[Federal Register Volume 72, Number 169 (Friday, August 31, 2007)]
[Notices]
[Pages 50516-50541]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-17199]



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Part IV





Department of Education





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Funding Priorities for the Disability and Rehabilitation Research 
Projects and Centers Program; Notice

  Federal Register / Vol. 72 , No. 169 / Friday, August 31, 2007 / 
Notices  

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DEPARTMENT OF EDUCATION


National Institute on Disability and Rehabilitation Research--
Disability and Rehabilitation Research Projects and Centers Program--
Disability Rehabilitation Research Projects (DRRPs), Rehabilitation 
Research and Training Centers (RRTCs), and Rehabilitation Engineering 
Research Centers (RERCs)

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

ACTION: Notice of proposed priorities for DRRPs, RRTCs, and RERCs.

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SUMMARY: The Assistant Secretary for Special Education and 
Rehabilitative Services proposes certain funding priorities for the 
Disability and Rehabilitation Research Projects and Centers Program 
administered by the National Institute on Disability and Rehabilitation 
Research (NIDRR). Specifically, this notice proposes 10 priorities for 
DRRPs, 11 priorities for RRTCs, and 6 priorities for RERCs. The 
Assistant Secretary may use these priorities for competitions in fiscal 
year (FY) 2008 and later years. We take this action to focus research 
attention on areas of national need. We intend these priorities to 
improve rehabilitation services and outcomes for individuals with 
disabilities.

DATES: We must receive your comments on or before October 1, 2007.

ADDRESSES: Address all comments about these proposed priorities to 
Donna Nangle, U.S. Department of Education, 400 Maryland Avenue, SW., 
Room 6029, Potomac Center Plaza, Washington, DC 20204-2700. If you 
prefer to send your comments through the Internet, use the following 
address: [email protected].
    You must include the term ``Proposed Priorities for DRRPs, RRTCs, 
and RERCs'' and the priority title in the subject line of your 
electronic message.

FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 245-
7462.
    If you use a telecommunications device for the deaf (TDD), you may 
call the Federal Relay Service (FRS) at 1-800-877-8339.
    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 under FOR FURTHER 
INFORMATION CONTACT.

SUPPLEMENTARY INFORMATION: This notice of proposed priorities is in 
concert with President George W. Bush's New Freedom Initiative (NFI) 
and NIDRR's Final Long-Range Plan for FY 2005-2009 (Plan). The NFI can 
be accessed on the Internet at the following site: http://www.whitehouse.gov/infocus/newfreedom.
    The Plan, which was published in the Federal Register on February 
15, 2006 (71 FR 8165), can be accessed on the Internet at the following 
site: http://www.ed.gov/about/offices/list/osers/nidrr/policy.html.
    Through the implementation of the NFI and the Plan, NIDRR seeks to: 
(1) Improve the quality and utility of disability and rehabilitation 
research; (2) foster an exchange of expertise, information, and 
training to facilitate the advancement of knowledge and understanding 
of the unique needs of traditionally underserved populations; (3) 
determine best strategies and programs to improve rehabilitation 
outcomes for underserved populations; (4) identify research gaps; (5) 
identify mechanisms of integrating research and practice; and (6) 
disseminate findings.
    One of the specific goals established in the Plan is for NIDRR to 
publish all of its proposed priorities, and following public comment, 
final priorities, annually, on a combined basis. Under this approach, 
NIDRR's constituents can submit comments at one time rather than at 
different times throughout the year, and NIDRR can move toward a fixed 
schedule for competitions and more efficient grant-making operations. 
This notice proposes priorities that NIDRR intends to use for DRRP, 
RRTC, and RERC competitions in FY 2008 and possibly later years. 
However, nothing precludes NIDRR from publishing additional priorities, 
if needed. Furthermore, NIDRR is under no obligation to make an award 
for each of these priorities. The decision to make an award will be 
based on the quality of applications received and available funding.
    NIDRR also intends to publish at least one additional separate 
notice of proposed priority for an additional DRRP that would focus on 
traditionally underserved populations, as required under section 21 of 
the Rehabilitation Act of 1973, as amended. Moreover, for FY 2008 
competitions using priorities that already have been established and 
for which publication of a notice of proposed priority is unnecessary 
(e.g., competitions for Field-Initiated Projects, Advanced 
Rehabilitation Research Training Projects, Fellowships, and Small 
Business Innovation Research Projects), NIDRR has published or will 
publish notices inviting applications. More information on these other 
projects and programs that NIDRR intends to fund in FY 2008 can be 
found on the Internet at the following site: http://www.ed.gov/fund/grant/apply/nidrr/priority-matrix.html.

Invitation To Comment

    We invite you to submit comments regarding these proposed 
priorities. To ensure that your comments have maximum effect in 
developing the notice of final priorities, we urge you to identify 
clearly the specific proposed priority or topic that each comment 
addresses.
    We invite you to assist us in complying with the specific 
requirements of Executive Order 12866 and its overall requirement of 
reducing regulatory burden that might result from these proposed 
priorities. Please let us know of any further opportunities we should 
take to reduce potential costs or increase potential benefits while 
preserving the effective and efficient administration of the program.
    During and after the comment period, you may inspect all public 
comments about these proposed priorities in room 6030, 550 12th Street, 
SW., Potomac Center Plaza, Washington, DC, between the hours of 8:30 
a.m. and 4 p.m., Eastern time, Monday through Friday of each week 
except Federal holidays.

Assistance to Individuals With Disabilities in Reviewing the Rulemaking 
Record

    On request, we will supply an appropriate aid, such as a reader or 
print magnifier, to an individual with a disability who needs 
assistance to review the comments or other documents in the public 
rulemaking record for these proposed priorities. If you want to 
schedule an appointment for this type of aid, please contact the person 
listed under FOR FURTHER INFORMATION CONTACT.
    We will announce the final priorities in one or more notices in the 
Federal Register. We will determine the final priorities after 
considering responses to this notice and other information available to 
the Department. This notice does not preclude us from proposing or 
using additional priorities, subject to meeting applicable rulemaking 
requirements.

    Note: This notice does not solicit applications. In any year in 
which we choose to use these proposed priorities, we invite 
applications through a notice in the Federal Register. When inviting 
applications we designate the priorities as absolute, competitive 
preference, or invitational.

    The effect of each type of priority follows:

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    Absolute priority: Under an absolute priority, we consider only 
applications that meet the priority (34 CFR 75.105(c)(3)).
    Competitive preference priority: Under a competitive preference 
priority, we give competitive preference to an application by either 
(1) Awarding additional points, depending on how well or the extent to 
which the application meets the competitive preference priority (34 CFR 
75.105(c)(2)(i)); or (2) selecting an application that meets the 
competitive preference priority over an application of comparable merit 
that does not meet the priority (34 CFR 75.105(c)(2)(ii)).
    Invitational priority: Under an invitational priority, we are 
particularly interested in applications that meet the invitational 
priority. However, we do not give an application that meets the 
invitational priority a competitive or absolute preference over other 
applications (34 CFR 75.105(c)(1)).

Priorities

    In this notice, we are proposing 10 priorities for DRRPs, 11 
priorities for RRTCs, and 6 priorities for RERCs.
    For DRRPs, the proposed priorities are:
     Priority 1--Health Care Coordination for Individuals with 
Physical Disabilities.
     Priority 2--Assistive Technology (AT) Reuse.
     Priority 3--Health and Health Care Disparities Among 
Individuals with Disabilities.
     Priority 4--Traumatic Brain Injury Model Systems (TBIMS) 
Centers Collaborative Research Projects.
     Priority 5--Classification and Measurement of Medical 
Rehabilitation Interventions.
     Priority 6--Vocational Rehabilitation Service Models for 
Individuals with Autism Spectrum Disorders.
     Priority 7--Center on Knowledge Translation for Assistive 
Technology Transfer.
     Priority 8--Asset Accumulation and Economic Self-
Sufficiency for Individuals with Disabilities.
     Priority 9--Technology Transfer in Resource-Limited 
Environments.
     Priority 10--Research and Knowledge Translation Center for 
Individuals with Disabilities and Their Families.
    For RRTCs, the proposed priorities are:
     Priority 11--General Rehabilitation Research and Training 
Center (RRTC) Requirements.
     Priority 12--Enhancing the Health and Wellness of 
Individuals with Neuromuscular Diseases.
     Priority 13--Enhancing the Health and Wellness of Persons 
with Arthritis.
     Priority 14--Stroke Rehabilitation.
     Priority 15--Personal Assistance Services (PAS) in the 
21st Century.
     Priority 16--Participation and Community Living for 
Individuals with Psychiatric Disabilities.
     Priority 17--Multiple Sclerosis: Interventions to Maximize 
Health, Well-Being, and Participation.
     Priority 18--Aging with Physical Disability: Reducing 
Secondary Conditions and Enhancing Health and Participation.
     Priority 19--Disability Statistics and Demographics.
     Priority 20--Health and Function Across the Lifespan of 
Individuals with Intellectual and Developmental Disabilities.
     Priority 21--Participation and Community Living for 
Individuals with Intellectual and Developmental Disabilities.
    For RERCs, the proposed priorities are:
     Priority 22--RERC for Hearing Enhancement.
     Priority 23--RERC for Accessible Public Transportation.
     Priority 24--RERC for Prosthetics and Orthotics.
     Priority 25--RERC for Communication Enhancement.
     Priority 26--RERC for Universal Interface and Information 
Technology Access.
     Priority 27--RERC for Wheeled Mobility.

Disability and Rehabilitation Research Projects (DRRP) Program

    The purpose of the DRRP program is to plan and conduct research, 
demonstration projects, training, and related activities to develop 
methods, procedures, and rehabilitation technologies that maximize the 
full inclusion and integration into society, employment, independent 
living, family support, and economic and social self-sufficiency of 
individuals with disabilities, especially individuals with the most 
severe disabilities, and to improve the effectiveness of services 
authorized under the Rehabilitation Act of 1973, as amended. DRRPs 
carry out one or more of the following types of activities, as 
specified and defined in 34 CFR 350.13 through 350.19: research, 
development, demonstration, training, dissemination, utilization, and 
technical assistance.
    An applicant for assistance under this program must demonstrate in 
its application how it will address, in whole or in part, the needs of 
individuals with disabilities from minority backgrounds (34 CFR 
350.40(a)). The approaches an applicant may take to meet this 
requirement are found in 34 CFR 350.40(b). In addition, NIDRR intends 
to require all DRRP applicants to meet the requirements of the General 
Disability and Rehabilitation Research Projects (DRRP) Requirements 
priority that it published in a notice of final priorities in the 
Federal Register on April 28, 2006 (71 FR 25472).
    Additional information on the DRRP program can be found at: http://www.ed.gov/rschstat/research/pubs/res-program.html#DRRP.

Proposed Priorities

Priority 1--Health Care Coordination for Individuals With Physical 
Disabilities

Background
    Individuals with disabilities use a disproportional share of health 
care services in the United States (DeJong et al., 2002). The Centers 
for Medicare and Medicaid Services (CMS) programs recognize this trend 
and try to control its economic consequences by enrolling individuals 
with disabilities in managed care programs in increasing numbers 
(Palsbo & Mastal, 2006). A small but growing number of Medicaid managed 
care plans are designed specifically for individuals with disabilities. 
These plans feature intensive care coordination services that integrate 
the complex health and long-term care needs of individuals with 
disabilities (Palsbo & Mastal, 2006; Master, 2003).
    Pursuant to the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003, CMS also contracts with a growing number of 
Medicare health plans to provide health care coordination and services 
for Medicare beneficiaries who have severe or disabling chronic 
conditions (Peters, 2005).
    Health care coordination is an increasingly important component of 
high-quality health care for individuals with disabilities (Cheng et 
al., 2004; Lawthers et al., 2003; Kroll, 2003). On average, individuals 
with disabilities have more complex and multi-faceted health care needs 
than individuals without disabilities. For example, individuals with 
disabilities often require the involvement of multiple medical and 
ancillary providers, including long-term care providers (DeJong et al., 
2002). Individuals with disabilities also often find it difficult to 
navigate the complex, fragmented health and long-term care service 
systems that are critical to maintaining their health, functional 
abilities, and independence in the community. Recognizing the

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importance of integration and coordination of health and long-term care 
services, NIDRR states that ``individuals with disabilities should have 
access to an integrated continuum of health care services, including 
primary care and health maintenance services, specialty care, medical 
rehabilitation, long-term care, and health promotion programs'' (NIDRR 
Long-Range Plan, 2005-2009). Toward this goal, NIDRR seeks to sponsor 
rigorous research to assess the outcomes associated with managed health 
care coordination programs for individuals with disabilities.
    A number of small pilot studies suggest an association between 
enrollment in managed health care coordination programs for individuals 
with disabilities and positive outcomes such as increased satisfaction 
with health care services, greater access to a wide variety of health 
and long-term care services, and decreased utilization of costly 
emergency and hospital-based services (Surpin, 2007; Palsbo, Mastal, & 
O'Donnell, 2006; Master, 2003). More systematic, peer-reviewed research 
is required to determine the extent to which these health care 
coordination programs for individuals with disabilities relate to 
improvements in both the health and health care experiences of their 
clients and to cost savings for public financing mechanisms.

References

Cheng, E., Siderow, A., Swarztrauber, K., Eisa, M., Lee, M., & 
Vickrey, B. (2004). Development of Quality of Care Indicators for 
Parkinson's Disease. Movement Disorders. 19(2): 136-150.
DeJong, G., Palsbo, S., Beatty, P., Jones, G., Kroll, T., & Neri, M. 
(2002). The Organization and Financing of Health Services for People 
With Disabilities. Milbank Quarterly. 80(2): 261-301.
Kroll, T. (2003). Towards Improving Health Care Delivery for People 
With Physical Disabilities: Findings From Focus Groups with Health 
Care Consumers in Minnesota. Managed Care Quarterly. 11(4): 8-14.
Lawthers, A., Pransky, G., Peterson, L., & Himmelstein, J. (2003). 
Rethinking Quality in the Context of Persons With Disability. 
International Journal for Quality in Health Care. 15(4): 279-281.
Master, R., Simon, L., & Goldfield, N. (2003). Commonwealth Care 
Alliance. A New Approach to Coordinated Care for the Chronically Ill 
and Frail Elderly That Organizationally Integrates Consumer 
Involvement. Journal of Ambulatory Care Management. 26(4): 355-361.
National Institute on Disability and Rehabilitation Research. Notice 
of Final Long Range Plan for Fiscal Years 2005-2009. Pages: 8166-
8200. http://www.ed.gov/about/offices/list/osers/nidrr/policy.html.
Palsbo, S. & Mastal, M. (2006). Disability Care Coordination Care 
Organizations: The Experience of Medicaid Managed Care Programs for 
People With Disabilities. Center for Health Care Strategies. 
Resource Paper. http://www.chcs.org/usr_doc/DCCOs.pdf.
Palsbo, S., Mastal, M., & O'Donnell, L. (2006). Disability Care 
Coordination Organizations: Improving Health and Function in People 
With Disabilities. Lippincotts Case Management. 11(5): 255-264.
Peters, C.P. (2005). Medicare Advantage SNPs: A New Opportunity for 
Integrated Care? Washington DC: National Health Policy Forum. Issue 
Brief  808.
Surpin, R. (2007). Independence Care System: A Disability Care 
Coordination Organization in New York City. Journal of Ambulatory 
Care Management. 30(1): 52-63.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Health Care Coordination for Individuals with 
Disabilities. The purpose of this priority is to conduct research on 
the outcomes of Medicare or Medicaid managed health care coordination 
programs for individuals with disabilities. Under this priority, the 
DRRP must be designed to contribute to the following outcomes:
    (a) New knowledge about the extent to which enrollment in health 
care coordination programs enhances access to health care for 
individuals with disabilities. The DRRP must contribute to this outcome 
by conducting research on, and evaluating, one or more existing 
Medicaid- or Medicare-funded health care coordination programs for 
individuals with disabilities.
    (b) New knowledge about the health outcomes associated with 
participation in health care coordination programs for individuals with 
disabilities. The DRRP must contribute to this outcome by conducting 
research on, and evaluating, one or more existing Medicaid- or 
Medicare-funded health care coordination programs for individuals with 
disabilities.
    (c) New knowledge about potential Medicaid or Medicare cost savings 
that are associated with health care coordination efforts for 
individuals with disabilities. The DRRP must contribute to this outcome 
by conducting research on, and evaluating, one or more existing 
Medicaid- or Medicare-funded health care coordination programs for 
individuals with disabilities.
    In addition, the DRRP must work with the NIDRR Project Officer to 
coordinate its research efforts with the Centers for Medicare and 
Medicaid Services--Office of Research, Development, and Information.

Priority 2--Assistive Technology (AT) Reuse

Background

    Reuse programs are emerging as one potential solution to providing 
more assistive technology (AT) to individuals with disabilities at 
lower costs (Pass It On Center). For example, the Rehabilitation 
Services Administration (RSA) of the U.S. Department of Education has 
funded model demonstration projects to establish or expand statewide AT 
device reutilization programs. Device reuse programs, such as exchange 
programs and reassignment programs, facilitate the transfer of 
previously-used AT from one consumer to another. Each of these programs 
has distinct features and benefits. An exchange program assists in 
connecting users to transfer AT directly among themselves. Reassignment 
programs, on the other hand, accept used AT, sanitize it, identify 
appropriate users, and redistribute the AT following sanitization and 
matching.
    One advantage of reuse programs, in general, is that they provide 
consumers with access to AT devices at reasonably lower costs. AT 
equipment provided through these programs also leads to an increased 
capacity for community living and participation by individuals with 
disabilities. AT reuse programs meet varied needs and circumstances 
surrounding consumer access to AT, such as access on a temporary basis, 
or access for trial purposes to assess the benefit and effectiveness of 
a device for a consumer's use.
    A number of barriers and obstacles limit the utility of AT reuse 
programs. A recent study found that individuals with disabilities or 
other family members, not third parties, most frequently pay for 
commonly used AT devices, special adaptations, and environmental 
accommodations (Carlson & Ehrlich, 2006). Consumer access to AT and 
compensation for AT is often limited by conflicting eligibility 
requirements of current policies regulating the provision of AT. In 
addition, third-party payment restrictions frequently minimize the 
extent to which Medicare, Medicaid, private insurance, and vocational 
rehabilitation can assist with AT costs. Increased awareness of the 
potential costs and benefits associated with AT reuse programs can 
positively impact their use, and in addition, has implications for 
third-party payment coverage for reused AT. Furthermore,

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AT reuse programs do not have the benefit of a national coordinated 
system to assist in sustaining or expanding programs. Nor do AT reuse 
programs have the benefit of research that has identified methods, 
models, and measures for enhancing program effectiveness and improving 
consumer outcomes.
    At the present time, there is little data available to guide the 
management, enhancement, or expansion of these programs. Few research 
studies have been conducted to inform the AT reuse field of validated 
methods, models, and measures that lead to improved program and 
consumer outcomes. This field needs new knowledge regarding factors 
that influence success of AT reutilization programs, e.g., program 
design, staffing, training, funding sources, and use of collaborative 
partnerships in operating AT reuse programs. Specifically, more 
research is needed to examine how these and other factors affect 
program outcomes and to identify the most effective measures available 
to assess program quality as well as the costs and benefits of the 
program. Numerous reuse programs in the United States could benefit 
from research in this area.

References

Carlson, D. & Ehrlich, N. (2006). Sources of payment for assistive 
technology: Findings from a national survey of persons with 
disabilities. Assistive Technology, 18(1), 77-86.

