# Presentation: 190066

## ESRA

## A Call for New 

**A Call for New **
**Transportation License Test Reforms **
**Sandy H. Straus**
**ESRA Consulting Corporation**
***to*****  The Department of Transportation**
**Washington, D.C.**
**28  September  2005**

**  ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

## ESRA Consulting Corporation Disclaimer

**Neither ESRA Consulting Corporation (ESRA), its affiliates, its associates, nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product or process disclosed, or represents that its use would not infringe privately owned rights.  References herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise, does not necessarily constitute or imply its endorsement, recommendation, or favoring by ESRA or any agency thereof.  The views and opinions of authors expressed herein do not necessarily state or reflect those of ESRA or any agency thereof.  This report is for informational purposes only.  Readers are encouraged to confirm the information contained herein with other sources. The information is not intended to replace medical advice offered by physicians. Reliance on any information in this report is solely at your own risk.  ESRA Consulting Corporation is not responsible or liable for any direct, indirect, consequential, special, exemplary, or other damages arising from any use of any product, information, idea, or instruction contained in this report and all publications and presentations and/ or implementations therefrom.  No part of this document may be reproduced in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from ESRA Consulting Corporation.  All materials ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

**ESRA Consulting Corporation Disclaimer**

## Notice is hereby provided that a patent application has been filed 

**Notice is hereby provided that a patent application has been filed **
**   ****on one or more of the systems and methods described herein.**
**Notice is hereby provided that ESRA may be involved in development and/ or marketing of products in the systems and/ or methods described herein.**
**In the event that consideration is given to any component in the system described herein in which ESRA may have a marketing arrangement or other involvement, at the time of such consideration, full disclosure will made.**** **

- ESRA

## OUTLINE

_**OUTLINE**_

**    ****Goal                                                         ****Motivation****                                       Objective                                 ****Methodologies****                                     Visual Acuity, Vision                            ****ESRA DATTM and ESRA DVATTM**** Driving simulators                             ****Relative Accident Involvement Ratio**** Bathtub curves                       ****Recommendations                                  ****Conclusions**

- ESRA

## 			GOAL  

**	****	****	**_**GOAL**_**  **
**To develop an efficient balance between safety and security to ensure the utmost quality of our nation’s transportation infrastructure.**

- ESRA

## Inadequate and inaccurate current license testing technologies.

_**Inadequate**_** and **_**inaccurate**_** ****current license testing technologies.**
**No comprehensive license testing methods exist in other transport sectors.**

- ESRA

_**MOTIVATION**_

## Promote safety through:  

**Promote safety through:**
**automated testing.**
**improved vision screening** **techniques.**** **

_**OBJECTIVES**_

- ESRA

**Photo ©  Copyright 2005 Systems Technology, Inc.**

**Notes:**
Visual, cognitive, and skill impairments

## METHODOLOGIES

**Collect**** ****and analyze collision data.**
**Survey**** ****all motor vehicle directors.**
**3.****	****Present**** ****design of an experimental automated  test system.**
**4.****	****Highlight**** ****the significance of vision screening measures other than standard visual acuity.**

_**METHODOLOGIES**_

- ESRA

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Notes:**
National and international survey success

## None of the vision testing equipment

- ESRA

_**None**_** of the vision testing equipment**
***currently***** in use:**
**screen licensees for vision and cognition problems.**
**promote road safety. **
**reduce collisions, injuries, and fatalities.****  **

_**CURRENT STATE OF THE ART**_

- Photo modified from http://www.car-accidents.com/pages/accident_story/3-5-04.html

**Notes:**
No empirical evidence!  Does not link equipment to collision risk.

##    VISUAL ACUITY

- ESRA

**a measure of the ability to visually distinguish          fine details.**
**accounts for less than 0.1%****of the visual field (Fink and Sadun, 2003).**** **

**   **_**VISUAL ACUITY**_

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Notes:**
20/20, 20/40, 20/60
Does not account for Visual field and Color vision, paramount to safe transportation.
Visual field is total area in which objects can be seen in the peripheral vision while the eye is focused on a central point .

