Judith L Charlton

• MSc, PhD
• Managing Director at Monash University (Australia)

Background and objectives Crash injury risk is reduced when a child correctly uses an appropriate restraint; however, incorrect restraint use remains widespread. The aim of this study was to determine whether product information developed using a user-driven approach increases correct child restraint use. Methods We conducted a two-arm double-blin...

Older drivers are more likely to have difficulty wayfinding in unfamiliar areas than younger people. The present study investigated the role of cognitive functioning and age on wayfinding difficulties and driving performance whilst driving in unfamiliar areas. Forty-seven participants aged between 21 and 82 years completed a wayfinding task in a dr...

Background Various sampling techniques have been implemented to assess child restraint use practices. However, little evidence exists about the impact of selection bias. This study explored differences in demographic characteristics and restraint practices between a random and self-selected sample of child restraint users. Method Data gathered fro...

Aim This study systematically reviewed the literature on motor vehicle crash (MVC) risk for drivers with hearing loss in medicine, psychology, and transport databases, that quantify its effect on MVC to enable licensing agencies to make evidence-based decisions on fitness-to-drive hearing standards. Results 1717 articles were identified of which 5...

Naturalistic driving studies (NDS) are a method in transportation research that is increasingly used to bridge the gap between epidemiological research (e.g., using population crash databases) and individual level or experimental research (e.g., self-reported surveys or driving simulators). This article begins with defining NDS and providing a brie...

Developing tools that accurately detect at-risk driving behaviors is a public-health priority. There is a need for a measure that accurately assesses older drivers’ level of competence on familiar roadways. The objective of this presentation is to describe the development of the procedures and scoring of a new approach, the Electronic Driving Obser...

As people age into older adulthood, they are more likely to experience events that impact their driving, such as age-related cognitive and functional declines, serious illness, or disability. The ability to demonstrate resilience following such adversity may influence one’s decisions and feelings about driving. This study investigated whether resil...

Background Incorrect use of child restraints is a long-standing problem that increases the risk of injury in crashes. We used user-centred design to develop prototype child restraint instructional materials. The objective of this study was to evaluate these materials in terms of comprehension and errors in the use of child restraints. The relations...

Using data from the Australian Naturalistic Driving Study (ANDS), this study examined patterns of secondary task engagement (e.g., mobile phone use, manipulating centre stack controls) during everyday driving trips to determine the type and duration of secondary task engaged in. Safety-related incidents associated with secondary task engagement wer...

Introduction Child occupant safety in motor-vehicle crashes is evaluated using Anthropomorphic Test Devices (ATD) seated in optimal positions. However, child occupants often assume suboptimal positions during real-world driving trips. Head impact to the seat back has been identified as one important injury causation scenario for seat belt restraine...

This paper describes changes in driving patterns for a cohort of older Australians. In-vehicle data-loggers installed in participants’ own vehicles monitored spatio-temporal characteristics of driving trips across three years for 164 participants aged 75+ years (Year 1: Male = 68.9%; Mean Age = 79.5 years, SD = 3.4 years, Range = 75 - 88 years). Th...

Purpose: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. Method: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of...

The aim of this study was to explore self-reported driving habits and the factors associated with these within the first three months of return to driving following traumatic brain injury (TBI). Participants included 24 individuals with moderate to severe TBI (post-traumatic amnesia duration M = 33.26, SD = 29.69 days) and 28 healthy age, education...

Objective: Restraint performance is evaluated using anthropomorphic test devices (ATDs) positioned in prescribed, optimal seating positions. Anecdotally, humans-children in particular-assume a variety of positions that may affect restraint performance. Naturalistic driving studies (NDSs), where cameras and other data acquisition systems are placed...

Background Correct use of an age-appropriate restraint reduces the risk of death and injury among child passengers. While rates of age-appropriate restraint continue to rise in most developed countries, misuse of restraints remains a significant problem. Measures that target the individual are effective in reducing misuse. Carers identify instructi...

Aim: The aim of this study was to develop and provide initial validation data for a self-awareness of on-road driving ability measure for individuals with brain injury. Method: Thirty-nine individuals with Traumatic Brain Injury completed an on-road driving assessment, the Self-Regulation Skills Interview (SRSI) and the newly developed Brain Inj...

Background: Good vision is essential for safe driving and studies have associated visual impairment with an increased crash risk. Currently, there is little information about the medical review of drivers with visual field loss. This study examines the prevalence of visual field loss among drivers referred for medical review in one Australian juri...

Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of...

Objective: We aimed to (a) describe the development and application of an automated approach for processing in-vehicle speech data from a naturalistic driving study (NDS), (b) examine the influence of child passenger presence on driving performance, and (c) model this relationship using in-vehicle speech data. Background: Parent drivers frequent...

RÉSUMÉ Cette étude a examiné une cohorte de 227 conducteurs âgés et a étudié la relation entre leur performance sur la grille d’observation e-DOS pour manœuvres de conduite et (1) les caractéristiques des conducteurs; (2) les capacités fonctionnelles; (3) les perceptions des capacités et le confort pendant la conduite, ainsi que (4) les restriction...

Objective: To examine self-rated, clinician-rated, and self-awareness of on-road driving performance in individuals with traumatic brain injury (TBI) deemed fit and unfit to resume driving and healthy controls, and to explore their associations with demographic, injury, cognitive, and mood variables. Methods: Participants included 37 individuals...

Purpose of the study: The Decisional Balance Scale (DBS) was developed to assess older adults' attitudes related to driving and includes both intrapersonal and interpersonal motivations for driving. This study examined the psychometric properties of the DBS ratings across 3 time points in a sample of 928 older drivers who participated in the Canad...

To examine pre- and post-injury self-reported driver behaviour and safety in individuals with traumatic brain injury (TBI) who returned to driving after occupational therapy driver assessment and on-road rehabilitation. A self-report questionnaire, administered at an average of 4.5 years after completing an on-road driver assessment, documenting pr...

Introduction Internal driver events such as emotional arousal do not consistently elicit observable behaviors. However, heart rate (HR) offers promise as a surrogate measure for predicting these states in drivers. Imaging photoplethysmography (IPPG) can measure HR from face video recorded in static, indoor settings, but has yet to be examined in an...

To determine the extent and nature of driving self-regulation in drivers with Parkinson disease (PD) and factors associated with self-regulatory practices. Although people with PD have consistently been shown to have driving impairments, few studies have examined self-regulatory driving practices and their relationship to driving performance. We us...

Background: Medical illnesses are associated with a modest increase in crash risk, although many individuals with acute or chronic conditions may remain safe to drive, or pose only temporary risks. Despite the extensive use of national guidelines about driving with medical illness, the quality of these guidelines has not been formally appraised. Ai...

Naturalistic driving studies (NDS) allow researchers to discreetly observe everyday, real-world driving to better understand the risk factors that contribute to hazardous situations. In particular, NDS designs provide high ecological validity in the study of driver distraction. With increasing dataset sizes, current best practice of manually review...

This paper presents findings from a project focusing on the specific needs of vulnerable generations - children and elderly people - in design teaching and training activities. The thirty-months project embodied a series of activities for developing, implementing and evaluating teaching materials focused on design for vulnerable generations, and id...

Objective: This pilot study aimed to investigate physiological responses during an on-road driving task for older and younger drivers. Methods: Five older drivers (mean age = 74.60 years [2.97]) and 5 younger drivers (mean age = 30.00 years [3.08]) completed a series of cognitive assessments (Montreal Cognitive Assessment [MoCA], Mini Mental Sta...

A key tenet of the safety in numbers theory is that as the number of people cycling increases, more drivers will also be cyclists and therefore will give greater consideration to cyclists when driving. We tested this theory in relation to self-reported behaviour, attitudes and knowledge in relation to cycling. An online survey was conducted of Aust...

Objective: The primary objective of this study was to better understand how self-regulatory driving practices at multiple levels of driver decision making are influenced by various factors. Specifically, the study investigated patterns of tactical and strategic self-regulation among a sample of 246 Australian older drivers. Of special interest was...

A cyclist crash with an open vehicle door can result in serious injury, sometimes fatal, outcomes. However, little is known about the frequency and range of injury outcomes of this crash type or the contributing factors. In this study, the factors associated with cyclist-open vehicle door collisions in Victoria, Australia were investigated using th...

Introduction: Appropriate self-regulation of driving– that is, adjusting one's driving patterns by driving less or avoiding specific situations considered challenging– shows promise as a strategy for extending safe driving. However, results on the extent of self-regulatory practices among older drivers vary considerably across studies. Method: The p...