    Pass It On Center. Http://www.passitoncenter.org.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Assistive Technology (AT) Reuse for individuals with 
disabilities. The purpose of this priority is to support research that 
will identify methods, systems, policies, and collaborative strategies 
to improve reutilization and recycling of AT. Under this priority, the 
DRRP must be designed to contribute to the following outcomes:
    (a) Enhanced understanding of how third-party payments for 
purchases of AT affect AT reuse programs. The DRRP must contribute to 
this outcome by conducting an analysis of current policy and consumer 
eligibility requirements and by generating relevant recommendations 
related to AT reuse.
    (b) New knowledge that positively affects the establishment, 
expansion, and maintenance of AT reuse programs. The DRRP must 
contribute to this outcome by conducting research studies validating 
effective methods and models for conducting AT reutilization activities 
(e.g., program design; alternative recycling methods; partnerships; 
program marketing strategies; and recruitment, retention, and training 
of AT reuse staff).
    (c) Improved methods and strategies for assessing the costs and 
benefits, including cost-savings, of AT reuse programs. The DRRP must 
contribute to this outcome by identifying, developing, and testing 
appropriate models to be used at the program level that can help inform 
third-party payers of the costs and benefits associated with AT reuse 
programs.
    (d) Improved understanding of AT reuse outcomes for individuals 
with disabilities. The DRRP must contribute to this outcome by 
conducting studies that assess and inform the AT field about the impact 
of acquiring AT through reuse programs.
    (e) Improved collaboration and use of research findings through 
effective coordination within the network of relevant NIDRR RRTCs, 
Rehabilitation Engineering Research Centers, DRRPs, and federally 
funded programs, such as the Rehabilitation Services Administration 
(RSA) AT State grants, the National AT Device Reutilization 
Coordination and Technical Assistance Center, and grantees under RSA's 
Model Demonstrations for AT Device Reutilization program.

Priority 3--Health and Health Care Disparities Among Individuals With 
Disabilities

Background

    In 2005, the U.S. Surgeon General released a ``Call to Action to 
Improve the Health and Wellness of Persons With Disabilities'' that 
delineated a series of strategies to optimize the health and wellness 
of individuals with disabilities, (U.S. Department of Health and Human 
Services (HHS), 2005). The Surgeon General proposed these strategies in 
light of the growing body of research literature indicating that 
individuals with disabilities are, on average, less likely than those 
without disabilities to report positive health (Krahn, Hammond, & 
Turner, 2006; Hough, 1999) and less likely to receive recommended 
health care services (Kroll et al., 2006; McCarthy et al., 2006; Jones 
& Beatty, 2003).
    While the body of research that examines health disparities between 
individuals with and without disabilities is expanding, few studies 
have examined the health and health care disparities within the diverse 
population of individuals with disabilities in the United States. 
Health disparities recently have been defined as ``observed clinically 
and statistically significant differences in health outcomes or health 
care use between socially distinct vulnerable and less vulnerable 
populations'' (Kilbourne et al., 2006). The broad population of 52 
million individuals with disabilities (HHS, 2005) is heterogeneous in 
terms of a number of factors that may be related to increased 
vulnerability for poor health care access and poor health. These 
factors include, but are not limited to, disabling condition category 
(i.e., mental illness, sensory, physical, cognitive, or combinations 
thereof), disability severity, age, gender, race, ethnicity, 
socioeconomic status, education level, urban/rural status, health 
insurance payer type (Medicare, Medicaid, private insurance), provider 
type, and other social, personal, and environmental characteristics.
    NIDRR recognizes that ``while health services researchers are 
increasingly attuned to racial and ethnic disparities in health care, 
less attention and fewer resources are devoted to disability-related 
disparities and the innovations in policy and practice that might 
reduce them'' (NIDRR Long Range Plan, 2005). The Health and Function 
chapter of the NIDRR Long Range Plan promotes research on the health 
and health care experiences of the wide diversity of individuals with 
disabilities (NIDRR Long Range Plan, 2005).
    Given the wide diversity of individuals with disabilities and the 
limited information available about existing health care access and 
outcome disparities that exist within this population, research is 
needed to improve our understanding about the factors that contribute 
to health disparities. New knowledge about these factors can be used to 
create targeted policies, programs, and interventions that promote 
health and wellness among the individuals with disabilities who are 
most vulnerable and most likely to demonstrate health outcomes 
traditionally attributed to disparate treatment or health care access 
difficulties.

References

Hough, J. (1999). Disability and Health: A National Public Health 
Agenda. In Simeonsson, R.J., McDevitt, L.N. (Eds.). Issues in 
Disability and Health. The Role of Secondary Conditions and Quality 
of Life. Chapel Hill NC: University of North Carolina Press.
Jones, G. & Beatty, P. (2003). Disparities in Preventive Service Use 
Amongst Working-Age Adults With Mobility Limitations. In Altman, B., 
Barnartt, S., Hendershot, G., & Larson, S. (Eds.)

[[Page 50520]]

Research in Social Science and Disability 1 Volume 3: Using Survey 
Data To Study Disability: Results From the National Health Interview 
Survey on Disability. Pages: 109-130. Oxford, UK: Elsevier.
Kilbourne, A., Switzer, G., Hyman, K., Crowley-Matoka, M., & Fine, 
M. (2006). Advancing Health Disparities Research Within the Health 
Care System: A Conceptual Framework. American Journal of Public 
Health. 96(12): 2113-2121.
Krahn, G., Hammond, L., & Turner, A. (2006). A Cascade of 
Disparities: Health and Health Care Access for People With 
Intellectual Disabilities. Mental Retardation and Developmental 
Disabilities Research Reviews. 12(1): 70-82.
Kroll, T., Jones, G., Kehn, M., & Neri, M. (2006). Barriers and 
Strategies Affecting the Utilization of Primary Preventive Services 
for People With Physical Disabilities: A Qualitative Inquiry. Health 
and Social Care in the Community. 14(4): 284-293.
McCarthy, E., Ngo, L., Roetzheim, R., Chirikos, T., Li, D., Drews, 
R., & Iezzoni, L. (2006). Disparities in Breast Cancer Treatment and 
Survival for Women With Disabilities. Annals of Internal Medicine. 
145(9): 637-645.
National Institute on Disability and Rehabilitation Research. Notice 
of Final Long Range Plan for Fiscal Years 2005-2009. Pages: 8166-
8200. http://www.ed.gov/about/offices/list/osers/nidrr/policy.html.

    U.S. Department of Health and Human Services (2005). The Surgeon 
General's Call to Action To Improve the Health and Wellness of Persons 
With Disabilities. U.S. Department of Health and Human Services, Office 
of the Surgeon General.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Health and Health Care Disparities Among Individuals 
With Disabilities. The purpose of this priority is to build a knowledge 
base about health care access and health outcomes among the diverse 
population of individuals with disabilities. Under this priority, the 
DRRP must be designed to contribute to the following outcomes:
    (a) A foundation of available knowledge about health disparities 
among subpopulations of individuals with disabilities. The DRRP must 
contribute to this outcome by conducting a review and synthesis of 
existing research on health and health care access among individuals 
with disabilities or subgroups of individuals with disabilities. The 
DRRP must then use this review and synthesis to inform the subsequent 
research and evaluation efforts of the DRRP.
    (b) New knowledge about system-level factors that are associated 
with the health and health care access of individuals with 
disabilities. The DRRP must contribute to this outcome by conducting 
research on the extent to which the health and health care access of 
individuals with disabilities are related to system-level factors that 
include, but are not limited to, rural or urban status, as well as 
characteristics of their health care insurance or health care 
providers.
    (c) New knowledge about the individual-level characteristics of 
individuals with disabilities that are associated with their health and 
access to health care. The DRRP must contribute to this outcome by 
conducting research on the extent to which the health and health care 
access of individuals with disabilities are related to their disabling 
condition categories (mental illness, sensory, physical, cognitive, or 
combinations thereof), disability severity, age, gender, race, 
ethnicity, socioeconomic status, education level, or other individual-
level characteristics.
    (d) Improved policies, programs, or interventions that promote the 
health and health care access of the subpopulations of individuals with 
disabilities who are least likely to receive recommended health care 
services. The DRRP must contribute to this outcome by applying 
knowledge derived from research conducted under paragraphs (a), (b), 
and (c) of this priority.
    In addition, the DRRP must collaborate with the Rehabilitation 
Research and Training Center on Health and Wellness, and other projects 
as identified through consultation with the NIDRR project officer.

Priority 4--Traumatic Brain Injury Model Systems (TBIMS) Centers 
Collaborative Research Projects

Background

    The Centers for Disease Control and Prevention (CDC) report that at 
least 1.4 million individuals sustain a traumatic brain injury (TBI) in 
the United States each year (Langlois, Rutland-Brown, & Thomas, 2004). 
Of these, approximately 50,000 die, 235,000 are hospitalized, and 1.1 
million are treated and released from emergency departments. These 
estimates do not include those individuals who sustained a TBI and did 
not seek medical care, or who were seen only in private doctors' 
offices. The three leading causes of TBI are motor vehicle/traffic 
collisions, falls, and assaults.
    CDC reports that each year an estimated 80,000 to 90,000 Americans 
sustain TBI resulting in permanent disability. At least 5.3 million 
Americans have a long-term or lifelong need for help to perform 
activities of daily living as a result of TBI (Thurman et al., 1999). 
The nature and extent of disability resulting from TBI depend on 
several factors, such as the severity and location of the injury, the 
length of impaired consciousness, the age and general health of the 
patient, and the intensity of rehabilitation services (Cifu et al., 
2003; Dikmen et al., 2003; Sarajuuri et al., 2005). Common clinical 
sequelae of TBI include problems with cognition, sensory processing, 
communication, and behavioral or mental health. Some TBI survivors also 
can develop long-term medical complications, such as Parkinson's 
disease and other motor problems, Alzheimer's disease, and post-
traumatic dementia (National Institute of Neurological Disorders and 
Stroke, 2002).
    NIDRR created the TBI Model Systems (TBIMS) program in 1987 to 
demonstrate the benefits of a coordinated system of neurotrauma and 
rehabilitation care and to conduct innovative research on all aspects 
of care for those who sustain TBI. The mission of the TBIMS program is 
to improve the lives of persons who experience TBI and their families 
by creating and disseminating new knowledge about the natural course of 
TBI and rehabilitation treatment and outcomes for individuals who 
sustain TBI. NIDRR currently funds 14 TBIMS centers throughout the 
United States. (Additional information on the TBIMS centers can be 
found at http://www.naric.com). These centers provide comprehensive 
systems of brain injury care to individuals who sustain TBI. They also 
conduct TBI research, including clinical research and the analyses of 
standardized data in collaboration with other related projects. The 
research activities of the TBIMS centers include participation in joint 
research module projects, which range from pilot research to more 
extensive studies. TBIMS centers also are required to contribute 
information on common data elements to a centralized TBIMS database. 
(Additional information on the TBIMS database can be found at http://www.tbindsc.org.) To date, TBIMS centers have contributed 6157 cases to 
the TBIMS database, with followup data extending to 15 years post 
injury.
    In 2003 NIDRR leveraged the capacity of the TBIMS program by 
funding large-scale collaborative research projects.

[[Page 50521]]

These collaborative projects included a randomized controlled trial of 
the effectiveness of amantadine hydrochloride in promoting recovery of 
functioning following TBI, and a study of the effect of scheduled 
telephone intervention on outcomes after TBI. Through the funding of 
this priority, the TBIMS program will continue to serve as a platform 
for multi-site research that contributes to evidence-based 
rehabilitation interventions and improves the lives of individuals with 
TBI.

References

Cifu, D.X., Kreutzer, J.S., Kolakowsky-Hayner, S.A., Marwitz, J.H., 
& Englander, J. (2003). The Relationship Between Therapy Intensity 
and Rehabilitative Outcomes After Traumatic Brain Injury: A 
Multicenter Analysis. Archives of Physical Medicine and 
Rehabilitation, 84(10): 1441-8.
Dikmen, S.S., Machamer, J.E., Powell, J.M., & Temkin, N.R. (2003). 
Outcome 3 to 5 Years After Moderate to Severe Traumatic Brain 
Injury. Archives of Physical Medicine and Rehabilitation, 84(10): 
1449-57.
Langlois, J.A., Rutland-Brown, W., & Thomas, K.E. (2004). Traumatic 
Brain Injury in the United States: Emergency Department Visits, 
Hospitalizations, and Deaths. Atlanta, GA: Centers for Disease 
Control and Prevention, National Center for Injury Prevention and 
Control.
National Institute of Neurological Disorders and Stroke (NINDS). 
(2002, February). Traumatic Brain Injury: Hope Through Research. 
Bethesda, MD: National Institute of Health. NIH Publication No. 02-
2478. See: http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm. 
Sarajuuri, J.M., Kaipio, M.L., Koskinen, S.K., Niemela, M.R., Servo, 
A.R., & Vilkki, J.S. (2005). Outcome of a Comprehensive 
Neurorehabilitation Program for Patients with Traumatic Brain 
Injury. Archives of Physical Medicine and Rehabilitation, 86(12): 
2296-302.
Thurman, D.J., Alverson, C.A., Dunn, K.A., Guerrero, J., & Sniezek, 
J.E. (1999). Traumatic Brain Injury in the United States: A Public 
Health Perspective. Journal of Head Trauma Rehabilitation, 14(6): 
602-615.

Proposed Priority

    The Assistant Secretary proposes a priority for Disability and 
Rehabilitation Research Projects (DRRPs) on Traumatic Brain Injury 
Model Systems (TBIMS) Collaborative Projects. Each DRRP under this 
priority must conduct research that contributes to evidence-based 
rehabilitation interventions, including, but not limited to, medical, 
psychological, vocational, and social interventions for the purpose of 
improving the lives of individuals with traumatic brain injury (TBI).
    To be eligible under this priority, an applicant must be currently 
funded under NIDRR's TBIMS program.
    Under this priority, each DRRP must be designed to contribute to 
the following outcomes:
    (a) Increased utilization of the TBIMS capacity. The DRRP must 
contribute to this outcome by collaborating with three or more of the 
NIDRR-funded TBIMS centers (for a minimum of four TBIMS sites).

    Note: Applicants under this priority may propose to include 
other TBI research sites that are not participating in a NIDRR-
funded TBIMS program in their collaborative research projects.

    (b) Improved long-term outcomes of individuals with TBI. The DRRP 
must contribute to this outcome by using clearly identified research 
designs to conduct collaborative research on questions of significance 
to TBI rehabilitation. The DRRP's research must focus on one or more 
specific domains identified in NIDRR's Final Long-Range Plan for FY 
2005-2009, including health and function, participation and community 
living, technology, and employment, and must be designed to ensure that 
the research study has appropriate research hypotheses and methods to 
generate reliable and valid findings.
    In addition, the DRRP must address the following requirements:
     Demonstrate the capacity to carry out collaborative, 
multi-site research projects, including the ability to coordinate 
research among centers; maintain data quality; and adhere to research 
protocols, confidentiality requirements, and data safety requirements.
     Coordinate with the NIDRR-funded Model Systems Knowledge 
Translation Center to provide scientific results and information for 
dissemination to clinical and consumer audiences. (Additional 
information on this center can be found at http://uwctds.washington.edu/projects/msktc.asp).

Priority 5--Classification and Measurement of Medical Rehabilitation 
Interventions

Background

    One of the central objectives of NIDRR-funded medical 
rehabilitation research is to ``increase the number of interventions 
demonstrated to be efficacious in improving health and function 
outcomes in targeted disability populations'' (NIDRR Long Range Plan, 
2005-2009). To demonstrate that a treatment is efficacious, both the 
intervention and the intended outcome must be operationally defined and 
measured in a rigorous way.
    NIDRR-sponsored researchers have been leaders in the development of 
widely used outcomes measures that are employed to help determine the 
impact of medical rehabilitation on the health and function of 
individuals with disabilities, as well as the impact of medical 
rehabilitation on the participation of these individuals in society. 
While the ability to measure outcomes of medical rehabilitation 
continues to mature through recent and ongoing NIDRR-sponsored 
research, the ability to classify, measure, and replicate specific 
interventions within the complex medical rehabilitation process is 
still in its infancy. A recent analysis of published research on 
medical rehabilitation interventions indicates that nearly two-thirds 
of articles fail to describe adequately the rehabilitative treatment 
being evaluated (Dijkers et al., 2002).
    Medical rehabilitation has been referred to as a ``black box'' 
because the wide-range of interventions that take place within 
rehabilitation settings have not been classified or measured in a 
systematic way (DeJong et al., 2004). Determining the components of the 
medical rehabilitation process that positively impact outcome (i.e., 
the ``active ingredients'') is challenging. This is due to the 
simultaneous delivery of inter-related treatments by a variety of 
allied health professionals to individuals with unique needs. 
Development of a treatment taxonomy (i.e., a systematic method for 
classifying and measuring rehabilitation interventions) will promote 
the quality and rigor of rehabilitation research and will foster the 
transfer of evidence-based treatments into clinical practice (Whyte, 
2003).
    In the past, NIDRR has sponsored rehabilitation outcomes research 
that can serve as a basis for future efforts to develop a taxonomy of 
medical rehabilitation interventions. For instance, a recent NIDRR-
funded stroke outcomes research project involved the creation of point-
of-contact forms for recording the delivery of rehabilitation 
interventions provided by physical therapists (Latham et al., 2005), 
occupational therapists (Richards et al., 2005), speech-language 
pathologists (Hatfield et al., 2005), and other allied health 
professionals. A major strength of this project was that it relied upon 
the rich experiences and expertise of front-line rehabilitation 
clinicians to create detailed forms for collecting data about specific 
interventions. A limitation of this bottom-up, inductive approach to 
classifying and measuring rehabilitation

[[Page 50522]]

interventions is its general lack of a theoretical foundation. A 
theoretical foundation would have the benefit of guiding the collection 
and analysis of treatment and outcomes data, and increase the field's 
ability to see how seemingly disparate treatments fit together into a 
coherent framework for rehabilitation practice and functional recovery 
(DeJong et al., 2004). Efforts to develop rehabilitation intervention 
taxonomies must be guided by treatment theories in order to increase 
the likelihood that ``active ingredients'' of rehabilitative care can 
be isolated and replicated (Whyte, 2006).
    Other clinical fields, such as nursing (Dochterman & Bulechek, 
2004), have been actively developing intervention taxonomies to guide 
clinical service delivery, rigorous clinical documentation, and 
effectiveness research in a wide range of nursing sub-fields. 
Literature describing intervention taxonomies and their development in 
other fields are likely to be instructive to those engaged in the 
development of a medical rehabilitation treatment classification 
system.