## Vision measures other than standard acuity needed for assessing at-risk drivers. 

- ESRA

**Vision measures other than ****standard acuity**** needed for assessing at-risk drivers.**** **
**Our systems promote ****older drivers**** to safely operate motor vehicles longer.**

**   **_**VISION**_

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

## TRADITIONAL 

- ESRA

_**TRADITIONAL **_
_**SNELLEN-TYPE CHARTS**_

**typically conducted in normal light conditions. **
**unable to detect eye diseases and dementia.**
**Alzheimer’s Disease and dementia linked with visual acuity under low luminance.**

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Notes:**
Traditional Snellen-type Charts typically conducted in normal light conditions. unable to detect eye diseases and dementia.
Alzheimer’s Disease and dementia linked with visual acuity under low luminance.
The Snellen fraction is a ratio, for instance 20/20 or 20/100 (metric equivalent 6/6, 6/30), measuring the acuity of a person's eyesight compared to a standard observer with good normal acuity. 20/20 means he can resolve 2 target features at 20 feet.

## Normal Vision

**Normal Vision**

## Age-Related Macular Degeneration

**Age-Related Macular Degeneration**

**Diabetic Retinopathy**

**Cataracts**

**Glaucoma**

**Notes:**
CATARACTS
affects people age 40 years and over and nearly 50% of the U.S. population of age 75 years and older. 
impacts color perception and glare.
Owsley et al. (1999) report Alabama driver licensees, ages 55- 85 years, with cataract are 2.5 times more likely to have at-fault collision involvement.
GLAUCOMA:
Affects 2.2 million Americans at age 40 years and over. 
Often tested through glare recovery.
Fades images and reduces contrast. 
Glare recovery is a test designed to measure the time it takes a patient to recover from the viewing of flashing bright lights, or glare.
AMD:   Affects more than 1.75 million Americans age 40 years and over.
May jump by 50% to 2.95 million Americans by 2020. 
Appears to be the leading cause of severe vision loss in the over age 65 cohorts. 
Diabetic Retinopathy:  Affects 4.1 million adult Americans 
   age 40 years and over. 
Impacts people with diabetes.
Impairs night vision. 

## What do these diseases now have in common?

- ESRA

**What do these diseases now have in common?**

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Notes:**
No vision tests at MVDs in the USA and other countries include a screening component for Glaucoma or Age-Relate Macular Degeneration (AMD), two of the fastest growing diseases that can result in vision loss.
Many people do not have health insurance and therefore may not have any way of detecting such insidious diseases.
It’s against the law to operate a vehicle without a license and insurance.  It’s not against the law to lack health insurance.

## No license test screening component for Glaucoma or Age-Relate Macular Degeneration (AMD), two of the fastest growing diseases that can result in          vision loss.

**No license test screening component for **_**Glaucoma**_** or **_**Age-Relate Macular Degeneration (AMD),**_** two of the fastest growing diseases that can result in          vision loss.**

- ESRA

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Notes:**
No vision tests at MVDs in the USA and other countries include a screening component for Glaucoma or Age-Relate Macular Degeneration (AMD), two of the fastest growing diseases that can result in vision loss.
Many people do not have health insurance and therefore may not have any way of detecting such insidious diseases.
It’s against the law to operate a vehicle without a license and insurance.  It’s not against the law to lack health insurance.

## Current MVD Vision Standards:

**antiquated ****1937**** visual standards.**
**1925**** report approved by the American Medical Association.**
**widespread implementations and modifications of the Snellen Eye Chart of the** **1860s****.**

_**Current MVD Vision Standards:**_

- ESRA

**Notes:**
improvements in road and motor vehicle designs, and dramatic shifts in population changes are apparent from 1925.

## HEALTH INSURANCE STATUS

- ESRA

_**HEALTH INSURANCE STATUS**_
**More than 80 million Americans lacked health insurance ****(American Public Health  Association, 2002- 2003).**
**Many drivers are not aware that they suffer with vision loss, visual impairment, or cognitive impairments.**
**	**

**Photo ©  Copyright 1983 Center for Disease Control.**

**Notes:**
Dementia drivers may also not be aware that they have dementia. These factors may contribute to the disproportionate number of at-fault older drivers and collision risks in many states. We can, therefore, conclude that there are countless drivers on our roads who have not been screened for eye disease or impairment.

