The extent of evaluation performed may vary from person to person depending on the severity of injury and presenting symptoms. Steps in evaluation can include:

1. An examination of vision. TBI can cause a range of visual problems, including blindness, diplopia, and multiple other problems [refer to TBI & Vision Problems fact sheet]
2. Examination by a physician familiar with physical problems caused by TBI, such as paresis, spasticity, ataxia, and diminished sensation, among many other things. A physiatrist is typically the specialist addressing these issues.
3. Examination of cognitive abilities, such as mental processing speed, attention, memory, and reasoning skills. Typically, this evaluation is performed by a neuropsychologist.
4. On the road driving evaluation is the gold standard. This typically involves the injured person driving under the supervision of a driving evaluator in a range of driving conditions. This evaluation can take several hours and provides a pass/fail designation. This evaluation is typically performed by an occupational therapist with specialized training in driving evaluation. Insurance does not pay for such evaluations, so it is the responsibility of the patient and family.

In some cases, based on a person’s progress physically, cognitively, and behaviorally, an on-the-road driving evaluation is not necessary. The injured person can be supervised by family members as driving is resumed in a measured and gradual fashion. A decision to pursue this path is best left to those with experience in evaluating those with TBI.

• Typical Patterns of Driving