Well, I just got back from a brief trip to Boston, and I have to agree that anyone who can drive in Boston will find Italy a piece of cake. I thought I was going to lose my life every time I got into a taxi in Boston and got on Storrow Drive!
That said, I think driving in Italy on the autostrade is really quite easy if you remember to stay in the right lane unless you want to pass or go very, very fast. Driving in the cities is incredibly difficult because of the traffic, failure to follow traffic signals, and general congestion. The areas along the coast where there are tunnels are hard for me, too - I find going in and out of tunnels traveling at high speeds is tiring and nervous-making. But apart from that, driving in Italy is actually pretty enjoyable.If nothing else, it's fun to get to the end of a vacation and be able to say you survived it!

Absolutely NO ISSUE on the the driving. It is a snap and I wholeheartedly agree that the European driver are much better than North American drives.

We found a great variance in rental car rates -estpecially when you take in to account all of the hidden insurance options and taxes (depending on where you rent tax can be 17 percent). We book the cheapest on the web. We book standard tranmission (automatic in our experience have been very expensive). Then we double check the rates periodically prior to our departure. Last time we did this, we were able to get a rate that was 30 percent lower that the rate we had previously reservered at. Supply and demand I guess or perhaps a 'special'.
Now, if they are going to spend time in Rome they may be better off to train it to Rome, do their sightseeing and then rent the car in Rome. They do NOT want to have the car in Rome and parking can be difficult/expensive to get.

On www.slowtrav.com/italy/road_signs/photos.htm

you will find all the information and pictures of Italian road signs you could ever need. On the right hand side of the page there are links for the different types of signs. I printed each group. Good Luck.

Thanks PLMN, that was very helpful.