Resumption of driving with aphasia following stroke

Abstract

Background: Fitness to drive may be compromised by a variety of medical conditions, including stroke. Driving may legally be resumed 1 month after stroke if clinical recovery is deemed satisfactory. Advice available for patients and medical practitioners is unclear and inconsistent as to whether return to driving is influenced by aphasia. Information on the opinions of medical practitioners and aphasia therapists regarding resumption of driving with aphasia, the return to driving experience of people with aphasia, and their road sign recognition ability, has been largely anecdotal. Aims: (1) To determine the views and practice of medical practitioners and aphasia therapists on return to driving with aphasia caused by stroke and the experience and effects for aphasic people of resuming or not resuming driving. (2) To assess the road sign recognition ability of aphasic people who had returned to driving or wished to do so in relation to a comparable non-stroke population. Methods and Procedures: People with aphasia following stroke (n = 18) who had returned to driving or wished to do so, medical practitioners (n = 11), and aphasia therapists (n = 18) were interviewed to determine the patient experience and medical practitioners' and therapists' views on driving with aphasia. Road sign recognition was assessed in the aphasic and a matched non-brain-damaged control group (n = 18). Outcome and Results : The majority of medical practitioners and aphasia therapists thought that in some cases driving with aphasia was contra-indicated. Reading comprehension was the communication aspect considered to be most important for driving fitness. The aphasic group was significantly less proficient than the control group in road sign recognition and in understanding written and spoken road sign descriptions. Few aphasic drivers described new driving problems and most now drove less, more carefully, and for reduced distances. Those who had not returned to driving felt social activity and wellbeing had been affected. Conclusions : Despite difficulties with road sign recognition and related reading and auditory comprehension, people with aphasia are driving, including some whose communication loss is severe. Where relevant, practice in recognition of road signs and written road information might be included in speech and language therapy management.