Screening for Driver Disorientation at the Iowa Department of Transportation, Motor Vehicle Division

Background and Purpose: Aging is associated with cognitive impairment, which interferes with safe driving ability. Cognitively-impaired drivers may present as confused and belligerent, creating challenges in differentiating these drivers from intoxicated or metabolically-impaired drivers. The Driver Orientation Screen for Cognitive Impairment (DOSCI) was developed to assist identification of disorientation and was piloted in the Iowa Department of Transportation. This study examined the feasibility, acceptability, and usefulness of the DOSCI at licensing agency offices, and to investigate the association between DOSCI performance and driver licensing outcomes. Methods: A sample of 2,510 DOSCI screens from 2,399 individuals was assessed. Data included the acceptability of the DOSCI among staff and clients, time to complete assessments, DOSCI outcomes, and final driver license status. Results: On a 5-point scale, mean score was 4.76 (SD=0.67) for Ease of Administration, 4.67 (SD=0.80) for Acceptance by Client, and 3.81 (SD=1.57) for Useful in Assessment. Clients who failed the assessment had significantly higher odds of not receiving a driver’s license than clients who passed (OR=2.556). Conclusion: The DOSCI was quick to administer, well-accepted, and was associated with licensing outcome. The tool has potential to contribute to traffic injury prevention by identifying potentially impaired drivers requiring closer examination in a licensing agency setting.