References

DeJong, G., Horn, S., Gassaway, J., Slavin, M., & Dijkers, M. 
(2004). Toward a Taxonomy of Rehabilitation Interventions: Using an 
Inductive Approach to Examine the ``Black Box'' of Rehabilitation. 
Archives of Physical Medicine and Rehabilitation. 85(4): 678-686.
Dijkers, M., Kropp, G., Esper, R., Yavuzer, G., Cullen, N., & 
Bakdalieh, Y. (2002). Quality of Intervention Research Reporting in 
Medical Rehabilitation Journals. American Journal of Physical 
Medicine and Rehabilitation. 81(1): 21-33.
Dochterman, J. & Bulechek, G. (Eds.). Nursing Interventions 
Classification (NIC) (4th ed.). St. Louis, MO: Mosby.
Hatfield, B., Millet, D., Coles, J., Gassaway, J., Conroy, B., & 
Smout, R. (2005). Characterizing Speech and Language Pathology 
Outcomes in Stroke Rehabilitation. Archives of Physical Medicine and 
Rehabilitation. 86(S2): S61-S72.
Latham, K., Jette, D., Slavin, M., Richards, L., Procino, A., Smout, 
R., & Horn, S. (2005). Physical Therapy During Stroke Rehabilitation 
for People With Different Walking Abilities. Archives of Physical 
Medicine and Rehabilitation. 86(S2): S41--S50.
National Institute on Disability and Rehabilitation Research (NIDRR) 
Final Long Range Plan, 2005-2009. Page 8187. http://www.ed.gov/about/offices/list/osers/nidrr/policy. html.
Richards, L., Latham, N., Jette, D., Rosenberg, L., Smout, R., & 
DeJong, G. (2005). Characterizing Occupational Therapy in Stroke 
Rehabilitation. Archives of Physical Medicine and Rehabilitation. 
86(S2): S51-S60.
Whyte, J. (2006). Using Treatment Theories to Refine the Designs of 
Brain Injury Rehabilitation Treatment Effectiveness Studies. Journal 
of Head Trauma Rehabilitation. 21(2): 99-106.
Whyte, J. (2003). It's More Than a Black Box; It's a Russian Doll: 
Defining Rehabilitation Treatments. American Journal of Physical 
Medicine and Rehabilitation. 82(8): 639-652.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Classification and Measurement of Medical 
Rehabilitation Interventions. This DRRP must conduct research and 
development toward the creation of a taxonomy of medical rehabilitation 
interventions. Under this priority, the DRRP must be designed to 
contribute to the following outcomes:
    (a) Enhanced research capacity and improved clinical practice in 
the field of medical rehabilitation. The DRRP must contribute to this 
outcome by conducting research to develop validated methods for the 
systematic classification of the broad range of medical rehabilitation 
interventions delivered by rehabilitation physicians, physical 
therapists, occupational therapists, speech language pathologists, 
rehabilitation nurses, rehabilitation psychologists, and other allied 
health professionals.
    (b) Enhanced research capacity and improved clinical practice in 
the field of medical rehabilitation through the application of one or 
more treatment theories to guide the development of a rehabilitation 
treatment taxonomy.
    (c) Collaboration with relevant NIDRR-sponsored projects, such as 
the Rehabilitation Research Training Center on Measuring Rehabilitation 
Outcomes, and other projects as identified through consultation with 
the NIDRR project officer.

Priority 6--Vocational Rehabilitation Service Models for Individuals 
With Autism Spectrum Disorders

Background

    In recent years, policy makers, educators, and rehabilitation 
service providers have become increasingly aware of the critical 
shortage of services available to youth and young adults with Autism 
Spectrum Disorders (ASDs), including vocational rehabilitation services 
(Dew & Alan, 2007). ASDs are a group of lifelong developmental 
disabilities that include autistic disorder, pervasive developmental 
disorder-not otherwise specified, and Asperger disorder. ASDs are 
characterized by impairments in social interactions and verbal and 
nonverbal communication, as well as the presence of repetitive or 
unusual behaviors and interests (Centers for Disease Control and 
Prevention (CDC), 2006a). The severity of impairments can range from 
mild to severe. Recent prevalence estimates vary, indicating that ASD 
occurs in 2 to 6 individuals per 1000 individuals, that is, between 1 
in 500 and 1 in 166 children have an ASD. ASDs are four times more 
likely to occur in boys than in girls. The CDC (2006b) reported that 
ASDs are more prevalent than certain other childhood disabilities, such 
as cerebral palsy (2.8 per 1000 children), hearing loss (1.1 per 1000 
children), vision impairment (0.9 per 1000 children), and Downs 
syndrome (1.25 per 1000 children) (CDC, 2006b). ASDs usually are 
diagnosed before the age of three, and the effects are lifelong, 
although impairments may be attenuated with intervention.
    Like other transition-age youth with disabilities, students 
diagnosed with ASD who have turned 22 or graduated from high school 
with a regular diploma generally no longer have a legal right to 
appropriate transition services, such as life skills training, 
transportation, vocational training, and individual and family 
counseling, under the Individuals with Disabilities Education Act 
(IDEA) (National Longitudinal Transition Study-2 (NLTS-2) 2005). Large 
proportions of youth with ASD rated low on self-care tasks, functional 
cognitive skills, social skills and communication when compared to the 
entire population of youth with disabilities served under IDEA (NLTS-2, 
2005). Many families find that the services provided to individuals 
diagnosed with ASD are not tailored to the needs of the children and 
young adults in this population. Families also report that locating, 
accessing, and financing needed services for these young adults 
requires navigating complicated public and private medical, social, and 
vocational rehabilitation service systems (American Society of Autism, 
2001).
    In 2005, fewer than 2,000 individuals with ASDs received vocational 
rehabilitation services. Of these individuals, only 1,200 were 
successfully employed (Dew & Alan, 2007). Of the youth with ASDs who 
were out of school one year or more, only 1 in 5 reported receiving 
services from a vocational rehabilitation State agency. These youth 
with ASDs also were less likely to be employed than youth with other 
disabilities, and the

[[Page 50523]]

employed youth with ASDs worked fewer hours than employed youth with 
other disabilities (NLTS-2, 2005). Increased vocational and 
rehabilitation interventions are needed if these individuals are to 
experience vocational and economic success equal to the success of 
transition-age youth without ASD.

References

Autism Society of America. (2001). Position Paper on The National 
Crisis in Adult Services for Individuals with Autism A Call to 
Action. See: http://www.autismservicescenter.org/articles2.htm.
Centers for Disease Control and Prevention. (2006a). Fact sheet: CDC 
Autism research. See: http://www.cdc.gov/ncbddd/autism/index.htm.
Centers for Disease Control and Prevention. (2006b). How common are 
Autism Spectrum Disorders (ASD)? See: http://www.cdc.gov/ncbddd/autism/asd_common.htm.
Dew, D. & Alan, G. (2007). Rehabilitation of Individuals With Autism 
Spectrum Disorders (Institute on Rehabilitation Issues Monograph No 
32). Washington, DC: The George Washington University, Center for 
Rehabilitation Counseling Research and Education.
U.S. Department of Education, Institute of Education Sciences, 
National Center for Special Education Research. (2005). National 
Longitudinal Transition Study-2 (NLTS2), Wave 3 parent interview and 
youth interview/survey. (This information has not yet been published 
on the NLTS-2 Web site. It will be published sometime early next 
year). \

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Vocational Rehabilitation Service Models for 
Individuals with Autism Spectrum Disorders (ASDs). This DRRP must 
conduct research on vocational rehabilitation (VR) service models for 
individuals with ASDs that contributes to evidence-based rehabilitation 
interventions to improve the lives of individuals with ASDs. Under this 
priority, the DRRP must be designed to contribute to one or both of the 
following outcomes:
    (a) Improved vocational and postsecondary education outcomes of 
individuals with ASDs. The DRRP must contribute to this outcome by 
developing or testing VR intervention strategies for individuals with 
ASDs, the measures needed to assess the effectiveness of VR 
intervention strategies for individuals with ASDs, or both.
    (b) Improved long-term vocational and postsecondary education 
services for individuals with ASDs. The DRRP must contribute to this 
outcome by analyzing the factors affecting the organization and 
delivery of these services to individuals with ASDs and by recommending 
changes that could improve these service delivery mechanisms.

Priority 7--Center on Knowledge Translation for Assistive Technology 
Transfer

Background

    While billions of dollars are expended on technology-related 
research and development efforts in the United States each year 
(Association of University Technology Managers, 2005), very little of 
this funding is applied toward development of technology to improve the 
lives of individuals with disabilities (National Council on Disability, 
2000). NIDRR addresses this critical niche with two grant programs that 
are dedicated to the application of technology and the development of 
products and devices that are intended to improve the lives of 
individuals with disabilities: The Rehabilitation Engineering Research 
Centers (RERC) and Small Business Innovation Research (SBIR) programs.
    For 30 years, the RERC program and its predecessor, the 
Rehabilitation Engineering Centers program, have been a major force in 
the development of technology to enhance independent function and 
societal participation for individuals with disabilities. For over a 
decade, NIDRR's SBIR program has encouraged small businesses to explore 
their technological potential by supporting proof of concept 
investigations of prototype devices intended to benefit individuals 
with disabilities.
    In addition to supporting the research and development of products 
and devices that are designed to improve the lives of individuals with 
disabilities through its RERC and SBIR programs, NIDRR is also 
expected, under section 200(3)(D) of the Rehabilitation Act of 1973, as 
amended, to promote the transfer of rehabilitation technology to 
individuals with disabilities through research and demonstration 
projects.
    The term ``technology transfer'' has been defined as the process by 
which university-developed technologies are commercialized (Powers, 
2004) and, more specifically, as the ``transmittal of developed ideas, 
products, and techniques from a research environment to one of 
practical application by consumers'' (National Council on Disability, 
2000). The processes involved in technology transfer are understood to 
be an important component of knowledge translation (KT), which refers 
to the steps between the generation of knowledge and its application to 
produce beneficial outcomes for society (Canadian Institutes for Health 
Research, 2005).
    Technology transfer for individuals with disabilities is a specific 
subset of the current technology transfer effort. Technology transfer 
for products intended for use by individuals with disabilities is often 
difficult because of the small markets served by any one particular 
assistive technology product or device. While several government and 
private agencies are working to promote technology transfer for larger 
and more lucrative markets, very few Federal efforts focus on the 
transfer of technology for use by individuals with disabilities 
(National Council on Disability, 2000). Not only is NIDRR mandated to 
fill this gap, but it is well positioned to do so, given the research 
and development work supported and the scientist-market networks 
established through its RERC and SBIR programs.
    Research from the broader technology transfer field provides 
limited guidance on how to improve technology transfer for individuals 
with disabilities. Although some researchers have examined the 
processes involved in technology transfer as well as methods for 
evaluating transfer efforts such as best practice analyses (e.g., Erich 
& Gutterman, 2003; Leahy, 2003; Tornatzky, 2001), research in this area 
is still limited. For example, best practices analyses have generally 
involved qualitative case descriptions rather than systematic tests of 
the models, methods, and measures used for successful technology 
transfer. A strong need remains for the systematic review of existing 
models, methods, and measures as well as for the identification of best 
practices in technology transfer. Once identified, best practices for 
technology transfer must be adopted by key stakeholders. Training and 
technical assistance have been named as important methods for promoting 
the adoption of best practices and, thus, for facilitating the success 
of the commercialization process (Canadian Institutes of Health 
Research, 2005).
    Current Federal investments are attempting to meet the need for 
technology transfer research generally, but little research has been 
devoted to examining the potential relevance, applicability, or 
usability of general technology transfer research within the specific 
subfield of assistive technology for individuals with disabilities 
(National Council on Disability, 2000).

[[Page 50524]]

    The need for further technology transfer research is especially 
acute among those who are developing and attempting to make 
technologies, products, and devices for individuals with disabilities.

References

Association of University Technology Managers (2005). AUTM U.S. 
Licensing Survey: FY 2005. Northbrook, IL. See: http://www.autm.net/surveys/dsp.surveyDetail.cfm?pid=33.
Canadian Institutes of Health Research. (2005). CIHR's 
commercialization and innovation strategy. Ottawa, Canada. See: 
http://www.cihr-irsc.gc.ca/e/30162.html.
Erlich, J.N. & Gutterman, A. (2003). A practical view of strategies 
for improving Federal technology transfer. Journal of Technology 
Transfer, 28, 215-226.
Leahy, J.A. (2003). Paths to market for supply push technology 
transfer. Journal of Technology Transfer, 28, 305-317.
National Council on Disability. (2000). Federal Policy Barriers to 
Assistive Technology. See: http://www.ncd.gov/newsroom/publications/2000/assisttechnology.htm.
Powers, J.B. (2004). R&D funding sources and university technology 
transfer: What is stimulating universities to be more 
entrepreneurial? Research in Higher Education, 45(1), 1-23.
Tornatzky, L.G. (2001). Benchmarking university-industry technology 
transfer: A six year retrospective. Journal of Technology Transfer, 
26, 269-277.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability and Rehabilitation 
Research Project to serve as the Center on Knowledge Translation for 
Assistive Technology Transfer (Center). The Center must conduct 
rigorous research, development, technical assistance, dissemination, 
and utilization activities to increase successful knowledge translation 
(KT) for technology transfer of products developed by NIDRR-funded 
technology grantees.
    The Center must partner with key stakeholders such as trade and 
professional associations, and relevant industry representatives, and 
focus on no more than three of the following technology areas, which 
are referenced in the NIDRR Long-Range Plan, 2005-2009: Sensory, 
Communication, Informational Technology and Telecommunications, and 
Environmental Access.
    Under this priority, the Center must be designed to contribute to 
the following outcomes:
    (a) Improved understanding of barriers to and facilitators of 
successful KT for technology transfer in different industries related 
to NIDRR's technology portfolio. The Center must contribute to this 
outcome by--
    (1) Identifying and compiling existing research-based knowledge 
about barriers to and facilitators of successful KT for technology 
transfer; and
    (2) Conducting research on barriers to and facilitators of 
successful KT for technology transfer related to the technology areas 
on which the Center focuses.
    (b) Advanced knowledge of best practices in KT for technology 
transfer. The Center must contribute to this outcome by--
    (1) Identifying existing models, methods, or measures of KT for 
technology transfer in different industries related to NIDRR's 
technology portfolio;
    (2) Further developing and testing models, methods, or measures in 
the technology areas on which the Center focuses; and
    (3) Establishing best technology transfer practices that can be 
used to effectively implement and evaluate the success of technology 
transfer activities in the technology areas on which the Center 
focuses.
    (c) Increased utilization of the validated best practices for KT 
for technology transfer. The Center must contribute to this outcome by 
providing training and technical assistance to NIDRR-funded technology 
grantees to implement and evaluate the success of such practices.

Priority 8--Asset Accumulation and Economic Self-Sufficiency for 
Individuals With Disabilities

Background

    The availability of savings and assets are important to all 
individuals because they promote and allow investment in long-term 
goals such as education and home ownership. Savings and assets are also 
associated with increased household stability, community involvement, 
political participation, and self-sufficiency in the general population 
(Abt Associates, 2000).
    For individuals with disabilities, the availability of financial 
savings and assets facilitates progress toward a wide range of 
community participation goals. Financial savings and assets can 
facilitate this progress in numerous ways, such as making it possible 
to purchase needed assistive technology (AT), make down payments on a 
home, modify one's home for greater accessibility, start a business, or 
pay for college (Putnam et al., 2005). Little is known about asset 
accumulation patterns among individuals with disabilities. One of the 
few relevant studies comparing individuals with and without 
disabilities indicates that individuals with musculoskeletal conditions 
and related health difficulties have fewer assets than those without 
musculoskeletal conditions (Yelin, 1997). Because working-age adults 
with disabilities are more likely than their non-disabled counterparts 
to live in poverty (Weathers, 2005) and are less likely to be employed 
(U.S. Census Bureau, 2002), they have less opportunity to accumulate 
savings and other assets. However, being low-income does not preclude 
savings and asset accumulation (Beverly, 1997).
    Research is required to generate new knowledge about both the 
barriers to, and facilitators of, savings and asset accumulation for 
individuals with disabilities. These barriers and facilitators are 
likely to exist at both the individual and system levels. At the 
individual level, the following factors have been shown to be 
associated with asset levels in the general population: income level, 
education level, employment status, marital status, motivation to save, 
racial and ethnic status, age, financial literacy, and maintenance of a 
bank account, among others (Putnam et al., 2005; Beverly, 1997) . In 
addition, factors associated with asset accumulation that are specific 
to individuals with disabilities may include type of disabling 
condition, disability severity, and age-of-onset.
    In addition to the individual-level factors described in the 
previous paragraph, there are also a number of barriers to, and 
facilitators of, asset accumulation at the system level. For example, 
individuals with disabilities who participate in Federal income support 
programs are placed under strict asset limits that preclude substantial 
accumulation of savings (Stapleton et al., 2006) . Low employment rates 
among individuals with disabilities are associated with reduced access 
to institutionalized saving mechanisms such as pensions or payroll 
deductions for retirement savings accounts (Beverly, 1997) . Sub-
optimal access to bank buildings and general financial services for 
individuals with disabilities may also reduce asset accumulation 
opportunities (Putnam et al., 2005).
    New knowledge about both the barriers to, and facilitators of, 
asset accumulation must be applied to the development of targeted 
interventions or to tailoring currently existing asset accumulation 
interventions to the specific needs and circumstances of individuals 
with disabilities. Financial literacy education, for example, could

[[Page 50525]]

be tailored to address the needs and circumstances of individuals with 
specific disabling conditions (Cook, 2007). Individual Development 
Accounts (i.e., special bank accounts that help individuals save money 
for a specific purpose such as their education or the purchase of a 
first home) could be established for savings goals that are 
particularly relevant to individuals with disabilities, such as 
offsetting out-of-pocket expenses for health care or personal 
assistance services, or purchasing AT or home modifications.

References

Abt Associates (2000). Evaluation of Asset Accumulation Initiatives: 
Final Report. See: http://abtassociates.com/reports/9031.pdf.
Beverly, S. (1997). How Can The Poor Save? Theory and Evidence on 
Saving in Low Income Households. Center for Social Development. 
Washington University, St. Louis, MO. Working Paper  97-3. 
See: http://gwbweb.wustl.edu/csd/Publications/1997/wp97-3.pdf.
Cook, J. (2007). Asset Accumulation Through Individual Development 
Accounts in Chicago. E-Newsletter published by the National 
Rehabilitation Research and Training Center on Psychiatric 
Disability, at the University of Illinois at Chicago. See: http://www.wid.org/publications/?page=equity_test⊂=200702&topic=pm.
Putnam, M., Sherraden, M., Edwards, K., Porterfield, S., Wittenburg, 
D., Holden, K., & Welch-Saleeby, P. (2005). Building Financial 
Bridges to Economic Development and Community Integration: 
Recommendations for a Research Agenda on Asset Development for 
People With Disabilities. Journal of Social Work in Disability & 
Rehabilitation. 4(3): 61-86.
Stapleton, D., O'Day, B., Livermore, G., & Imparato, A. (2006). 
Dismantling the Poverty Trap. Disability Policy for the 21st 
Century. Milbank Quarterly. 84(4): 701-732.
U.S. Census Bureau (2002). Survey of Income and Program 
Participation. Table 5: Disability Status, Employment, and Annual 
Earnings: Individuals 21 to 64 Years Old: 2002. See: http://www.census.gov/hhes/www/disability/sipp/disable02.html.
Weathers, R. (2005). A Guide to Disability Statistics From The 
American Community Survey. Disability Statistics User Guide Series. 
Employment and Disability Institute. Cornell University.
Yelin, E. (1997). The Earnings, Income, and Assets of Persons aged 
51-61 With and Without Musculoskeletal Conditions. The Journal of 
Rheumatology. 24(10): 2024-2030.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability and Rehabilitation 
Research Project (DRRP) on Asset Accumulation and Economic Self-
Sufficiency for Individuals with Disabilities. This DRRP must create 
new research-based knowledge to promote asset accumulation among 
individuals with disabilities. Under this priority, the DRRP must be 
designed to contribute to the following outcomes:
    (a) New knowledge of both the barriers to, and facilitators of, 
asset accumulation and economic self-sufficiency for low- to moderate-
income individuals with disabilities and their families. This DRRP must 
contribute to this outcome by focusing on the individual-level 
characteristics that may affect savings and asset accumulation, as well 
as system-level factors that include policies or programs designed to 
create system-level incentives or disincentives to the accumulation of 
assets.
    (b) Improved asset accumulation outcomes and economic self-
sufficiency among individuals with disabilities. The DRRP must 
contribute to this outcome by developing and testing no more than two 
interventions that capitalize on the facilitators and address the 
barriers to asset accumulation described in paragraph (a) of this 
priority. These interventions may include the tailoring of existing 
asset accumulation interventions to the specific needs and 
circumstances of individuals with disabilities.

