot accelerators. This is what we call them. Various piece of equipment for the steering wheel, hand controls and so on and so forth.
Uh, those recommendations are usually done in the form of number of hours. So we'll say, Hey, we think we can, you know, we think you need five hours or 10 hours. It might be 20 hours. If you're a new driver, you know, Uh, neuro-typical, uh, driver in the state of Texas it's recommended they have 44 hours a driver's training. So that's quite a bit. Yeah, that's quite a bit, um, And, you know, that's kind of where we're at.
Yeah. I think it's actually really well to be hearing this because, um, It seems a lot more thorough and it's actually really good for brain injury survivors to know that it's not just a simply like, oh, today you, you should be back to better here. Go jump in the car and let's go. Like, I think it's really good to be hearing that there's a good process and it's more detailed for brain injury survivors then like, ah, I want to say this, but it's not their best where it's like a normal driver.
Right, right. I think it's really good to be hearing it. Thank you so much for sharing that.
I am with brain injury, you know? Of course. You know, sometimes the outcomes are quite good. You know, I'll evaluate somebody and they have that very fixed gaze because, you know, they're just not used to using their ocular motor skills in a dynamic way. You know, and, and I'll do the initial evaluation. They're looking straight ahead; their missing stuff. The processing speeds. Very slow. Uh, and I'm like, wow, I don't know.
But, you know, we give them some time behind the wheel and they, that neuroplasticity, they start retraining their brain and things start making connections. And like I said, we do a slow progression up. That's not everybody's course. We know that, you know, that's not everybody's course, but you know, sometimes we do get some good outcomes. You know, and then, Hey, you know, but it might took 20 hours. It might took 30 hours, you know, but now they're driving. Great. You know?
Um, and so it just all depends.
Yeah. It's kind of like everyone says, you know, once you've met a brain injury, you've met and brain injury. So everyone is a little different and then what they're going to get do y'all have, like, I know when I was an OT, I didn't go through a program like yours, but I know in OT I had the little car simulator. Right. Like a video game, right. That annoyed the crap out of me.
I know. Yeah. Yeah. Yeah. I don't want to talk bad about driving simulators that, but I think they have a, I think they have a tool. I think they have a place we don't have. I don't have one, you know, I, you know, I think, you know, In the, in the rehab center, like in a CNS or Baylor or Pate. You know, just to see if somebody is in the ballpark. Yeah. Let's just see if they're even in the ballpark of getting back to driving, you know, but then actual, like, uh, Identifying. I don't know.
You know, it's, it's hard to say. There's also simulator sickness, you know, similar sickness is a big deal. Uh, it's not talked about enough, but that is an issue as well. So, what is that? That for whatever reason, the way that you're visually processing, you know, what's going on in that, that simulator people get sick. And there's a percentage of people that just experienced simulator sickness.
I'm having flashbacks to 16 sitting in that and sitting in that. Um, the what's the word? Um, He didn't say it. Buildings at one. We're part of the school. I mean, it was just full of those little cars and we would sit in there. Oh, yeah. Yeah. Yeah. And then they finally get you behind the wheel.
Yeah. I mean, you know, I don't know. It's hard for me to say, you know, a, we don't use them. Yeah. Okay. We'll get you behind the wheel.
Yeah, and I think that's brain injury survivors. Like it does happen. I mean, for me, it was an older age. I was already driving or should have been, but city, girl doesn't drive. Um, so yeah, so, you know, it's, it's good to be able to go back into. Well, we normally use right. And not like a video. So I think that's really good. Yeah. Right. Yeah. Um, I think earlier we did talk about like some accommodations and like, um, how things can.
The process, if you have like a aphasia or some cognitive issues or some visual things. So I think that's really good. Um, we also had a question also about medication and, um, if you, if you can, like one of the questions was, are there certain medicines that are just like, if you take the certain medicine, you should not be driving at all.
No, I think that's at your doctor's discretion. Yeah. You know, uh, the doctor has a lot of power when it comes to those things. Now if you are, uh, if you do have seizures, And you're all on medication for anticonvulsant. Um, The medical advisory board recommends that you have your driver's license updated. And I can't remember the name of the restriction. We could look it up. But basically there's a restriction. Just like we were talking about either a restriction for corrective lenses.
You have a T restriction for automatic transmission. These folks have this restriction. This is they can not operate a passenger vehicle. To include taxi cabs, school buses, or emergency vehicles. Okay, because they're on the medication. Sure. Now, if they want to get into that down the road and come off their medication, the doctor. You know, at the end of the day, it's at the doctors. Discretion. You know, we used to say that in the army, it's at the commander's discretion.
It's at the doctor's discretion. There is a form. And the form is called a DL for driver's license. 1 77. That's a DPS form. And the medical advisory board have, they've said that they're going to stop using this form, but I like it and they're using it right now. And on the form. It says this, this driver is under your care for this diagnosis. They're on these medications and your professional opinion. Do you recommend they return to driving? Yes or no?
