COMMUNITY INTEGRATION POLICY
AND PRACTICE ABSTRACTS
FIFTH EDITION

Over the period of three years, 13 children who disclosed sexual abuse through facilitated communication were seen at a tertiary care hospital outpatient child sexual abuse program. Previously determined developmental diagnoses included mental retardation, speech delay, and autism. Physical examinations found that four of the children had evidence of sexual abuse, two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed. Although the results neither support nor refute validation of facilitated communication, they suggest that each child's case should be evaluated without bias.

Over a 5-year period, of the 461 cases of sexual abuse of adults with mental retardation, 37% were confirmed by the Abuse Investigation Division of the Connecticut Office of Protection and Advocacy for Persons with Disabilities. As expected, most of the victims were women (72%); their average age at the time of the incident was 30 years. Victims, for the most part, had no problems communicating verbally and had few, if any, secondary disabilities. As is the case in the general population, the majority of the perpetrators were men (88%) and included other adults with mental retardation, paid staff, family members, and others. Most sexual abuse occurred in the victim's residence, and in 92% of the cases the victim knew his or her abuser. Results were discussed and several concerns raised.

Although there has been acknowledgement and some media attention to the sexual abuse of people with developmental disabilities, this paper focuses on the subtle abuse that occurs daily. Abuse occurs in residential facilities, schools, and sometimes in people's own homes, due in part to the inability of others to listen to an individual's choice. Despite policies that emphasize participation and choice, people with disabilities are often ignored and abused by those with power.

This paper is based upon ideas developed by the authors during their past 6 years work on issues of sexuality and sexual abuse in a wide variety of learning disability settings in Britain. The paper argues that some features of service design in themselves make sexual abuse more likely to occur. It suggests ways of reducing risk, which should work alongside the more usually suggested educative approaches to individuals and groups of vulnerable people.

The new challenges in supporting people with mental retardation in the community, the nature and extent of the problem of sexual abuse in programs serving this population, and the differing judicial approaches taken to assessing their ability to consent to sexual relations were discussed. Potential sources of provider liability for harm caused to program participants were explained, and recommendations to improve practices were offered.

This paper presents a brief account of communication interventions and describes recent developments in the field resulting in shifts in intervention focus, perspectives, and strategies. In examining communication interventions as one example of professional efforts to ameliorate the effects of disability, the author concluded that the real point of such efforts is not so much improved communication as membership in society. The concept of membership was explored, including the ways in which individuals construct stories that make the communication acts of individuals with severe disabilities commonplace and socially valuable. Efforts to foster communication (e.g., change behavior, adjust movement) should shift to ensuring that membership in society is achieved.

Interactive and literacy-based language use of young children within the context of an inclusive preschool classroom was explored. An interpretivist framework and qualitative research methods, including participant observation, were used to examine and analyze language in five preschool classes that were composed of children with and without disabilities. Children's language use included spoken, written, signed, and typed. Results showed complex communicative and literacy language use on the part of young children outside conventional adult perspectives. Also, children who used expressive methods other than speech were often left out of the contexts where spoken language was richest and most complex.

This qualitative case study is a description of a young man with autism who communicated using speech, sign language, facilitated communication, body language, and his mother's conversational supports. Participant observation, interviews, and review of the records were used to explore his current and past communication practices. These practices illustrate his preference for speaking and the complexity of choosing among communication means on an ongoing basis. Although the young man and his mother differed in their thinking about communication, they revealed a common goal: for Michael to participate in ordinary life activities as a member with a voice.

For all their adult years the Ward brothers have been subsistence dairy farmers in a small rural community in central New York. in the spring of 1990 one of them was found dead and his brother, Delbert, was charged with murder and subsequently tried. A psychologist who testified for the defense put Delbert through a range of standard diagnostic procedures and declared he was "mentally retarded." Townfolks reacted to the events with a tremendous outpouring of unified support for Delbert and his brothers. Their reaction was so emphatic and so pronounced it attracted regional and national media attention. Paralleling current interest in the integration of people with various disabilities into the community, this paper discussed this family's natural acceptance in the community and the nature of community support.