Priority 9--Technology Transfer in Resource-Limited Environments

Background

    Growth in the number of older people in the populations of the 
United States, Europe, Asia, and elsewhere suggest that there will be a 
steady increase in demand over the next several decades for a broad 
spectrum of assistive technology (AT) devices from hearing aids and 
canes to advanced wheelchairs, specially equipped automobiles, and 
personal communication devices. However, despite an increasing demand 
for AT, many individuals with disabilities still cannot access the AT 
devices they need (Bureau of Industry and Security, 2003).
    Moreover, in developing countries, environmental constraints often 
affect the usability of many AT products. For example, products that 
are developed to enhance mobility may be affected by the lack of paved 
roads. Lack of maintenance and repair facilities also may affect 
distribution to, and usability of, technology by individuals with 
disabilities in many parts of the world. Distance and limited 
distribution networks tend to inhibit access to AT equipment and 
services. These constraints are particularly significant in rural 
areas, where farm accidents account for many disabilities, and in 
countries where landmine injuries affect individuals whose primary 
occupation is farming (Swanson, 2007).
    In the United States, the U.S. Department of Agriculture has 
recognized the needs of farmers and ranchers with disabilities by 
funding the AgriAbility project, which provides training, technical 
assistance, and information about technology and other services through 
agricultural extension services. NIDRR has also funded research 
projects to examine service delivery needs for farmers with 
disabilities. While NIDRR and other Federal agencies have funded 
successful projects in this area, and although these projects have 
resulted in the development of low-tech products for use by individuals 
with disabilities in the United States and in international settings, 
there is still a persistent need to develop methods of moving new 
technologies into practice in settings where resources may be scarce.
    Many barriers to implementing knowledge translation (KT) strategies 
for technology development also exist. The three major barriers to the 
acquisition of technology products in developing countries, and certain 
parts of the United States, are: lack of awareness of their existence 
or how to acquire them, lack of necessary materials to produce them, 
and lack of expertise needed to produce them locally (Jeserich, 2003a; 
Jeserich, 2003b; Ripat & Booth, 2005; Robitaille, 2003).
    Several models exist to guide the development, manufacture, and 
distribution of low-cost, high-quality products in developing countries 
or economically disadvantaged areas within the United States. Each of 
these models highlights different aspects of product development, 
manufacturing or distribution processes. For example, in the charitable 
model, it is common to use regional distribution points to make 
products available to those who need them. Likewise, the workshop model 
focuses on training individuals to construct products that are needed 
by individuals in their community by using locally available resources, 
and the manufacturing model requires teaching individuals to construct 
products by setting up local factories and distributing the products 
regionally or nationally. The globalization model requires that an 
established company expand into a region either by establishing a 
factory or importing products there (Pearlman et al., 2006).
    None of these models, however, offers a universal solution to the 
challenge of

[[Page 50526]]

designing, developing, manufacturing, and distributing low-cost, high-
quality products to individuals in developing countries or in 
economically disadvantaged regions of the United States. Different 
aspects of these models work well under different environmental 
conditions. Research is needed to expand our understanding of how best 
to foster the transfer of technology in these settings.

References

Canadian Institutes of Health Research (CIHR) (2005). CIHR IRSC 
Innovation in action: Knowledge translation strategy--2004-2009. 
Ottawa: See http://www.cihr-irsc.gc.ca/e/documents/kt_strategy_2004-2009_e.pdf.
Jeserich, M. (2003a, January 15). Building Appropriate Chairs for 
the Developing World: Whirlwind Wheelchair International brings 
access to the third world. AT Journal, 65. See: http://www.atnet.org/news/2003/jan03/011501.htm.
Jeserich, M. (2003b, February 1). Cubans make due with limited 
assistive technology: Even with a more independent culture, Cuba's 
streets and lack of resources provide barriers. AT Journal, 66. See: 
http://www.atnet.org/news/2003/feb03/020101.htm.
National Institute on Disability and Rehabilitation Research. Notice 
of Final Long Range Plan for Fiscal Years 2005-2009. Pages: 8165-
8200. http://www.ed.gov/about/offices/list/osers/nidrr/policy.html.
Pearlman, J., Cooper, R.A., Zipfel, E., Cooper, R., & McCartney, M. 
(2006). Towards the development of an effective technology transfer 
model of wheelchairs to developing countries. Disability and 
Rehabilitation: Assistive Technology, 1 (1-2), 103-110.
Ripat, J. & Booth, A. (2005). Characteristics of assistive 
technology service delivery models: Stakeholder perspectives and 
preferences. Disability and Rehabilitation, 27(24), 1461-1470.
Robitaille, S. (2003, August 21). Assistive tech needs a hand in DC. 
Business Week Online.
Swanson, L. (1997). Canadian farmers with disabilities. Abilities, 
30, pages 50-51.
    U.S. Department of Commerce, Bureau of Industry and Security 
(BIS) (2003). Technology Assessment of the U.S. Assistive Technology 
Industry. Washington, DC: See: http://www.bis.doc.gov/DefenseIndustrialBasePrograms/OSIES/DefMarketResearchRpts/assisttechrept/index.htm.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability Rehabilitation Research 
Project (DRRP) on Technology Transfer in Resource-Limited Environments. 
Under this priority, the DRRP must be designed to contribute to the 
following outcomes:
    (a) Increased access to, and acquisition of, high-quality, low-cost 
technology products by individuals with disabilities who need them. The 
DRRP must contribute to this outcome by conducting research to evaluate 
the application of various models of transferring technology products 
to individuals with disabilities in resource-limited environments, 
either in the United States or abroad. The DRRP's research must examine 
the relationship of factors such as type of technology, delivery system 
options, socio-economic conditions, and disability type, on successful 
transfer of needed technologies to individuals with disabilities. NIDRR 
is particularly concerned about providing technology to support 
individuals engaged in agricultural occupations due to a significant 
need for AT by this population.
    (b) Increased awareness by individuals with disabilities of high-
quality, low-cost technology products, already developed or in 
development, for use in resource-limited environments. The DRRP must 
contribute to this outcome by conducting research on methods of 
providing information on available products to individuals with 
disabilities and their caregivers in resource-limited environments in 
the United States, developing countries, or both. The DRRP's research 
must examine the relationship of factors, such as literacy rates and 
the availability of print, Internet, or other communication resources, 
as well as socioeconomic factors and disability type on effective 
strategies to increase awareness among individuals with disabilities in 
these areas.

Priority 10--Research and Knowledge Translation Center for Individuals 
With Disabilities and Their Families

Background

    In the United States, there are approximately 20.3 million 
households in which at least one individual has a disability. This 
includes households in which at least one child under the age of 18 has 
a disability and those in which at least one adult has a disability. 
NIDRR has funded research on children with disabilities and their 
families (e.g., the Rehabilitation Research and Training Center on 
Policies Affecting Families of Children With Disabilities), as well as 
on adults with disabilities who are parents of children under the age 
of 18 (e.g., the National Resource Center for Parents with 
Disabilities). The family is a critical unit of analysis in both of 
these important research areas.
    It is necessary to understand the experiences of individuals with 
disabilities and their families as they attempt to navigate programs 
and service delivery systems that are critical to their participation 
in society. The needs and experiences of individuals with disabilities 
and their families differ based on the underlying condition and age of 
the individual, as well as key sociodemographic characteristics and 
structure of the individual's family. High-quality, in-depth research 
on these heterogeneous needs and experiences must serve as an empirical 
basis for the ongoing development, delivery, and evaluation of targeted 
information resources for families that include an individual with a 
disability, whether that individual is a child or the parent of a 
child.
    Individuals with disabilities and their families could benefit from 
research-based training and technical assistance resources that are 
designed to help them navigate relevant programs and service delivery 
systems more effectively (Mitchell & Sloper, 2002). These programs and 
service delivery systems include, but are not limited to, childcare, 
family law, long-term care, and health care programs and services. 
Accordingly, NIDRR seeks to fund a center that will translate existing 
research-based knowledge about these complex programs and service 
delivery systems to ensure that such resources are available to 
individuals with disabilities and their families. Additional work in 
this area will help promote the achievement of one of NIDRR's primary 
goals, the successful dissemination of research-based knowledge and 
products for use by intended target audiences, including individuals 
with disabilities and their families and caregivers (NIDRR Long Range 
Plan, 2005-2009).
    Research has been conducted on the many programs and service 
delivery systems that individuals with disabilities and their families 
must navigate. There is a need for translation of this research into 
materials that can be used by individuals with disabilities and their 
families as they make critical decisions and choices about the services 
that are available to them. For example, the families of children with 
disabilities could benefit from translation and widespread 
dissemination of peer-reviewed research on child care services (Devore 
& Bowers, 2006), respite and related support services (McGill, 
Papachristoforou, & Cooper, 2006), and effectively meeting the complex 
health care needs of children with disabilities

[[Page 50527]]

in the community (American Academy of Pediatrics, 2005).
    In addition, adults with disabilities who are parents may come into 
contact with components of the complex family law system that often 
assume that disability precludes effective parenting (Kirshbaum & 
Olkin, 2002). These components of the family law system include 
statutes and case law related to custody, adoption, and divorce. 
Translation of legal research on parenting with a disability (Odegard, 
1993) may be useful to parents with disabilities and their families. 
Parents with physical disabilities also would benefit from translation 
of research on baby care adaptations (Tuleja & DeMoss, 1999), as well 
as research on the more general experiences of parents with 
disabilities (Wade, Mildon, & Matthews, 2007; Conley-Jung & Olkin, 
2001).
    Families that include one or more individuals with disabilities 
must often make decisions about an array of options for providing and 
financing the long-term services and supports that are necessary to 
help the family member live and participate in the community. Research 
on the effectiveness of various service delivery models (Hagglund, 
Clark, Farmer, & Sherman, 2004; Benjamin, Matthias, & Franke, 2000) 
could be translated into information that helps individuals with 
disabilities and their families make critical long-term care decisions.
    Regardless of the age of the family member with a disability, 
working within the health care system to receive needed services is 
important to maintaining health, function, and high levels of 
participation in the community. The translation of peer-reviewed 
research on health promotion programs (Ravesloot, Seekins, Cahill, 
Lindgren, & Nary, 2006), health care coordination programs (Palsbo, 
Mastal, & O'Donnell, 2006), and preventive care (Smeltzer, 2006) are 
likely to be useful to individuals and their families as they make 
decisions about their health and well being.

References

American Academy of Pediatrics (2005). Clinical Report: Helping 
Families Raise Children with Special Health Care Needs at Home. 
Pediatrics. 115(2): 507-512.
Benjamin, A., Matthias, R., & Franke, T. (2000). Comparing Consumer-
Directed and Agency Models For Providing Supportive Services at 
Home. Health Services Research. 35(1): 351-366.
Conley-Jung, C. & Olkin, R. (2001). Mothers With Visual Impairments 
or Blindness Raising Young Children. Journal of Visual Impairment 
and Blindness. 91(1): 14-29.
Devore, S. & Bowers, B. (2006). Childcare for Children With 
Disabilities: Families Search for Specialized Care and Cooperative 
Childcare Partnerships. Infants & Young Children: An 
Interdisciplinary Journal of Special Care Practices. 19(3): 203-212.
Hagglund, K., Clark, M., Farmer, J., & Sherman, A. (2004). A 
Comparison of Consumer-Directed and Agency-Directed Personal 
Assistance Services Programs. Disability and Rehabilitation. 26(9): 
518-527.
Kirshbaum, M. & Olkin, R. (2002). Parents With Physical, Systemic, 
or Visual Disabilities. Sexuality and Disability. 20(1): 65-80.
Mcgill, P., Papachristoforou, E., & Cooper, V. (2006). Support for 
Family Carers of Children and Young People with Developmental 
Disabilities and Challenging Behavior. Child: Care, Health & 
Development. 32(2): 159-165.
Mitchell, W. & Sloper, P. (2002). Information that Informs Rather 
Than Alienates Families With Disabled Children: Developing a Good 
Model of Practice. Health and Social Care in the Community. 10(2): 
74-81.
National Institute on Disability and Rehabilitation Research. Notice 
of Final Long Range Plan for Fiscal Years 2005-2009. Page: 8174. 
http://www.ed.gov/about/offices/list/osers/nidrr/policy.html.
Odegard, J. (1993). The Americans With Disabilities Act: Creating 
``Family Values'' for Physically Disabled Parents. Law and 
Inequality. 11: 533-653.
Palsbo, S., Mastal, M., & O'Donnell, L. (2006). Disability Care 
Coordination Organizations: Improving Health and Function in People 
With Disabilities. Lippincott's Case Management. 11(5): 255-264.
Ravesloot, C., Seekins, T., Cahill, T., Lindgren, S., & Nary, D. 
(2006). Health Promotion for People With Disabilities: Development 
and Evaluation of the Living Well With a Disability Program. Health 
Education Research Online. Published on October 10, 2006. See: 
http://her.oxfordjournals.org/cgi/content/abstract/cyl114v1.
Smeltzer, S. (2006). Preventive Health Screening For Breast and 
Cervical Cancer and Osteoporosis in Women With Physical 
Disabilities. Family and Community Health. 29(1 Suppl): 35S-43S.
Tuleja, C. & DeMoss, A. (1999). Baby Care Assistive Technology. 
Technology and Disability. 11(1,2): 71-78.
Wade, C., Milton, R., & Matthews, J. (2007). Service Delivery to 
Parents With An Intellectual Disability: Family-Centered or 
Professionally Centered? Journal of Applied Research in Intellectual 
Disabilities. 20(2): 87-98.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Disability and Rehabilitation 
Research Project (DRRP) to serve as the Research and Knowledge 
Translation Center for Individuals with Disabilities and Their Families 
(Center). The Center must conduct research on the experiences and 
knowledge needs of individuals with disabilities and their families, 
and translate these findings into training, technical assistance, and 
informational resources.
    The Center must focus on the knowledge needs of families that 
include a child with a disability, an adult with a disability who is a 
parent of at least one child under the age of eighteen, or both.
    Under this priority, the Center must be designed to contribute to 
the following outcomes:
    (a) Increased knowledge about the experiences and information needs 
of individuals with disabilities and their families, and how those 
experiences and needs differ by variables such as condition type, 
severity, and age, as well as key characteristics of other family 
members and the overall structure of the family. The Center must 
contribute to this outcome by synthesizing existing research and 
advancing the knowledge base through the collection and analysis of 
data about the experiences and knowledge needs of families that include 
one or more individuals with a disability. Through this research and 
analysis, the Center must examine the extent to which the needs of 
individuals with disabilities and their families are being met by the 
programs and service systems that are critical to their community 
integration and participation (e.g., statutes and case law related to 
custody, adoption, and divorce; health care; long-term care; assistive 
technology provision programs; child care; transportation; and a wide 
variety of related social support services).
    (b) Improved participation and community integration of individuals 
with disabilities. The Center must contribute to this outcome by 
developing, implementing, and evaluating research-based training, 
technical assistance, and informational resources that are targeted to 
the specific knowledge needs of individuals with disabilities and their 
families, as those needs are identified through the research activities 
described in paragraph (a) of this priority, or other research-based 
knowledge.
    In addition, the Center must coordinate with relevant NIDRR 
Knowledge Translation grantees to develop and implement a method for 
identifying high-quality, research-based information for dissemination 
to individuals with disabilities and their families.

[[Page 50528]]

Rehabilitation Research and Training Centers (RRTCs)

    RRTCs conduct coordinated and integrated advanced programs of 
research targeted toward the production of new knowledge to improve 
rehabilitation methodology and service delivery systems, alleviate or 
stabilize disability conditions, or promote maximum social and economic 
independence for individuals with disabilities. Additional information 
on the RRTC program can be found at: http://www.ed.gov/rschstat/research/pubs/res-program.html#RRTC.

Statutory and Regulatory Requirements of RRTCs

    RRTCs must--
     Carry out coordinated advanced programs of rehabilitation 
research;
     Provide training, including graduate, pre-service, and in-
service training, to help rehabilitation personnel more effectively 
provide rehabilitation services to individuals with disabilities;
     Provide technical assistance to individuals with 
disabilities, their representatives, providers, and other interested 
parties;
     Demonstrate in their applications how they will address, 
in whole or in part, the needs of individuals with disabilities from 
minority backgrounds;
     Disseminate informational materials to individuals with 
disabilities, their representatives, providers, and other interested 
parties; and
     Serve as centers of national excellence in rehabilitation 
research for individuals with disabilities, their representatives, 
providers, and other interested parties.

Priority 11--General Rehabilitation Research and Training Center (RRTC) 
Requirements

Background

    NIDRR proposes the following General RRTC Requirements priority 
because it believes that the effectiveness of any RRTC depends on, 
among other things, how well the RRTC coordinates its research efforts 
with the research of other NIDRR-funded projects, involves individuals 
with disabilities in its activities, and identifies specific 
anticipated outcomes that are linked to its objectives in applying for 
RRTC funding. Accordingly, NIDRR intends to use proposed Priority 11--
General RRTC Requirements in conjunction with each of the other RRTC 
priorities proposed in this notice (i.e., priorities 12 through 21).

Proposed Priority

    To meet this priority, the Rehabilitation Research and Training 
Center (RRTC) must--
    (a) Conduct a state-of-the-science conference on its respective 
area of research by the fourth year of the grant cycle and publish a 
comprehensive report on the final outcomes of the conference by the end 
of the fourth year of the grant cycle. This conference must include 
materials from the experts internal and external to the RRTC;
    (b) Coordinate on research projects of mutual interest with 
relevant NIDRR-funded projects as identified through consultation with 
the NIDRR project officer;
    (c) Involve individuals with disabilities in planning and 
implementing its research, training, and dissemination activities, and 
in evaluating the RRTC; and
    (d) Coordinate with the appropriate NIDRR-funded Knowledge 
Translation Centers and professional and consumer organizations, to 
provide scientific results and information for dissemination to 
policymakers, service providers, researchers, and others.

Priority 12--Enhancing the Health and Wellness of Persons With 
Neuromuscular Diseases

Background

    The term ``muscular dystrophy'' is used to refer to the more than 
40 neuromuscular diseases (NMDs). The Muscular Dystrophies are 
currently classified in nine types (Myotonic, Duchenne, Becker, Limb-
Girdle, Facioscapulohumeral, Congenital, Oculopharyngeal, Distal and 
Emery-Dreifuss), and some of these are categorized into further 
subtypes. NMDs affect individuals of both sexes at every stage of life: 
infancy, adolescence, adulthood, and old age. Their effects range from 
gradual loss of mobility and independence to severe disability and 
death. The most common NMD is Duchenne/Becker Muscular Dystrophy 
(DBMD). DBMD affects approximately 1 out of every 3,500 to 5,000 boys 
(Single Gene Disorders and Disability, 2006).
    Individuals with NMDs face health, psychosocial, and economic 
problems that negatively affect their overall health and well-being, as 
reported at the National Institutes of Health (NIH) ``Burden of Muscle 
Disease Workshop,'' hosted by the National Institute of Arthritis and 
Musculoskeletal and Skin Diseases (NIAMS) and the NIH Office of Rare 
Diseases on January 26-27, 2005 (Burden of Muscle Disease Workshop, 
2005). Neuromuscular diseases may contribute to significant health 
problems because of muscle weakness, difficulty with exercise, fatigue, 
poor endurance, weight problems (e.g., obesity), pulmonary 
complications and associated sleep disorders. Research is needed to 
generate new knowledge about secondary conditions of NMD that are not 
as well understood--such as pain, reduced bone content, and metabolic 
complications.
    Exercise and nutrition have been a focus of rehabilitation 
interventions because they are key factors in successful participation 
in health and wellness programs for individuals with NMDs (Kilmer, 
2002). However, due to the loss of functional muscle tissue from NMDs, 
few studies have examined the response of individuals with NMDs to 
cardiopulmonary testing and aerobic exercise training (McDonald, 2005). 
In order to facilitate high-quality research in the areas of 
cardiopulmonary testing and aerobic exercise training, the capacity to 
measure physical, functional, and social participation outcomes must be 
enhanced (Muscular Dystrophy Coordinating Committee Report, 2005) 
through the development of new outcome measures, or validation of 
existing measures in populations of individuals with NMD.