Until recently, objective data have been lacking on the extent to which older adults modify their driving by driving less or avoiding situations considered challenging; a process commonly referred to as self-regulation. Advances in technology now make it possible to examine driving exposure, patterns, and habits using low-cost global positioning sy...

The Driving Observation Schedule (eDOS) was developed for use in the Candrive/Ozcandrive five-year prospective study of older drivers to observe the driving behavior of older drivers and monitor changes in driving behaviors over time. The aim of this study is to describe participants' driving performance during the eDOS driving task and investigate...

Objective: This study aimed to investigate the importance of vehicle safety to older consumers in the vehicle purchase process. Methods: Older (n = 102), middle-aged (n = 791), and younger (n = 109) participants throughout the eastern Australian states of Victoria, New South Wales, and Queensland who had recently purchased a new or used vehicle...

Although the vast majority of active, older drivers are safe drivers, health conditions and related functional declines associated with increasing age can affect driving ability. This is a concern for older drivers, their families, and the public, as well as government agencies. To address these issues, the Canadian Institutes of Health Research (C...

Some older drivers experience difficulties driving whilst wayfinding in unfamiliar areas. Difficulties in wayfinding have been associated with poorer driving performance and reduced driving mobility. The objective of the current study was to identify cognitive and demographic predictors in older drivers of perceived wayfinding difficulty, avoidance...

Self-regulation shows promise as a means by which older adults can continue to drive at some level without having to stop altogether. Self-regulation is generally described as the process of modifying or adjusting one's driving patterns by driving less or intentionally avoiding driving situations considered to be challenging, typically in response...

This paper describes the development and evaluation of an on-road procedure, the Driving Observation Schedule (DOS), for monitoring individual driving behavior. DOS was developed for use in the Candrive/Ozcandrive five-year prospective study of older drivers. Key features included observations in drivers' own vehicles, in familiar environments chos...

The main aims of the current study were to (1) investigate misuse and/or inappropriate use across different booster seat types (including high back booster seats, booster seat cushions, and booster seats/cushions used in combination with an H-harness) through an Australian CRS/booster seat inspection program conducted between October 2004 and Octob...

Objective: The current study aimed to investigate the incidence of child restraint system (CRS) misuse and/or inappropriate use of CRS through an Australian CRS inspection program conducted by CRS fitting specialists between October 2004 and October 2011 and to determine whether CRS misuse and/or inappropriate use of CRS changed following new Aust...

The Candrive II/Ozcandrive study, a multicentre prospective cohort study examining the predictive validity of tools for assessing fitness to drive, aims to develop an in-office screening tool that will help clinicians identify older drivers who may be unsafe to drive. This paper describes the study protocol. We are following a cohort of drivers age...

Previous research has found that only older drivers with low annual driving mileages had a heightened crash risk relative to other age groups. These drivers tend to drive mainly in urban areas, where the prevalence of complex traffic situations increases crash risk. However it might also be that some drivers may have reduced their driving due to pe...

This study examined older driver engagement in distracting behaviours (secondary activities) at intersections using naturalistic driving data from a larger study based in Melbourne, Australia. Of interest was whether engagement in secondary activities at intersections was influenced by factors such as driver gender and situational variables, in par...

This study investigated parents' attitudes, knowledge and behaviours relating to safe child occupant travel following new Australian legislation regarding child restraint system (CRS) and motor vehicle restraint use for children aged 7 years and under. A questionnaire exploring attitudes, knowledge and behaviours regarding general road safety, as w...

While there is a large body of research indicating that individuals with moderate to severe dementia are unfit to drive, relatively little is known about the driving performance of older drivers with mild cognitive impairment (MCI). The aim of the current study was to examine the driving performance of older drivers with MCI on approach to intersec...

In many parts of the world, licensing guidelines state that drivers with medical conditions such as epilepsy are restricted or prohibited from driving. These guidelines are sometimes subjective and not strongly evidence-based, rendering the task of assessing fitness to drive a complex one. Determining fitness to drive is not only essential for main...

This study investigated the behavioural, attitudinal and traffic factors contributing to red light infringement by Australian cyclists using a national online survey. The survey was conducted from February to May 2010. In total, 2061 cyclists completed the survey and 37.3% reported that they had ridden through a signalised intersection during the r...

Driver distraction represents a well-documented and growing contribution to the road safety problem. This study used a naturalistic, observational approach to examine if children in vehicles are a significant source of driving distraction. Families with children aged between 1 and 8 years drove an instrumented "study vehicle" on their regular trips...

