Paige Castellow, an occupational therapist with the Driving Solutions program, helps Lauren Saxe, right, relearn driving skills after a brain injury.

Beth Anderson's clients want to drive. But sometimes they shouldn't.

As an occupational therapist and certified driver rehabilitation specialist at DeKalb Medical Center, Anderson and Paige Castellow run Driving Solutions, a program that helps get drivers on - or off - the road. This is no driver's education program, however.

Clients - ranging in age from 15 to the mid-80s - are referred to the duo by physicians. About half of their clients have disabilities, such as a brain injury or cerebral palsy, that may hinder their driving ability. Some may have been injured on the job, and their employers want to make sure they can drive safely when they return to work.

"In some cases, it's a family member who is concerned about how the person is driving; they may not have had a specific medical problem, but it may be an accumulation of problems," Anderson said.

Sometimes it's a teenager who hasn't yet hit the road, but needs to be evaluated because of a medical problem.

Anderson will do an evaluation of the client in her office at DeKalb Medical, and then take them out on the road - unless they fail the vision test, she said.

Anderson first does a clinical assessment of the client, looking at vision, strength, coordination and reaction time. "This gives us a ballpark on what problems we can expect to see on the road," she said.

Then it is into the specially equipped driver's-ed car - and out into Atlanta's traffic.

"I've evaluated people in their late 80s and some are fine ... and then there are people younger than that, and it's 'oh, no, this the end of the road.' "

Telling someone that they can't drive is difficult; but it's something Anderson is trained to do.

"In a lot of cases the family doesn't want to be the ones to lower the boom; neither does the person's physician," she said. "We can be the bad guy. In a lot of cases we don't get to the point of revocation - we just try to convince the person they need to stop [driving]."

If the person's license is going to be revoked, Anderson reports back to the physician and the state. "It's not easy, breaking the news," Anderson said. "Hopefully, the family is along to talk to them. And in some cases, if it's the result of stroke, after several months they can improve with some rehab, and they could possibly resume driving.

"Most people assume everything is black and white - it's truly not. It can be a pass - but that you can only drive during the day, or in familiar areas. Or it can be a fail, you don't need to be driving at all."

Anderson also makes recommendations for specialized driving equipment and follows through to the manufacturer, who must structurally modify the vehicle to those recommendations.

Both Anderson and Castellow are among just 15 certified driving rehab specialists in Georgia; both are occupational therapists who, by state law, are licensed as driver's education instructors.

For information on the program, call 404-501-5749.

The Association for Driver Rehabilitation Specialists, ADED (originally the Association of Drivers Educators for the Disabled) offers a national certification exam, education courses and hosts an annual national conference. Their Web site is www.aded.net.