References

Burden of Muscle Disease Workshop Report, January 26-27, 2005. See: 
http://www.niams.nih.gov/ne/reports/sci_wrk/2005/muscle_dis_summ.htm
Kilmer, D.D. (2002). Response to Aerobic Exercise Training in Humans 
with Neuromuscular Disease. American Journal of Physical Medicine 
and Rehabilitation, 81(11 Suppl), S148-50.
McDonald, C. (2005). Childhood Neurological Disorders: crosscutting 
breakout session. Neurorehabilitation and Neural Repair, 10(1), S91.
Muscular Dystrophy Coordinating Committee Report Scientific Working 
Group, August 16-17, 2005. See: http://www.ninds.nih.gov/find_people/groups/mdcc/MDCC_Action_Plan.doc
Single Gene Disorders and Disability (SGDD) (2006). See: http://www.cdc.gov/ncbddd/duchenne/who.htm.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Enhancing the Health and Wellness of Persons with 
Neuromuscular Diseases (NMDs). This RRTC must conduct rigorous 
research, training, technical assistance, and dissemination activities 
to improve rehabilitation outcome measures and rehabilitation 
interventions that can be applied in clinical or community-based 
settings.

[[Page 50529]]

    In doing so, the RRTC must focus on no more than two of the 
following dimensions: Prevention or reduction of secondary conditions 
(e.g., pain, fatigue, muscle weakness, associated sleep disorders, 
metabolic complications); improved mobility; emotional well-being; and 
access to community-based health promotion services and programs (e.g., 
fitness, recreation, and nutrition). Under this priority, the RRTC must 
be designed to contribute to the following outcomes:
    (a) Improved outcome measures for use with individuals with NMDs. 
The RRTC must contribute to this outcome by identifying or developing 
and testing methods and measures to assess health and rehabilitation 
outcomes, participation in community-based programs, or both.
    (b) Improved medical rehabilitation or community-based 
rehabilitation interventions. The RRTC must contribute to this outcome 
by identifying or developing and testing new rehabilitation 
interventions, replicating promising practices or programs, or both.

Priority 13--Enhancing the Health and Wellness of Individuals With 
Arthritis

Background

    Approximately 60 million adults in United States will have 
arthritis by the year 2020. Currently, approximately 21 million 
individuals have osteoarthritis, and another 2.1 million have 
rheumatoid arthritis (National Arthritis Action Plan, 1999). Arthritis 
is the leading cause of disability in the United States for individuals 
15 years of age and older, potentially limiting affected persons from 
walking a few blocks or climbing a flight of stairs (Centers for 
Disease Control and Prevention, Morbidity and Mortality Weekly Report, 
(2007)). Arthritis is also the second leading cause of work-related 
disability in the United States (Cakmak & Bolukbas, 2005).
    Arthritis impacts an individual physically, emotionally, and 
socially and is characterized by several factors such as pain, 
inflammation, damage to joint tissue, decreased mobility, fatigue, 
stress, and depression. Developing interventions to alleviate arthritis 
pain and functional limitations that are associated with arthritis are 
particularly important. Exercise is an essential tool in managing 
arthritis pain and stiffness and in improving mobility. Muscle strength 
training is considered to be an important cornerstone of non-
pharmacological treatment for individuals with arthritis (Hakkinen, 
2004). However, the rates of participation in regular exercise are 
lower among individuals with arthritis than those without arthritis 
(Barclay, 2006).
    Arthritis also can lead to diminished enjoyment of, and 
participation in, daily activities and community-based programs (e.g., 
going to church and socializing), which in turn can contribute to 
feelings of isolation and depression. A depression management program 
consisting of coordination of medications and counseling can reduce 
both depression and arthritis pain and disability in older adults (Lin 
et al., 2003).
    Outcome measures are required to assess the effectiveness of 
specific interventions to reduce the physical, functional, emotional, 
and social sequelae of arthritis. While arthritis researchers have 
access to effective measures of disease status, physical and functional 
abilities, and quality of life, measures of social participation for 
this population are less well developed (Backman, 2006). Research is 
required to fill this gap in outcome measures through the development 
of arthritis-specific measures of participation, or the validation of 
existing measures of participation that have been developed for other 
subpopulations of individuals with disabilities (Whiteneck et al., 
1992).

References

Backman, C.L. (2006). Outcomes Measures for Arthritis Care Research: 
Recommendations from CARE III Conference. Journal of Rheumatology, 
33, 1908-11.
Barclay, L. (2006). Perceived barriers to exercise identified for 
patients with Arthritis. Arthritis Care Research 55:000-000. See: 
http://www.medscape.com/viewarticle/541721.
Cakmak, A. & Bolukbas, N. (2005). Juvenile Rheumatoid Arthritis: 
Physical Therapy and Rehabilitation. Southern Medical Journal, 
98(2), 212-216.
Centers for Disease Control and Prevention, Morbidity and Mortality 
Weekly Report, (2007). National and State Medical Expenditures and 
Lost Earnings Attributable to Arthritis and Other Rheumatic 
Condition--United States, 2003. See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5601a2.htm?s_cid=mm5601a2_e
Hakkinen, A. (2004). Effective and Safety of Strength Training in 
Rheumatoid Arthritis. Current Opinion in Rheumatology, 16(2), 132-
137.
Lin, E., Katon, W., Von Korff, M., Tang, L., Williams, J., Kroenke, 
K., Hunkeler, E., Harpole, L., Hegel, M., Arean, P., Hoffing, M., 
Della Penna, R., Langston, C. & Unutzer, J. (2003). Effect of 
Improving Depression Care on Pain and Functional Outcomes Among 
Older Adults With Arthritis: A Randomized Controlled Trial. Journal 
of the American Medical Association. 290(18): 2428-2429.
National Arthritis Action Plan (1999): A Public Health Strategy. 
See: http://www.arthritis.org/resources/about_naap.asp.
Whiteneck, G.G., Charlifue, S.W., Gerhart, K.A., Overholser, J.D., & 
Richardson, G.H. (1992). Quantifying handicap: a new measure of 
long-term rehabilitation outcomes. Archives of Physical Medicine and 
Rehabilitation, 73(6), 519-26.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Enhancing the Health and Wellness of Individuals with 
Arthritis. This RRTC must conduct rigorous research, training, 
technical assistance, and dissemination activities to improve 
rehabilitation outcome measures and rehabilitation interventions that 
can be applied in clinical or community-based settings.
    In doing so, the RRTC must focus on no more than two of the 
following dimensions: prevention or reduction of secondary conditions 
(e.g., pain, fatigue, depression); improved mobility; emotional well-
being; and access to community-based health promotion services and 
programs (e.g., fitness, recreation, and nutrition). Under this 
priority, the RRTC must be designed to contribute to the following 
outcomes:
    (a) Improved outcome measures for use with persons with arthritis. 
The RRTC must contribute to this outcome by identifying or developing 
and testing methods and measures to assess health and rehabilitation 
outcomes, participation in community-based programs, or both.
    (b) Improved medical rehabilitation or community-based 
rehabilitation interventions. The RRTC must contribute to this outcome 
by identifying or developing and testing new rehabilitation 
interventions, replicating promising practices or programs, or both.

Priority 14--Stroke Rehabilitation

Background

    Approximately 730,000 individuals experience strokes in the United 
States each year. Nearly five million individuals in the United States 
today have survived a stroke. Stroke patients continue to be the 
largest diagnostic group in medical rehabilitation, and stroke is often 
associated with high levels of disability (American Heart Association, 
2006).
    With the help of new technologies, significant progress has been 
made in the development of rehabilitation

[[Page 50530]]

interventions and in the assessment of outcomes for those who have 
experienced a stroke. Examples of recent advances in rehabilitation 
interventions and outcomes assessment include the Extremity Constraint-
Induced Therapy Evaluation (EXCITE), a repetitive training of upper 
extremities on task-oriented activities that enhances functional 
abilities of stroke survivors 3 to 9 months after stroke (Wolf et al., 
2006; Messe & Cucchiara, 2006). A novel and promising technology, the 
BION, is an implantable neuromuscular stimulation device to treat 
complications of paralysis and disuse atrophy, including shoulder 
subluxation, hand contractures, drop foot, and osteoarthritis (Loeb et 
al., 2006).
    Given the large and growing incidence of stroke in the United 
States and the high levels of physical and cognitive disability often 
associated with stroke, there is a need for further research on 
promising new interventions, such as constraint-induced (CI) therapy, 
bodyweight-supported treadmill training (BWS-TT), electrical 
stimulation, and robotic technology (Bassett, 2006). In addition, 
research is needed to develop more sensitive measures of neuro-recovery 
and post-stroke secondary health conditions, as well as to develop 
interventions to prevent a variety of post-stroke secondary health 
conditions such as fatigue (Gladstone et al., 2002; Roth, 2005).

References

American Heart Association (AHA) (2006). Heart Disease and Stroke 
Statistics--2006 Update: A report from the American Heart 
Association Statistics Subcommittee. See: http://circ.ahajournals.org/cgi/content/short/113/6/e85.
Bassett, J. (2006). A Lifelong Journey. Advance for Directors in 
Rehabilitation, 15(10), 42-48.
Gladstone, D.J., Danells, C.J., & Black, S.E. (2002). The fugl-meyer 
assessment of motor recovery after stroke: a critical review of its 
measurement properties. Neurorehabilitation and Neural Repairs, 
16(3): 232-40. See: http://www.medscape.com/medline/abstract/12234086.
Loeb, G.E., Richmond F.J.R., & Baker L.L. (2006). The BION Devices: 
Injectable interfaces with peripheral nerves and muscles. 
Neurosurgery Focus, 20(5). See: http://www.medscape.com/viewarticle/542356.
Messe, S.R. & Cucchiara, B.L. (2006). Highlights of the 
International Stroke Conference 2006. Neurology and Neurosurgery, 
8(1). See: http://www.medscape.com/viewarticle/527458.
Roth, E. (2005). Aging Issues: Neurological Disorders: crosscutting 
breakout session. Neurorehabilitation and Neural Repair, 10(1), S70.
Wolf, S.L., Weinstein, C.J., Miller, J.P., Taub, E., Uswatte, G., 
Morris, D., Giuliani, C., Light, K.E., & Nichols-Larsen, D. (2006). 
Effect of constraint-induced movement therapy on upper extremity 
function 3 to 9 months after stroke. Journal of the American Medical 
Association, 296(17), 2095-2104.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Stroke Rehabilitation. This RRTC must conduct rigorous 
research, training, technical assistance, and dissemination activities 
to improve rehabilitation outcome measures and rehabilitation 
interventions that can be applied in clinical or community-based 
settings.
    In doing so, the RRTC must focus on no more than two of the 
following dimensions: prevention or reduction of secondary conditions 
(e.g., pain, fatigue, depression); improved mobility; emotional well-
being; and access to community-based health promotion services and 
programs (e.g., fitness, recreation, and nutrition). Under this 
priority, the RRTC must be designed to contribute to the following 
outcomes:
    (a) Improved outcome measures for use with persons with stroke. The 
RRTC must contribute to this outcome by identifying or developing and 
testing methods and measures to assess health and rehabilitation 
outcomes, participation in community-based programs, or both.
    (b) Improved medical rehabilitation or community-based 
rehabilitation interventions. The RRTC must contribute to this outcome 
by identifying or developing and testing new rehabilitation 
interventions, replicating promising practices or programs, or both.

Priority 15--Personal Assistance Services (PAS) in the 21st Century

Background

    In 2005, health-related problems resulted in about 3.8 million 
adults needing help from another person with personal care activities, 
and about 7.8 million adults requiring help from another person with 
daily activities, such as household chores or shopping. Among adults 
ages 75 and over, a rapidly growing population, about 10 percent 
required help with personal care and 19 percent required help with 
daily activities (Adams, Dey, & Vickerie, 2005; Population Projections 
Branch, 2004). Most personal assistance services (PAS) are provided by 
unpaid caregivers such as family members or friends; in 2004, over 44 
million adults provided help with care to an adult family member or 
friend (Naiditch & Wasan, 2006). However, paid personal and home care 
aides held only about 701,000 jobs in 2004 (Bureau of Labor Statistics 
(BLS), U.S. Department of Labor (DOL), 2006).
    The demand for personal and home care aides is expected to increase 
greatly over the next 10 years because of the aging of the U.S. 
population (BLS, DOL, 2006). The expected increase in demand is 
especially troubling because a labor shortage crisis in the available 
pool of caregivers already exists. This labor shortage crisis has 
``potentially negative consequences for quality of care and quality of 
life'' for individuals requiring personal and home care (Stone & 
Wiener, 2001). In addition, many unpaid caregivers themselves are aging 
and face their own ``considerable personal toll--physically, mentally, 
emotionally, and financially, and in terms of retirement insecurity, 
lost jobs or other missed opportunities'' (Miller & Mor, 2006). 
Finally, the need for an improved network of PAS providers extends 
beyond day-to-day activities; there is also an emerging need for PAS 
providers during emergencies and disaster situations (National Council 
on Disability, 2006).
    The cost of PAS can be covered by a variety of sources, depending 
on a person's income and the type of services provided. For example, 
individuals with disabilities who work and receive Supplemental 
Security Income (SSI) benefits may deduct PAS performed in an 
employment setting or in preparing for, or traveling to or from, the 
workplace as an Impairment-Related Work Expense. This deduction is used 
to calculate available income and ultimately the amount of a person's 
SSI cash benefit (Social Security Administration, 2006). While the loss 
of such benefits has frequently been seen as a hindrance to securing or 
maintaining employment, there is little research on the economic impact 
of covering PAS costs for adults who are working and not eligible for 
public assistance. A study of elderly adults with disabilities also 
suggests that the use of assistive technology by an individual with 
disabilities reduces the number of PAS hours required for that 
individual (Hoenig, Taylor, & Sloan, 2003). However, there has been 
little research on the relationship between the use of AT by working-
age adults with disabilities and the number of PAS hours required by 
those individuals.

[[Page 50531]]

References

Adams, P.F., Dey, A.N., & Vickerie, J.L. (2005). Summary Health 
Statistics for the U.S. Population: National Health Interview 
Survey, 2005. Series 10, No. 233 Provisional Report. Hyattsville, 
MD: National Center for Health Statistics. See: http://www.cdc.gov/nchs/data/series/sr_10/sr10_233.pdf.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational 
Outlook Handbook, 2006-07 Edition, Personal and Home Care Aides. 
Washington, DC: Bureau of Labor Statistics, U.S. Department of 
Labor. See: http://www.bls.gov/oco/ocos173.htm.
Hoenig, H., Taylor, D.H., & Sloan, F.A. (2003). Does Assistive 
Technology Substitute for Personal Assistance Among the Elderly? 
American Journal of Public Health, 93(2), 330-337.
Miller, E.A. & Mor, V. (2006). Out of the Shadows: Envisioning a 
Brighter Future for Long-Term Care in America. Providence, RI: Brown 
University Center for Gerontology and Health Care Research. See: 
http://www/chcr.brown.edu/PDFS/BROWN_UNIVERSITY_LTC_REPORT_FINAL.PDF.
Naiditch, L. & Wasan, P. (2006). Evercare Study of Caregivers in 
Decline: Findings from a National Survey. Bethesda, MD: National 
Alliance for Caregiving. See: http://www.caregiving.org/data/Caregivers%20in%20Decline%20Study-FINAL-lowres.pdf.
National Council on Disability (2006). The Impact Of Hurricanes 
Katrina And Rita On People With Disabilities: A Look Back And 
Remaining Challenges. Washington, DC: National Council on 
Disability. See: http://www.ncd.gov/newsroom/publications/2006/hurricanes_impact.htm.
Population Projections Branch (2004). U.S. Interim Projections by 
Age, Sex, Race, and Hispanic origin. Washington, DC: U.S. Census 
Bureau. See: http://www.census.gov/ipc/www/usinterimproj/.
Social Security Administration (2006). Understanding Supplemental 
Security Income (SSI). Washington, DC: U.S. Social Security 
Administration. See: http://www.ssa.gov/notices/supplemental-security-income/ussi-2006.pdf.
Stone, R.I. & Wiener, J.M. (2001). Who Will Care For Us? Addressing 
the Long-Term Care Workforce Crisis. Washington DC: The Urban 
Institute.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Personal Assistance Services (PAS) in the 21st 
Century. This RRTC must conduct rigorous research, develop 
interventions, and provide training that address future demands for PAS 
and caregiving. Under this priority, the RRTC must be designed to 
contribute to the following outcomes:
    (a) Improved access to PAS by individuals with disabilities. The 
RRTC must contribute to this outcome by: (1) Analyzing and describing 
trends and needs of the population of PAS consumers; (2) identifying 
gaps in programs and services; (3) developing effective evidence-based 
interventions to address unmet needs for PAS; and (4) proposing 
strategies to coordinate and secure PAS services during emergencies.
    (b) A larger and better prepared paid and unpaid PAS workforce. The 
RRTC must contribute to this outcome by: (1) Developing tools and 
supports for unpaid caregivers that reflect the changing needs of 
caregivers as they age; (2) developing strategies that lead to a PAS 
workforce that is geographically diverse and that maximizes workforce 
recruitment, retention, compensation and benefits, professional 
training, development, and networking; and (3) identifying and 
evaluating interventions and labor resources, such as job training 
services, that help to improve workforce capacity of PAS providers.
    (c) An understanding of the complexity of the economics of PAS. The 
RRTC must contribute to this outcome by: (1) Analyzing the 
interrelationship between the use of assistive technology, employment 
supports, and PAS; and (2) analyzing the role of tax laws that affect 
reimbursement for PAS.

Priority 16--Participation and Community Living for Individuals With 
Psychiatric Disabilities

Background

    Individuals with psychiatric disabilities have one of the lowest 
rates of employment of any disability group--only 1 in 3 individuals 
with psychiatric disabilities is employed (Kaye, 2002). They also 
comprise the largest diagnostic category of working-aged adults 
receiving Supplemental Security Income or Social Security Disability 
Insurance (McAlpine and Warner, 2001).
    In addition, individuals with psychiatric disabilities constitute a 
large proportion of the homeless population. Of 2 million adults 
experiencing an episode of homelessness, for example, 46 percent have a 
psychiatric disability (Burt, 2001).
    In April 2002, the President signed Executive Order 13263, 
establishing a New Freedom Commission on Mental Health, and charged the 
Commission with completing a comprehensive study of the mental health 
service delivery system in the United States. The Commission's report, 
Achieving the Promise: Transforming Mental Health Care in America, set 
the course for public and private efforts across the country to improve 
the state of mental health care (New Freedom Commission on Mental 
Health, 2003). The Commission calls for a transformation of the mental 
health service delivery system, focusing on recovery and resilience for 
individuals with psychiatric disabilities. Recovery is, in part, ``the 
process in which people are able to live, work, learn, and participate 
fully in their communities,'' while resilience indicates ``the personal 
and community qualities that enable us to rebound from adversity, 
trauma, tragedy, threats, or other stresses--and to go on with life 
with a sense of mastery, competence, and hope'' (New Freedom Commission 
on Mental Health, 2003).
    Being part of a community means being included, involved, and 
valued; it means holding social roles that are meaningful. Inclusion 
requires full access to opportunities and support in areas such as 
employment, housing, education, health and mental health care, 
recreation, social relationships, and other public and private sector 
activities. Research, including NIDRR-funded research, has advanced the 
knowledge base in these and other areas through a focus on recovery-
oriented services, peer supports, supported education, psychiatric 
rehabilitation, and the avoidance of stigma. This research has led to 
advances in theory development, measurement tools, treatment options, 
and a variety of community-based supports. However, further research is 
needed in these areas to maximize participation and community living 
outcomes.
    In addition, there is a strong need for research on understudied 
aspects of participation and community living for individuals with 
psychiatric disabilities. Two examples among many are emergency 
preparedness and mental health disparities for traditionally 
underserved populations (e.g., individuals from diverse racial, ethnic, 
linguistic, and geographic backgrounds, and individuals with multiple 
disabilities) (National Council on Disability, 2006; New Freedom 
Commission on Mental Health, 2003; U.S. Public Health Service, Office 
of the Surgeon General, 2001).
    Finally, there is extensive documentation about the need to 
accelerate the incorporation of research findings in mental health 
service delivery so that individual lives can change as a result of the 
research.

