[Federal Register Volume 66, Number 123 (Tuesday, June 26, 2001)]
[Notices]
[Pages 34026-34034]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-15959]



[[Page 34025]]

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Part IV





Department of Education





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National Institute on Disability and Rehabilitation Research



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Final Funding Priorities for Fiscal Years 2001-2003 for Four Disability 
and Rehabilitation Research Projects; Invitation for Applications for 
Fiscal Year 2001 New Awards and Announcement of Pre-Application 
Meetings; Notices

  Federal Register / Vol. 66, No. 123 / Tuesday, June 26, 2001 / 
Notices  

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DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research; 
Notice of Final Funding Priorities for Fiscal Years 2001-2003 for Four 
Disability and Rehabilitation Research Projects

AGENCY: Office of Special Education and Rehabilitative Services, 
Department of Education.

ACTION: Notice of final funding priorities for fiscal years 2001-2003 
for four disability and rehabilitation research projects.

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SUMMARY: We are announcing four final funding priorities under the 
Disability and Rehabilitation Research Projects and Centers Program 
(DRRP) of the National Institute on Disability and Rehabilitation 
Research (NIDRR) for FY 2001-2003: Assistive Technology Outcomes, 
Impacts and Assistive Technology Research Projects for Individuals with 
Cognitive Disabilities, Resource Center for Community-based Research on 
Technology for Independence, and Community-based Research Projects on 
Technology for Independence. We take this action to focus research 
attention on areas of national need. We intend these priorities to 
improve the rehabilitation services and outcomes for individuals with 
disabilities.

DATES: These priorities take effect on July 26, 2001.

FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 205-
5880. Individuals who use a telecommunications device for the deaf 
(TDD) may call the TDD number at (202) 205-4475. Internet: 
[email protected]
    Individuals with disabilities may obtain this document in an 
alternative format (e.g., Braille, large print, audiotape, or computer 
diskette) on request to the contact person listed in the preceding 
paragraph.

SUPPLEMENTARY INFORMATION: This notice contains final priorities under 
the Disability and Rehabilitation Research Projects and Centers Program 
(DRRP) for Assistive Technology Outcomes, Impacts and Assistive 
Technology Research Projects for Individuals with Cognitive 
Disabilities, Resource Center for Community-based Research on 
Technology for Independence, and Community-based Research Projects on 
Technology for Independence.
    The final priorities refer to NIDRR's Long-Range Plan (the Plan). 
The Plan can be accessed on the World Wide Web at: http://www.ed.gov/offices/OSERS/NIDRR/#LRP.

National Education Goals

    The eight National Education Goals focus the Nation's education 
reform efforts and provide a framework for improving teaching and 
learning.
    This notice addresses the National Education Goal that every adult 
American will be literate and will possess the knowledge and skills 
necessary to compete in a global economy and exercise the rights and 
responsibilities of citizenship.
    The authority for the program to establish research priorities by 
reserving funds to support particular research activities is contained 
in sections 202(g) and 204 of the Rehabilitation Act of 1973, as 
amended (29 U.S.C. 762(g) and 764(b)). Regulations governing this 
program are found in 34 CFR part 350.

    Note: This notice does not solicit applications. A notice 
inviting applications is published in this issue of the Federal 
Register.

Analysis of Comments and Changes

    On April 6, 2001, we published a notice of proposed priorities on 
the Assistive Technology Outcomes and Impacts and the Assistive 
Technology Research Projects for Individuals with Cognitive 
Disabilities in the Federal Register (66 FR 18366). The Department of 
Education received 12 letters commenting on the notice of proposed 
priorities by the deadline date. Technical and other minor changes--and 
suggested changes we are not legally authorized to make under statutory 
authority--are not addressed.

Priority 1: Assistive Technology Outcomes and Impacts

    Comment: The primary stakeholder regarding AT outcomes is the 
person who uses (or is expected to use) a particular AT device. Family 
members and caregivers are secondary consumers, however, they may be 
considered primary stakeholders in the sense that two thirds of all AT 
is procured through first party and family funding. Therefore, it is 
crucial that this priority require applicants to focus on the 
individual with a disability rather than other primary and secondary 
stakeholders.
    Discussion: NIDRR feels the priority is sufficiently flexible to 
allow the applicant to propose methodological approaches that focus on 
the needs of primary stakeholders such as individuals with 
disabilities. The peer review process will evaluate the merits of the 
proposal.
    Changes: None.
    Comment: One commenter is concerned about using the word 
``intervention'' in the general purpose statement suggesting that it is 
a poor choice of words and may be misinterpreted. The commenter 
recommends dropping the word altogether so that the last sentence of 
the general purpose statement reads ``* * * determine the efficacy and 
utility of AT and the implications.''
    Discussion: NIDRR agrees that the term ``interventions'' may be 
misconstrued because of varying definitions and interpretations.
    Changes: The word ``interventions'' has been dropped from the 
general purpose statement.
    Comment: The second bulleted activity lists a number of relevant 
organizations that applicants must collaborate with. Given that AT 
users are the primary targets of this priority, this bulleted activity 
should be expanded to include AT users.
    Discussion: The second bulleted activity enumerates relevant NIDRR 
projects and not specific stakeholders. The purpose of this priority is 
to investigate AT outcomes and 2 impacts and cannot be carried out 
without the full participation and support of AT users.
    Changes: None.
    Comment: The assessment and evaluation of AT should include 
questions related to both positive and negative impacts of AT use and 
the acquisition of AT through various financial means.
    Discussion: Economic and cost factors, as well as positive and 
negative outcomes, of AT use are discussed in the background statement. 
An applicant can propose methodological approaches to measure outcomes 
and impacts that take into account both positive and negative impacts 
of AT use and the acquisition of AT through various financial means and 
the peer review process will evaluate the merits of the proposal.
    Changes: None.
    Comment: One commenter feels that the application of AT to specific 
populations (such as frail elderly persons, infants and toddlers, and 
their care providers) should be examined in terms of financial benefits 
to individuals and care systems as well as functional outcomes for 
individuals.
    Discussion: NIDRR agrees with the commenter that an examination of 
the application of AT to specific populations and its impact on care 
systems as well as individuals is critical to the development of useful 
measurement systems and this was mentioned in the background statement. 
An applicant may propose to examine the financial benefits to 
individuals and