This study determined the rate and associated factors of red light infringement among urban commuter cyclists. A cross-sectional observational study was conducted using a covert video camera to record cyclists at 10 sites across metropolitan Melbourne, Australia from October 2008 to April 2009. In total, 4225 cyclists faced a red light and 6.9% wer...

The Problem. Driving simulators offer a safe, convenient alternative to measuring driving performance on-road. However, the results of simulator studies may not generalize to driving in the real world if the simulator lacks behavioral validity. Behavioral validity refers to the extent to which the simulator elicits the same driving behaviors that o...

This study sought to investigate the impact of external cue validity on simulated driving performance in 19 Parkinson's disease (PD) patients and 19 healthy age-matched controls. Braking points and distance between deceleration point and braking point were analysed for red traffic signals preceded either by Valid Cues (correctly predicting signal),...

For many older adults in most of the Western world, continued mobility (with associated health, well-being, independence and quality of life) means access to a private vehicle, either as a driver or as a passenger. However older driver serious injury and fatality rates per distance travelled are higher than middle-aged drivers, and crash and injury...

Background: The aim was to develop a naturalistic cycling method using a helmet-mounted video camera to investigate the behaviour of on-road commuter cyclists and their interactions with other road users in urban areas. Cycling is increasing in popularity popular in Australia; however, cyclists are physically vulnerable road users. To date, thereha...

This paper describes an investigation of safety, mobility and travel patterns in a sample of older women drivers and former drivers aged 60 years and over. Participants provided information on general health and functional abilities, travel and driving patterns, driving experiences and confidence, difficulty with and avoidance of driving situations...

Child restraint systems (CRS) for vehicles are designed to provide specialized protection for child occupants in the event of a crash. The effectiveness of these restraint systems is influenced by many variables including the way that children are positioned in their CRS. This study used a naturalistic, observational approach to examine how childre...

The study aim was to identify risk factors for collisions/near-collisions involving on-road commuter cyclists and drivers. A naturalistic cycling study was conducted in Melbourne, Australia, with cyclists wearing helmet-mounted video cameras. Video recordings captured cyclists' perspective of the road and traffic behaviours including head checks, r...

Motor vehicle crashes are one of the leading causes of child death and acquired disability. Child restraint systems (CRS) for vehicles are designed to provide specialized protection for child occupants in the event of a crash. However, the effectiveness of a CRS is critically dependent on: correct installation of the CRS in the vehicle, the correct...

Safe travel remains an essential goal for any society, however, recognition of the benefits of continued mobility and, conversely, serious consequences of loss of mobility must also be considered. Driving affords the greatest mobility for many older adults and this often means access to a private vehicle for as long as it is safe to drive. Unfortun...

Road safety education is considered essential to teach children to interact with traffic safely. Many programs, however, do not consider the separate component skills of the road-crossing task, the functional and behavioural factors that may put some children at increased risk, and the most beneficial methods to transfer knowledge to improved behav...

A range of medical conditions can lead to visual impairments either through effects on the eye or the visual pathways and brain. The prevalence of visual impairment increases with age. Furthermore, research evidence has shown that aging is related to a number of other processes that can lead to changes in cognitive functioning and sensory perceptio...

Most licensing jurisdictions in Australia currently employ age-based assessment programs as a means to manage older driver safety, yet available evidence suggests that these programs have no safety benefits. This paper describes a community referral-based model license re assessment procedure for identifying and assessing potentially unsafe drivers...

Guidelines for assessing fitness to drive in individuals with neurodegenerative disorders, such as Parkinson's disease (PD), are subjective. It is therefore timely to review the current status of the literature not only for health professionals who are required to assess fitness to drive, but also for the development of future research directions....

Whilst there has been a significant increase in the amount of consumer interest in the safety performance of privately owned vehicles, the role that it plays in consumers' purchase decisions is poorly understood. The aims of the current study were to determine: how important vehicle safety is in the new vehicle purchase process; what importance con...

To examine the relationship between child weight and vehicle booster seat usage in the context of current Australasian booster seat standards. Questionnaire survey conducted between February and April 2005. A convenience sample of parents with children aged 4-11 years in New South Wales and Victoria completed a questionnaire, reporting on the heigh...

This study investigated the factors associated with the premature graduation into seatbelts for Australian children aged 4-11 years. From 699 child restraint use questionnaires, 195 children were identified as meeting the booster seat height-weight criteria (height: 100-145 cm and weight: 14-26 kg). Of these children, 44% were correctly traveling i...