This paper describes a study of the experience of disability in a local community. The study unfolded within a carefully constructed and collaborative framework, so that the people in whose interests the study was focused could inform its process, and take opportunities to benefit from it and each other. Outcomes included the establishment of a local support group, a family support project involving the University and the local community, and considerably developed understandings of neighborhood support and the experiences of disability, most specifically from the point of view of carers. Finally, a model of community support service was proposed. In conclusion, the paper highlights the processes of local collaboration and research. It describes research in which the actions taken and proposed to improve local supports were informed by the ongoing processes of research, and in turn the research process itself was informed by the local experiences of participants.

A policy evaluation of Community Support Services, an assistance group created by the Minnesota Department of Human Services to prevent admission of individuals with developmental disabilities to large state facilities, were presented. The model of these out-reach services was described. Program evaluation data was presented. The possible effect of Community Support Services on admissions to large state facilities, characteristics of individuals served compared to those waiting for these services, cost-benefit issues of operating Community Support Services, and community service providers' satisfaction with these services were discussed. Issues related to the establishment and operation of Community Support Services were also presented.

When individuals with a developmental disability experience a behavioral or psychiatric crisis, their community placement may be threatened. A model crisis intervention program for individuals with dual diagnoses was discussed and performance and outcomes of such a service for 267 children and adults reviewed. Analysis indicated that 69% of the individuals required only one crisis intervention. Of the 31% requiring two or more, nearly all were referred earlier than 2 years post initial crisis intervention. The central, gulf-bridging role of a crisis intervention service in a comprehensive, coordinated, community-based mental health system for dually diagnosed individuals was discussed.

This article addresses organizational change at a community agency in Tennessee. The author reviews some principles for guiding the change, advantages of the change, and remaining barriers.

This paper provides a documentation and discussion of the diverse experiences that different disabled people have with regards to access in the built environment. It begins by outlining the various ways in which disabled people's access needs and requirements are articulated in public policies and practices towards the development and regulation of the built environment. As the material indicates, disabled people's needs are poorly articulated and/or represented in the design and development of the built environment while the regulatory controls which oversee disabled people's access are weak. In the second part of the paper, disabled people's values, attitudes and practices towards access in the built environment are discussed by referring to the findings of focus group research. The material shows that many disabled people feel estranged and oppressed by facets of the built environment and generally feel powerless to do anything about it. We conclude by suggesting a number of ways of interconnecting the design and implementation of public policy toward the built environment with the daily lived experiences of disabled people.

The paper reviews research exploring the degree of community integration of people with learning disabilities. In the majority of studies reviewed "integration" is measured in terms of the activities undertaken within the community and/or the character of personal and social relationships. Although in much of the work the focus on these indicators of outcomes is informed by the value assumptions embodied in the principle of normalisation, the paper begins by drawing attention to the potentially contested nature of these assumptions. This is followed by a description and a critique of studies of community integration. The picture which emerges is of the apparently continued gap between being physically within and socially a part of the community. The paper highlights some of the issues this raises for service provision and draws attention to issues of research practice.

Supported living for people with developmental disabilities challenges many common service policies, practices, and assumptions. Until recently, professionals assumed that such people who did not reside with their families needed to live in some kind of service facility. Today, a growing number of people with developmental disabilities have challenged this assumption by living, with personalized support, in their own homes. Meeting this challenges calls for new relationships among people receiving support, those who provide support, and families that are focused on assisting people with developmental disabilities to establish a sense of place, security of place, and effective personalized control over their homes and the assistance they require.

A behavioral support and crisis response demonstration project authorized by the Minnesota Legislature in 1992 was evaluated. We described the demonstration program, its service users, and satisfaction and concerns with the program of service recipients, their families and care providers, and county case managers. We also provided follow-up data on the outcomes of the first year service users and gave the service outcomes projected by case managers had the program not been established. These projected outcomes were validated by follow-up of a comparison group of persons unable to access the program's services. Cost-effectiveness was computed from costs of establishing and operating the demonstration program and the actual average costs of the services that were projected to otherwise have been used.