## HEALTH INSURANCE STATUS

- ESRA

_**HEALTH INSURANCE STATUS**_
**In the USA, it is illegal to operate a vehicle without a license and insurance.**
**It is not illegal to lack health insurance.**
**	**

**Photo ©  Copyright 1983 Center for Disease Control.**

**Notes:**
Dementia drivers may also not be aware that they have dementia. These factors may contribute to the disproportionate number of at-fault older drivers and collision risks in many states. We can, therefore, conclude that there are countless drivers on our roads who have not been screened for eye disease or impairment.

##   We call for a radical departure from the traditional and inadequate testing currently in place.

- ESRA

**  ****We call for a radical departure from the traditional and inadequate testing currently in place.**

_**TEST  RECOMMENDATION**_

**Photo ©  Copyright 2005 Systems Technology, Inc.**

## Bye-bye, long lines.  Hello, ESRA. TM

- ESRA

**Bye-bye, long lines.  *****Hello*****, ESRA. ****TM**

## ESRA Dynamic Vision Assessment for TransportationTM DVATTM

**We proudly introduce the**

**ESRA ****Dynamic ****Vision Assessment for TransportationTM ****DVATTM**

- ESRA

**  ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

**Notes:**
Examples of high vs. low contrast (black vs. gray) stimuli used to screen visual acuity at 20/40 and 20/80 (smaller and larger characters), where the position of the dissimilar character varies randomly across repeated and automated test trials. 

## Automated vision function test

**Automated vision function test**

**Automated vision condition test**

**Driving simulator vision status test**

**Computer network to allow for complete computer automation features, tests, score reports, records, and databases**

- ESRA

**  ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

**Notes:**
Examples of high vs. low contrast (black vs. gray) stimuli used to screen visual acuity at 20/40 and 20/80 (smaller and larger characters), where the position of the dissimilar character varies randomly across repeated and automated test trials. 

- ESRA

**We also proudly introduce**

**ESRA ****Dynamic ****Assessment for TransportationTM ****DATTM**

**Photo ©  Copyright 1983 Center for Disease Control.**

**  ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

- ESRA

**ESRA Dynamic  Assessment for TransportationTM (ESRA DVATTM)**

**Vision attention/ cognition test      **
**             **

**Knowledge, safety, laws, and identification test**

**Operation skills test**

**Computer network to allow for complete computer automation features, tests, score reports, records, and databases**

**Photo ©  Copyright 1983 Center for Disease Control.**

**  ****© Copyright 2005 ESRA Consulting Corporation.  All rights reserved.**

**Notes:**
The knowledge, safety, laws, and identification test is commonly known as the written test.
The operation skills test is known as the road or driving skills test in driver’s license applications.
The latter may be partially automated.

## May be beneficial to novice licensees. 

- ESRA

**May be beneficial to novice licensees.**** **
**May be useful for screening at-risk licensees and others with dementia, especially Alzheimer’s Disease.**

_**ESRA DATTM **_
_**DRIVING SIMULATORS***_

**Photo ©  Copyright 2005 Systems Technology, Inc.**

**Safety studies and potential liability issues need to be addressed for all driving simulator usage as discussed in “New, Improved, Comprehensive, and Automated Driver’s License Test and Vision Screening System” by Sandy H. Straus.**

**Notes:**
Drivers may especially benefit due to a lack of experience navigating roads in ambient light and weather conditions.

## ESRA DAT TM DRIVING SIMULATORS FEATURES

_**ESRA DAT TM DRIVING SIMULATORS FEATURES**_
**           **
**weather and light conditions.**
**Self-customization driving scenarios.**
**simulated visibility and contrast reduction due to **
**  ****fog, rain, and snow.**** **

- ESRA

**Photo ©  Copyright 2005 Systems Technology, Inc.**

## ESRA DVATTM and DATTM

_**ESRA DVATTM and DATTM**_

**cost-effective.**
**objective.**
**environmentally friendly. **
**long line reductions. **

- ESRA

## We used RAIR to quantify millions of collisions among Arizona and Florida drivers of all ages through databases of two-vehicle accidents. 

