Miriam Monahan

Miriam Monahan
Dominican University of California · Occupational Therapy

OTD

About

25
Publications
2,681
Reads
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335
Citations
Introduction
Dr. Monahan is Clinical Assistant Professor at University of Florida, Adjunct Professor at Dominican University of California, a business owner, and a practicing clinician. Her research and scholarly work focuses on interventions to assist individuals with neurological conditions such as stroke, autism, and PTSD, as well as beginner drivers.
Additional affiliations
January 2016 - January 2017
The University of Western Ontario
Position
  • Clinical Educator-MClSc in Driving Rehabilitation Therapy Program
June 2011 - July 2014
University of Florida
Position
  • Adjunct Scholar

Publications

Publications (25)
Article
This study aimed to establish inter-rater reliability among three raters while training new driver rehabilitation specialists to correctly identify driving errors on a DriveSafety 250 driving simulator. Five participants completed adaptation, residential and suburban, and city and highway scenarios. Intraclass correlation coefficients indicated sco...
Article
Background: Drivers with multiple sclerosis (MS) may experience visual-cognitive impairment that affects their fitness to drive. Due to limitations associated with the on-road assessment, an alternative assessment that measures driving performance is warranted. Whether clinical indicators of on-road outcomes can also predict driving performance ou...
Article
Objective The purpose of this study is threefold: (1) To compare and determine the differences in higher-order cognitive functions and driving errors underlying the strategic driving maneuver between persons with Multiple Sclerosis (PwMS) who pass versus fail the University of Western Ontario (UWO) on-road assessment; (2) To quantify the bivariate...
Article
Full-text available
Background: Cognitive impairment is common in multiple sclerosis (MS). In other populations, cognitive impairment is known to affect fitness-to-drive. Few studies have focused on fitness-to-drive in MS and no studies have solely focused on the influence of cognitive impairment. Objective: To assess fitness-to-drive in persons with MS with cognit...
Article
Full-text available
The impact of visual and visual-cognitive impairments on fitness to drive in persons with multiple sclerosis (PwMS) are not well studied. We quantified visual correlates of fitness to drive in 30 PwMS. PwMS completed visual ability and visual attention assessments, and a standardized on-road assessment, and were compared with 145 older volunteer dr...
Article
Full-text available
Date Presented 3/31/2017 Motor vehicle collisions are a leading cause of deaths for combat veterans, and effective occupational therapy driving interventions (OT–DIs) are needed. We conducted an analysis of an efficacy trial comparing an OT–DI with traffic safety education and demonstrated a reduction in driving errors for the OT–DI group. Primary...
Article
Full-text available
Date Presented 3/30/2017 Combat veterans (CVs) face an increased risk of motor vehicle crash and report driving difficulty that impacts community reintegration. Grounded theory methods were used to examine CVs’ driving perception and behaviors. Clinicians working with this population can use findings to tailor interventions. Primary Author and Spea...
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Full-text available
Driving errors that predict on-road outcomes for persons with multiple sclerosis (PwMS) are not well studied. The objective of this study was to determine whether adjustment-to-stimuli and gap acceptance errors significantly predict passing/failing a standardized on-road assessment of PwMS. Thirty-seven participants completed visual ability and vis...
Article
Full-text available
Background: Little empirical support exists for interrater reliability between evaluators from different backgrounds when assessing on-road outcomes of drivers. Purpose: We quantified interrater reliability of on-road outcomes between a certified driving school instructor (DI) and an occupational therapist and certified driver rehabilitation spe...
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Full-text available
Increased crash incidence following deployment and veterans' reports of driving difficulty spurred traffic safety research for this population. We conducted an interim analysis on the efficacy of a simulator-based occupational therapy driving intervention (OT-DI) compared with traffic safety education (TSE) in a randomized controlled trial. During...
Article
Although used across North America, many on-road studies do not explicitly document the content and metrics of on-road courses and accompanying assessments. This article discusses the development of the University of Western Ontario’s on-road course, and elucidates the validity of its accompanying on-road assessment. We identified main components f...
