Medical Driving Evaluations

Driving with Spina Bifida

Posted by Joan Cramer on Sep 24, 2019 7:35:56 AM
Joan Cramer
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If your child has grown up overcoming the challenges of spina bifida, the idea of them successfully operating a motor vehicle may seem out of the question. 

However, in reality, there are actually a number of different ways, through adaptive driving equipment and additional training, that people with spina bifida can successfully learn to drive

In this article, we’ll explore spina bifida and how it can affect your child’s driving ability. Then, we’ll touch on some of the ways that your child can overcome these challenges, and with the help of some specialized training and guidance gain the mobility and independence of the open road.

What is Spina Bifida?

Spina bifida is one of the most common neurologic birth defects worldwide, affecting about 3 out of every 10,000 children. These complications first manifest during the first few weeks of pregnancy and result in the spinal cord to form incorrectly, which can cause a number of problems with nerve tissue.

Though the exact cause of spina bifida is unknown, studies have shown that folate deficiencies, uncontrolled diabetes, obesity, and certain medications (particularly anti-seizure medicines) can all increase the risk of this medical condition.

There are three types of spina bifida with varying degrees of severity.

Spina Bifida Occulta

The mildest form of spina bifida is spina bifida occulta, which occurs when one or more vertebrae don’t form correctly, but generally has limited symptoms and may go undetected for years. 

When this form of spina bifida does have symptoms, they typically include pain, numbness, or weakness in the back and legs or curvature of the spine known as scoliosis.

Meningocele Spina Bifida

Meningocele spina bifida occurs when the bones of the spinal cord do not close properly and the lining around the cord, known as the meninges, herniates out. This often results in a fluid-filled sack over the affected area of the spine. 

In this form of spina bifida, the nerves are generally not affected or only mildly affected, so while it may require corrective surgery, there are rarely serious deficits.

Myelomeningocele Spina Bifida

Nearly three-fourths of spinal bifida cases are myelomeningocele spina bifida. This is also the most serious form of the disease and can lead to paralysis, lower-limb deformities, hydrocephalus (water on the brain), cognitive impairment, incontinence, and a number of other challenges.

In some cases, spina bifida can be addressed surgically while the baby is still in the womb, or in the first few days after birth, though these surgeries can result in some long term complications and nerve damage. 

Along with other complications like excess cerebral spinal fluid (CSF) in the baby’s brain that can have long-lasting effects, between 20 and 50% of people with myelomeningocele spina bifida will end up in a wheelchair later in life.

How Can Spina Bifida Affect My Child’s Ability to Drive?

Spina bifida affects everyone differently. However, there are some common symptoms.

How Spina Bifida Affects a Driver’s Cognitive Abilities

Some cases of spina bifida may cause hydrocephalus or damage to other portions of the brain, which can lead to learning disabilities or memory problems, issues with hand-eye coordination, or problems with perception and focus. 

In some cases, these challenges just make it more difficult for learners with spina bifida to learn the rules of the road, but in other cases, it can significantly increase their risk on the road. 

How Spina Bifida Affects a Driver’s Physical Abilities

Many children with spina bifida experience an eventual loss of function in their legs, which can make operating pedals difficult or ultimately require a wheelchair. 

However, most of these challenges can be effectively overcome with vehicle modifications like hand controls and wheelchair lifts. 

How Spina Bifida Affects a Driver’s Visual Abilities

Many people with spina bifida have some sort of vision problem, usually in direct association with hydrocephalus. Increased pressure inside the skull from excess CSF can cause damage to the optic nerve, which reduces its signal to the brain. 

Ultimately, this can cause problems with acuity, color vision, their field of vision, and a number of other challenges that make it difficult to safely drive. 

What Can I Do to Help Prepare My Child for Driving with Spina Bifida?

To prepare for the physical challenges of driving, you can work with a physical therapist, who can help your child with specific exercises that will help them improve their muscle strength and range of motion.

If your child has any learning disabilities, getting them started early with the rules of the road can be a valuable head start. Many driver’s education programs also have additional help and guidance if your child needs it. 

And finally, ensuring that your child is eating a healthy diet, getting adequate sleep, and exercising frequently can go a long way towards improving their overall health.

Who Determines If My Child Can Drive with Spina Bifida?

There are no laws in Connecticut that prohibit someone with spina bifida from driving, but your child will still need to pass state driving tests, including any special tests needed for any necessary adaptive driving equipment.

What this means is that your child and their situation will be the biggest determining factor in whether or not they’re able to drive. Consider all of the facts about their unique challenges, as well if they even want to drive, and you should have a good starting point.

From here, we recommend working with a Certified Driver Rehabilitation Specialist (CDRS). These occupational therapists are specialists at helping people with disabilities hone their driving skills and can layout any special equipment or adaptive driving programs they may need to get out on the road. 

What Does Next Street Look For When Assessing Spina Bifida Patients?

Our CDRSs can meet you and your child in your home for an initial driver evaluation, which is an initial assessment of their physical, mental, and visual abilities. They shouldn’t worry about studying, just make sure to get a good night’s sleep and eat well, as this assessment can last up to two hours. 

Then, our CDRSs will take time to get to know your child and their unique situation, as they assess all of the physical, mental, and visual factors that might present obstacles while they’re driving (like visual acuity, mobility, and coordination, memory and judgment). 

Based on this initial evaluation, our team may refer them to another specialist, make a recommendation to address specific needs, or schedule a behind-the-wheel evaluation at a later date.

Possible Driving Outcomes

Drive On

Some cases of spina bifida, particularly of spina bifida occulta, can be mild enough that they do not create any serious deficits. In these cases, your child will be safe to drive confidently and comfortably.

Adaptive Driving Devices

In some other cases, drivers with spina bifida might require adaptive driving devices like hand controls, or a wheel chair lift. 

In these cases, our CDRSs can make recommendations for equipment and training, and help your child get through the certification process with their new equipment. 

Restricted Driving Privilege

In some cases, your child may have challenges that make it safe to drive in some conditions, but not in others, especially with mild visual or cognitive impairments. 

For example, slowed reaction times might make your child safe for local road driving during the day, but present an increased risk at night or on the freeway. Our CDRSs can help give you and your child a sense of any restrictions it might be smart to follow. 

Unable to Drive

For some people with spina bifida, their cognitive challenges are significant enough that even with adaptive equipment, they cannot safely operate a vehicle. 

If this is the case, our CDRSs can work with you and your child to create an alternate transportation plan, which can involve public transport, ride services, specialty transit, or rides from loved ones.

Take the Next Step

Here at Next Street, our goal is to help everyone we work with find a transportation plan that keeps them mobile and independent while also remaining as safe and comfortable as possible. 

If your child has spina bifida and is reaching the driving age, and you’d like to consider starting the process to get them safely behind the wheel, you can reach out to us for a free consultation.


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Topics: driver rehab, medical driving, adaptive driving, spina bifida

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We Are Here to Keep You Safe Behind the Wheel

Our Driver Rehabilitation program works with patients whose change in health may affect their ability to safely drive. We have a team of Certified Driving Rehab Specialists that will work with patients on evaluating your driving abilities. We also have a team of professional instructors to help you gain or regain the skills you need to drive. We created this blog to talk about the various diagnoses we experience and how they may affect your experience behind the wheel. 

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