[[Page 50532]]

According to the Institute on Medicine report, Crossing the Quality 
Chasm: A New Health System for the 21st Century, the time lag between 
the discovery of effective medical treatments and the incorporation 
into practice is 15 to 20 years. The President's New Freedom Commission 
on Mental Health has called for a reduction in this delay as part of an 
overall transformation of mental health care in America (Substance 
Abuse and Mental Health Services Administration, 2005; New Freedom 
Commission on Mental Health, 2003; Institute of Medicine, 2001).

References

Burt, M.R. (2001). What will it take to end homelessness? Urban 
Institute Brief. Washington, DC: Urban Institute.
Institute of Medicine (2001). Crossing the Quality Chasm: A New 
Health System for the 21st Century. Washington, DC: National Academy 
Press.
Kaye, H.S. (2002). Employment and Social Participation Among People 
With Mental Health Disabilities. In San Francisco, CA: National 
Disability Statistics & Policy Forum.
McAlpine, D.D. and Warner, L. (2001). Barriers to Employment Among 
Persons With Mental Illness: A Review of the Literature. New 
Brunswick, NJ: Institute for Health.
National Council on Disability (July 7, 2006). The Needs of People 
With Psychiatric Disabilities During and After Hurricanes Katrina 
and Rita: Position Paper and Recommendations. http://www.ncd.gov/newsroom/publications/2006/peopleneeds. htm.
New Freedom Commission on Mental Health, Achieving the Promise: 
Transforming Mental Health Care in America. Final Report. DHHS Pub. 
No. SMA-03-3832. Rockville, MD: 2003.
Substance Abuse and Mental Health Services Administration, U.S. 
Department of Health and Human Services, Transforming Mental Health 
Care in America. Federal Action Agenda: First Steps. DHHS Pub. No. 
SMA-05-4060. Rockville, MD: 2005.
U.S. General Accounting Office (1996, April). SSA disability: 
Program redesign necessary to encourage return to work. Report to 
the Chairman, Special Committee on Aging and the U.S. Senate. GAO/
HEHS 96-62. Washington, DC: U.S. General Accounting Office.
United States Public Health Service Office of the Surgeon General 
(2001). Mental Health: Culture, Race, and Ethnicity: A Supplement to 
Mental Health: A Report of the Surgeon General. Rockville, MD: 
Department of Health and Human Services, U.S. Public Health Service.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Participation and Community Living for Individuals 
with Psychiatric Disabilities. The RRTC must conduct rigorous research, 
training, technical assistance, and dissemination activities that 
contribute to improved participation and community living outcomes for 
individuals with psychiatric disabilities. Under this priority, the 
RRTC must be designed to contribute to the following outcomes:
    (a) Improved individual and system capacity to maximize the 
meaningful involvement of individuals with psychiatric disabilities in 
community life. The RRTC must contribute to this outcome by:
    (1) Advancing the knowledge base and application of theories, 
measures, methods, interventions, or a combination of those activities 
that facilitate participation and community living. This must include a 
focus on at least three of the following areas: employment, housing, 
education, health and mental health care, recreation, social 
relationships, or other public and private sector activities related to 
community living.
    (2) Reducing disparities in service delivery and program 
development by including a focus on one or more of the following 
understudied areas: (i) Emergency preparedness for individuals with 
psychiatric disabilities; (ii) individuals with psychiatric 
disabilities from diverse racial, ethnic, linguistic, and geographic 
backgrounds; or (iii) individuals with psychiatric disabilities who 
have co-occurring sensory or physical disabilities.
    (b) Increased incorporation of mental health research findings into 
practice or policy. The RRTC must contribute to this outcome by 
coordinating with appropriate NIDRR-funded knowledge translation 
grantees to advance or add to their work in the following areas:
    (1) Developing and implementing procedures to evaluate the 
readiness of mental health research findings for translation into 
practice.
    (2) Collaborating with stakeholder groups to develop, evaluate, or 
implement strategies to increase utilization of mental health research 
findings.
    (3) Conducting training, technical assistance, and dissemination 
activities to facilitate knowledge translation in the context of mental 
health research.

Priority 17--Multiple Sclerosis: Interventions To Maximize Health, 
Well-Being, and Participation

Background

    Approximately 400,000 Americans have multiple sclerosis (MS), and, 
each week, about 200 more individuals in the United States are 
diagnosed with MS (National Multiple Sclerosis Society, 2005). 
Individuals with MS may have symptoms such as fatigue, motor weakness, 
spasticity, poor balance, heat sensitivity, pain, cognitive impairment, 
and mood disorders (Wynn, 2006; Mikol, 2006). The impact of the variety 
of symptoms that an individual with MS may experience and the uncertain 
prognosis of a given course of MS can impair an individual's routine 
activities; vocational, social and interpersonal functioning; and 
quality of life (Kalb, 2004). Treatment of MS may include: medication, 
rehabilitation, integrative medicine, and other interventions (Yadav et 
al., 2006). Surveys indicate that 50 to 75 percent of individuals with 
MS have tried dietary changes, nutritional or herbal supplements, mind-
body therapies, and similar approaches to manage MS. Interestingly, 
patients seem unlikely to discuss these types of strategies with their 
neurologists (Yadav et al., 2006).
    While some research has been conducted regarding the functional 
outcomes of individuals with MS, there is a significant need for 
further research in the areas of outcomes measurement and 
rehabilitation interventions to maximize the health, well-being, and 
participation of individuals with MS. Providers of care who treat 
individuals with MS have cited their own need for clinical consultation 
and continuing medical education (CME) about treatment of MS-associated 
symptoms (Turner et al., 2006). Fatigue, depression, cognitive 
impairment, and pain are among the most frequently cited areas for 
consult and CME (Mikol, 2006). Future research should address the 
frequent co-occurrence of these four symptoms as well as the impact of 
central-nervous-system-active medications used to treat them (Oken et 
al., 2006). For individuals with MS, there is a ``continued need for 
effective therapeutic approaches to symptom management'' (Joy & 
Johnston, 2001).
    Recent research underscores the need for a continued focus on the 
role of environmental and lifestyle factors affecting individuals with 
MS, and also on the impact co-existing chronic health conditions have 
on an aging population of individuals with MS (Marrie, 2006; Buchanan 
et al., 2006; Snook et al., 2006). For example, treatment disparities 
and variations in disease characteristics have been found when 
comparing individuals with MS from rural versus urban environments 
(Buchanan et al., 2006). There is also a strong relationship between 
physical inactivity and risk for obesity among individuals with MS 
(Snook et al.,

[[Page 50533]]

2006). In addition, a variety of autoimmune diseases ``are reported to 
occur more frequently than expected in patients with MS'' (Marrie, 
2006). These findings support the need for further research on outcomes 
measurement and promotion of health and participation for individuals 
with MS.

References

Buchanan, R.J., Schiffer, R., Stuifbergen, A., Zhu, L., Wang, S., 
Chakravorty, B.J., & Kim, M. (2006). Demographic and Disease 
Characteristics of People with Multiple Sclerosis Living in Urban 
and Rural Areas. International Journal of MS Care, February 2006, 
vol. 8, Supplement 1.
Joy, J.E. & Johnston, R.B. (Eds.) (2001). Multiple Sclerosis: 
Current Status and Strategies for the Future. Washington, D.C.: 
National Academy Press.
Kalb, R.C. (2004). Multiple Sclerosis: The Questions You Have--The 
Answers You Need, 3rd Edition. New York: Demos Medical Publishing.
Marrie, R.M. (2006). Multiple Sclerosis and Coexisting Health 
Conditions. Multiple Sclerosis Quarterly Report, Winter 2006, vol. 
25, no. 4.
Mikol, D. (2006). Management of Fatigue, Cognitive Dysfunction, and 
Mood Disorders. International Journal of MS Care, February 2006, 
vol. 8, Supplement 1.
National Multiple Sclerosis Society (2005). Multiple Sclerosis 
Information Sourcebook. New York: National Multiple Sclerosis 
Society. See: http://www.nationalmssociety.org/Sourcebook-Topic.asp.
Oken, B.S., Flegal, K., Zajdel, D., Kishiyama, S.S., Lovera, J., 
Bagert, B., & Bourdette, D.N. (2006). Cognition and Fatigue in 
Multiple Sclerosis: Potential Effects of Medications With Central 
Nervous System Activity. Journal of Rehabilitation Research & 
Development, January/February 2006, vol. 43, no. 1.
Snook, E.N., Mojtahedi, M.C., Evans, E.M., McAuley, E., & Motl, R.W. 
(2005). Physical Activity and Body Composition Among Ambulatory 
Individuals with Multiple Sclerosis. International Journal of MS 
Care, Winter 2005/2006, vol. 7, no. 4.
Turner, A.P., Martin, C., Williams, R.M., Goudreau, K., Bowen, J.D., 
Hatzakis, M., Whitham, R.H., Bourdette, D.N., Walker, L., & 
Haselkorn, J.K. (2006). Exploring Educational Needs of Multiple 
Sclerosis Care Providers: Results of a Care-Provider Survey. Journal 
of Rehabilitation Research & Development, January/February 2006, 
vol. 43, no. 1.
Wynn, D.R. (2006). Management of Physical Symptoms. International 
Journal of MS Care, February 2006, vol. 8, Supplement 1.
Yadav, V., Shinto, L., Morris, C., Senders, A., Baldauf-Wagner, S., 
& Bourdette, D. (2006). Use and Self-Reported Benefit of 
Complementary and Alternative Medicine Among Multiple Sclerosis. 
International Journal of MS Care, Spring 2006, vol. 8, no. 1.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Multiple Sclerosis: Interventions to Maximize Health, 
Well-Being, and Participation. This RRTC must conduct rigorous 
research, training, technical assistance, and dissemination activities 
to improve rehabilitation outcome measures and rehabilitation 
interventions that can be applied in clinical or community-based 
settings.
    In doing so, the RRTC must focus on no more than two of the 
following dimensions: prevention or reduction of secondary conditions 
(e.g., pain, fatigue, depression); improved mobility; emotional well-
being; and access to community-based health promotion services and 
programs (e.g., fitness, recreation, and nutrition). Under this 
priority, the RRTC must be designed to contribute to the following 
outcomes:
    (a) Improved outcome measures for use with persons with MS. The 
RRTC must contribute to this outcome by identifying or developing and 
testing methods and measures to assess health and rehabilitation 
outcomes, participation in community-based programs, or both.
    (b) Improved medical rehabilitation or community-based 
rehabilitation interventions. The RRTC must contribute to this outcome 
by identifying or developing and testing new rehabilitation 
interventions for individuals with MS, replicating promising practices 
or programs for individuals with MS, or both.

Priority 18--Aging With Physical Disability: Reducing Secondary 
Conditions and Enhancing Health and Participation

Background

    With medical and technological advancements, many individuals with 
early onset physical disabilities, acquired at birth, in childhood or 
young adulthood, are surviving long enough to experience the rewards 
and challenges of aging (Campbell, Sheets & Strong, 1999). Determining 
the size of this emerging segment of the disabled population has been 
difficult due to the lack of sufficient population data on age of onset 
and duration of disability (Kemp, 2005). The only national estimate 
available to date comes from a secondary analysis of the 1990 U.S. 
Census data, which suggests that there may be as many as 25,000,000 
Americans who are aging with various long-term disabilities (McNeil, 
1994).
    As many researchers have documented, a primary challenge associated 
with increased longevity among this population is an increased risk of 
``secondary conditions.'' The term secondary conditions, or secondary 
health conditions, is shorthand for the various types of medical and 
functional problems that individuals with long-term physical 
disabilities experience post-onset as they age (Kemp & Mosqueda, 2004). 
Although there is widespread agreement that secondary conditions can be 
debilitating, costly in terms of financial and social consequences, and 
potentially fatal in some circumstances, how to define secondary 
conditions remains an active debate within the disability community 
(Wilber et al., 2002; Rimmer, 2005).
    While a precise definition of secondary conditions is still 
evolving, the emerging consensus is that secondary conditions often 
increase the severity of an individual's disability (Brandt & Pope, 
1997). As individuals with long-term physical disabilities age into 
middle and later adulthood, there is an enormous physical and 
psychological burden associated with having to manage various secondary 
health conditions, in addition to managing the chronic health effects 
related to the aging process generally (Rimmer, 2005). There is, 
however, widespread agreement that certain secondary conditions are 
preventable, and that learning how to prevent the onset or reduce the 
severity and impact of these new or increased impairments, functional 
limitations, and age-related health problems is vital to enhancing the 
health and participation of individuals aging with long-term 
disabilities (Simeonsson et al., 1999; Lollar, 2002; Wilber et al., 
2002).
    To date there are no national estimates of the number of 
individuals with long-term physical disabilities who are experiencing 
one or more types of secondary conditions. Most of what is known about 
the prevalence and consequences of secondary conditions for health and 
participation comes from clinical studies of patients, a handful of 
community-based studies and secondary analyses of population surveys, 
and the evolving theoretical understanding of the general aging process 
(Cristian, 2005; Kemp, 2005; Seekins et al., 1994; Campbell, Sheets, & 
Strong, 1999; Wilber et al., 2002; Verbrugge & Yang, 2002; Kinne et 
al., 2004).
    Results of these studies underscore the importance of improving 
treatment options to prevent or reduce the consequences of secondary 
conditions. Exercise, lifestyle and behavioral

[[Page 50534]]

changes, and psychosocial and environmental factors are acknowledged as 
mediators, or potential mediators, for the development of secondary 
health conditions (Seekins et al., 1994; Wilber et al., 2002; Kemp, 
2005; Rimmer, 2005). However, research on these factors has been 
limited by the lack of measurement tools to characterize the types and 
severity of secondary conditions experienced by individuals aging with 
disabilities, and the lack of experimental and quasi-experimental 
studies to test the effectiveness of various intervention strategies 
(Wilber et al.; Rimmer, 2005).

References

Brandt, E.N. & Pope, A.M. (1997). Enabling America: Assessing the 
Role of Rehabilitation Science and Engineering. Committee on 
Disability Research, Institute of Medicine, National Academy of 
Sciences. National Academies Press; pp. 25.
Campbell, M.L., Sheets, D.S., & Strong, P.S. (1999). Secondary 
health conditions among middle-aged individuals with chronic 
physical disabilities: Implications for ``unmet needs'' for 
services. Assistive Technology, 11(2), 3-18. Cristian, A. (Ed.) 
(2005). Aging with a Disability: An Issue of Physical Medicine and 
Rehabilitation Clinics of North America, Volume 16. Oxford, UK: 
Elsevier.
Kemp, B.J. (2005). What the rehabilitation professional and the 
consumer need to know. In Adrian Cristian (ED), Aging with a 
Disability: Physical Medicine and Rehabilitation Clinics of North 
America, Volume 16: Pages 1-18. Oxford, UK: Elsevier.
Kemp, B.J. & Mosqueda, L. (Eds.) (2004). Aging with a Disability. 
Baltimore: The Johns Hopkins University Press.
Kinne, S., Patrick, D.L., & Lochner, D.D. (2004). Prevalence of 
secondary conditions among people with disabilities. American 
Journal of Public Health. Vol 94(3): 443-445.
Lollar D. (2002). Public health and disability: emerging trends. 
Public Health Report. Vol.117:131-136. McNeil, J. (1994). Americans 
with Disabilities, Bureau of the Census, Statistical Brief, SB/94-1. 
In LaPlante, M. Disability in the United States: Prevalence and 
Causes, 1992.
Rimmer, J.L. (2005). Exercise and physical activity in persons aging 
with a physical disability. In Adrian Cristian (Ed), Aging with a 
Disability: Physical Medicine and Rehabilitation Clinics of North 
America, Volume 16: Pages 41-56. Oxford, UK: Elsevier.
Seekins, T., Clay, J., & Ravesloot, C.H. (1994). A descriptive study 
of secondary conditions reported by a population of adults with 
physical disabilities served by 3 independent living centers in a 
rural state. Journal of Rehabilitation, Vol. 60:47-51.
Simeonsson, R.J., Bailey, D.B., Scandlin, D., Huntington, G.S., & 
Roth, M. (1999). Disability, health, secondary conditions and 
quality of life: Emerging issues in public health. In: Simeonsson, 
RJ, McDevitt, LN (Eds.) Issues in Disability and Health: The Role of 
Secondary Conditions and Quality of Life. Chapel Hill: University of 
North Carolina Press; 51-72.
Wilber, N., Mitra, M., Walker, D.K., Allen D., Meyers, A.R., & 
Tupper, P. (2002). Disability as a public health issue: findings and 
reflections from the Massachusetts Survey of Secondary Conditions. 
Milbank Quarterly; Vol. 80:393-421.
Verbrugge, L.M. & Yang, L. (2002). Aging with Disability and 
Disability with Aging. Journal of Disability Policy Studies; Vol. 
12(4):253-267.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Aging with Physical Disability: Reducing Secondary 
Conditions and Enhancing Health and Participation. This RRTC must 
conduct rigorous research, training, technical assistance, and 
dissemination activities to improve rehabilitation outcome measures and 
rehabilitation interventions that can be applied in clinical or 
community-based settings and used by other researchers. The intended 
outcome of the RRTC is to enhance the health and participation of 
individuals aging with long-term physical disabilities in work and the 
community by advancing knowledge about the identification, assessment, 
treatment and improved management of the secondary conditions likely 
experienced by this target population.
    In addressing this priority, the RRTC must propose no more than 
four synergistic, cross-disability research projects to address the 
secondary conditions that are most relevant to the health, employment, 
or community participation of individuals with disabilities. To ensure 
the feasibility of the RRTC's proposed activities and increase the 
likelihood of achieving planned outcomes, the RRTC must focus on no 
more than three discrete impairment groups, and must limit 
interventions strategies to no more than two of the following 
modalities: exercise, health promotion, psychological adaptation, life 
planning or self-management skills, and environmental or technological 
supports. Under this priority, the RRTC must be designed to contribute 
to the following outcomes:
    (a) Enhanced understanding of the natural course of aging with 
physical disability. The RRTC must contribute to this outcome by 
documenting the life trajectories and average age of onset of the major 
types of secondary conditions experienced by individuals living with 
long-term physical disabilities, and examining the interrelationships 
among different types of secondary conditions and the consequences of 
variations in timing of onset for health and participation.
    (b) Improved tools and measures for use with individuals aging with 
long-term physical disabilities. The RRTC must contribute to this 
outcome by identifying, developing or modifying, and testing new 
measurement tools that improve the identification and assessment of the 
major types of secondary conditions discussed in the literature, as 
well as the outcomes of interventions designed to prevent or reduce 
these conditions.
    (c) Improved rehabilitation or community-based interventions that 
enhance the health and participation in work and the community of 
individuals aging with physical disabilities. The RRTC must contribute 
to this outcome by identifying, developing, or modifying, and testing 
new interventions that are effective in preventing the onset or 
improving the management and reducing the impact of secondary 
conditions, and replicating promising practices or programs that are 
effective in preventing the onset or improving the management and 
reducing the impact of secondary conditions, or both.