Article
Full-text available
Date Presented 4/7/2016 Combat veterans may face driving difficulties, impaired fitness to drive, and increased crash risk. Our randomized trial examined a simulator-based occupational therapy driving intervention with findings regarding driving error reduction suggesting efficacy. Primary Author and Speaker: Sandra Winter Contributing Authors: Ste...
Article
Full-text available
Date Presented 4/7/2016 Combat veterans face an increased risk of motor vehicle crash, injury, or death and report driving difficulty. Our focus group addressed five themes: deployment training, deployment driving experiences, postdeployment driving experiences and challenges, strategies, and intervention preferences. Primary Author and Speaker: Sa...
Article
For studies relying on rater judgments of a vulnerable population, such as returning combat veterans, high consistency between primary and secondary raters is necessary. This study examined the inter-rater reliability of a primary and two secondary raters on scoring simulated driving assessments. Seven volunteer drivers were rated in two rounds (Ro...
Article
Polytrauma, including mild traumatic brain injury, posttraumatic stress disorder, and orthopedic conditions, is common among combat veterans (CVs) from Operations Enduring Freedom and Iraqi Freedom. Medical conditions, coupled with deployment-related training, may affect CVs' fitness to drive and contribute to post-deployment crash and injury risks...
Article
Many combat veterans are injured in motor vehicle crashes shortly after returning to civilian life, yet little evidence exists on effective driving interventions. In this single-subject design study, we compared clinical test results and driving errors in a returning combat veteran before and after an occupational therapy driving intervention. A ce...
Article
OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions. METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recom...
Article
Adolescents with attention deficit hyperactivity disorder (ADHD) have an increased risk for committing traffic violations, and they are four times more likely than neurotypical peers to be crash involved, making them a potentially high risk group for driving. We used a two-group design to measure differences in demographics, clinical off-road tests...
Article
Age-related medical conditions such as Parkinson's disease (PD) compromise driver fitness. Results from studies are unclear on the specific driving errors that underlie passing or failing an on-road assessment. In this study, we determined the between-group differences and quantified the on-road driving errors that predicted pass or fail on-road ou...
Article
Motor vehicle crashes are leading causes of death among teens. Those teens with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or a dual diagnosis of ADHD/ASD have defining characteristics placing them at a greater risk for crashes. This study examined the between-group demographic, clinical, and simulated driving...
Article
Vehicle crashes are a leading cause of death among teens. Teens with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or both (ADHD-ASD) may have a greater crash risk. We examined the between-groups demographic, clinical, and predriving performance differences of 22 teens with ADHD-ASD (mean age = 15.05, standard dev...
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Full-text available
Adolescents are at high risk for motor vehicle crashes (MVCs). Teens with autism spectrum disorder (ASD) may have an even greater risk for MVCs due to impaired visual, cognitive, and motor skills critical for driving. This prospective two group study demonstrated the demographic, clinical, and simulated driving skill differences of seven adolescent...
Article
Vehicle crashes are the leading cause of death among teens, and those teens with attention-deficit/hyperactivity disorder and autism spectrum disorder (ADHD/ASD) may have a greater crash risk. This case study compared the pre-driving skills of a teen with ADHD/ASD to an age- and gender-matched healthy control (HC). Data were collected from performa...
Article
Objective: We conducted an evidence-based review of intervention studies and predictor studies related to driving outcomes in teens with attention deficit-hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Methods: Ten primary studies were classified using the American Academy of Neurology's criteria (class I-IV, I = highest level...
Article
The purpose of this translational research article is to illustrate how general practice occupational therapists have the skills and knowledge to address driving as a valued occupation using an algorithm based on the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; American Occupational Therapy Association, 2008b). Evidence to...

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