Driving With Cerebral Palsy

Growing up is a natural part of life. For those of us with special needs children, the thought of letting them become independent adults can be both frightening and relieving. If your child has cerebral palsy, you have already struggled through years of coping with physical, sensory, or cognitive disabilities. You may wonder if it is even possible for your son or daughter to drive a car. In most cases, with the help of special techniques or adaptive driving equipment, your child can compensate for any impairments and safely get behind the wheel.


What is a Cerebral Palsy?

Cerebral palsy (CP) is a non-progressive motor disorder usually caused by damage to the brain during pregnancy, childbirth, or early childhood development. 

The most common part of the brain to be damaged is the cerebral cortex, which controls sensation, thought, and motor functions, among other things. When this area is damaged, the child can have weakness, muscle stiffness, involuntary muscle movements, and difficulty with controlling and coordinating movement.  This form of CP is known as spastic CP

The second most common form of CP is ataxic CP, which is caused when the cerebellum is damaged. When this occurs, the person’s muscles become too flexible, which can lead to weakness and floppiness in the limbs. They may also suffer from balance and coordination problems.

How can my child prepare for driving with cerebral palsy?

Cerebral palsy is a life-long condition. Because it is rooted in damage to the brain, it is irreversible. However, there are things that can be done to improve general health, which will, in turn, help your child be in better shape for driving.

Operating a vehicle can be both physically and mentally taxing at times, so make sure they are getting enough sleep and eating a healthy diet. Exercise is also very beneficial. The right exercises and stretches can help improve their strength, control, and range of motion. Healthier muscles make it easier to minimize uncontrolled and jerky movements, which will help them maintain better control of their car. They don’t need to rush into these exercises too quickly, as this could cause injury. A gradual increase in the difficulty of their workouts will help them build their strength and stamina. Talk to their physician or physical therapist to determine which exercises are best for their unique symptoms.

How CP affects cognitive abilities

  1. May have problems with memory, which may make learning the rules of the road a challenge or interfere with recalling where they are and where they are driving
  2. A person with CP might struggle with decision making and problem solving, which could make it dangerous for them to drive in heavy traffic or other situations where they will need to respond quickly or suddenly adjust what they are doing, such as when there are construction detours.
  3. It is also possible that they may have a hard time recognizing objects and processing visual stimuli to determine its relevance. This makes reading and reacting to signs and traffic lights difficult.

How CP Affects Physical Abilities

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  1. Improper communication between the brain and the muscles results in inappropriate, uncoordinated movements or paralysis of limbs. If the legs are affected, this can make using the gas, brakes or clutch difficult. If the arms are affected, it can be challenging to operate the steering wheel or other controls.
  2. Sometimes, those with CP have the problem that when they start to make one movement, it results in a different, undesired movement. This could pose a danger behind the wheel if reaching to change radio stations with one hand causes the other to move and turn the steering wheel, for example.
  3. Those with ataxic CP may also have problems with balance and coordination. They may need additional support to stay upright in the driver’s seat, especially during turns, or may struggle with reacting quickly and appropriately to stimuli such as changing lights or merging traffic.
  4. Nearly a third of people with cerebral palsy will also have epilepsy. Having seizures behind the wheel can lead to car accidents, and it is very important that these are controlled with proper medication before pursuing a driver’s license.

How a Stroke Affects Visual Abilities

  1. One common visual problem is amblyopia, which results from improper function in nerve pathways to the eyes and causes strabismus, a problem where the eyes look in different directions. This, in turn, can lead to poor hand-eye coordination. This can make steering and reacting to vehicles and obstacles on the road more challenging.
  2. A person with CP may also have problems with refractive errors, which take the form of nearsightedness or farsightedness. This can make seeing the road difficult but is easily remedied with corrective lenses.
  3. Around 10% of people with cerebral palsy will have such severe vision problems that they are legally blind. This often occurs with other severe mental and physical disabilities, leaving them incapable of driving.

What Next Street Looks For When Assessing

Whenever possible, we try to meet with our patients in the comfort of their own homes to carry out an assessment of your abilities. All your child needs to do to prepare is to get a good night’s sleep and eat normal meals so they have the strength and energy to get through the visit, which can take up to two hours. They don’t need to worry about memorizing anything, this isn’t a test of their knowledge, it is an assessment of their motor skills and cognitive and visual abilities.

We start out by taking the time to get to know your child and their unique situation. Then we evaluate their visual, physical, and cognitive abilities. We check their visual acuity, peripheral vision, and ability to move their eyes about and scan their environment. We check physical flexibility, strength, and coordination. This includes both muscle coordination and hand-eye coordination. There will also be several exercises we do to evaluate memory, awareness, judgment, and the ability to follow directions. If this all goes well, we will recommend them for a behind-the-wheel evaluation at a later date where we will determine needed adaptive equipment and develop a driver training program that includes the adaptive equipment. 


Want to read and learn more?

Check out the Driver Rehab blog to learn more about driving while aging.

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