Priority 19--Disability Statistics and Demographics

Background

    A 2003 report from the Interagency Committee on Disability Research 
(ICDR) identified 67 Federal statutory definitions of the term 
``disability.'' These definitions directly influence the collection of 
national, State, administrative, and other data about individuals with 
disabilities (Cherry Engineering Support Services (CSSI), Inc., 2003). 
``Because surveys produce different types of information on disability, 
they can provide additional perspectives on the sources and effects of 
disabilities, but they can also cause confusion because of the 
differences in the way disability is being measured'' (Government 
Accountability Office, 2006). As a result of such confusion, 
policymakers, service providers, individuals with disabilities, and 
others may not be able to identify the best available statistics to 
inform their efforts to enhance the well-being and participation of 
individuals with disabilities.
    An ongoing need exists to bridge the gap between producers and 
users of disability statistics, particularly as the

[[Page 50535]]

population ages and injuries caused by such factors as war and 
environmental changes lead to growing numbers of individuals with 
disabilities (National Council on Disability (NCD), 2006). Policymakers 
cite the need for information about the indirect and direct costs of 
disability, unmet needs for services or technologies that facilitate 
environmental access and enhance participation, and individuals with 
disabilities living in institutional settings (Healthy People 2010, 
2000; NCD, 2006).
    Though there are a number of useful sources of disability data, 
``controversy has been generated by variations in disability statistics 
achieved by different researchers, using varied data collection 
instruments, differing data sources and different data mining 
techniques'' (NCD, 2006). Methodological research will improve the 
quality and consistency of data and increase confidence in the research 
findings (Stern, 2004; McMenamin, Miller, & Polivka, 2006). Improved 
questionnaire design and innovative data collection strategies can 
facilitate availability of valid and reliable data (NCD, 2006; Kroll et 
al., in press). Research to evaluate best practices for conducting 
surveys of and about individuals with disabilities will improve our 
understanding of the needs of the population. Development of 
methodologies to improve collections or analyses of data about 
populations with low-incidence disabilities, or small demographic 
subgroups of individuals with disabilities, would advance knowledge 
about the population. A recent review indicates that ``there is a solid 
base of theory on which to base research among low-incidence 
populations'' but notes the lack of ``a large body of work in which 
this theory has been applied to populations with disabilities'' (CESSI, 
2005). For these reasons, NIDRR seeks to fund an RRTC that improves the 
quality of disability statistics.

References

Cherry Engineering Support Services (CSSI), Inc. (2005). Research 
Methods for Low-Incidence Populations. Prepared for the Interagency 
Committee on Disability Research (ICDR). McLean, VA: CESSI.
Cherry Engineering Support Services (CSSI), Inc. (2003). Federal 
Statutory Definitions of Disability. Prepared for the Interagency 
Committee on Disability Research (ICDR). McLean, VA: CESSI. See: 
http://www.icdr.us/documents/definitions.htm. 
Government Accountability Office (GAO) (2006). Federal Information 
Collection: A Reexamination of the Portfolio of Major Federal 
Household Surveys is Needed, GAO-07-62. Washington, DC: GAO.
Kroll, T., Keer, D., Placek, P., Cyril, J., & Hendershot, G. (in 
press). Towards Best Practices for Surveying People with 
Disabilities. Volume 1. New York: Nova Publishers, Inc.
McMenamin, T., Miller, S., & Polivka, A. (2006). Discussion and 
Presentation of the Disability Test Results from the Current 
Population Survey. Washington, DC: Bureau of Labor Statistics. See: 
http://econpapers.repec.org/paper/blswpaper/ec060080.htm.
National Council on Disability (2006). National Disability Policy: A 
Progress Report, December 2004--December 2005. Washington, DC: 
National Council on Disability. See: http://www.ncd.gov/newsroom/publications/2006/progress_report.htm.
Stern, S. (2004). Counting People with Disabilities: How Survey 
Methodology Influences Estimates in Census 2000 and the Census 2000 
Supplementary Survey. Washington, DC: U.S. Census Bureau. See: 
http://www.census.gov/hhes/www/disability/finalstern.pdf.
U.S. Department of Health and Human Services (2000). Healthy People 
2010. 2nd ed. With Understanding and Improving Health and Objectives 
for Improving Health. 2 vols. Washington, DC: U.S. Government 
Printing Office.

Proposed Priority

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Disability Statistics and Demographics. This RRTC must 
conduct rigorous research, knowledge translation, training, 
dissemination, and technical assistance that advance the use of 
rigorous disability statistics and demographics to inform disability 
policy and service provision. Under this priority, the RRTC must be 
designed to contribute to the following outcomes:
    (a) Rigorous and timely demographic research to inform the 
development of disability policy and programs. The RRTC must contribute 
to this outcome by: (1) Producing meta-analyses of national, State, and 
administrative data that address critical program and service needs; 
and (2) providing statistical consultation, including specialized 
analyses, to facilitate the use of survey and administrative data by 
policymakers and others.
    (b) Improved disability data and statistics. The RRTC must conduct 
research about methodologies that advance the practice for (1) 
Conducting surveys of individuals with disabilities, including 
individuals with low-prevalence disabilities; (2) analyzing data about 
low-incidence populations of individuals with disabilities; and (3) 
other issues related to survey or administrative data.
    (c) Effective use of disability statistics and demographic 
information. The RRTC must contribute to this outcome by: (1) Serving 
as a resource on disability statistics and demographics for Federal and 
other government agencies, policymakers, consumers, advocates, 
researchers, and others; and (2) transferring research findings to 
enhance planning, policymaking, program administration, and delivery of 
services to individuals with disabilities.

Priorities 20 and 21--Health and Function Across the Lifespan of 
Individuals With Intellectual and Developmental Disabilities (Priority 
20) and Participation and Community Living for Individuals With 
Intellectual and Developmental Disabilities (Priority 21)

Background

    For purposes of priorities 20 and 21, individuals with 
intellectual, developmental, mental, and cognitive disabilities, 
including individuals with cerebral palsy, Downs syndrome, autism, and 
related conditions, will be referred to as persons with intellectual 
disabilities or developmental disabilities (ID/DD). Individuals are 
considered to have an intellectual disability (ID) when their 
intellectual functioning level (IQ) is below 70-75; they have 
significant limitations in conceptual, social, and practical adaptive 
skills such as communication, self-care, home living, social skills, 
leisure, health and safety, self-direction, functional academics 
(reading, writing, basic math), and work; and the disability originated 
before the age of 18. Developmental disabilities (DD) are defined as 
severe, chronic disabilities that first appear before age 22, are 
likely to continue indefinitely, and cause substantial limitations in 
three or more of the following areas: Self-care, language, learning, 
mobility, self-direction, and capacity for independent living. These 
definitions of ID and DD, however, may have limitations when applied in 
research or in the administration of public assistance programs because 
of diagnostic ambiguities, implementation and measurement problems, or 
the temporary nature of certain context-specific disabilities (Larson 
et al., 2001).
    Individuals with ID/DD constitute a diverse group of underserved, 
underemployed or unemployed, and marginalized individuals. While 
estimates about the size and composition of this population in the 
United States range from 1.6 percent to nearly 3 percent of the 
population (between 4.5 million and 8 million), depending on the source 
of data and the types of diagnoses used, clear patterns

[[Page 50536]]

of disadvantage are apparent in this population (Lakin & Turnbull, 
2005; National Institute of Child Health and Human Development, 2002; 
U.S. Department of Health and Human Services, Office of the Assistant 
Secretary for Planning and Evaluation, 2006).
    According to a 2004 report issued by the President's Committee for 
People with Intellectual Disabilities (2004), around 90 percent of 
adults with ID/DD were not employed. Among those individuals with ID/DD 
who were employed, over 365,000 attended sheltered workshops or were in 
day programs or prevocational services. Levels of educational 
attainment are quite low for individuals with ID/DD. According to the 
2004 report, 26 percent of youth with ID/DD dropped out of school, and 
fewer than 15 percent participated in postsecondary education. Levels 
of income and wealth are also low among individuals with ID/DD. 
Supplemental Security Income (SSI) or Social Security Disability 
Insurance (SSDI) were a major source of income for individuals with ID/
DD (in December 2001, there were almost 1.1 million adults and children 
receiving SSI payments based on ID/DD; there were almost 600,000 
receiving SSDI benefits). Over 700,000 individuals with ID/DD lived 
with parents aged 60 or older. Less than one percent of individuals 
with ID/DD owned their own home (President's Committee for People with 
Intellectual Disabilities, 2004).
    These statistics provide a small glimpse into the everyday life 
experiences of individuals with ID/DD and their families and 
caregivers. Depending on the severity of their disability, individuals 
with ID/DD need assistance in most, if not all, activities of daily 
living (e.g., walking, dressing, bathing) and instrumental activities 
of daily living (e.g., shopping or managing money). Such assistance is 
time consuming and costly, particularly if skilled personal assistance 
services and professional rehabilitation services are needed.
    Besides needing significant amounts of care, many individuals with 
ID/DD are at an increased risk of being isolated from the community, 
particularly if they have been placed under institutional supervision 
or care. Limited educational attainment and job skills are key barriers 
to inclusion in communal activities. As a result, many individuals with 
ID/DD have difficulties developing independent living and social 
skills. They remain dependent on family, friends, and personal 
caregivers. Where such supports are not available, they must resort to 
institutional care.
    Individuals with ID/DD have been found to suffer from a wide range 
of illnesses and impairments (National Institute of Child Health and 
Human Development, 2002). The onset of many conditions is at birth or 
in infancy (for example, cerebral palsy). Moreover, many other 
conditions, such as obesity, diabetes, or Alzheimer's disease occur 
earlier in adulthood for individuals with ID/DD than most individuals 
in the general population. As a result, individuals with ID/DD have 
greater needs for health care services than members of the general 
population. To obtain the full benefits of these services, the 
individuals must have access to skilled staff at service facilities who 
are informed about, and equipped to respond to, the special needs of 
individuals with ID/DD. If skilled staff are not available, consumers 
and providers may consider the help of intermediaries, direct support 
providers, or other social service providers specializing in the care 
of individuals with ID/DD.
    For these reasons, NIDRR seeks to fund two RRTCs designed to 
increase the levels of health, function, and community living/
participation of individuals with ID/DD by developing and applying 
scientifically validated procedures, treatments, and interventions. The 
goal of these procedures, treatments, and interventions is to create 
measurable benefits or outcomes for individuals with ID/DD and their 
families and caregivers.

References

Lakin, K. & Turnbull, A., Eds. (2005). National Goals and Research 
for People With Intellectual and Developmental Disabilities. 
Washington, DC: American Association on Mental Retardation.
Larson, S.A., Lakin, C.K., Anderson, Lynda, K., Nohon, L., Jeoung, 
H., & Anderson, D. (2001). Prevalence of Mental Retardation and 
Developmental Disabilities: Estimates from the 1994/1995 National 
Health Interview Survey Disability Supplements. American Journal on 
Mental Retardation 106(3):231-252.
National Institute of Child Health and Human Development (2002). 
Closing the Gap: A National Blueprint to Improve the Health of 
Persons with Mental Retardation. Report of the Surgeon General's 
Conference on Health Disparities and Mental Retardation. Washington, 
DC.
President's Committee for People with Intellectual Disabilities 
(2004). A Charge We Have To Keep. A Road Map to Personal and 
Economic Freedom for People with Intellectual Disabilities in the 
21st Century. Washington, DC: U.S. Department of Health and Human 
Services, Administration for Children and Families.
U.S. Department of Health and Human Services, Office of the 
Assistant Secretary for Planning and Evaluation (2006). The Supply 
of Direct Support Professionals Serving Individuals with 
Intellectual Disabilities and Other Developmental Disabilities: 
Report to Congress. Washington, DC.

Proposed Priority 20--Health and Function Across the Lifespan of 
Individuals With Intellectual and Developmental Disabilities

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) on Health and Function Across the Lifespan of Individuals 
with Intellectual and Developmental Disabilities (ID/DD). This RRTC 
must focus on rigorous research, training, technical assistance, and 
dissemination of strategies and interventions that improve the health 
and function of individuals with ID/DD, and access to community-based 
health and social services by individuals with ID/DD. The research 
conducted by this RRTC also must focus on improving the health and 
function of individuals with ID/DD and on promoting family and 
caregiver supports that enable persons with ID/DD to receive long-term 
care.
    When applying for a grant under this priority, an applicant must 
identify, in its application, the subjects of interest from the diverse 
population of individuals with ID/DD to be served by the proposed 
research and describe how the proposed research will benefit this 
group.
    Under this priority, the RRTC must be designed to contribute to the 
following outcomes:
    (a) Conceptually sound theories and methodologies for research on 
community-based rehabilitation and health and social service provision, 
including research on long-term care or care provided by family members 
to individuals with ID/DD. The RRTC must contribute to this outcome by 
investigating existing theories that may help organize or frame 
research on ID/DD, including theories from fields such as long-term 
care, or frameworks related to delivery of rehabilitation or health 
services in the community.
    (b) Improved instruments and measures that help to evaluate the 
suitability and quality of personal assistance services, and the 
effectiveness and efficiency of community-based health and social 
services for individuals with ID/DD. The RRTC must contribute to this 
outcome by assessing current measures and instruments, reporting on 
their validity

[[Page 50537]]

and reliability, and then developing and testing improved measures as 
needed.
    (c) Improved rehabilitation or community-based interventions that 
demonstrate measurable reductions in barriers to access and utilization 
of community-based services or community-based interventions that 
otherwise contribute to improved health and function of individuals 
with ID/DD. The RRTC must contribute to this outcome by identifying and 
testing potential interventions and providing a thorough assessment of 
the basis on which these interventions were selected, including any 
preliminary evidence of their usefulness and relevance to individuals 
with ID/DD and their families.

Proposed Priority 21--Participation and Community Living for 
Individuals With Intellectual and Developmental Disabilities

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes a priority for a Rehabilitation Research and Training 
Center (RRTC) for Participation and Community Living for Individuals 
with Intellectual and Developmental Disabilities (ID/DD). The RRTC must 
focus on rigorous research, training, technical assistance, and 
dissemination to enhance inclusion and self-determination of 
individuals with ID/DD. This RRTC also must focus on developing 
interventions that support self-determination, informed choice, 
consumer control, family involvement, and participation and community 
living of individuals with ID/DD.
    When applying for a grant under this priority, an applicant must 
identify, in its application, the subjects of interest from the diverse 
population of individuals with ID/DD to be served by the proposed 
research and describe how the proposed research will benefit this 
group.
    Under this priority, the RRTC must be designed to contribute to the 
following outcomes:
    (a) Improved concepts and theories of societal participation and 
community living, and self-determination to guide the study of needs 
and abilities of individuals with ID/DD. The RRTC must contribute to 
this outcome by investigating existing theories of societal 
participation, community living, and self-determination to frame 
research on these topics for individuals with ID/DD.
    (b) Improved instruments and measures of participation and 
community living to assess the type, frequency, and quality of 
activities that individuals with ID/DD wish to engage in, or are able 
to engage in outside the home or residential facility. The RRTC must 
contribute to this outcome by assessing current measures and 
instruments used to determine outcomes in the areas of access to 
community facilities, social participation, self advocacy, employment 
choice, and housing selection by individuals with ID/DD, reporting on 
the validity and reliability of these measures, and then developing and 
testing improved measures as needed.
    (c) Improved rehabilitation or community-based interventions that 
demonstrate a measurable impact in areas such as access to communal 
facilities and events, social participation and interaction with 
members of the community, self-advocacy, employment opportunities, and 
housing choices. The RRTC must contribute to this outcome by 
identifying and testing potential interventions for individuals with 
ID/DD, providing a thorough assessment of the basis on which these 
interventions were selected, including any preliminary evidence of 
their usefulness and relevance to individuals with ID/DD and their 
families.

Rehabilitation Engineering Research Centers Program General 
Requirements of Rehabilitation Engineering Research Centers (RERCs)

    RERCs carry out research or demonstration activities in support of 
the Rehabilitation Act of 1973, as amended, by--
     Developing and disseminating innovative methods of 
applying advanced technology, scientific achievement, and psychological 
and social knowledge to: (a) Solve rehabilitation problems and remove 
environmental barriers; and (b) study and evaluate new or emerging 
technologies, products, or environments and their effectiveness and 
benefits; or
     Demonstrating and disseminating: (a) Innovative models for 
the delivery of cost-effective rehabilitation technology services to 
rural and urban areas; and (b) other scientific research to assist in 
meeting the employment and independent living needs of individuals with 
severe disabilities; and
     Facilitating service delivery systems change through: (a) 
The development, evaluation, and dissemination of consumer-responsive 
and individual and family-centered innovative models for the delivery 
to both rural and urban areas of innovative cost-effective 
rehabilitation technology services; and (b) other scientific research 
to assist in meeting the employment and independence needs of 
individuals with severe disabilities.
    Each RERC must be operated by or in collaboration with one or more 
institutions of higher education or one or more nonprofit 
organizations.
    Each RERC must provide training opportunities, in conjunction with 
institutions of higher education and nonprofit organizations, to assist 
individuals, including individuals with disabilities, to become 
rehabilitation technology researchers and practitioners.
    Additional information on the RERC program can be found at: http://www.ed.gov/rschstat/research/pubs/index.html.

Priorities 22, 23, 24, 25, 26, and 27--Rehabilitation Engineering 
Research Centers (RERCs) for Hearing Enhancement (Priority 22), 
Accessible Public Transportation (Priority 23), Prosthetics and 
Orthotics (Priority 24), Communication Enhancement (Priority 25), 
Universal Interface and Information Technology Access (Priority 26), 
and Wheeled Mobility (Priority 27)

Background

    Individuals with disabilities regularly use products that have been 
developed as the result of rehabilitation and biomedical research in 
order to achieve and maintain maximum physical function, live 
independently, study and learn, and attain gainful employment. 
Rehabilitation engineering research encompasses research on assistive 
technology, technology at the systems level (e.g., the built 
environment, transportation), and technology that allows individuals to 
interface with technology at the systems or environmental levels.
    Advancements in basic biomedical science and technology have 
resulted in new opportunities to enhance further the lives of 
individuals with disabilities. Specifically, recent advances in 
biomaterials research, composite technologies, information and 
telecommunication technologies, nanotechnologies, micro electro 
mechanical systems (MEMS), sensor technologies, and the neurosciences 
provide a wealth of opportunities for individuals with disabilities and 
could be incorporated into research focused on disability and 
rehabilitation.
    Through the following proposed priorities, NIDRR intends to fund 
RERCs that advance rehabilitation engineering research in the following 
priority research areas: Hearing Enhancement, Accessible Public 
Transportation, Prosthetics and Orthotics, Communication Enhancement, 
Universal Interface and Information

[[Page 50538]]

Technology Access, and Wheeled Mobility.