[[Page 34027]]

care systems as well as functional outcomes for individuals with 
disabilities and the peer review process will evaluate the merits of 
the proposal.
    Changes: None.
    Comment: One commenter suggested that long-term outcomes need to be 
addressed specifically. Preliminary research indicates that the use of 
AT will delay institutionalization and, along with personal attendant 
services, will maintain a person in a relatively independent state for 
a given period of time. For people with significant disabilities, 
including those with Alzheimer's and other dementia diseases who use 
assistive devices, it may be useful and instructive to discover the 
long-term effects of reliance on AT for independent living.
    Discussion: NIDRR agrees that maintaining an independent life style 
for as long as possible is critical for all people and that the use of 
AT plays an important role in independent living. The background 
statement and the priority support the commenter's contention. An 
applicant may propose ways to measure the impact of AT on maintaining 
independence in its application and the peer review process will 
evaluate the merits of the proposal.
    Changes: None.
    Comment: The cost-benefit of AT on healthcare is an essential 
impact question. Efforts to evaluate the appropriate use of AT and its 
financial benefits to insurance providers (both public and private) are 
essential. Related to this issue is the impact of managed care systems 
on the appropriate provision of AT to persons with disabilities. The 
positive or negative effects of this type of delivery system should be 
investigated in terms of long-term health outcome, including the 
reduction of time spent in healthcare institutions, for individuals 
with disabilities.
    Discussion: NIDRR agrees that there are a myriad of issues related 
to the cost, economics, and financial benefits of AT. An applicant may 
propose to investigate issues related to the cost, economics, and 
financial benefits of AT and the peer review process will evaluate the 
merits of the proposal.
    Changes: None.
    Comment: The same commenter believes that the impact of expanding 
approved lists of durable medical equipment through DMERCs on 
individual outcomes should also be assessed.
    Discussion: Developing lists of approved durable medical equipment 
through DMERCs and assessing their impact on individual outcomes is 
beyond the scope of this priority.
    Changes: None.
    Comment: One commenter cites the need to develop methods and 
standards of practice to help organizations monitor the quality of 
services and outcomes.
    Discussion: Developing methods and standards of practice for 
organizational monitoring of quality assurance is beyond the scope of 
this priority.
    Changes: None.
    Comment: The same commenter feels that three levels of information 
must be measured; the impact of AT on the individual, the impact on the 
community and how and in what context the service was delivered.
    Discussion: NIDRR agrees that these are important dimensions of AT 
use and addressed these factors in the background statement. An 
applicant may propose ways to measure the different levels of impact of 
the provision of AT on the consumer, on the community, and the context 
in which the AT was provided. The peer review process will evaluate the 
merits of the proposal.
    Changes: None.

Priority 2: Assistive Technology Research Projects for Individuals With 
Cognitive Disabilities

    Comment: Four commenters suggest that an activity should be added 
to the priority requiring applicants to investigate ways of making the 
Internet accessible to people with cognitive disabilities.
    Discussion: NIDRR agrees that access to the Internet, and 
therefore, information is extremely important for persons with 
cognitive disabilities. An applicant could propose to investigate ways 
to make the Internet more accessible for persons with cognitive 
disabilities and the peer review process will evaluate the merits of 
the proposal.
    Changes: None.

Priority 3: Resource Center for Community-Based Research for 
Independence; Priority 4: Community-Based Research Projects on 
Technology for Independence

    On April 6, 2001, we published a notice of proposed priorities in 
the Federal Register (66 FR 18360). The Department of Education 
received 14 letters commenting on the notice of proposed priorities by 
the deadline date. Many of the comments concerned both priorities, 
raised multiple issues and suggestions, and overlapped with other 
comments. NIDRR is responding to the comments on priority one and 
priority two jointly. As a group, the comments indicated a need to 
clarify the purposes and expectations for these priorities and to 
explain some of the legislative and regulatory constraints under which 
they were proposed. Technical and other minor changes--and suggested 
changes we are not legally authorized to make under statutory 
authority--are not addressed.

General Comments

    Comment: Several commenters suggested that each project be required 
to address a variety of different topics, such as rural areas, effects 
of technology on health outcomes, 5 specific disability populations, 
such as deaf individuals, caregivers, or families.
    Discussion: A major purpose of this program is to address issues, 
within the general area of access to appropriate technology, that are 
identified as important by individuals with disabilities. This priority 
is concerned generally with research on understanding potential roles 
for community-based disability organizations in research on increasing 
access to Assistive Technology (AT) and systems technology, and with 
developing partnerships and research strategies for use by community-
based disability organizations. NIDRR elects not to further constrict 
the selection of problems for study. Applicants may elect to study 
issues of single disability populations or cross-disability concerns, 
and may target any populations relevant to improving access to 
technology, including families, caregivers, professional service 
providers, product distributors, or others. It is up to the applicants 
to convince the peer reviewers of the importance of the problem they 
elect to address.
    Changes: None.
    Comment: Several commenters discussed the definition of community-
based disability organization and of consumer control. The gist of 
these comments related to either: declaring certain types of 
organizations (e.g., University Affiliated Programs, now named 
University Centers of Excellence, or facility-based employment 
programs) to be community-based organizations; restricting the 
competition to consumer-directed organizations; or declaring various 
types of organizations to be either eligible or ineligible for the 
competition. One commenter argued that the intent to ``involve 
community disability organizations'' is objectionable, and that grants 
should be made only to grassroots organizations, and not universities.
    Discussion: NIDRR does not have the authority to restrict 
eligibility for the DRRP competition beyond that specified in the 
statute. The regulations specify that any public or private 
organization,