**We used**** **_**RAIR**_** ****to quantify millions of collisions among Arizona and Florida drivers of **_**all**_** ages ****through databases of two-vehicle accidents.**** **

- ESRA

_**RELATIVE ACCIDENT**__**INVOLVEMENT RATIO**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

##                           (D1 i,j /ΣΣD1 i,j )

**                ****          ****(D1**** *****i,******j***** ****/ΣΣD1**** *****i,******j***** ****)**
**RAIR**** *****i,******j*****	****=****	****	****___________**
**	****	****	****      ****(D2**** *****i,******j***** ****/ΣΣD2**** *****i,******j***** ****)**

**Where:****  **** *****i ****** *****= type of drivers;****   *****j ****** *****= type of conditions**

**D1**** *****i,******j***** ****= **** ****number of at-fault drivers of driver type**** *****i *****for type**** *****j***** ****conditions. **
**D2**** *****i******,j***** ****=  number of **_**not**_**-at-fault drivers of driver type**** *****i *****for type**** *****j***** ****conditions.**** **

- ESRA

_**RAIR CALCULATION**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

## RAIR Age 80 to 89 years most likely at-fault in collisions compared to all other age cohorts.  

- ESRA

**RAIR Age 80 to 89 years most likely **_**at-fault**_** in collisions compared to all other age cohorts.**

**RAIR Ages 50 to 59 years most likely **_**at-fault**_** in **_**environmental factors**_** and **_**manner of collisions.**_

_**RAIR CONCLUSIONS**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

## These results are consistent among drivers cited for collision involvement due to visual defects.  

- ESRA

**These results are consistent among drivers cited for collision involvement due to ****visual defects****.**

_**RAIR VISUAL DEFECT CONCLUSIONS**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

## Drivers ages 80 to 89 years are about twice as likely to be at-fault when compared to the cohorts ages 16 to 19 years in several categories of collisions. 

- ESRA

**Drivers ages ****80 to 89**** years are about ****twice**** as likely to be at-fault when compared to the cohorts ages ****16 to 19**** years in several categories of collisions.**** **

_**RAIR OLDER DRIVER CONCLUSIONS**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

## We find that many of our results follow reliability engineering principles based on bathtub curves.

- ESRA

**We find that many of our results follow reliability engineering principles based on**** ****bathtub curves.**

_**RAIR BATHTUB CURVE CONCLUSIONS**_

**Photo modified from http://www.daihatsu.com/motorshow/geneva05/sirion/bigimg/safety/img****/****02.jpg**

**Notes:**
RAIR allows us to analyze which drivers, by age cohorts, are most likely to be at-fault in a motor vehicle collision.

## Bathtub Curve

**Failure rate**

**Early Failure Period**

**Wear out Failure Period**

**Useful Life Period**

**time**

***f(t)= b θ(θtt)******b*****-1 ****exp***** *****[-(*****e*****(θ*****b*****)*****b******   - θt******b****** – *****1)]  **
- for *b*> 0, *θ *> 0, t _>_ 0

**Bathtub Curve**

_**FAILURE PROBABILITY DENSITY FUNCTION**_

- ESRA

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

**Begins at   age 50 years.**** **

**Begins at   age 20 years.**** **

**Notes:**
The failure probability density function illustrates the type of behavior shown in a bathtub curve:We expect this because older drivers are most vulnerable to collision-related injury or death due to frailty associated with older age.  Similarly, fatigue causes deterioration of mechanical and electrical components and susceptibility to external stresses.  Design or defects of a product sometimes contributes to brittle behavior of a material.  Therefore, in order to maximize safety of both people and products, we seek to minimize these stress factors. In traffic-related collisions, these may be due to visual, cognitive, or motor impairments, or any combination thereof, of the drivers.  Through improvements to driver license testing methods, we may have an edge on screening at-risk drivers.  Through a follow-up medical evaluation, these drivers may seek possible remedies to continue to drive or consider alternative methods of transportation. 