Priority 22--Hearing Enhancement

    Approximately 28.6 million Americans have an auditory disorder. In 
the United States, an estimated 1 to 6 in 1,000 newborns are born 
profoundly deaf, and another 2 to 3 out of 1,000 babies are born with 
partial hearing loss, making hearing loss the number one birth defect 
in America (Kochkin, 2001; Kemper & Downs, 2000; Cunningham & Cox, 
2003).
    Despite advances in hearing assistive technologies such as digital 
hearing aids, cochlear implants, induction loop (IL), frequency 
modulation (FM) and infrared (IR) assistive listening systems, and 
video relay, many challenges and opportunities for future research and 
development exist (Stika, Ross, & Cuevas, 2002; Schow et al., 1993). 
For example, there is a need for new fitting methods for hearing aids 
and cochlear implants that adaptively adjust signal processing 
parameters such as compression threshold, compression ratio, gain, and 
frequency to maximize performance goals for an individual, both in the 
clinic and in the field (Stika, Ross & Cuevas, 2002; Schow, Balsara, 
Smedley & Whitcomb, 1993). In addition, there is a need to explore how 
rehabilitation or training can be provided so that individual users of 
hearing enhancement technologies can readily adopt new technologies and 
adapt to the new stimulation and information being received (Schow et 
al., 1993).
    Accordingly, NIDRR seeks to fund an RERC that researches and 
develops innovative models of aural rehabilitation tools, services, and 
training, in order to improve assessment and fitting of hearing 
enhancement technologies and to increase the availability, knowledge, 
and use of hearing enhancement devices and services.

References

Cunningham, M. & Cox, E.O. (2003). Hearing assessment in infants and 
children: Recommendations beyond neonatal screening. Pediatrics, 
111(2): 436-440.
Kemper, A.R. & Downs, S.M. (2000). A cost-effectiveness analysis of 
newborn hearing screening strategies. Archives of Pediatric and 
Adolescent Medicine, 154(5): 484-488.
Kochkin, S. (2001). MarkeTrak VI: The VA and direct mail sales spark 
growth in hearing aid market. The Hearing Review, 8(12): 16-24, 63-
65.
Schow, R., Balsara, N., Smedley, T., & Whitcomb, C. (1993). Aural 
rehabilitation by ASHA audiologists: 1980-1990, American Journal of 
Audiology, 2(3): 28-37.
Stika, C.J., Ross, M., & Cuevas, C. (2002). Hearing Aid Services and 
Satisfaction: The Consumer Viewpoint, Hearing Loss: the Journal of 
Self Help for Hard of Hearing People, 23(3): 25-31.

Priority 23--Accessible Public Transportation

    Inaccessible transportation is a major barrier to independent 
living and limits the ability of individuals with disabilities to 
participate fully in their communities. One-third of individuals with 
disabilities report that inadequate transportation is a significant 
problem, and they are twice as likely to have inadequate transportation 
than individuals without disabilities (N.O.D./Harris Survey, 2004). 
Addressing the problems of accessibility of public transportation may 
help to provide the same degree of convenience, connection, and safety 
the general public enjoys when traveling via plane, train, or bus.
    Points of entry and exit, public rights-of-way, communications, and 
bus and rail stations and stops are just a few of the areas posing 
transportation accessibility problems for individuals with 
disabilities. The physical dimensions and space limitations of the 
transport vehicle may prohibit easy entry, transfer to vehicle seats, 
or use of the services and facilities available on a plane, train, or 
bus. In addition, costs, physical ability, and perceptions of safety 
are all considered barriers to public transportation (Peck & Hess, 
2006).
    Accordingly, NIDRR seeks to fund an RERC on Accessible Public 
Transportation to address the need for improvements in the 
accessibility of public transportation, provide safe and dignified 
travel for individuals with disabilities, and increase community 
participation by individuals with disabilities. The focus of this RERC 
is on travel via air, rail, and bus.

References

N.O.D./Harris Survey of Americans with Disabilities (2004). Harris 
Interactive, 111 Fifth Avenue, New York, NY 10003.
Peck, M. & Hess D. (2006). Barriers to Using Public Transit among 
Diverse Older Adults: Implications for Social Work. http://sswr.confex.com/sswr/2007/techprogram/P7047.HTM

Priority 24--Prosthetics and Orthotics

    In the United States, it is estimated that there are 1.2 to 1.9 
million individuals living with limb loss (Adams, Hendershot, & Marano, 
1999). In addition, it is estimated that 75 percent of individuals with 
limb loss use a prosthetic device (Nielsen, 2002). The majority of 
amputations are generally the result of peripheral vascular disease. 
Cancer, congenital limb loss, and trauma are the other major causes of 
amputation. It is difficult to accurately estimate orthotic use in the 
United States, because orthotics are used by many different pathology 
populations (stroke, spinal cord injury, cerebral palsy, orthopedic 
impairment) and orthoses are not often used on a permanent basis.
    Increased knowledge and understanding about prosthetics and 
orthotics, and a greater emphasis on objective measures, such as 
performance, efficacy, and energy expenditures, that inform clinical 
practice should lead to the development of new concepts and devices to 
improve the quality, cost-effectiveness, and delivery of prosthetic and 
orthotic fittings.
    Accordingly, NIDRR seeks to fund an RERC that researches and 
develops innovative prosthetic and orthotic technologies and designs to 
enhance the ability of individuals with limb loss and impaired limb 
function to perform activities of daily living, to have expanded 
employment options, to participate in sports and leisure activities, 
and to improve their health and participation outcomes.

References

Adams, P.F., Hendershot, G.E., & Marano, M.A. (1999). Current 
estimates from the National Health Interview Survey, 1996. National 
Center for Health Statistics. Vital Health Stat 10(200).
Nielsen, C. (2002). Issues Affecting The Future Demand for 
Orthotists and Prosthetists: Update 2002. A study updated for the 
National Commission on Orthotic and Prosthetic Education, May 2002.

Priority 25--Communication Enhancement

    ``Approximately 1.3 percent of all individuals [in the United 
States] (i.e., more than 3.5 million Americans) have such significant 
communication disabilities that they cannot rely on their natural 
speech to meet their daily communication needs.'' (Beukelman, 2005). 
For these individuals, augmentative and alternative communication (AAC) 
strategies would facilitate participation and independence.
    The number of individuals who may benefit from AAC will continue to 
grow as the American population ages and the associated prevalence of 
acquired communication disorders increases. Also, improvements in 
medical practices and technologies have resulted in increased survival 
rates among at risk infants and children, which, in turn, has

[[Page 50539]]

led to an increase in the number of individuals with moderate to severe 
disabilities (Hack et al., 2005). In addition, the prevalence of autism 
spectrum disorders (ASD) has increased and more individuals with ASD 
and their caregivers are actively seeking, and expecting to find, 
intervention services that include AAC (Blackstone, 2005).
    Accordingly, NIDRR seeks to fund an RERC that enhances 
communication for individuals with communication disabilities, promotes 
greater participation of individuals with communication disabilities in 
employment and education, increases independence for these individuals, 
and researches and develops innovative technologies and techniques to 
improve the state of the science and usability of AAC technology.

References

Beukelman, D.R. & Mirenda, P. (2005). Augmentative and Alternative 
Communication: Supporting children and adults with complex 
communication needs. (3rd edition). Baltimore: Paul H. Brookes 
Publishing, p.3.
Blackstone, S.W. (2003). Overview and Update. Augmentative 
Communication News. 15:4, 2-3.
Hack, M., Taylor, H., Drotar, D., Schluchter, M., Cartar, L., 
Andreias, L., Wilson-Costello, D., & Klein, N. (2005). Chronic 
Conditions, Functional Limitations, and Special Health Care Needs of 
School-Aged Children Born with Extra Low Birth Weight in the 1990's. 
Journal of the American Medical Association (JAMA), 294(3), 318-325.

Priority 26--Universal Interface and Information Technology Access

    Information technologies have the potential to provide or increase 
access to professional, educational, social, and economic resources 
among individuals with disabilities (Gorski & Clark, 2002). 
Unfortunately, large discrepancies in the rates of use of information 
technologies exist between individuals with and without disabilities. 
According to data collected by the Bureau of Labor Statistics and the 
U.S. Census, 57.6 percent and 54.4 percent of individuals without 
disabilities use a computer at home and access the Internet at home, 
respectively. These same data suggest that only 30.2 percent and 26.4 
percent of individuals with disabilities use a computer at home and 
access the Internet at home, respectively. In addition, while 63.6 
percent of individuals without disabilities access the Internet at some 
location, only 30.8 percent of individuals with disabilities do so 
(Dobransky & Hargittai, 2006).
    Information technology access development efforts are utilizing V2 
Information Technology Access Interface standards to build and test new 
universally designed interfaces that accommodate individuals with and 
without disabilities (International Committee for Information 
Technology Standards, 2006). These ``smart devices'' would 
automatically offer the user the appropriate interface and adapt to the 
way in which the user interacts with it (Horn & West, 2005).
    Despite the promise of a universally designed information 
technology (IT) interface or device, most currently existing IT devices 
still need to be retrofitted with customized input and output 
interfaces so individuals with disabilities can use them. Further 
research on the effectiveness of existing alternative input and output 
interfaces and the design specifications necessary to construct 
universally designed IT interfaces and devices of the future is needed.
    Accordingly, NIDRR seeks to fund an RERC that enhances the 
effectiveness of currently available input and output IT interfaces and 
devices used by individuals with varying disabilities to facilitate 
community participation and independent living.

References

Dobransky, K. & Hargittai, E. (2006). The disability divide in 
Internet access and use. Information, Communication & Society. 9(3), 
313-334.
Gorski, P. & Clark, C. (2002). Multicultural Education and the 
Digital Divide: Focus on Disability. Multicultural Perspectives. 
4(4), 28-36.
Horn, P. & West, F. (2005). Introduction. IBM systems Journal. 
44(3), 1-2.
International Committee for Information Technology Standards (2006). 
V2--Information Technology Access Interfaces. Gaithersburg, MD: 
National Institute of Standards and Technology. See: http://v2.incits.org/.

Priority 27--Wheeled Mobility

    Among the United States population of individuals aged 15 years and 
older, 2.7 million individuals use a wheelchair or similar device (2002 
SIPP data cited in Steinmetz, 2006). As more individuals with 
disabilities advance in age and as more aging individuals acquire 
disabilities, the number of wheeled-mobility device users will increase 
(White House Conference on Aging, 2005). Addressing the needs of this 
diverse population requires engineering and related fields to develop 
new solutions to existing problems and provide innovation and 
advancement in wheeled mobility.
    Despite advances in knowledge in wheelchair propulsion technique, 
secondary injury prevention, wheelchair-user interface, and wheelchair 
skills training, many challenges and opportunities for future research 
and development exist. For example, over-use injuries resulting from 
long-term wheelchair use are still a major problem (Arthanat & Strobel, 
2006; Van der Woude, de Groot, & Janssen, 2006; Van der Woude, Janssen, 
& Vegger, 2005). In addition, there is a need for more information on 
the ergonomics of wheelchair and scooter design and use within and 
across different environments (e.g., work, home, school, and outdoors) 
(Arthanat & Strobel, 2006; Van der Woude, de Groot, & Janssen, 2006).
    Advances in wheelchair technology may provide users with greater 
functional potential, including increases in participation and 
activity, and decreases in secondary injuries, such as pressure sores 
and repetitive strain injuries. Accordingly, NIDRR seeks to fund an 
RERC that improves understanding of the ergonomics, design, 
development, testing, and use of wheelchairs and scooters within and 
across different environments.

References

Arthanat, S. & Strobel, W. (2006). Wheelchair ergonomics: 
Implications for vocational participation. Journal of Vocational 
Rehabilitation, 24, 97-109.
Steinmetz, E. (2006). Current Population Reports: Americans with 
Disabilities 2002. Washington, DC: U.S. Department of Commerce, 
Economics and Statistics Administration, U.S. Census Bureau. See: 
http://www.census.gov/prod/2006pubs/p70-107.pdf.
Van der Woude, L.H., de Groot, S., & Janssen, T.W.J. (2006). Manual 
wheelchairs: Research and innovation in rehabilitation, sports, 
daily life and health. Medical Engineering & Physics, 28(9), 905-
915.
Van der Woude, L.H., Janssen, T.W.J., & Vegger, D.J. (2005). 3rd 
International Congress ``Restoration of wheeled mobility in SCI 
rehabilitation: State of the art III'': its background. Technology 
and Disability, 17, 55-61.
White House Conference on Aging (2005). Final Report to the 
President and Congress: The Booming Dynamics of Aging: From 
awareness to action. See: http://www.whcoa.gov/about/about.asp#report.

Proposed Priorities

    The Assistant Secretary for Special Education and Rehabilitative 
Services proposes the following six priorities for the establishment of 
(a) An RERC for Hearing Enhancement (priority 22); (b) an RERC for 
Accessible Public Transportation (priority 23); (c) an RERC for 
Prosthetics and Orthotics (priority 24); (d) an RERC for Communication 
Enhancement (priority 25); (e) an RERC for Universal Interface and 
Information Technology Access (priority 26); and (f)

[[Page 50540]]

an RERC for Wheeled Mobility (priority 27). Within its designated 
priority research area, each RERC will focus on innovative 
technological solutions, new knowledge, and concepts that will improve 
the lives of individuals with disabilities.
    (a) RERC for Hearing Enhancement (Priority 22). Under this 
priority, the RERC must research and develop methods, systems, and 
technologies that will assist hearing professionals with the process of 
matching hearing enhancement assistive technologies to individuals with 
hearing loss and associated conditions such as tinnitus. This includes 
improving the compatibility of hearing enhancement technologies with 
various environments such as school, work, recreation, and social 
settings.
    (b) RERC for Accessible Public Transportation (Priority 23). Under 
this priority, the RERC must research and develop methods, systems, and 
devices that will promote and enhance the ability of individuals with 
disabilities to safely, comfortably, and efficiently identify 
destination information, board and disembark, and use services and 
facilities on various types of public transportation systems such as 
buses, passenger trains, and airplanes. This RERC must emphasize the 
principles of universal design in its product research and development.
    (c) RERC for Prosthetics and Orthotics (Priority 24). Under this 
priority, the RERC must increase the understanding of the scientific 
and engineering principles pertaining to human locomotion, reaching, 
grasping, and manipulation, and incorporate those principles into the 
design and fitting of prosthetic and orthotic devices.
    (d) RERC for Communication Enhancement (Priority 25). Under this 
priority, the RERC must research and develop augmentative and 
alternative communication technologies and strategies that will enhance 
the communicative capacity of individuals of all ages with significant 
communication disorders across environments (i.e., education, 
employment, recreation, social).
    (e) RERC for Universal Interface and Information Technology Access 
(Priority 26). Under this priority, the RERC must research and develop 
innovative technological solutions for, and promote universal access 
to, current and emerging information technologies and technology 
interfaces that promote a seamless integration of the multiple 
technologies used by individuals with disabilities in the home, the 
community, and the workplace. This RERC must work collaboratively with 
the RERC on Telecommunication Access, the RERC on Mobile Wireless 
Technologies, and the NIDRR-funded Information Technology Technical 
Assistance and Training Center.
    (f) RERC for Wheeled Mobility (Priority 27). Under this priority, 
the RERC must research and develop innovative technologies and 
strategies that will improve the current state of the science, design 
standards, and usability of wheeled mobility devices and wheelchair 
seating systems.
    Under each priority, the RERC must be designed to contribute to the 
following outcomes:
    (1) Increased technical and scientific knowledge base relevant to 
its designated priority research area. The RERC must contribute to this 
outcome by conducting high-quality, rigorous research and development 
projects.
    (2) Innovative technologies, products, environments, performance 
guidelines, and monitoring and assessment tools as applicable to its 
designated priority research area. The RERC must contribute to this 
outcome through the development and testing of these innovations.
    (3) Improved research capacity in its designated priority research 
area. The RERC must contribute to this outcome by collaborating with 
the relevant industry, professional associations, and institutions of 
higher education.
    (4) Improved focus on cutting edge developments in technologies 
within its designated priority research area. The RERC must contribute 
to this outcome by identifying and communicating with NIDRR and the 
field regarding trends and evolving product concepts related to its 
designated priority research area.
    (5) Increased impact of research in the designated priority 
research area. The RERC must contribute to this outcome by providing 
technical assistance to public and private organizations, individuals 
with disabilities, and employers on policies, guidelines, and standards 
related to its designated priority research area.
    (6) Increased transfer of RERC-developed technologies to the 
marketplace. The RERC must contribute to this outcome by developing and 
implementing a plan for ensuring that all technologies developed by the 
RERC are made available to the public. The technology transfer plan 
must be developed in the first year of the project period in 
consultation with the NIDRR-funded Disability Rehabilitation Research 
Project, Center on Knowledge Translation for Technology Transfer.
    In addition, under each priority, the RERC must--
     Have the capability to design, build, and test prototype 
devices and assist in the transfer of successful solutions to relevant 
production and service delivery settings;
     Evaluate the efficacy and safety of its new products, 
instrumentation, or assistive devices;
     Provide as part of its proposal, and then implement, a 
plan that describes how it will include, as appropriate, individuals 
with disabilities or their representatives in all phases of its 
activities, including research, development, training, dissemination, 
and evaluation;
     Provide as part of its proposal, and then implement, in 
consultation with the NIDRR-funded National Center for the 
Dissemination of Disability Research (NCDDR), a plan to disseminate its 
research results to individuals with disabilities, their 
representatives, disability organizations, service providers, 
professional journals, manufacturers, and other interested parties;
     Conduct a state-of-the-science conference on its 
designated priority research area in the fourth year of the project 
period, and publish a comprehensive report on the final outcomes of the 
conference in the fifth year of the project period; and
     Coordinate research projects of mutual interest with 
relevant NIDRR-funded projects, as identified through consultation with 
the NIDRR project officer.

Executive Order 12866

    This notice of proposed priorities has been reviewed in accordance 
with Executive Order 12866. Under the terms of the order, we have 
assessed the potential costs and benefits of this regulatory action.
    The potential costs associated with this notice of proposed 
priorities are those resulting from statutory requirements and those we 
have determined as necessary for administering this program effectively 
and efficiently.
    In assessing the potential costs and benefits--both quantitative 
and qualitative--of this notice of proposed priorities, we have 
determined that the benefits of the proposed priorities justify the 
costs.

Summary of Potential Costs and Benefits

    The benefits of the Disability and Rehabilitation Research Projects 
and Centers Programs have been well established over the years in that 
similar projects have been completed successfully. These proposed 
priorities

[[Page 50541]]

will generate new knowledge and technologies through research, 
development, dissemination, utilization, and technical assistance 
projects.
    Another benefit of these proposed priorities is that the 
establishment of new DRRPs, new RRTCs, and new RERCs will support the 
President's NFI and will improve the lives of individuals with 
disabilities. The new DRRPs, RRTCs, and RERCs will generate, 
disseminate, and promote the use of new information that will improve 
the options for individuals with disabilities to perform regular 
activities in the community.

Intergovernmental Review

    This program is not subject to Executive Order 12372 and the 
regulations in 34 part 79.
    Applicable Program Regulations: 34 CFR part 350.
Electronic Access to This Document
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free at this site. If you have questions about using PDF, call the U.S. 
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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.gpoaccess.gov/nara/index.html.


(Catalog of Federal Domestic Assistance Numbers 84.133A Disability 
Rehabilitation Research Projects, 84.133B Rehabilitation Research 
and Training Centers and 84.133E Rehabilitation Engineering Research 
Centers Program)

    Program Authority:  29 U.S.C. 762(g), 764(a), 764(b)(2), and 
764(b)(3).

    Dated: August 27, 2007.
William W. Knudsen,
Acting Deputy Assistant Secretary for Special Education and 
Rehabilitative Services.
[FR Doc. E7-17199 Filed 8-30-07; 8:45 am]
BILLING CODE 4000-01-P