Clinical Interests

Cognitive assessment and intervention, awareness deficits after brain injury, driving and community mobility

Research Interests

Dr. Barco’s research interests focus on driving performance in older adults with various medical impairments. Her research goals are to develop ways clinicians can better assess driving performance in their clients as well as to identify interventions to prolong driving and community mobility throughout the lifespan. She collaborates closely with David Carr, MD, in grant-funded research studying fitness to drive in various populations including older adults with dementia, stroke, Parkinson's disease and visual disorders. She developed a tool to score driving errors which has been utilized in their fitness to drive studies as well as a NIH funded study at Washington University Alzheimer’s Disease and Research Center investigating driving and pre-clinical Alzheimer’s Disease.

Additionally, Dr. Barco is collaborating with Eric Lenze, MD, and his research team to study the effectiveness of an innovative training based program focused on increasing motivation and therapy intensity in older adults receiving occupational and physical therapy services with the goal to improve functional outcomes (NIH R01 PI: Lenze). 

Teaching Roles

Dr. Barco teaches in multiple areas including cognitive assessment, cognitive intervention and classes that relate to driving evaluation and rehabilitation. She is the course master of the cognitive intervention course (Interventions Supporting Recovery and Participation of Individuals with Cognitive and Learning Challenges). Through her teaching, she provides opportunities for students to work directly with clients at rehabilitation facilities throughout St. Louis to integrate clinical experience and classroom learning throughout the semester.      


2013: Doctorate in Occupational Therapy (OTD), Washington University School of Medicine in St. Louis, Program in Occupational Therapy
1987: MS in occupational therapy, Washington University School of Medicine in St. Louis, Program in Occupational Therapy
1984: BS in occupational therapy, Washington University School of Medicine in St. Louis, Program in Occupational Therapy
1981: Bachelor in Social Work, University of Missouri-Columbia


Dr. Barco specializes in the assessment and treatment of adolescents and adults with brain injuries. Prior to joining the faculty, she was the program coordinator for the Head Injury Resource Center for 15 years (currently located Mercy Medical Center in St. Louis), and the administrative director of medical services at The Center for Head Injury Services, a not-for-profit comprehensive community integration center in St. Louis. She assisted in the development of a model of practice addressing awareness deficits after brain injury which is currently in textbooks and utilized in treatment programs today.

Dr. Barco is specialty certified by American Occupational Therapy Association (AOTA) in driving and community mobility. She is the driving and community mobility representative for the Board and Specialty Certification Committee for AOTA. Dr. Barco has performed driving assessments and interventions for more than 15 years and has been instrumental in the development of driving programs in rehabilitation facilities associated with major medical centers, including the development of DRIVING Connections at The Rehabilitation Institute of St. Louis (TRISL).

Selected Publications

Barco, PP, Baum CM, Ott BR, Ice S, Johnson A, Wallendorf M, and Carr DB. Driving Errors in Persons with Dementia. Journal of American Geriatrics Society, 2015. (in press)

Barco, PP, Carr, DB. Rutkoski, KR, Xiong, C., Roe, CM (2015). Brief Report - Inter-rater reliability of the record of driving errors (RODE), American Journal of Occupational Therapy, 69, 6902350020.

Barco PP, Wallendorf MJ, Snellgrove CA, Ott BR, Carr DB (2014). Predicting Road Test Performance in Drivers with Stroke. American Journal of Occupational Therapy, 68(2), 221-229. (Not supported by NIH funds)

Aufman EL, Bland MD, Barco PP, Carr DB, Lang CE. Predictors of Return to Driving after Stroke (2013). American Journal of Physical Medicine & Rehabilitation, 92(7), 627-634. doi:10.1097/PHM.0b013e318282bc0d

Hetland AJ, Carr DB, Wallendorf MJ, Barco PP (2014). Potentially driver impairing’ (PDI) medication use in medically impaired adults referred for driving evaluation. Annuals of Pharmacotherapy. 2014 Jan 28. [Epub ahead of print] PMID:24473491

Meuser T, Berg-Weger M, Niewoehner P, Harmon A, Kuenzie, Carr DB, & Barco PP (2012). Physician input and licensing of at-risk drivers: A review of all-inclusive medical evaluation forms in the US and Canada. Accident Analysis and Prevention, 46: 8-17. ISSN 0001-4575, 10.1016/j.aap.2011.12.009. (Not supported by NIH funds)

Ott, B. R., Papandonatos, G. D., Davis, J. D., & Barco, P. P. (2012). Naturalistic Validation of an On-Road Driving Test of Older Drivers. Human Factors, 54(4), 663-674. doi: 10.1177/0018720811435235

Carr, D.B., Barco, P.P., Wallendorf, M.J., Snellgrove, C.A., Ott, B.R (2011). Predicting road test performance in drivers with Dementia. Journal of American Geriatrics Society, 59: 2112-2117. (PMCID:PMC3228409)

Crosson B, Barco PP, Velozo CA, Bolesta MM, Werts D, and Brobeck TC (1989). Levels of awareness and compensation in post-acute head injury rehabilitation. The Journal of Head Trauma Rehabilitation, 4(3): 46-54.

Book Chapters and Other

Barco, P.P. & Dappen, MS. Occupational Therapy for Individuals with Stroke in the Outpatient Rehabilitation Setting. In: T. Wolf (ed). Stroke: Interventions to Support Occupational Performance. Neurorehabilitation in Occupational Therapy Series, Vol ll, AOTA Press, in press.

Barco, P.P., Stav, W. B., Arnold, R., & Carr, D. (2012). Cognition and community mobility. In M. J. McGuire & E. Schold Davis (Eds.). AOTA Self-paced clinical course: Driving and community mobility. Bethesda, MD: AOTA.

Carr D and Barco P. The older driver (introduction, functional assessment, interventions, medical assessment). In: Berkow R and Beers MH, eds. The Merck Manual of Medical Information, Professional Edition. Whitehouse Station, NJ: Merck Publishing Co. Whitehouse Station, NJ; 2010. Available at:

Barco PP, Crosson BC, Bolesta MM, Werts D, and Stout R. Training awareness and compensation in post acute head injury rehabilitation. In: Kreutzer JS and. Wehman PH, eds. Cognitive Rehabilitation for Persons with Traumatic Brain Injury: A Functional Approach. Baltimore, MD: Paul H. Brookes Publishing Company; 1991: 129-147.

Sandson J, Crosson B, Posner MI, Brobeck TC, Barco PP, and Velozo CA. Attentional imbalances following head injury. In: J.M. Williams JM and C.J. Long CJ, eds. Cognitive Approaches to Neuropsychology. New York, NY: Plenum; 1988: 45-49. 


2017: Roster of Fellows, American Occupational Therapy Association
2013: Jerome Ely Human Factors Article Award for best article in 2012, Volume of Human Factors: Naturalistic Validation of an On-Road Driving Test of Older Drivers
2007: Roberta Sheldon Award for Prevention and Education in Brain Injury
1997: Spirit of Excellence Award (from Brain Injury Association of Missouri)
1993: YMCA Working Women of Achievement Award

Barco, Peggy


Associate Professor of Occupational Therapy and Medicine

Curriculum Vitae

Contact Information

Phone: (314) 286-1654
Fax: (314) 286-1601

Research Laboratory

Driving and Community Mobility Laboratory

Ranked as the Number Three OT Program in the Nation

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