This research was carried out between January and July 1993. The study was an evaluation of housing needs of disabled people who were wheelchair users through a process of consumer consultation. It was concerned to find out the extent and nature of that need whilst also testing out consultation through the use of research methods in comparison with a non-consultative approach taken by the local authorities. The nature of need was found to be qualitatively different from that found through the study of normative needs. A significant number of disabled people were being made more dependent by their housing and this was being reinforced by the agencies that were intended to help them. In particular, the failure to consult disabled people was leading the local authorities to make inappropriate plans for newly built housing while the major need for adaptations was being undermined by their operation of the Disabled Facilities Grant. The findings support the call from other writers that the solutions to housing problems will only come through viewing disability as a civil rights issue.

Individual Habilitation Plan objectives for adults with mental retardation living in institutional or community settings were evaluated for effectiveness and quality. Effectiveness was assessed by contrasting change in relevant outcomes over time for participants with and without individual plan objectives in specified content areas. No significant change in outcomes associated with having an objective was detected for any of the content areas. Except for functionality, ratings of individual plans on all quality domains were poor. Regression analyses mostly failed to show any significant relationship between quality domain ratings and outcomes, although there was weak but inconsistent evidence for validity of the technical adequacy and data-collection quality domains. Findings present a challenge to current expectations that presence and quality of IHP objectives are associated with improved outcomes.

The transformation of a large, private, non-for-profit, church affiliated provider of residential services from an institutionally based to community-based service system was described. Closure of a 200-person ICF/MR facility was discussed. Factors influencing the decision to close the institution as well as the guidelines used in effecting the transformation were described. Finally, data were presented indicating that consumer and staff satisfaction and judgment of program quality remained high during the period of transformation.

The places where people spend time and the experiences they have in these places are critical to the development of a sense of place and community connections. This study, based on individual experiences, reveals that adults with developmental disabilities commonly spend time in places designated for people with disabilities versus private places, and in places characterized by business transactions versus social interactions. Within the community, the research participants have a variety of experiences. They range from a sense of vulnerability to a sense of safety, a feeling of being socially anonymous or isolated to a feeling of being known, from disaffiliation to identification, from unfamiliarity to familiarity, from a sense of being rejected to a sense of being liked or accepted, and from a sense of unwillingness/willingness to provide accommodations. The article concludes with strategies that service providers and others can use to increase opportunities for positive community experiences and sense of place.

The Supreme Court recently decided that the death penalty as it applies to persons with mental retardation is not a violation of constitutional protection from cruel and unusual punishment as long as juries consider the convicted person's disabilities during trial proceedings. Advocates for persons with mental retardation have argued that because their disability reduces culpability in capital offenses, the death penalty is always inappropriate. In this paper we argued that the latter position makes unwarranted categorical assumptions about mental retardation, fails to consider the individualized and situation-specific determinants of culpability for a capital offense, and undermines the very assumptions required to restore respect and value for citizens with mental retardation as participants in society.

Johnny Lee Wilson is currently in jail for a murder that somebody else admitted to. Although there was no physical evidence linking him to the scene of the crime, law officials saw him as an irrational person who 'confessed' to the murder after an investigative interrogation. Perske states that the police took advantage of Wilson's disability in order to solve the case.

Perske gives examples of three people with mental retardation who confessed to murder following police interrogation. He lists twenty characteristics that people with mental retardation tend to display at times of such distress, in answer to the question of why these men confessed so easily. He concludes that police should be trained to be aware of these issues, and that teachers and advocates could help do this. In addition, people with mental retardation should be taught how to react to questions from the policy.

The authors reflect on articles published in American Journal of Mental Retardation that address the protection of people with mental retardation from capital punishment. They state that the articles were not able to provide a viable argument of categorical assumptions based on intellectual rationale. However, they did raise important moral and practical objections that included the pessimistic views of the legal system and the dubious system of classification which may exclude people with a known margin of error. They conclude that people with mental retardation can be protected from capital punishment when it is not an option for anyone, and/or that we need to increase services and expertise in our justice system.

Celeste argues that just as persons with mental retardation are not entitled to every job, that individual is not entitled to every criminal penalty. They need protection from the law due to their vulnerability. It is not realistic to assume that every person with mental retardation will be able to secure a highly sophisticated case-by-case defense that they would need. People with mental retardation should always be exempt from the death penalty.