Using data from i) a simulated road-crossing task, ii) a battery of functional performance assessments, and iii) a survey of parents, some factors that may predict poor road-crossing skill were identified. Children aged between 6 and 10 years made road-crossing decisions in a simulated road environment in which time gap and speed of approaching veh...

This study examined the performance of a booster seat in different seating configurations in side-impact hyGe sled tests (crash severity 30 km/h) with two attachment systems: a standard seatbelt and ISOfix (rigid). The objectives of the study were twofold: (i) to identify the relative benefits of ISOfix attachment compared with seatbelt attachment...

With increasing rates of survival associated with traffic crashes, a shift to understand the consequences of injury has risen to prominence. This prospective cohort study set out to examine general health status and functional disability at 2 months and 6-8 months post-crash. Participants were otherwise healthy adults aged 18-59 years admitted to h...

Despite the potential benefits that fleet vehicle purchase decisions could have on road safety, the role that vehicle safety plays in fleet managers' purchase decisions is poorly understood. In this study, fleet managers from Sweden and Spain completed a questionnaire regarding the importance of vehicle safety in the new vehicle purchase/lease proc...

This paper reports the findings of a study of younger and older driver behaviour to hazardous traffic manoeuvres in a driving simulator. Hazardous situations on a highway and residential drive were studied and drivers' vision and vehicle performance responses were collected. While all drivers were able to avoid crashes, the finding that older drive...

Pedestrian crashes are among the most common causes of death and serious injury to young children in the developed world. An initial phase of our research showed that younger children (6-7 year olds) and those with poor or under-developed functional skills may be at higher risk of crash involvement, compared with older children with well developed...

Older drivers are frequently viewed as overly represented in crashes, particularly when crash involvement per distance travelled is considered. This perception has led to a call for tighter licensing conditions for older drivers, a policy which inevitably results in mobility restrictions for at least some drivers. However there is a growing body of...

Numerous studies previously have reported reduced driving performance in people with Parkinson's disease (PD). Few studies to date, however, have examined how specific cognitive difficulties associated with PD impact on specific aspects of driving performance in this population. In this study, the impact of a concurrent task on driving performance...

This paper describes a survey of self-regulatory driving practices of 656 drivers aged 55 years and older. Types and prevalence of self-regulatory behaviours were examined and key characteristics of self-regulators were identified. Overall, the majority of drivers reported being very confident in potentially difficult driving situations and relativ...

This article was published in the journal, Transportation Research F [© Elsevier] and is also available at: http://www.sciencedirect.com/science/journal/13698478. For some time now, it has been recognised that a major shift is occurring in the population age distributions of most motorised countries resulting in a growing number of older persons wi...

In this study the association between cognitive symptoms of PD and driving performance was investigated by examining the correlation between neuropsychological test performance and driving simulator behavior. Eighteen participants with PD and 18 healthy participants in a matched comparison group completed a range of neuropsychological measures. The...

Anxiety and traumatic stress symptoms are common post-crash. This study documents generalised anxiety responses post-crash, and examines the association between Acute Stress Disorder and Post-Traumatic Stress Disorder (PTSD) with personality and coping styles. Sixty-two patients aged 18-60 admitted to hospital were interviewed prior to discharge, a...

The over-representation of older pedestrians in serious injury and fatal crashes compared to younger adults may be due, in part, to age-related diminished ability to select gaps in oncoming traffic for safe road-crossing. Two experiments are described that examine age differences in gap selection decisions in a simulated road-crossing environment....

Numerous aspects of driving performance seem compromised in people with Parkinson's disease (PD). Measures of cognitive impairment consistently correlate with poor driving simulator performance in this population; however, the effects of specific cognitive difficulties on discrete aspects of driving behavior have not been investigated thoroughly. P...

Recent studies have shown that survivors of road traffic crashes experience significant psychological health difficulties. Perception of another party as being responsible for the occurrence of a crash has been associated with on-going distress and lower psychological well-being. This paper extends this research by examining the influence of percei...

Using data from i) a self-administered survey of 673 older female drivers, and ii) a case-control study of 48 crash-involved and 44 non crash-involved older female drivers, some factors that may predict crash involvement were identified. Survey data gathered self-reported information on demographic characteristics, health status, travel patterns an...

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