Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Clinical perspectives on the impact of aphasia on driving safety: Findings from an international multidisciplinary survey. (139469)

Helen E Wallace 1 2 3 , Hannah L Gullo 4 5 , David A Copland 1 2 , Sarah J Wallace 1 2
  1. Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
  2. Surgical Treatment and Rehabilitation Service (STARS), Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Queensland, Australia
  3. School of Allied Health and Human Performance, Adelaide University, Adelaide, South Australia, Australia
  4. Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  5. Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Queensland, Australia

Background/Aims:

Despite increasing interest in the role of aphasia in fitness-to-drive post-stroke (1,2), the evidence base remains insufficient to guide practice, and clinical opinion drives decision-making. We surveyed international stroke and return-to-driving clinicians to understand their views on aphasia and driving safety.

Methods:

Cross-sectional online survey of international stroke and return-to-driving clinicians, reported as per the Consensus-Based Checklist for Reporting of Survey Studies (3). 

Results

Data were collected from 202 participants across 10 countries (Aotearoa New Zealand: n=16; Australia: n=111; Canada: n=7; UK: n=33; US: n=24; other: n=11). Most were speech pathologists (34%), followed by occupational therapy driver assessors/driving rehabilitation specialists (27%), and occupational therapists (13%), with the remainder comprising medical specialists, neuropsychologists/clinical psychologists, general practitioners, and driving examiners/instructors. Although 59% of respondents felt aphasia should not prevent return to driving; 85% believed aphasia can impact driving safety post-stroke. Key concerns were: 1) reading and interpreting road signs (79%); 2) understanding road laws (56%); 3) maintaining focus amid auditory distractions (55%). Most respondents believed existing guidelines are inadequate to support decision-making (68%) or guide assessment (68%) for return to driving for individuals with aphasia.

Conclusion

Our findings reveal a tension in clinical practice: most clinicians believe aphasia should not automatically prevent return to driving, but do believe it has the potential to compromise driving safety. There is a need for research, first to establish whether and how aphasia impacts driving safety, and then to develop evidence-based guidelines and resources to support clinical decision-making.

 

  1. 1. Gasne, C., Ranchet, M., Evennou, M., Delebecque, M.-C., Hoang, I., Coignard, P., & Paire-Ficout, L. (2024). Fitness-to-drive recommendations in post-stroke patients: a retrospective study. Journal of Stroke and Cerebrovascular Diseases, 33(8). https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107781
  2. 2. Schendel, K., Santavicca, I., Herron, T. J., Lwi, S. J., Curran, B. C., Chok, J. M., & Baldo, J. (2026). Impact of left vs. right hemisphere stroke on driving: lateralized attention deficits and executive dysfunction linked to impaired driving [Original Research]. Frontiers in Stroke, Volume 5 - 2026. https://doi.org/10.3389/fstro.2026.1679668
  3. 3. Sharma, A., Minh Duc, N. T., Luu Lam Thang, T., Nam, N. H., Ng, S. J., Abbas, K. S., Huy, N. T., Marušić, A., Paul, C. L., Kwok, J., Karbwang, J., de Waure, C., Drummond, F. J., Kizawa, Y., Taal, E., Vermeulen, J., Lee, G. H. M., Gyedu, A., To, K. G., . . . Karamouzian, M. (2021). A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Journal of General Internal Medicine, 36(10), 3179-3187. https://doi.org/10.1007/s11606-021-06737-1