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whether nonprofit or for-profit, institution of higher education, or 
Indian tribe or tribal organization, is eligible to apply for a grant 
in this program. Since the purpose of this priority is to build 
research capacity in community-based disability organizations to study 
problems of access to technology, NIDRR requires in the priority that 
any application to be funded must include a community-based disability 
organization, either as sole applicant or as a partner in the endeavor. 
According to the priority, ``A community-based disability organization 
is a consumer-directed disability organization * * * consumer control 
is the key.'' While NIDRR regulations do not define these terms, 
regulations for the Independent Living Programs, also funded under the 
Rehabilitation Act, as amended, define ``consumer control'' to mean 
that ``a center or eligible agency vests power and authority in 
individuals with disabilities * * *'' [34 CFR 364.4 (b)]. Further, 
dictionary definitions and the sense of this priority indicate that 
community-based organizations are not institution-based, and that 
disability organizations are those of, by, and for persons with 
disabilities. It will be up to the peer reviewers in applying the 
selection criteria to judge how well an application responds to the 
purposes of the priority of building research capacity in community-
based disability organizations and works through community-based 
disability organizations to ``* * * broaden the inclusion of persons 
with disabilities in developing practical and affordable solutions to 
AT and environmental access problems and needs''.
    Changes: None.
    Comment: Several commenters discussed standards and requirements 
for AT to be developed under these grants. At the same time, other 
commenters pointed out that there were many barriers to access beyond 
the development of new technology.
    Discussion: The priority does not address development of 
technology, but rather research on improved access to technology. 
Applicants could propose to develop new technology or devices if the 
project met the basic purposes of building research capacity in 
community-based disability organizations by addressing issues of 
increasing access to technology, both individual AT and systems 
(environmental access). However, NIDRR does not anticipate that 
development of new technology will be the focus of all, or even any, of 
these projects. Issues of improving access also include distribution, 
diagnosis and prescription, funding, maintenance, training, and other 
problems. Potential applicants are referred to both the NIDRR Long-
Range Plan (1999) and the Blueprint for the Millennium: An Analysis of 
Regional Hearings on Assistive Technology for People with Disabilities 
(1998) for discussions of the complex issues in technology access for 
individuals with disabilities. It is up to the applicants to convince 
the peer reviewers of the importance of the problem they elect to 
address.
    Changes: None.
    Comment: Several commenters asked that additional NIDRR centers or 
entities funded from other sources be specified as resources for 
cooperation in the priority.
    Discussion: The priority states, ``Coordinate with appropriate 
federally-funded projects.'' The priority then provides examples of 
what may be included. It is not feasible or necessary to list all 
potential cooperators, and astute applicants will survey the field to 
identify the most appropriate organizations for coordination to advance 
the success of their proposed projects.
    Changes: None.
    Comment: One commenter requested a clarification of the meaning of 
``environmental access'' and whether it applies only to AT, or could 
include other environmental issues.
    Discussion: The priority refers to AT and environmental access. The 
Plan refers to technology to improve function and technology to improve 
access to the built environment. Modifications to the physical and 
telecommunications environments, including applications of universal 
design, may include architectural modifications, signage for persons 
with sensory or cognitive limitations, and public transit modifications 
that enable persons with disabilities to access the broader 
environment.
    Changes: None.
    Comment: One commenter stated that there should be a requirement 
that every applicant must indicate how they are developing research 
capacity among individuals with disabilities.
    Discussion: NIDRR agrees that this is an important aspect of the 
projects and has added language in the priority to this effect.
    Changes: The language ``applicants must describe how they will 
develop research capacity among individuals with disabilities at the 
community level'' has been inserted as paragraph (c) in the final 
section of both priorities.
    Comment: One commenter noted that although dissemination of project 
findings through electronic media is often effective, it would be 
inappropriate to limit the dissemination of findings to electronic 
media and that accessible electronic media in combination with other 
accessible media should be used.
    Discussion: Selection criteria for dissemination activities address 
appropriateness of dissemination approaches and that such methods are 
accessible to individuals with various disabilities.
    Changes: None.

Disability and Rehabilitation Research Projects and Centers Program

    The authority for Disability and Rehabilitation Research Projects 
(DRRP) is contained in section 204 of the Rehabilitation Act of 1973, 
as amended (29 U.S.C. 762(g) and 764(b)). The purpose of the DRRP 
program is to plan and conduct research, demonstration projects, 
training, and related activities to--
    (a) Develop methods, procedures, and rehabilitation technology that 
maximizes the full inclusion and integration into society, employment, 
independent living, family support, and economic and social self-
sufficiency of individuals with disabilities; and
    (b) Improve the effectiveness of services authorized under the Act.

Priority 1: Assistive Technology Outcomes and Impacts

Background

    One of the greatest challenges facing health care systems, social 
services providers and policymakers is to ensure that scarce resources 
are used efficiently. To a large extent, this challenge explains the 
growing interest in outcomes research and evidence-based medicine.
    Particular interest in outcomes of assistive technology (AT) is 
related to the amount of dollars spent on developing and manufacturing 
AT, AT service delivery and to the need to improve the functional 
independence and well-being of persons with disabilities of all ages. 
Yet, assessment of the impact of technology on function and other 
productivity and quality of life outcomes lags behind outcomes 
measurement in other areas of rehabilitation.
    There are several factors that promote concern about the paucity of 
outcomes research in AT including the: (a) Ability to demonstrate 
efficacy of new devices; (b) need to examine effectiveness of devices 
over time; and (c) need to chart future research and development to 
improve devices (Fuhrer, M. J., ``Assistive technology outcomes

[[Page 34029]]

