Foot pedals can be raised, relocated (for instance swapped to be used by the opposite leg) or replaced with hand-controlled devices. The common form of hand controls consists of a push-pull handle mounted below and projecting to the side of the steering wheel housing. The bar connects by levers to the accelerator and brake pedals, and is typically pivoted so that pushing applies the accelerator while pulling applies the brake. As there is no facility to work a clutch pedal, hand controls must generally be used in cars with automatic transmissions. With one hand continuously engaged working the hand controls, the steering wheel will generally also be fitted with a steering knob to allow one-handed use. More complex fittings may also connect into the electronic circuitry of the vehicle to place indicator and other switches in easy reach of the driver without requiring them to release the hand controls or steering knob. A guard plate may be fitted to prevent inadvertent contact between the driver's feet and the pedals. Extension levers or adapted grips may also be fitted to the parking brake to allow it to be applied by a driver with limited hand or arm strength.
Adaptions may be individually customised and in more extensive adaptions the traditional pedals and steering wheel may be entirely replaced by a joystick control, or by a secondary mini-steering wheel adapted for users with restricted grip and/or arm movement. Steering knobs may also be adapted for users with restricted grip, using a three-pronged tetra-grip, or for users with a prosthetic hook.
Wheelchair and mobility device access
Standard vehicles are not fitted for wheelchair or mobility device access, leaving users of mobility devices with the choice of either transferring out of their mobility device, or purchasing a vehicle adapted for mobility device access via a lift or ramp. A range of vehicles can be adapted to fit a lift or a ramp, together with appropriate restraints to secure the mobility device, if necessary. Some users of mobility devices will either transfer directly from their mobility device into the vehicle, with use of a lift or they may be able to do a standing transfer. Some may be able to walk the distance between the boot of the vehicle and the doors of the vehicle. In any case, their mobility device will still need to placed in or on the vehicle. While some users are able to lift their mobility device into the vehicle manually, stowing it either in the boot, on the front passenger seat, or behind the front seats, others may require the assistance of a hoist to lift it into the vehicle, onto the roof, or onto a trailer behind the vehicle.
Generally, the more limiting the disability, the more expensive the adaptation needed for the vehicle. Financial assistance is available through some organizations, such as Motability in the United Kingdom, which requires a contribution by the prospective vehicle lessor. Motability makes vehicles available for lease to disabled users in receipt of the Higher Rate Mobility Component of Disability Living Allowance (DLA) or its successor, Personal Independence Payment (PIP). If a UK-based employee with a disability requires an adapted car for work use, this would potentially be considered grounds for a "reasonable adjustment" by the employer in accordance with the Equality Act 2010. In this case the responsibility for funding the adaption would either lie with the employer or potentially be covered by the government-operated Access to Work scheme.
Disabled people who cannot access assisted purchase schemes must generally pay for their own vehicles to be adapted. This will add considerably to the cost of a vehicle, doubly so as adaptions generally require the purchase of a more expensive automatic model rather than one with a manual transmission, which may restrict choice to more expensive ranges, as may the need for the vehicle to have sufficient space to accommodate a wheelchair in the boot or at the driver's position. In the case of a second hand vehicle the cost of typical adaptions could well exceed the value of the vehicle. Adapting a vehicle may negatively affect the resale value, as adaptions are considered unattractive to non-disabled users, in the case of a low value vehicle sometimes rendering it worthless.
A challenge for mobility-impaired drivers is renting a vehicle when they travel. Organizations that specialize in adaptive tourism can assist in finding a vehicle, when possible. In New Zealand, Enable Tourism is an organization that helps drivers with disabilities to locate car rentals offering adapted cars or vans. In France, adapted cars with hand-controls are available from leading car rental businesses, however, it is advisable for drivers with disabilities to reserve a car well in advance of travelling. Several designs of portable push-pull hand-controls are also available which may be quickly connected to a new vehicle by screwing clamps to the pedals, however these may not be suitable for drivers with more extensive requirements.
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