The next slide is in your professional opinion, do you recommend they need further testing? Yes or no. Then at the bottom of that form, the doctor has to put his medical license on it. And he faxes that to Austin. You know, to me, that is, that's a great form. You. You know, but I've heard there's talks if they're going to do away with that and revamp it.
But, um, you know, that's one of those situations where the doctor should fill that form out and say, yeah, Hey look, she drives with this medication, but I think she's safe to return to driving. Here's my medical license number. I'll put that behind that, you know? Cause here's model thing your doctor says, okay. I think it's okay for your turn to drive. Okay. Too easy. Fill out this form. And give me a copy and fax it to Austin, that's it. Sure.
Yeah, I think that that makes. I mean, if that were me, I would be very safe. I would feel very, also confident on myself, just by simply saying, you know, this doctor believes in me and supports me and me moving forward to my dependence.
And if they don't feel comfortable, filling out the form. Okay. But, you know, it's all time. Oh, my doctor said I'm fine. Okay. Okay. Right. Thought this form. Because if you get in a wreck and hurt or kill somebody, You know, I just want a little bit of liability covered now at the end of the day, I don't know what can happen in the court of law.
Right. Sure. Yeah, that makes sense.
And I have a question. I know we've talked a lot about aphasia as far as how it effects your speech and that kind of bit. What about, I guess, more cognitive if. The aphasia is affecting them with the reading. And let's say that, you know, they. They maybe can't read the street signs. Well enough or the name street names. So they're always passing them. Is there. Well, I mean, you need to help with that.
That's where I really think you need to come to our program or a program like our program. And we can further test that. Like, can you compensate with GPS? You know, can you compensate now receptive aphasia? Can you understand the verbal language or do you have uh or maybe you can't, and maybe you, but can you visually look at it and says that. Okay. That's telling me I need to go right at the next street. Or I need to make a left at the next street.
Or am I just going to stay in the area that I know that I have memorized? You know, uh, those are recommendations that we can make. You know it. And so our goal is we want to keep you independent for as long as possible, and we will provide those recommendations. Hey, stay in your area. Because when you get out of your area, if you get lost, Sure. We get 10 minutes. But, um, the, uh, so does that make sense? I mean it. You know, I've seen people. Most of the time.
Not most time, but I've had a couple people with aphasia that are excellent drivers. But for me to provide like audible instruction, it just was not going to happen. I had to do hand gestures and that's what I'm talking about when they retake the road test, some of those accommodations could be, Hey, that evaluator knows if they can't understand. Language and that they give them audible. Uh, I'm sorry, physical key. Yeah.
Yeah. Yeah. And, um, that notification. It just needs to give us a little pause. Like let's slow down a little bit. So basically yeah. So, um, just listen. Giving all of our listeners, just some time to remember, to press like on all of the buttons and follow us every Thursday so we can continue having all these conversations. And then we go back to you. That's about it. Yeah.
So, yeah. And then on aphasia you know, about the communication and pedigree. Okay.
We did. I actually. I shouldn't have been the ones that speak right now. Cause I forgot my question. Um, So. Basically. Oh, my goodness. I might totally brain dead right now. Um, we, I had a question about, um, basically right now, what you were talking about. Uh, with driving. Oh, yes. So for evaluations that you were talking about earlier. Um, when I was in rehabilitation, my neuro neuro. I can't say these words. Um, but the validation I did that. Uh, told me I had a phasia.
Went along with my family. Uh, do you do these, like, um, is there a certain part of the driving and what you teach and what you evaluate and then also tell people, do you also do that for the families present so that they know, like, you know,
A hundred percent. Yeah. We highly recommend a family member. There is there for a loved one, whoever. Yeah. And we bring them in, you know, a lot of times we bring them in for that initial interview and I'm like, okay, does this line up? And sometimes the family member has to help out quite a bit. Sure. Especially with aphasia. Uh, and then at the end, the family members there for the recommendations. Okay.
Yeah. Yeah, I think that's all important because a lot of the times like, yes, we are the client where the patient or the client, we are the person that has to take these actions. But really we're also with our caregivers, our family, our friends, our supporters that are kind of like, kind of like backing us up. So we, you know, keeping them informed is something very important. Um, yeah, a hundred percent.
Yeah. And I think that was something very like, uh, valuable for my experience that I had a really good support system. So I think that's awesome that you offer that too.
Yeah. Yeah.
Yeah. Yeah. Yeah. Now there's one thing that we didn't talk about that. Not really, I guess it's a legal requirement, but not but. How does or does having a brain injury when you go back to driving? Can it or does it affect your car insurance account?