research: challenges met and yet unmet,'' American Journal of Physical 
Medicine and Rehabilitation, 2001, In press). Outcomes research and 
analysis is also needed to guide decisionmaking across multiple levels 
of policy and program development, including: (a) Decisions on a 
societal level regarding types of public programs and services to fund; 
(b) decisions on a programmatic level regarding what services to 
continue, enhance, modify or eliminate; (c) decisions on an individual 
level regarding AT recommendations and interventions; and (d) decisions 
on a research level regarding the comparative effectiveness of 
individual devices and the impact on future designs (Smith, R., 
``Measuring the outcomes of assistive technology: challenge and 
innovation'', Assistive Technology, Vol. 8, No. 2, pgs. 71-81, 1996).
    In the face of a growing interest in outcomes, the inconsistent use 
of terminology contributes to the confusion that exists in the 
application of a generally accepted outcomes approach. In the field of 
rehabilitation, outcomes measurement has focused on creating outcomes 
management systems and measuring and communicating outcomes. 
Rehabilitation has led the health care field in its emphasis on changes 
in function as an outcomes measure. Still, even in rehabilitation, 
outcomes measurement systems have typically focused on process 
variables, i.e., the outputs of products and services, and not on gains 
to the individual or society in either the short or long term. 
Wilkerson posits that this emphasis on process will change because of 
three factors: (a) The pressure to cut costs; (b) growth of consumerism 
leading to increased input from users and increased focus on the needs 
of the end user; and (c) concerns about quality in relation to costs 
(Wilkerson, D., ``Outcomes and accreditation--The paradigm is shifting 
toward outcome,'' Rehab Management, August/September, pgs. 112-115, 
1997).
    Outcomes research is defined in different ways across 
rehabilitation and health services research as well as in the social 
services field. The Foundation for Health Services Research (Foundation 
for Health Services Research, Health Outcomes Research: A Primer, 
Washington, DC, 1994) characterized outcomes research as research 
focused on the ``end results of medical care--the effect of the health 
care process on the health and well-being of patients and 
populations.'' The Institute of Medicine (IOM) (Feasley, J.C., ed., 
Health Outcomes for Older People: Questions for the Coming Decade, 
Washington, DC: National Academy Press, 1996) expanded this definition 
to include ``the clinical signs and symptoms, well-being or mental and 
emotional functioning; physical, cognitive, and social functioning; 
satisfaction with care; health-related quality of life, and costs and 
appropriate use of resources.'' Outcomes research has also been defined 
as research designed to discover the sustained impact of rehabilitative 
strategies and treatments in the everyday lives of persons with 
disabilities. ``Outcomes research attempts to build a bridge between 
interventions and long-term improvements in the lives of persons served 
as they reenter the community'' (Johnston, M., et al., ``Outcomes 
research in medical rehabilitation--foundations from the past and 
directions for the future,'' Assessing Medical Rehabilitation 
Practices: The Promise of Outcomes Research, Marcus J. Fuhrer, ed., 
pgs. 1-42, 1997). Regardless of how it is defined, outcomes research is 
part of the larger framework of program evaluation (Fuhrer, op. cit., 
1997), and includes both outcomes analysis and outcomes measurement 
also known as performance measurement (Jennings, B.M. and Staggers, N., 
The language of outcomes, Journal of Rehabilitation Outcomes 
Measurement, Vol. 3, No. 1, pgs. 59-64, 1999).
    Rehabilitation outcomes are changes produced by rehabilitation 
services in the lives of service recipients and their environments. 
Outcome indicators are measures of the amount and frequency of those 
occurrences, and include service quality. Within this perspective, some 
analysts use the word ``impacts'' to distinguish between long-term 
outcomes or end results that occur on a societal versus an individual 
level. Still others use the term ``impact'' more strictly to refer to 
estimates of the extent to which the program actually ``caused'' 
particular outcomes (Hatry, H., et al., Customer Surveys for agency 
managers: What Managers Need to Know, Washington, DC: Urban Institute, 
1998). Deconstructing these various definitions and types of outcomes 
and impacts requires recognition of complexity on many levels.
    Although AT has grown as a discipline and as an industry over the 
past two decades, there has not been a corresponding maturity in 
developing or assessing the outcomes or impacts of AT upon individuals 
with disabilities. AT devices and services outcomes also may be 
difficult to define because of the ways AT is used. For example, AT is 
used to increase participation in the environment, enhance normative 
social roles, promote and sustain employment, and facilitate activities 
of daily living. Some devices, such as computers, increase access to 
information and support life long learning. AT devices vary 
significantly from highly complex and sophisticated computer-operated 
systems to low tech approaches that can be easily purchased or built. 
Complicating the issue even further are the individual characteristics 
of the AT user and the varied environments in which users live, work, 
and learn.
    Approximately one-third of AT devices will be abandoned by the user 
(Phillips, B. and Zhao, H. ``Predictors of assistive technology 
abandonment'', Assistive Technology, Vol. 5, pgs. 36-45, 1995). There 
are many reasons why individuals with disabilities choose to accept or 
reject AT devices. Since public funds provide a major source for 
purchasing AT devices and services, useful and accurate measures of 
outcomes and impacts is critical for accountability and to avoid 
wasteful outcomes. Is abandonment a negative or could it be a positive 
outcome? Abandonment has been viewed as the end result of fragmented 
service provision, poor assessment techniques, lack of consumer choice 
in device selection, inattention to device use across environments, 
inadequate training, costly repairs, need to upgrade and obsolete or 
inappropriate technology. However, abandonment may be a natural 
phenomenon related to improved physical or cognitive function, the 
result of a technology upgrade or because different technology is a 
better fit between the end-user and the environment.
    There are other reasons to account for the lack of momentum in 
measurement development and outcomes and impact research on AT. Most of 
the endorsements of a particular device or service are based on 
anecdotal information (Fuhrer, 1999) rather than data generated from 
research. Frank DeRuyter (``Evaluating outcomes in assistive 
technology: do we understand the commitment,'' Assistive Technology, 
Vol. 7, No. 1, pgs. 3-16, 1995), observed that historically, AT was 
considered a remedy to impairment or dysfunction, and the urgency of 
consumer need was of greater importance than relying upon data to 
document the efficacy of a particular device. In addition, quality was 
perceived as too abstract and difficult to measure and define. Vendors 
and practitioners may feel threatened by potential findings and 
accountability demands, which may also have contributed to the lack of 
outcomes studies (DeRuyter, op. cit., 1995).
    While the AT arena is complex and broad, several outcomes studies 
have

[[Page 34030]]