**where:**
***b = *****shape parameter,**
***t= *****time,**
***θ= *****scale parameter**

***f(t)= b θ(θtt)******b*****-1 ****exp***** *****[-(*****e*****(*****θb*****)*****b******   - θt******b****** – *****1)]  **
- for *b*> 0, *θ *> 0, t _>_ 0

_**FAILURE PROBABILITY DENSITY FUNCTION**_
_**DEFINITIONS**_

- ESRA

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

##   Develop a new vision standard for driver’s license issuance and renewal. 

**  ****Develop a new vision standard for driver’s license issuance and renewal. **

_**VISION STANDARD RECOMMENDATION**_

- ESRA

**Notes:**
This can be accomplished with the cooperation of local, state, national, and international medical and government agencies. Ranges of vision loss, as prescribed by the International Council of Ophthalmology (2002), should not only be based on visual acuity. 

## RECOMMENDATION

**Ensure that the ESRA DATTM  or ESRA DVATTM system provides:**
**instant scoring. **
**short and effective on-site testing. **
**score reports linked by network.**
**bilingual capabilities. **

_**RECOMMENDATION**_

- ESRA

## ADDITIONAL FEATURES 

_**ADDITIONAL FEATURES **_
_**RECOMMENDATION**_

- ESRA

**   ****The ESRA DVATTM, and ESRA DATTM can incorporate other features:**
**biometrics, **
**automated written tests, **
**and/ or cognition skills tests.****  **

## MEDICAL RECOMMENDATION

_**MEDICAL RECOMMENDATION**_

**Combine forces with medical agencies and officials, as well as other transport licensing bureaus, on developing a method of assessing scores submitted through the ESRA DATTM  and ESRA DVATTM Systems.**

- ESRA

**	**
**  ****Shorten the periods between driver’s license issuance and renewal for vision testing, in particular for:**

_**LICENSE TESTING RECOMMENDATION**_

- ESRA

**Notes:**
For the sake of driver safety, an increasing number of states modify driver’s license policy, renewal procedures, and vision testing frequencies.  Florida, most recently, follows a newly enacted law for all drivers age 80 years and over to either complete an on-site vision screening test at a local Driver’s License Bureau or obtain certified vision testing results from a physician.  A similar law follows enactment in Virginia. While these on-site Driver’s License Bureau examinations may, in the short term, allow for limited identification of drivers with visual impairments, they completely fail, in the long term, to improve the actual vision testing process and screen the most at-risk drivers.  The methodology remains unchanged so a placebo effect is effectively created unless a new vision testing system for driver’s licensees and applicants is designed and, ultimately, implemented. 

## TESTING 

**Drivers age 15-19 years **
**   ****(every two years).**
**Drivers age 50-70 years **
**  ****(every two years).**
**Drivers age 70 years and over **
**  ****(every one year).**
**All other drivers (every four years).**

_**TESTING **_
_**RECOMMENDATIONS**_

- ESRA

## VISUAL STANDARD RECOMMENDATION

**  ****We call for new and uniform**** ****federal visual standards and vision tests**** ****in all the    United States.****  **

_**VISUAL STANDARD **__**RECOMMENDATION**_

- ESRA

**Photo © 2004 United States National Eye Institute, National Institutes of Health**

## 

   A completely automated system can be used to identify all licensees, irrespective of their residency.  This would simplify the licensure process and paperwork.

**   ****A**** ****completely automated system**** ****can**** ****be used to identify all licensees, irrespective of their residency.  This would simplify the licensure process and paperwork.**

- ESRA

_**AUTOMATED SYSTEM RECOMMENDATION**_

**Photo ©  Copyright 1983 Center for Disease Control.**

## FEDERAL VISUAL STANDARD RECOMMENDATION

- ESRA

_**FEDERAL VISUAL STANDARD RECOMMENDATION**_

**    ****Federal visual standards**** ****would also eliminate those who may not visually or cognitively qualify for a license in one state from obtaining a license in another state. **

## Federal visual standards support similar recommendations as these relate to driver's licenses and other documents introduced through the  9/11 Commission and by the McCain-Lieberman bill introduced in the U.S. Senate, The Intelligence Reform Bill, and H.R. 418. 

