The rack on top of Robert Rohan's minivan used to carry his bicycle. Now, it sometimes secures his wheelchair. Air bags are not in the front of this van, but in the rear, where they help operate the hydraulic system that lowers a ramp.
A star triathlete at El Camino Real High School in Woodland Hills in the late 1980s, Rohan suffered a broken neck in a 1989 bicycle accident, leaving him with limited use of his arms and no feeling below his mid-chest area.
Yet, after two years of therapy, he was ready to try driving again--this time in a specially equipped van and with help through a program designed for physically disabled drivers.
"At first, I didn't think I was going to do it," said the 20-year-old Pierce College student, who lives in West Hills. "But like anything else, I took it as a challenge."
The Driver Preparation Program at Northridge Hospital Medical Center helps a variety of patients--including people in wheelchairs and stroke victims--learn to drive again. The program is the only one of its kind in the San Fernando Valley and one of a handful in Southern California.
"Driving is a social issue. It's not just a functional issue; it's also adulthood," hospital occupational therapist Gayle San Marco said. "It's a lot of fun because you're helping people to realize that in spite of this horrible thing that happened to them, they can get back out there."
The preparation program begins with written tests, a physical evaluation and a behind-the-wheel driving test. Depending on their physical recovery and emotional state, San Marco said, some patients can take the test within a few months after their accident or illness. For others, it may be several years before they are ready.
Some are confident in their abilities when they arrive for the test, she said. Others are uncertain, seeking a second opinion, sent by family members who are skeptical that the person should be driving at all.
Patients' mental skills are judged by several tests, including one in which they are asked to identify drawings that have been separated and scattered like puzzle pieces. Other quizzes test their ability to follow instructions and to draw various shapes. The results demonstrate how well the patient's brain is interpreting information to help therapists determine if the person is ready to make the kinds of split-second decisions required in driving.
In some cases, the patients are advised to wait a bit longer to give their bodies more time to mend. Those who are on the borderline may be asked to perform a lengthier evaluation to judge how well they are progressing, San Marco said. A few are told that they are ready to drive again without any additional training.
Last year, the hospital evaluated about 100 patients for the driving program. They ranged in age from 15 1/2--the minimum age to receive a learner's permit in California--to the mid-80s, according to program administrators. Most are between 30 and 50.
Patients who are accepted into the program and need driver's training are given at least four hours of car practice and up to 20 hours if they need a modified van. Wheelchair-bound drivers first learn to get in and out of the van and, in some cases, to transfer themselves into the driver's seat. Other patients test new equipment such as left-foot accelerators and hand controls that they will need once they leave the program.
Practice driving is done in a hospital-owned sedan or a specially equipped van over a variety of Valley streets and freeways. The acid test is Box Canyon Road, a windy, steep road in the hills between Los Angeles and Ventura counties.
Recently, Rohan displayed his driving skills in his $40,000 minivan that enables him to drive with just his hands. His left hand operates a lever that controls braking, acceleration and turn signals. Meanwhile, he steers with his right hand using a three-pronged device on the steering wheel.
The brakes and steering wheel respond with less pressure than normal car controls so that he can work them more easily.
It wasn't easy to learn to drive again, but Rohan said the effort was well worth it.
"It means independence. For two years, I always had to wait for rides to go out with my friends. Now, I just get to go," he said, sitting in the driver's seat. "When you're disabled, it's probably the most independence you're going to get from your chair."
The program is not cheap. A standard evaluation, which includes a driving test and written work, runs three to four hours and costs $445, with added expenses for an extended evaluation. Driver's training runs $90 an hour.
Because few insurance companies cover driver's training, most patients must pay for the program themselves. There is no financial aid through the hospital, but San Marco said a few students have been able to qualify for government grants and others have received assistance from religious organizations or community groups.