Driving with an Intellectual Disability: The OT Assessment Process
Learning to drive is a significant step toward independence. For people with an intellectual disability, it's often a goal that matters deeply, not just for practical transport, but for what it represents: autonomy, freedom, and being able to do things on your own terms.
The good news is that some people with milder intellectual disabilities can learn to drive successfully. The process often takes longer and benefits from specialist support, but the destination is the same.
An OT driving assessment is usually the starting point.
Can people with an intellectual disability drive?
An intellectual disability doesn't automatically mean someone can't drive. Some people with an intellectual disability do go on to get their licence. It comes down to the individual, their abilities, and whether they can meet the same safety and licensing requirements as any other driver.
That said, some of the cognitive skills involved in driving (processing speed, decision-making under pressure, reading and interpreting signs, managing multiple tasks at once) can be more challenging for some people with intellectual disabilities. An OT assessment helps work out where each individual sits, and what support they need.
The key word is individual. The impact of an intellectual disability on driving varies enormously from person to person, and a blanket assumption either way isn't useful.
Why an OT assessment helps
Starting driving lessons without an OT assessment isn't always the best approach for learners with an intellectual disability. Here's why.
Standard driving instructors are trained to teach driving. They're generally not trained to identify or work with the cognitive, perceptual, or learning differences that may come with an intellectual disability. If a learner is struggling and the instructor doesn't know why, lessons can become expensive, frustrating, and unproductive.
An OT assessment before (or early in) the learning process gives everyone a clearer picture:
What cognitive skills are strong, and which may need additional support
Whether the learner is ready to start on-road lessons, or whether pre-driving skills need work first
What type of instruction is most likely to be effective (for example, more structured routines, visual supports, simpler language, shorter lesson durations)
Whether any vehicle modifications or adaptive equipment might help
How many lessons are likely to be needed, which helps with NDIS planning
This targeted approach typically saves time and money compared to a trial-and-error approach with standard lessons.
What the OT assessment involves
Part 1: Off-road (clinical) assessment
This is conducted at the learner's home and takes approximately 60 minutes. The OT will work through:
A clinical interview. A conversation with the learner and their family or support worker about their goals, their current abilities, their experience with road safety and transport, and any concerns. This is informal and relaxed.
Vision screening. Visual acuity, visual fields, and related skills.
Cognitive assessment. Using validated tools, the OT assesses the thinking skills most relevant to driving: attention, concentration, processing speed, decision-making, spatial awareness, memory, and the ability to follow instructions. For learners with intellectual disabilities, the OT selects assessment tools that are appropriate and fair.
Road rule knowledge. The OT will assess the learner's understanding of basic road rules and signs. This isn't expected to be perfect at this stage, but it gives an indication of readiness and highlights areas to work on.
Physical assessment. Strength, coordination, reaction time, and fine motor control.
Part 2: On-road assessment (if appropriate)
For learners who have already had some driving experience, the assessment includes an on-road drive with the OT and a specialist driving instructor.
For learners who are at the very beginning of the process (no prior driving experience at all), the assessment may be off-road only at this stage. The OT will then recommend a pathway that includes building pre-driving skills and starting lessons, with a follow-up on-road assessment once the learner has some experience.
During the on-road component, the OT observes:
How the learner handles the vehicle
Their understanding and application of road rules
Processing speed in real traffic situations
Response to instruction
Self-monitoring and error correction
How they manage the sensory and cognitive demands of driving
Possible outcomes
Ready to proceed with driving lessons. The assessment shows no significant barriers, and the learner can start (or continue) lessons.
Lessons recommended with specific focus areas. The OT identifies particular skills to target and recommends lessons with a rehabilitation driving instructor who has experience with learners who have intellectual disabilities. A structured lesson plan is provided.
Pre-driving skill development recommended. For some learners, developing foundational skills before starting on-road lessons will be more effective. This might include road rule study, cognitive skill-building activities, or structured exposure to driving situations (e.g., watching driving videos, practising hazard perception, or passenger-seat observation).
Not ready to learn at this stage. In some cases, the assessment identifies that the learner's current cognitive or perceptual skills are not sufficient for safe driving. This doesn't close the door permanently. The OT may recommend reassessment after a period of skill development.
How NDIS funding works for driving
For NDIS participants, driving is often a fundable goal because of the direct link to independence and community access.
The typical NDIS-funded pathway looks like this:
Step 1: Include driving as a goal in the NDIS plan. This is usually framed around independence, community participation, and social and economic access. For example: "I want to learn to drive so I can get to work independently" or "I want to gain my licence to access community activities without relying on family."
Step 2: OT driving assessment. This initial assessment evaluates the learner's readiness and recommends a pathway. It's typically funded under Capacity Building: Improved Daily Living.
Step 3: Rehabilitation driving lessons. A block of lessons with a specialist driving instructor, tailored based on the OT's findings. Also typically funded under Capacity Building.
Step 4: Reassessment. After the lesson block, the OT reassesses to evaluate progress and determine next steps (more lessons, readiness for the Transport for NSW driving test, or a revised approach).
Step 5: Ongoing lessons if needed. Some learners need more time, and additional lesson blocks can be requested at plan reviews.
Your support coordinator, plan manager, or local area coordinator can help with the funding details. The OT can likely provide a report supporting the funding request if needed.
The pathway to a licence
In NSW, the steps to getting a licence as a learner driver with a disability are:
Pass the Driver Knowledge Test (DKT) to get a learner's permit
Complete the required supervised driving hours (120 hours for under-25s)
Complete an OT driving assessment (if recommended by your doctor or if required by Transport for NSW)
Complete any recommended driving lessons
Pass the practical driving test (the disability driving test if vehicle modifications are involved, or the standard test if not)
Some learners with intellectual disabilities find the DKT challenging. There are resources available to help, including practice tests or simplified study materials. Transport for NSW can advise on the accommodations available.
A note on timelines
Learning to drive with an intellectual disability often takes longer than the standard learning period. This is normal and expected.
This doesn't mean something is wrong. It just means the learner needs more time, and rushing the process doesn't help anyone. A patient, structured approach, guided by the OT's recommendations, is almost always the best investment.
How to start
Your GP, paediatrician, or specialist can refer you for an OT driving assessment. If driving is part of your NDIS plan, your support coordinator can also help arrange the referral.
You can start the process at steerdriving.com.au/referral.
This article was written by Elise, an AHPRA-registered Occupational Therapist and Transport for NSW-registered driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice in Sydney.
Frequently Asked Questions
Can someone with an intellectual disability get a driver's licence? Yes, however this does depend on the severity and how it impacts you. The process often takes longer and benefits from specialist OT and instructor support, but the goal is achievable for many learners.
Does an intellectual disability need to be reported to Transport for NSW? It depends on the individual situation. If the disability may affect driving ability, it should be reported. Your doctor can advise on whether this applies.
Can the NDIS fund driving lessons for someone with an intellectual disability? Yes, for eligible participants. Driving is commonly funded under Capacity Building when it supports independence and community access goals. Your support coordinator can help with the specifics.
How many driving lessons will someone with an intellectual disability need? This varies significantly. Some learners are ready for the driving test after 50 lessons, others need 100 or more. The OT assessment provides a realistic estimate based on the individual's current skills.
Is a special driving test required? If vehicle modifications are needed, the learner will need to pass the disability driving test through Transport for NSW. If no modifications are required, the standard driving test applies.
What if the learner isn't ready to drive yet? The OT will recommend a pathway that may include pre-driving skill development before starting on-road lessons. This isn't a closed door; it's a more structured route to the same destination.