Although the author finds capital punishment morally reprehensible, it is stated that a categorical exemption is wrong. Whereas it is understood that people with mental retardation are more often victimized, and that this often occurs within the criminal justice system, each case should be taken separately as to the particular circumstances.

Although Field agrees with Calnen and Blackman's argument of the counterproductivity of categorically excusing people with mental retardation from the execution, it is stated that they should not be subject to the death penalty. This is due to the point that we cannot be certain enough of the justice of the verdict.

Schalock argues that although he agrees with Calnen and Blackman intellectually and ideally, people with mental retardation need to be protected from the death penalty due to their history of vulnerability in the criminal justice system, the harsh treatment often received, and a tendency not to exercise their legal rights. Professionals in the field of mental retardation should be available to assist the justice system.

The author of this article reviews the history of the discussion of disability culture and its current status from the perspective of his personal experiences. He includes overviews of the development and progress of the disability culture movement, as well as evidence, through song lyrics and poetry, of its continued existence.

This article, based on a paper presented to the Association for Education in Journalism and Mass Communication, begins by discussing evidence for the emergence of a disability culture. John presents his study, which examined the content of three issues of three magazines that target audiences interested in disability issues. Using a categorization model adopted by Westfall (1994), John explored the topics of articles contained in the magazines for areas of most and least priority. John uses this information as further evidence of a distinct disability culture, although he notes that a larger sample of publications would yield stronger evidence.

This essay responds to a chapter on disability in the book, Reflections on multiculturalism (Robert Eddy, ed.). The chapter author, James Helten, a former wheelchair athlete and current assistant professor of English, discusses his perceptions of a lack of disability culture-related research and publications. Pfeiffer uses this essay to point out many sources for disability related research, culture, and interest groups. He takes issue with Helten's portrayal of disability as an individual problem to be overcome rather than as a minority group experiencing structural oppression. Pfeiffer includes a reference list at the end of his article.

During the elementary and middle school years, the needs of the child with disabilities center on acquiring appropriate academic, social, community access, and self-management skills. Family members must work together with a wide array of educational and related services personnel on behalf of their child with a disability and, at the same time, care for the needs of all members of the family. This article describes models and methods of advocacy, including self-advocacy, social support advocacy, interpersonal advocacy, and legal advocacy. Particular emphasis is placed on advocacy strategies for individual family members of the child with disabilities during the elementary school years.

The authors on a study of student attitudes towards disabled students in three colleges of further education. They found that many non-disabled students were not aware of the various issues facing disabled students at the colleges. Social contact between disabled and non-disabled students was not extensive, although those who had attended school with disabled pupils were more likely to have friendships with disabled students at college. Whilst non-disabled students were strongly supportive of inclusive education in principle, many saw inclusion in the mainstream as conditional on the particular impairment of an individual. Disabled and non-disabled students supported the view that early social and educational contact results in greater mutual understanding, and is of benefits to all students.

Difficulties in translating innovations that have been validated by researchers into practices that will be used by practitioners are widely acknowledged. Nevertheless, research on systems change is sparse and teachers are seldom asked for their perspectives on the implementation of innovations. Special education teachers (n=83) from five states in regions known for their knowledge and skills, the actual presence of quality indicators in their programs, and difficulties they experience in implementing various most promising practices. The results indicate that the self-reported ratings of the presence of the indicators is correlated with both teacher skill and degree of implementation difficulty. Analyses of teachers' comments to an open-ended question reveal common concerns regarding time constraints and administrative support as major obstacles to implementation. The results are discussed in the context of the nature of education as an applied science, the need for a research-to-practice literature on the implementation process for practitioners, and the need to acknowledge explicitly the support variables present in research on educational innovations that may be essential to implementation in practice.

Disabled people wishing to enter higher education are confronted with a number of barriers, yet relatively little research has been carried out to identify the level and nature of such obstacles. The short study reported here was designed to examine policy and practice within a number of social work training institutions in Scotland. Interviews were held with disabled students and ex-students, course tutors and practice teachers. Barriers to training are identified in five main areas: first, the disabling physical environment; secondly, problems of typification (whereby global assumptions of impairment are made about individuals); thirdly, failure of equal opportunities policies; fourthly, the practice of treating all students in the same way, resulting in discrimination against a few; and, finally, self-censorship on the part of students. It is argued that the reluctance of some students to `declare' an impairment is a rational response to the disabling policies pursued, albeit inadvertently, by institutions. The implications of these findings for policy and practice are discussed.