focused on a discrete segment of the entire system. Smith says that 
there are essentially two domains of outcome measurement: the 
performance of an individual using assistive technology and the cost of 
achieving the level of performance (Smith, R. O., ``Accountability in 
assistive technology interventions: measuring outcomes,'' Volume I--
RESNA Resource Guide of Assistive Technology Outcomes: Measurement 
Tools, pgs. 15-43, 1998). Minkel proposed that the primary measure to 
determine the value of the assistive technology is the basic formula of 
outcomes divided by cost (Minkel, J., ``Assistive technology and 
outcomes measurement: Where do we begin?'' Technology and Disability, 
July, pgs. 285-288, 1996). There are others within the AT community who 
operate under the assumption that improvements and innovation in 
technology will ``naturally'' lead to successful use and 
implementation, and therefore do not need to be evaluated. From this 
perspective, technological solutions have been viewed as a panacea 
without the benefit of data to support prevailing assumptions 
(DeRuyter, F., ``Concepts and rationale for accountability in assistive 
technology,'' Volume I--RESNA Resource Guide of Assistive Technology 
Outcomes: Measurement Tools, pgs. 2-15, 1998).
    At a minimum, the process of evaluating AT outcomes must measure 
and establish a baseline of what works, identify how well and for whom 
it works, and at what level of economy and efficiency. This process 
will necessitate taking information from several performance monitoring 
dimensions (De Ruyter, op. cit., 1998). In approaching the challenges 
of AT outcomes measurement, it is important to identify if the outcomes 
relate to the AT product or service, the user, or to the environment in 
which the technology is being used. While not standardized or widely 
endorsed, a variety of measurement techniques and instruments are 
currently utilized. These measurement tools tend to be specific to a 
given practice area or limited to a functional domain, (Volume I: 
RESNA--Resource Guide for Assistive Technology Outcomes: Measurement 
Tools, 1998).
    To proceed with assessing AT outcomes and impacts, the following 
questions need to be addressed. First, what are the key gaps and 
weaknesses in our knowledge of AT use and its impacts? Are the key 
research questions related to a particular intervention at a particular 
point in time? How do device modifications and upgrades change the 
intervention? How do characteristics of the population including 
severity of impairment, duration of disability, presence of co-
morbidities, aging and other sociodemographic factors influence 
technology utilization and bias outcomes study? What is the role of 
environmental, economic, awareness and training barriers in AT use and 
outcomes? These different levels of outcomes can look at impacts and 
effects of technology at one point in time, more typically a clinical 
or functional outcome, or can be examined in terms of long-term impacts 
on individual quality of life, productivity and social participation. 
As one researcher expressed it, in addition to longitudinal studies, 
``the research agenda must consider lifelong use of assistive 
technology, documenting effectiveness of that technology as an 
intervention, identifying stages for reconsideration of its use, and 
defining environmental and social considerations'' (Turk, M. A., 
``Early development-related condition,'' Assessing Medical 
Rehabilitation Practices--The Promise of Outcomes Research, Marcus J. 
Fuhrer, ed., pgs. 367-392, 1997).
    Innovations in AT will continue to evolve and many AT users, as 
they have in the recent past, will experience increases in 
independence, function, and general well being. Concurrently, the gap 
between the promise of technology and the ability of individuals and 
funding sources to afford them will continue to widen. This will result 
in a greater need for knowledge about the cost-effectiveness and 
efficiency of particular devices and services (Fuhrer, M.J., 
``Assistive technology outcomes research: challenges met and yet 
unmet,'' American Journal of Physical Medicine and Rehabilitation, 
2001, In press).

Priority 1

    We will establish multiple research projects on AT outcomes and 
impacts to determine the efficacy and utility of AT and the 
implications for abandonment of AT devices. In carrying out these 
purposes, the projects must:
    (a) Assess the current status of AT outcomes and impacts 
measurement systems and approaches, identifying measurement 
methodologies, characteristics of key instruments including utility to 
AT field, and critical gaps in measurement;
    (b) Based upon the findings of paragraph (a), evaluate efficacy of 
existing measurement instruments or develop and evaluate new outcomes 
and impacts measurement methodologies to meet the needs of AT 
stakeholders; and
    (c) Investigate and analyze the complexity of factors contributing 
to the abandonment of AT, including age-related changes, and identify 
how these factors are incorporated into outcomes and impacts 
measurement instruments.
    In addition to activities proposed by the applicants to carry out 
these purposes, each project must:
     Develop and disseminate to AT stakeholders and other 
interested and relevant audiences, as determined by NIDRR, materials on 
AT outcomes studies and impacts analyses and, periodic updates on the 
project's milestones, products and results; and
     Collaborate with relevant NIDRR-sponsored projects, such 
as the AT/IT Consumer Survey (University of Michigan), the RESNA 
Technical Assistance projects, and the RRTC on Medical Rehabilitation 
Outcomes, as identified through consultation with the NIDRR Project 
Officer.

Priority 2: Assistive Technology Research Projects for Individuals 
With Cognitive Disabilities

Background

    Technology and assistive devices have commonly been used to assist 
persons with mobility, communication and sensory difficulties. Because 
of the positive impact that technology has played in the lives of these 
individuals, there is now a strong push toward the development of such 
devices for people with cognitive disabilities. The Assistive 
Technology Act of 1998 defines an AT device to be any item, piece of 
equipment or product system whether acquired commercially off the 
shelf, modified or customized that is used to increase, maintain or 
improve functional capabilities of individuals with disabilities. Rapid 
advances in technology provide great potential for development of new 
devices or adaptation of available devices to assist individuals with 
cognitive disabilities to develop and maintain skills.
    Technology professionals, such as computer scientists and 
rehabilitation engineers, have limited experience applying AT solutions 
to users with cognitive disabilities. Nor do they yet understand the 
mapping between specific needs and equally specific design solutions. 
Most people with cognitive disabilities have a range of learning and 
processing capabilities. Wide variations in cognitive functioning make 
it difficult to develop generic solutions appropriate for all 
individuals. Functional capabilities associated with these disabilities 
may include wide ranges of ability in memory, reasoning, and language 
comprehension. Cognitive

[[Page 34031]]

