Date Presented 04/22/2023

Online self-awareness can prompt self-regulatory behaviors and modifications of driving performance. This study describes the importance of online self-awareness for predicting fitness to drive among people at risk for compromised driving skills.

Primary Author and Speaker: Meirav Rosenfeld

Contributing Authors: Yael Goverover, Penina Weiss

Driving is strongly associated with an active lifestyle, well-being, and quality of life. Independent driving requires cognitive, motor, and visual skills. In the cognitive domain, attention skills and online self-awareness-the ability to monitor performance and recognize problems within the stream of action-are crucial for driving, especially in the rapidly changing environment of driving. This study examines if cognitive (i.e., online self-awareness and attention) and motor abilities (i.e., physical response time) can predict fitness to drive among individuals referred to OT evaluation with concerns about their driving ability. This is a case-control retrospective study, with 39 participants who were referred to in-clinic evaluation and on-road test due to changes in their health status, older age, a license renewal requirement, or prior car accidents. 23 of them were classified as fit to drive and 16 as unfit to drive, based on a licensed driving instructor (DI) and registered OT practitioner evaluation. Attention was assessed by Color Trails Test and physical response time by Vericom Stationary Perception-Reaction Timer. Online self-awareness was assessed by comparing the DI evaluation to the participants’ estimation of their driving performance, and its score indicates if the participants’ over-, under-, or accurately estimated their driving ability. Participants who were fit to drive showed better attention skills and shorter physical response times than those unfit to drive. The unfit to drive group overestimated their driving ability while the fit to drive group showed accurate or almost accurate estimation. Online self-awareness was a significant predictor of participants’ fitness to drive. This study indicates the importance of online self-awareness for predicting fitness to drive among people at risk for compromised driving skills. Thus, online self-awareness can provide important information during evaluation and should be addressed within OT intervention.


Dickerson, A., Schold Davis, E., & Carr, D. B. (2018). Driving Decisions: Distinguishing Evaluations, Providers and Outcomes. Geriatrics, 3(2), 25.

Gooden, J. R., Ponsford, J. L., Charlton, J. L., Ross, P. E., Marshall, S., Gagnon, S., Bédard, M., & Stolwyk, R. J. (2017). Self-Awareness and Self-Ratings of On-Road Driving Performance After Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 32(1), E50–E59.

Samuelsson, K., Lundqvist, A., Selander, H., & Wressle, E. (2022). Fitness to drive after acquired brain injury: Results from patient cognitive screening and on-road assessment compared to age-adjusted norm values. Scandinavian Journal of Psychology, 63(1), 55–63.

Toglia, J., & Goverover, Y. (2022). Revisiting the dynamic comprehensive model of self-awareness: A scoping review and thematic analysis of its impact 20 years later. Neuropsychological Rehabilitation, 1–50.