Is the Rookwood Driving Battery an Effective Measure of Driving Ability?
10th November 2023
Written by JJ Wellock, Assistant Psychologist.
What is the Rookwood Driving Battery (RDB)?
A popular and easily administered predictor of driving ability for those with general neurological conditions. Taking only 30-40 minutes to complete, it is ideal for people who suffer from cognitive fatigue; it is economically friendly and accessible to those with physical conditions. The RDB is a series of neuropsychological assessments designed to test a person’s cognitive fitness to drive, with a focus on praxis, executive functioning and visual perception – skills required to move a vehicle, navigate traffic conditions and react to spontaneous events.
Evaluation of the RDB
McKenna et al (2004) showed the RDB to be highly accurate at predicting on-road failure in those with a brain injury at 92% sensitivity, and 100% accuracy for those aged under 69. However, it was found that some of the participants who passed the RDB, then failed the on-road test, showing a reduced accuracy for predicting on-road test success.
Photo by Jan Baborák on Unsplash
Whilst the RDB is generally used for all neurological conditions, professionals should heed warning when using this as the sole assessment, since there is reduced validity with certain groups when compared to other tests.
For instance, Vella and Lincoln (2014) identified that when the cut off score for the RDB was > 10 (as recommended by McKenna & Bell, 2007), only 54% of participants with dementia were predicted correctly as unsafe to drive. When used for groups over the age of 70, a recommended cut off of >6 increased the sensitivity to 66%. In comparison, a Dementia Driver’s Screening Assessment (DDSA) showed an 82% sensitivity when predicting unsafe drivers.
Of the 24 participants overall, they also found a discrepancy with six participants, three of which agreed to do an on-road test. All three, who had failed the RDB but passed the DDSA, were found as safe to drive following the road test. This finding was also consistent with a study by Kontou (2012), who found that the MS-Driver’s Screening Assessment (MSDSA) was more effective at identifying unsafe drivers in 29 individuals with MS, compared to the RDB.
McKenna and Bell (2007) suggested that “the aim of the cognitive battery is not to identify everyone who will fail on-road as there are factors other than those cognitive functions represented by the battery that will cause a fail” but that “The purpose of the battery is two fold: first, to contribute to the information in the clinical assessment of fitness to drive at the centre and the second, to obtain a cut off that will confidently predict a fail on road because of a cognitive deficit”.
Conclusions
The decision to declare someone unfit to drive could have significant detrimental effects on their quality of life. Whilst declaring someone fit to drive who are otherwise, could be dangerous to themselves and others. Although there is no doubt that the RDB can be an effective tool for predicting on-road test failure, it is not a guaranteed precursor of their overall driving ability, and it should be used alongside other tests with its strengths and limitations in mind.
References
Kontou, E. (2012). Validation of Two Neuropsychological Batteries for Assessing Fitness to Drive in People with Multiple Sclerosis (Doctoral dissertation, University of Sheffield).
McKenna, P., Jefferies, L., Dobson, A., & Frude, N. (2004). The use of a cognitive battery to predict who will fail an on‐road driving test. British Journal of Clinical Psychology, 43(3), 325-336.
McKenna, P., & Bell, V. (2007). Fitness to drive following cerebral pathology: The Rookwood Driving Battery as a tool for predicting on‐road driving performance. Journal of neuropsychology, 1(1), 85-100.
Rees, J., McKenna, P., Bell, V., Skucek, E., Nichols, E., & Fisher, P. (2008). The Rookwood driving battery: normative older adult performance. British journal of clinical psychology, 47(2), 139-151.
Vella, K., & Lincoln, N. B. (2014). Comparison of assessments of fitness to drive for people with dementia. Neuropsychological rehabilitation, 24(5), 770-783.