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A fly buzzing inside the cabin, a dog wandering onto the sidewalk, or the tactile lure of the buttons on a steering wheel—for many drivers with ADHD, the road is a landscape of competing stimuli. Diana Loos, a 46-year-old driving school owner who lives with an attention disorder herself, notes that her students often uncover themselves captivated by details that are entirely irrelevant to the task of driving. Yet, with the right guidance or medication, she observes, they often drive exceptionally well.
This practical reality has finally aligned with Dutch law. As of Wednesday, April 1, the mandatory medical examination for individuals with ADHD and autism seeking a driver’s license has been officially abolished. The move ends a 18-year era of systemic screening that often placed a financial and psychological burden on neurodivergent applicants without providing a proportional increase in road safety.
The policy shift reflects a growing medical consensus that a diagnosis of ADHD or autism does not, by itself, indicate a lack of fitness to drive. For nearly two decades, the Centraal Bureau Rijvaardigheidsbewijzen (CBR)—the agency responsible for driver testing in the Netherlands—required these individuals to be cleared by an independent psychiatrist. This requirement, established in 2008 following advice from the Health Council, was based on the premise that these disorders could make drivers inherently more dangerous.
However, recent data suggests that when isolated from other psychiatric comorbidities, neurodivergent drivers are generally as safe as the general population. The decision to scrap the mandate follows a 2025 determination by then-demissionary Minister of Infrastructure Robert Tieman (BBB), who deemed the blanket requirement disproportionate.
Distinguishing Skill from Fitness
At the heart of the policy change is a critical medical distinction between “driving skill” (rijvaardigheid) and “driving fitness” (rijgeschiktheid). According to Anne Laird, head of Medical Affairs at the CBR, the agency employs a risk-based policy to determine who poses a higher likelihood of accidents or violations.
Driving skill refers to the technical ability to control a vehicle and understand traffic laws. Driving fitness, conversely, is the physical and mental capacity to operate a vehicle safely. Recent research indicates that the vast majority of people with autism or ADHD are fully fit to drive, provided they do not suffer from additional complications such as severe depression, anxiety disorders, or substance abuse.
Medical professionals note that while impulsivity and distractibility are hallmarks of ADHD, these are not universal constants. Many drivers manage these traits through behavioral strategies or medication. Most ADHD medications do not impair reaction times—and in some cases, may actually improve the focus required for safe navigation—meaning they do not trigger the same medical red flags as heavy sedatives or certain antipsychotics.
The Human and Financial Cost of Screening
For many, the mandatory exams felt more like a bureaucratic hurdle than a safety measure. Caroline Verkerk, director of the Dutch Association for Autism (NVA), stated that the organization has lobbied for this change for five years. Verkerk noted that members often found the examinations—conducted by psychiatrists who were strangers to them—to be superficial, sometimes lasting only a few minutes.
The financial burden was also significant. Diana Loos recalls that when she pursued her motorcycle license years after her own ADHD diagnosis, she had to navigate a costly medical process that cost her 200 euros. For many applicants, this expense was an unnecessary barrier to independence.
The Role of the Driving Instructor
With the psychiatrist removed from the equation, the responsibility for assessing readiness shifts toward driving instructors and CBR examiners. Julie Houben, an advocate at Impuls & Woortblind, argues that instructors are best positioned to see if a student can “preserve their head in the game” or if they are too impulsive to operate a vehicle safely. She notes that modern distractions—such as smartphone notifications—affect all drivers, not just those with ADHD.
However, some professionals express caution. Sergiu Hauer, a driving instructor with 35 years of experience in The Hague, worries that the lack of a medical “stop” could lead to some students taking an excessive number of lessons. Hauer suggests that without a formal medical disqualification, some students might be “kept on the line” by schools that profit from endless lessons, even when it is clear the student is not making progress.
Hauer argues that the ideal system would involve the physician who originally diagnosed the patient—rather than an independent psychiatrist—making the determination of fitness, as they possess a deeper understanding of the individual’s specific clinical profile.
What Remains in the Process
The removal of the automatic exam does not mean the end of medical oversight. All applicants are still required to complete the Gezondheidsverklaring (Health Declaration). While a diagnosis of ADHD or autism alone no longer triggers a mandatory psychiatric review, other conditions must still be disclosed.
| Requirement | Pre-April 2026 Policy | Current Policy |
|---|---|---|
| ADHD/Autism Diagnosis | Mandatory independent psychiatric exam | No automatic exam required |
| Health Declaration | Required for all applicants | Required for all applicants |
| Comorbidities (e.g., Depression) | Triggers medical review | Triggers medical review |
| Strong Psychoactive Meds | Triggers medical review | Triggers medical review |
If an applicant discloses a severe anxiety disorder, a major depressive episode, or the use of medication that significantly impairs reaction time, the CBR may still mandate a medical examination. This ensures that the safety net remains for those with complex clinical needs while removing the stigma and cost for those whose neurodivergence is well-managed.
those who are truly unfit to drive will likely be filtered out by the practical driving exam. As Hauer notes, a student who cannot maintain focus will simply fail the test, though the absence of an early medical screen may mean they only discover this after a significant investment of time and money.
Disclaimer: This article is for informational purposes only and does not constitute medical or legal advice. Individuals should consult with their healthcare provider and the CBR for specific guidance on driving fitness.
The CBR continues to monitor road safety data to ensure that this risk-based approach maintains public safety. Further reviews of the impact of these changes are expected as more neurodivergent applicants move through the system under the new guidelines.
Do you believe the responsibility of assessing fitness should lie with the instructor or a medical professional? Share your thoughts in the comments below.
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