functioning also includes perception, problem-solving, conceptualizing, 
reading, thinking and sequencing (Electronic and Information Technology 
Access Advisory Committee, ``EITAAC Report, May 13, 1999,'' A Report to 
the Architectural and Transportation Barriers Compliance Board). Common 
strategies to improve functioning in activities of daily living across 
various cognitive disabilities need to be identified, as do, issues 
regarding information processing that may be unique to each of these 
groups.
    Persons with cognitive disabilities often have difficulty in 
carrying out Instrumental Activities of Daily Living (IADLs) because of 
problems with time management and information retrieval. Researchers 
are experimenting with the use of electronic personal computers to 
compensate for memory problems. Other researchers are examining methods 
of matching individual cognitive problems with compensatory strategies 
provided by a variety of commercially available portable electronic 
devices. In traumatic brain injury treatment, researchers are 
investigating the use of virtual reality technology to test visual 
acuity and reaction times to stimulus. Research is also being conducted 
on the use of text-based messages to enhance communication.
    Technology is often viewed as facilitating employment of persons 
with disabilities. However, inaccessible technology can be a barrier to 
all persons with disabilities. This is particularly true for persons 
with cognitive impairments who may have difficulty using telephones, 
computers, and other equipment that are staples of most work 
environments. Developers and manufacturers of AT often do not consider 
issues of cognitive access and flexibility when designing their 
products.
    While the congruence between the promise of AT and the needs of 
many people attempting to achieve community integration is obvious, 
little has been written about the manner in which technology affects 
community adaptation or the service needs of individuals with cognitive 
disabilities in community settings. While specific manifestations of AT 
have identifiable benefits, the central question needs to be 
empirically addressed--how can assistive technologies contribute to 
community integration and in what manner can the linkage be 
facilitated? The state of knowledge about the use of AT for persons 
with cognitive disabilities, as well as the outcomes of that use or 
lack of use and the cost-effectiveness in achieving community 
integration is limited. There are only a few large assessments of the 
technology needs of persons with cognitive disabilities and results are 
ambiguous because of difficulties in identifying persons with low 
incidence conditions and specific technology needs within the study 
population (Lakin, C. et al., NIDRR Long-Range Plan Commissioned Paper 
on Community Integration, 1996).
    In order to take advantage of any potential that technological 
advances may have, it is important to define what makes a device easier 
or more difficult for a person with a cognitive disability to use. 
Products that are simpler and require fewer cognitive skills are easier 
to operate for everyone (Vanderheiden, G., 1992, ``A brief look at 
technology and mental retardation in the 21st century,'' in Mental 
Retardation in the Year 2000, Louis Rowitz, ed., New York: Springer-
Verlag). ``Design guidelines'' must then be communicated to the 
manufacturers of consumer products and business information systems. 
Instructions for training on the use and maintenance of the device also 
need to be part of this design process. It is important for designers 
to be aware of the real world tasks with which the user has difficulty; 
hence, research needs to include persons with cognitive disabilities at 
the front end of all technology development. End product affordability 
is important not only in meeting consumer needs, but also in creating 
the market demand that will encourage manufacturers to enter 
production.
    The NIDRR Long-Range Plan discusses three objectives in developing 
technology to meet the needs of people with limitations in cognitive 
functioning: to assure that new technologies are accessible and do not 
exacerbate exclusion from mainstream activities; to assist people with 
cognitive limitations in the performance of daily activities; and to 
develop technologies that can enhance or restore some cognitive 
functions (NIDRR, Long-Range Plan: 1999-2003, pg. 57).
    The University of Colorado recently accepted a gift of $250 
million. The endowment will fund advanced research and development of 
innovative technologies to enhance the lives of people with cognitive 
disabilities. The endowment, to be paid over five years, will be used 
to establish the Coleman Institute for Cognitive Disabilities located 
at the University of Colorado. Applicants for this project should 
provide information on proposed coordination with the Coleman 
Institute.

Priority 2

    We will establish multiple research projects on technology access 
for persons with cognitive disabilities leading to practical and 
affordable solutions to identified community and workplace needs of 
this population. The projects must:
    (a) Conduct an assessment of state-of-the-art technology 
applications for persons with cognitive disabilities;
    (b) Based on the assessment results of paragraph (a), identify 
technology gaps and needs for persons with cognitive disabilities and 
make recommendations for new technology and modifications to existing 
technology;
    (c) Identify features that may be incorporated into existing, 
commercially available technology that could benefit persons with 
cognitive disabilities; and
    (d) Develop and explore strategies for strengthening partnerships 
with developers and manufacturers of devices in order to facilitate the 
development of new technologies and applications to incorporate 
cognitive access.
    In addition to the activities proposed by the applicants to carry 
out these purposes, the projects must:
     Coordinate with the appropriate Federal agencies and 
privately-funded projects, such as the University of Colorado's Coleman 
Institute for Cognitive Disabilities, that are relevant to the 
applicants proposed activities as identified through consultation with 
the NIDRR project officer; and
     Involve individuals with cognitive disabilities in all 
aspects of the project.

Priorities for Community-Based Rehabilitation Projects on 
Technology for Independence

Background on Issues in Involvement of Community-Based Organizations of 
People With Disabilities in Promoting Technology for Independence

    As stated in the Plan, ``It is the mission of NIDRR to generate, 
disseminate, and promote the full use of new knowledge that will 
improve substantially the options for disabled individuals to perform 
regular activities in the community, and the capacity of society to 
provide full opportunities and appropriate supports for its disabled 
citizens.'' Assistive Technology (AT) and environmental access play key 
roles in this mission. The Plan provides detailed definitions, 
examples, and research objectives for AT and environmental access, 
including universal design.
    According to a National Center for Health Statistics report titled 
``Trends

[[Page 34032]]