**Federal visual standards support similar recommendations as these relate to driver's licenses and other documents introduced through the  ****9/11 Commission and by the McCain-Lieberman bill introduced in the U.S. Senate, T****he Intelligence Reform Bill, and H.R. 418.**** **

_**FEDERAL VISUAL STANDARD RECOMMENDATION**_

- ESRA

**Photo ©  Copyright 2005 Systems Technology, Inc.**

**Notes:**
The Congress should ensure privacy and protection of personal data associated with federal driver.s licenses. This may be accomplished through sufficient backup copies,
encryption, and automation techniques, among other methodologies.  

## CONCLUSIONS

- ESRA

**New vision screening methodologies     and standards are now needed to:**
**promote safety, **
**predict visual impairment, and **
**evaluate possible restriction or **
** ****confiscation of transportation licenses.**** **

_**CONCLUSIONS**_

## CONCLUSIONS

- ESRA

**Self-assessment tools, education courses, and, e.g., driving skill programs**** can only *****complement*****  ****the new ESRA transportation license test designs and reforms.**

_**CONCLUSIONS**_

## Safe, improved, and comprehensive testing is now needed.

**Safe, improved, and comprehensive testing is now needed.**
**ESRA automated systems and methodologies will ultimately benefit all sectors of transportation.**

- ESRA

_**TESTING CONCLUSIONS**_

**Photo ©  Copyright 2005 Systems Technology, Inc.**

**Notes:**
agriculture, aviation, medical, rail, maritime, commercial vehicles, and motorcycle sectors, among others.

##   These ESRA systems and procedures may also reduce the incidence of fraud as these relate to license issuances such as hazardous materials transport.

**  ****These ESRA systems and procedures may also reduce the incidence of fraud as these relate to license issuances such as hazardous materials transport.**

- ESRA

_**HAZMAT CONCLUSION**_

**Notes:**
fraudulent schemes and issuances of driver’s licenses, commercial driver’s licenses, and hazardous materials transportation licenses in all U.S. states. 

## The  ESRA DATTM may be the first of its kind in any transportation agency in the world to implement the most sophisticated technology available.

- ESRA

**The  ESRA DATTM may be the first of its kind in any transportation agency in the world to implement the most sophisticated technology available.**

_**ESRA  DATTM CONCLUSIONS**_

**Notes:**
to screen drivers for cognition, knowledge, vision condition, function, disease, and status, among other other elements. 

## New policies are now needed at the federal and state levels to immediately implement transportation license test designs and reforms as envisaged by ESRA.

- ESRA

**New policies are now needed at the federal and state levels to immediately implement transportation license test designs and reforms as envisaged by ESRA.**

_**FINAL CONCLUSION**_

**Notes:**
to screen drivers for cognition, knowledge, vision condition, function, disease, and status, among other other elements. 

## 
Please refer to the ESRA reports,

SPR 559: New, Improved, Comprehensive, and Automated Driver's License Test and 
Vision Screening System

FHWA-AZ-04-559(1)
   for further information, including the safety and research of these products and others.   These reports are downloadable at: http://www.esracorp.com

**Please refer to the ESRA reports,**
_***SPR 559: ***__***New, Improved, Comprehensive, and Automated Driver's License Test and ***_
_***Vision Screening System***_
_***FHWA-AZ-04-559(1)***_
**   ****for further information, including the safety and research of these products and others.   These reports are downloadable at: ****http://www.esracorp.com**

- ESRA

## With special thanks to:

***With special thanks to:***
** ****Arizona Transportation Research Center  **
**Arizona Department of Transportation**
**Arizona Department of Motor Vehicles**
**United States Department of Transportation**
**Federal Highway Administration**
**Florida Highway Safety and Motor Vehicles**

##  http://www.esracorp.com

**Royal Palm Towers**
**1650 South Dixie Highway, Third Floor**
**Boca Raton, Florida 33432**
** ****USA**
** ****Telephone:  ( 5 6 1) 3 6 1 – 0 0 0 4**
** ****http://www.esracorp.com**

- ESRA

- E S R A

## ESRA