Freedom and independence hold a special place in many of the hearts of those with disabilities - especially those who have suffered a spinal cord injury, and have lost much of their motor function.
My world came to a screeching halt when I was 19 after being shot in the back and paralyzed from the waist down. I was just beginning to experience the concept of independence and what that meant as an able-bodied teenager, in particular from my parents.
A large piece of gaining freedom and independence in my life was learning how to drive. Think back to when you were young, what did learning to drive mean for you? To me, it meant exploring the world on my own whether that was driving down the street to meet a friend, taking a road trip across the country, or simply driving myself to school. The world was my oyster - or so I thought.
Many of us take for granted the simple act of hopping in our cars, and runnig out for a simple errand. When I was injured, a plethora of freedoms were abruptly taken from me, and the results were devastating. One of the first tasks I hoped to accomplish in rehab in the early days of my injury was to get certified to drive with hand controls. I was determined to take back this seemingly small piece of my independence.
In 1987 insurance companies allowed patients to remain in in-patient rehab for months on end, as opposed to our healthcare system today which mandaetes patients leave rehab facilities within 14 to 30 days. (Frankly, I think it’s disgraceful, but that’s another topic for another day.) This afforded me the opportunity to become certified to drive with hand controls before I was discharged from the hospital. I was fortunate because Methodist Rehabilitation Hospital in Jackson Mississippi, where I did my stent in in-patient rehab, employed an occupational therapist who was also a Certified Driver Rehabilitation Specialist (CDRS). My CDRS assisted me in completing hand control training in a simulator and then in a driver’s training car. I was discharged from rehab with approval to apply for a driver’s license when I got home. I distinctly remember this as one of the most freeing feelings I experienced after my injury, and to this day driving brings me great pleasure, independence, and mental sanity.
However, there is quite a tedious process that must be followed to ensure that you find hand controls that are safe and comfortable for you Having been through the experience myself, I’d like to outline important steps to finding the right equipment, people, and services.
Find a Certified Driver Rehabilitation Specialist
Before going to the DMV to obtain a driver’s license you will first need a driving evaluation. An important part of the driving evaluation will be listening to the guidance of the experienced professionals. They will help you find the best adaptive driving technology for your specific abilities.
This is one of those situations where you want to get it right the first time. Hand controls and accessible vehicles are strikingly expensive, and if you don’t get advice from a knowledgeable professional you could be make a very expensive mistake. Also, if you are in an accident and you have not performed the state-required training you will incur additional tickets and fines.
Most states require an evaluation be completed by a Certified Driver Rehabilitation Specialist (CDRS). The Association for Driver Rehabilitation Specialists (ADED)
provides information on the courses required to become a CDRS.
Before you hire a professional to evaluate you for driving make, sure you have researched their credentials. This is really important! If the evaluator has been certified through ADED they will have a badge that explains their specialty. Your certified instructor may have an “Older Driver badge,” a “Specialized Instructor Badge,” or both. If you need to find a Certified Driver Rehabilitation Specialist in your area click here.
Thankfully, I had the opportunity to interview Dan Allison, who is an Occupational Therapist and has been a Certified Driving Specialist since 2008. Dan spent the last 8 years at the Shepherd Center in Atlanta teaching people with disabilities how to drive adapted vehicles. Dan explained that the process of learning to drive with hand controls begins with a prescription from your doctor.
In the first session with your instructor, you will complete a clinical evaluation. Your CDRS will review your medical history, balance, hand dexterity, and grip strength. In addition to physical abilities, your instructor will also evaluate psychological factors, such as judgment and decision-making.
Dan explained that some instructors start by training on a driving simulator, while others start with a car or van equipped with passenger-side brakes. Driving trainers have evaluator kits, which allow the student to experiment with several different types of controls. This is how your evaluator will determine which system works best for your particular physical challenges.
Dan recommends that new drivers
go to the ADED website and read the page created to answer basic questions and check out vehicle discount programs offered by multiple car manufacturers. ADED also provides a series of tip sheets,
which explain driving evaluations as they relate to a specific diagnosis.
In my conversation with Dan, he explained that cars made prior to 2007 use electronic controls to operate the gas only. The brakes are still mechanical, which means they are connected by a rod that goes to the brake pedal. The fully mechanical controls can still be used on newer vehicles, but the electronic controls are often prescribed because they can be turned on and off by a switch. This makes driving safer and easier when an
able-bodied person drives with their feet.
Different Types of Hand Controls
Tri-Pin Electric Hand Control System
- Push Rock Hand Controls are a popular style of hand control that is attached mechanically. The handle is upright and you push the handle forward to brake, and pull it towards the driver to accelerate. The Push Rock style is simple, reliable, and reasonably priced. They are also called “universal hand controls” because they can be used for people with most types of disabilities.
- Right Angle Hand Controls are the least fatiguing type on the market. The brake is applied by using a forward motion and the accelerator is applied when a downward motion is used. I have used this type of hand control more than any other, and I find them easy to use as well as most reliable. I have never had any service issues when using the Right Angle hand controls. The Right Angle hand controls leave a large amount of legroom, which makes transferring in and out of the car much easier.
- Push-Pull Hand Controls can be installed on the left or the right side of the steering wheel. Push-Pull hand controls also brake by pushing the handle forward. You pull the handle backward toward yourself to accelerate. Push-Pull is a good style for people with limited hand movement, and strength.
- Push Rotate Hand Controls are accelerated by twisting the handle like a motorcycle. I have used this type of control before and I found it a little more difficult to accelerate. On occasion, I had to twist the handle several times to accelerate quickly. The twisting motion necessary for acceleration can get tiring on long drives.
This is a great system for high-level quadriplegics who are incomplete and are able to drive with minimal arm movement. Two separate Tri-Pins can be installed and one can be used for steering while the other one is used to accelerate, and brake. There are also joystick options for people with limited upper body movement. Another manufacturer called Driving Systems Incorporated (dSi)
also has an interesting system that allows quadriplegics to drive independently. Electronic Mobility Controls (EMC)
makes the Aevit 2.0 a “drive by wire” system meaning the movements by the driver with the steering input device (joystick, yoke, and steering wheel) is not transmitted mechanically, but instead goes through the steering column, and then to the front wheels.
If you have an injury above T10 and you balance problems, you can get turn signal extensions. Another item your driving instructors might recommend is a torso support belt. This will give a driver with balance issues the extra feeling of security; and it helps to decrease driver fatigue. If the driver is held in place by the torso belt they will nothave to work as hard to hold themselves in place, and therefore conserve energy.
In addition to the different types of hand controls, there are many different brands including, MPS
, and more. The prices and features vary. If you are interested in hand controls or an accessible van click here
and someone from AMS Vans will contact you with more information. I advise doing a lot of research before settling on the best hand controls for you. Some hand controls are not compatible with certain makes and models of vehicles - remember to ask your installer before making your final decision.
Many people with different degrees of mobility impairment can find controls that enable them to get out on the road. The ability to drive has afforded me, and so many others like me, the opportunity to take back a level of independence. Each step you take towards living a life of “normalcy” allows many of us to enjoy life to its fullest.