Eighty one young people with myelomeningocele and hydrocephalus were assessed for driving ability during the period 1982-1984. All except 6 were eligible to hold a provisional license. At December 1988, over 50% were qualified drivers. Differences in the number of hours of tuition, tests and the difficulties encountered varied for both the driver group and those who had discontinued tuition. Difficulties related to (a) practical and financial considerations and (b) the organisation of tuition. A smaller group of 20 was monitored during tuition within a two year period. Prior to tuition, 10 attended a one week driving course designed to introduce car control skills and simple road procedures. A further 10 learner drivers, who had not attended a course, were similarly monitored through the tuition period. Learner drivers were reviewed by in-car testing and interview after each ten hours' tuition. At the end of the two year period, 40% of learner drivers had passed the driving test, 45% were still receiving tuition and 15% had discontinued lessons. Equal numbers from both groups were qualified drivers but 30% of those who had not attended a course had discontinued tuition. Significant factors for driving success included the availability of instructors and suitably adapted cars, frequency of tuition and level of parental and community support. Future planning for driver education should consider providing driving facilities in local centres. Facilities would need to include adapted cars, experienced instructors and key-workers to coordinate tuition and fulfill a supportive role.