It should not. They sh they should not be able to discriminate against you under that. Uh, disabilities act. Uh, The under the, um, That, what is it, ADA? The, uh, That legislation. They should not be able to discriminate against you on that. Now, if you have modifications done to your vehicle, You would we recommend that you let your insurance know, because if you get in a wreck. And those are destroyed. They can potentially pay for those.
Okay. But. They're not supposed to be able to allow to raise your rates or adjust your rates because you have a disability.
Oh, that's really strong. That's really good to understand and to know, right, right. Because there's a lot of limitations that I think as brain injury survivors, we put on ourselves, right? Like, oh, I can't do this because that's happened to me. But no there's, there should no, not be any limitation that other puts like. Place on ourselves. Right. Okay, cool. Yeah.
And just so you know, I mean, we talked about the retake and the road test and all that. You know, eventually you have to go into the DPS, um, you know, depending on your age. And when you go in and fill out that application, they're going to ask you if you have any of those medical conditions.
So, yeah. And so then when asked those questions, there's no negativity to say like, yes, I had a stroke. No,
I don't think so. It will kind of be tedious. Yeah. Yeah. They're going to, you know, there's. Yes. Potentially, you got to take the road test you potentially, you're going to get this big packet in the mail and you got to go to your neurologist or maybe even your visual neuro optometrist. And you've got to get all this stuff filled out and then you got to fax it to Austin. And they got to sit in front of the board, you know, and so on and so forth.
But you're covered from a liability standpoint, right?
And that's, I think that's the most important part that we want to get across to all our listeners and the other brain injured survivors. I know my friend, Carl, and I tell people that all the time. It's really as simple as same way. Correct. And I'm not going to spell that out cause we're a family podcast. Um, but I think everybody knows what I mean, but yeah, it is.
If you get in a wreck and the other person's attorney finds out, you've had a brain injury, they're going to do everything within their power to prove that it was because of your brain injury and it was not. Their client's fault.
Right. And they might even come back and Sue me. You know, that's happened. You know, I have a colleague down in Houston and he's been doing this for like 35, 40 years. At Chad Strowmatt, if you're down in Houston, listen to this podcast. Strowmatt, great rehab, a travel company. And we get together and talk every once in a while. And, uh, it's just amazing. You know what the lawyers can get a cooked up. You know, and it's, it's, it's terrible, but it is what it is. You know, so.
Yeah. I mean, eventually you're going to have to go into the DPS and you're going to have to check that box. So why not? Let's get ahead of it. Right. And then they could always call. We're not going to charge you. You know, To help you to that process. Sure. You know, we're going to educate you for free. And if I need to I'll call one of the local managers. Uh, not saying I can pull any strings or anything, but these, the answers to these questions are not always out front.
You know, you've got to kind of do some research and it's subjective. Yeah. But at the end of the day, Thank would beat that dead horse. You've had a brain injury, I think. you should we retake the road? Sure.
I mean, I know I re took it, like I said, for my, my own peace of mind and maybe not just for my own peace of mind. But I bet from my mom and dad's to.
Guess what you go to this Plano DPS right here. And I don't care that I'm calling them out. It is what it is. The manager right here in Plano. Doesn't understand that. Yeah. Um, and she's telling people, no, don't do that. You're opening up a can of worms. Well, once again, just write that out ma'am and sign it. And let me get your point of contact. So if I get in a wreck or kill somebody, I'll just say the managerat Plano DPS and I didn't have to retake the road test.
I would open up a can of worms. You got to advocate for yourself. That's what and your family? You know, that's what you gotta do.
I think a lot of the times with a lot of the questions you've reiterated, like it's to our benefit and then also to advocate, right. You just have to advocate for ourselves. Um, I wanted to just ask, uh, like kind of like a last question of like, what would you really like to say, like in shortest way possible? Um, To go on with the independence and going back to driving. What are the needs for. Brain injury survivor for family and supporters. What would be your best advice?
What. Like I said, just, if you feel like, um, You know, you're ready to return to driving. I would just consult with, like you said, the family members. And maybe you have a third therapist. You know, your OT or your, um, speech therapist and say, Hey, what do you think you think I need further evaluation? You know, or, and maybe they don't know. And then that's when you come see me. Uh, and ask your neurologist.
We were talking earlier, you know, if you feel like that, You've made some big gains, you know, and it's been a couple of years, talk to your neurologist. Hey. I feel like, you know, I might, might've made some big gains and then come see somebody like me, you know? Uh, and we can do that evaluation. You can get that peace of mind because I want to do all that testing. And then I'm going to get in the car and watch. Right. Yeah. And I do this every day. This is all I do.
And then talk to us. Right. Yeah. So. Awesome. Well, I would love to thank you so much for giving up your time to come here and then do, um, like making us aware and educating us on going back into driving after a brain injury. Um, it has taken some time and we're so grateful for you coming in.
Yeah. Thanks for having me.
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