and Differential Use of Assistive Technology Devices: United States, 
1994,'' approximately 17 million people used at least one AT device. AT 
and related environmental access approaches (environmental access 
approaches include the concept of universal design) help people with 
disabilities function on a more equal basis in society. For more 
information on the contributions of AT and access solutions, see the 
examples and links to relevant web sites provided by the United States 
Architectural and Transportation Barriers Compliance Board, also known 
as the Access Board (http://www.access-board.gov/), and the Doorway to 
Research on Technology for Access and Function at the National Center 
for the Dissemination of Disability Research (NCDDR) (http://www.ncddr.org/rpp/techaf/index.html).
    The new paradigm of disability embodied in the Plan requires 
analysis of the extent to which AT and environmental access helps 
individuals with disabilities in attaining full participation in 
society. Much of NIDRR's work reflects the components of the 
Independent Living (IL) philosophy: consumer control, self-help, 
advocacy, peer relationships and peer role models, and equal access to 
society, programs, and activities. IL and achieving community 
integration to the maximum extent possible are issues at the crux of 
NIDRR's mission. Furthermore, NIDRR is committed to the creation of a 
theoretical framework with measurable outcomes that is based upon the 
experiences of individuals with disabilities.
    To improve ``end-user'' participation in addressing AT problems, 
and related environmental access solutions, NIDRR will support projects 
that involve community-based organizations in researching AT related 
problems and needs. Two types of projects will be supported. The first 
type includes research projects that will investigate the use of, and 
need for, AT devices and services at the community level. The second 
type of project is a community-based research ``Resource Center'' that 
will develop, evaluate, and disseminate improved research and training 
methods appropriate to AT and environmental access involvement of 
community-based disability organizations. The Resource Center will also 
provide AT and environmental access technical assistance to community-
based organizations and will foster cooperation among the funded 
projects. These community-based research projects will broaden the 
inclusion of persons with disabilities in developing practical and 
affordable solutions to AT and environmental access problems and needs.
    In recent years, a number of NIDRR grant competitions have led to 
research projects and activities that aim at improving access to AT and 
reducing environmental barriers. For many years, NIDRR funded grants to 
States under the Technology-Related Assistance for Individuals with 
Disabilities Act of 1988 (Tech Act). In addition to research programs 
under title II of the Rehabilitation Act of 1973, as amended (29 U.S.C. 
796) (the Rehabilitation Act), NIDRR now has responsibility for AT 
programs under the Assistive Technology Act of 1998 (AT Act), which 
replaced the Tech Act. A June 5, 2000 notice (65 FR 35768-35774) for a 
new Alternative Financing Program under title III of the AT Act 
identified numerous issues affecting access of people with disabilities 
to AT. An April 5, 1999 notice (64 FR 16531) under NIDRR's 
Rehabilitation Engineering Research Center (RERC) program discussed the 
importance of improving access to the environment through universal 
design. For information on ongoing and completed NIDRR-supported 
activities in these areas, contact the National Rehabilitation 
Information Center at or telephone 1-800-346-2742.
    This year, NIDRR anticipates awarding a number of projects related 
to AT and environmental access. For updates on the status of 
announcements please see the Education Department Forecast of Funding 
Opportunities under Department of Education Discretionary Grant 
Programs for FY 2001 at: http://ocfo.ed.gov/grntinfo/forecast/forecast.htm
    According to the Rehabilitation Act, the purpose of IL programs is 
``to promote a philosophy of consumer control, peer support, self-help, 
self-determination, equal access, and individual empowerment, equal 
access, and system advocacy, in order to maximize the leadership, 
empowerment, independence, and productivity of individuals with 
disabilities, and the integration and full inclusion of individuals 
with disabilities into the mainstream of American society.'' The 
concepts in this philosophy of consumer control, peer support, and 
self-help place these title VII independent living centers (CILs) 
within a broader world-wide grouping known as ``community-based'' 
organizations.
    The term ``community-based'' organization has varying meanings in 
disability and rehabilitation programs and in social research. For the 
purpose of these two priorities, a ``community-based disability 
organization'' is a consumer-directed community organization such as a 
CIL. Consumer control is the key. Some community rehabilitation service 
organizations, for example psychosocial rehabilitation programs, also 
value consumer direction. Other disability-related organizations are 
located in community settings, but do not have significant consumer 
direction. Section 7 of the Rehabilitation Act, for example, identifies 
community rehabilitation programs as providers of AT devices and 
services for persons with disabilities, but such organizations may or 
may not be consumer directed. Organizations with consumer direction, 
including CILs and other organizations such as protection and advocacy 
(P&A) agencies, are in a unique position to help identify and study the 
specific needs for AT and environmental access of individuals from 
diverse populations and therefore are the focus of this research 
effort.
    A number of private foundations and international agencies have 
identified the value of investing in ``grassroots'', consumer-directed 
organizations, particularly in public health and economic development. 
These organizations aim at reducing poverty or specific diseases such 
as HIV/AIDS, or they provide assistance to special needs groups such as 
people in troubled urban and rural areas (see the World Wide Web sites 
or publications of the Pew Fund for Health and Human Services http://www.pewtrusts.com/, the World Health Organization http://www.who.int/, 
and the Robert Wood Johnson Foundation http://www.rwjf/org/index.jsp 
for examples).
    Community-based research encompasses a broad set of research 
activities with differing, and sometimes competing, concepts and 
methods. Sociology, anthropology, community psychology and public 
health, for example, use applied community research methods. For the 
purpose of these two proposed priorities, community-based research is 
intensive, systematic study directed toward new or full scientific 
knowledge or understanding of AT or environmental access problems. In 
addition, the research must be completed in the community under the 
direction of community-based disability organizations (Sclove, R.E, 
Scammell, M.L. & Holland, B. (1998). Community-based Research in the 
U.S. Amherst, MA: The Loka Institute (http://www.loka.org/)).
    Community-based disability and rehabilitation research puts primary 
emphasis on assisting persons with

[[Page 34033]]

disabilities by producing and disseminating knowledge and technology 
and promoting and advancing the rehabilitation and integration process 
at the community level. Community-based disability and rehabilitation 
research, according to these two priorities, applies to the use of, or 
need for, AT devices and services by persons with disabilities in the 
community, and related issues of environmental access. Such research 
should be performed by qualified researchers in cooperation with 
community-based disability organizations. NIDRR supports the notion 
that persons with disabilities provide unique perspectives about living 
with disability and must be included in community-based research 
projects to the greatest possible extent. Their experience with, and 
interest in, finding practical solutions to problems encountered in 
home, school, place of work, and community make them informed 
participants, if not particularly qualified researchers. To ensure that 
technology-related problems relevant to persons with disabilities are 
studied, contributions from such persons are encouraged. In addition, 
university-based research on disability needs to be complemented by 
community-based research to provide the community with useful and 
immediate tools, technologies, and knowledge for overcoming barriers to 
access and participation in economy and society.
    Community-based rehabilitation research is particularly suited for 
persons with disabilities. According to the University of Washington 
School of Public Health and Community Medicine's Principles of 
Community-Based Research, a research partnership between a university 
and community-based organizations should accomplish the following:
     Community partners should be involved at the earliest 
stages of the project, helping to define research objectives and having 
input into how the project will be organized.
     Community partners should have real influence on project 
direction--that is, enough leverage to ensure that the original goals, 
mission, and methods of the project are observed.
     Research processes and outcomes should benefit the 
community. Community members should be hired and trained whenever 
possible and appropriate, and the research should help build and 
enhance community assets.
     Community members should be part of the analysis and 
interpretation of data and should have input into how the results are 
distributed. This does not imply censorship of data or of publication, 
but rather the opportunity to make clear the community's views about 
the interpretation prior to final publication.
     Productive partnerships between researchers and community 
members should be encouraged to last beyond the life of the project. 
This will make it more likely that research findings will be 
incorporated into ongoing community programs and therefore provide the 
greatest possible benefit to the community from research.
     Community members should be empowered to initiate their 
own research projects that address needs they identify themselves.

Priority 3: Resource Center for Community-Based Disability and 
Rehabilitation Research Projects on Technology for Independence

    There is a need for capacity-building on conceptual and 
methodological approaches to research on the involvement of community-
based organizations of people with disabilities in promoting technology 
for independence. There is need for training, technical assistance, and 
dissemination efforts to guide ongoing efforts. Advice and strategies 
are needed in specific areas including, but not limited to, research 
designs and methodologies, case studies, focus group research, AT and 
environmental assessment, small sample surveys, participant 
observation, ethnography, and participatory action research. There is a 
need to develop ``how-to-do'' materials on disability-related AT and 
environmental access community-based research, reference resources, 
web-based access to materials, and other means of communicating 
knowledge about community-based rehabilitation research in the U.S.

Priority 3

    We will establish a resource center to assist Disability and 
Rehabilitation Research Projects on Technology for Independence and 
other related NIDRR activities under the Plan with capacity-building 
for improving the involvement of community-based organizations of 
people with disabilities in promoting technology for independence.
    In carrying out these purposes, the project must:
    (a) Establish and conduct a significant and substantial resource 
program on capacity-building in research, training, and TA on the 
involvement of community-based disability organizations in promoting 
technology for access and function that will contribute to the 
advancement of knowledge in accordance with the Plan.
    (b) Disseminate findings from the Resource Center's program on 
community-based research to DRRPs on Technology for Independence and 
other related NIDRR-funded activities under the Plan; and
    (c) Describe how the resource center will develop research capacity 
among individuals with disabilities at the community level.
    In addition to the activities proposed by the applicant to carry 
out these purposes, the Resource Center must:
     Involve individuals with disabilities and, if appropriate, 
their representatives, in planning and implementing the research, 
training, and dissemination activities, and in evaluating the Center;
     Coordinate with appropriate federally funded projects. 
Coordination responsibilities will be identified through consultation 
with the NIDRR project officer and may include outreach to specific 
NIDRR DRRPs, RERCs, RRTCs, DBTACs and AT Projects; Office of Special 
Education technology projects and Parent Training and Information 
Centers; and Rehabilitation Services Administration training, special 
demonstration, and IL projects;
     Convene a formative review session within six months of 
project award with the DRRPs on Technology for Independence to assist 
these community-based rehabilitation researchers in the finalization of 
their research plans, and to help them with the commencement of their 
research projects; and
     Conduct a state-of-the-science conference, including the 
DRRPs on Technology for Independence, in the third year of the grant 
and publish a comprehensive report on the final outcomes of the 
conference in the fourth year of the grant.

Priority 4: Community-Based Disability and Rehabilitation Research 
Projects on Technology for Independence

    The Plan identifies disability in terms of the relationship between 
the individual and the natural, built, cultural, and social 
environments (63 FR 57189-57219). The Plan focuses on both individual 
and systemic factors that have an impact on the ability of people to 
function. The elements of the Plan include employment outcomes, health 
and function, technology for access and function, and IL and community 
integration. To attain the goals in these areas, the Plan also includes 
capacity building for research and training, and to ensure knowledge 
dissemination and utilization. Each area

[[Page 34034]]

of the Plan includes objectives at both the individual and system 
levels. For example, the technology for access and function area of the 
Plan includes research objectives to develop AT that supports people 
with disabilities to function and live independently and obtain better 
employment outcomes, and research objectives to promote improved access 
to the built environment and concepts of universal design. It is clear 
that the challenges and opportunities for AT and improved environmental 
access reflect all of the priority areas of the Plan.

Priority 4

    We will establish research projects to involve community-based 
disability organizations in AT and environmental access research 
leading to practical and affordable solutions to identified problems 
and needs, and building research capacity at the community level and in 
community-based organizations serving persons with disabilities.
    In carrying out these purposes, a project must:
    (a) From the examples of research objectives below, conduct a 
significant and substantial research program on the involvement of 
community-based disability organizations in promoting technology for 
access and function that will contribute to the advancement of 
knowledge in accordance with the Plan by:
     Investigating and developing research questions, 
methodologies, and recommendations for use by other research entities 
in solving technology-related, engineering, psychosocial, economic and 
other problems at the individual and systems levels, in the United 
States (U.S.); and
     Designing and testing models for partnership of community-
based disability organizations in research, participant observation 
studies and other qualitative and quantitative research approaches to 
using technology in community-based settings;
    (b) Disseminate findings from community-based research to persons 
with disabilities, their representatives, disability and rehabilitation 
service providers, researchers, planners, and policy makers; and
    (c) Describe how the applicant will develop research capacity among 
individuals with disabilities at the community level.
    In carrying out these purposes, the project must:
     Coordinate with appropriate federally funded projects. 
Coordination responsibilities will be identified through consultation 
with the NIDRR project officer and may include outreach to specific 
NIDRR DRRPs, RERCs, Rehabilitation Research and Training Centers 
(RRTCs), Disability Business Technical Assistance Centers (DBTACs) and 
AT Projects; Office of Special Education technology projects and Parent 
Training and Information Centers; and Rehabilitation Services 
Administration training, special demonstration, and IL projects.
     Involve individuals with disabilities in key decision-
making.
     Participate in a formative review session to be convened 
by the Resource Center within six months of award, and cooperate with 
the Resource Center's capacity-building and evaluation activities.
     Participate in a state-of-the-science conference in the 
third year of the grant.

Selection Criteria

    The selection criteria to be used for these competitions will be 
provided in the application package for each competition.
    Applicable Program Regulations: 34 CFR part 350.

Electronic Access to This Document

    You may view this document, as well as all other Department of 
Education documents published in the Federal Register, in text or Adobe 
Portable Document Format (PDF) on the Internet at the following site: 
www.ed.gov/legislation/FedRegister
    To use PDF you must have Adobe Acrobat Reader, which is available 
free at this site. If you have questions about using PDF, call the U.S. 
Government Printing Office (GPO), toll free, at 1-888-293-6498; or in 
the Washington, DC, area at (202) 512-1530.

    Note: The official version of the document is published in the 
Federal Register. Free Internet access to the official edition of 
the Federal Register and the Code of Federal Regulations is 
available on GPO Access at: http://www.access.gpo.gov/nara/index.html

(Catalog of Federal Domestic Assistance Numbers 84.133A, Disability 
Rehabilitation Research Project)

    Program Authority: 29 U.S.C. 762(g) and 764(b).


    Dated: June 20, 2001.
Francis V. Corrigan,
Deputy Director, National Institute on Disability and Rehabilitation 
Research.
[FR Doc. 01-15959 Filed 6-25-01; 8:45 am]
BILLING CODE 4000-01-P