This study assessed factors that contributed to global program quality in early childhood settings. The sample consisted of 180 community-based child care centers from 12 geographically and economically diverse regions in North Carolina. The Early Childhood Environment Rating Scale (ECERS) total mean score was used as the primary measure of global program quality. The study found that 62 (34%) of the early childhood programs reported enrolling at least one child with disabilities. The study also found that inclusive early childhood programs scored significantly higher on the ECERS overall than did noninclusive programs. Results of an Analysis of Covariance (ANCOVA) indicated three other predictors of global program quality: teacher education, professional experience, and teacher self-ratings of knowledge and skill.

The promotion of friendship development for children with disabilities is now considered a primary educational goal. Peer-mediated interventions have been used successfully to increase social interaction between children with and without disabilities, although implementation has usually been restricted to play time. We investigated the effects of alternative strategies that included pairing four children with disabilities with several trained peers ("buddies") during a variety of activities across the school day and teaching interaction skills to both children with and without disabilities. Interactions between children with and without disabilities increased significantly after peer training; supplemental dyadic training resulted in minimal increases in responsiveness on the part of children with disabilities. This intervention appears to be a useful approach for promoting peer interactions, a prerequisite for the development of friendships in integrated preschools.

The least restrictive environment (LRE) provisions of the Individuals with Disabilities Education Act (IDEA) require that children with disabilities be educated in regular education classrooms unless "the nature and severity of the disability is such that education in the regular classes with the use of supplementary aids and services cannot be achieved satisfactorily." Prior court decisions and the 1997 Amendments to IDEA require that individualized education program (IEP) teams discuss and consider a full range of supplemental aids and services so children benefit from educational programs in the LRE. This article reviews the legal basis for the mandatory consideration of supplementary aids and services and presents a four-step approach for teams to use in determining supplementary aids and services for children with disabilities.

This study examined the effects of contact, books, and discussions on the attitudes of kindergarten-age children toward people with disabilities. Children in the high-contact groups participated in a program designed to promote acceptance of people with disabilities; the low-contact group had incidental contact with children with disabilities; the no-contact group had neither direct nor indirect contact with children with disabilities. At pretest, all participants had low levels of acceptance of people with disabilities. At posttest, significant gains in levels of acceptance were found only in the high-contact group. The program appears to be an effective strategy for promoting acceptance of people with disabilities.

This research addressed two questions about instruction to enhance the social competence of students with disabilities: (a) How adequate were individualized education program (IEP) statements of present level of functioning and goals related to peer interaction? and (b) How appropriate to pupil peer interaction needs and how extensive was instruction? Data sources included IEPs; observations of pupils and teachers in content area, special area, and special education settings; and interviews. Analysis indicated that the IEP accurately characterized peer interactions, but that instructional practices to foster peer interaction were not appropriate, and were provided only to a limited extent. General education settings were somewhat more likely than special education settings to foster peer interactions, providing supports for claims that inclusion fosters social integration.

Two mail surveys, one with a follow-up, were conducted to determine if consensus existed among general and special education teachers on (a) the conditions and supports that are critical to including children with substantial disabilities in general education classrooms and (b) problems faced in implementing inclusive education. The data were collected in three stages. The first stage was a questionnaire sent to teachers in Pennsylvania who had experience including children with moderate to severe disabilities in general education classrooms. Through two open ended questions, they were asked to identify critical supports for inclusion and major problems they faced when including children with disabilities. For the second stage, the same respondents were asked to rate the importance of the categories of supports and to rate the significance of the problems they faced. The results indicated that training, support from a team of professionals, and having help in the classroom were mentioned by a large portion of the respondents. The third stage involved a national sample of elementary, general education teachers responding to the open ended questions. The respondents in the national sample (teachers who may or may not have bene involved in a supported program of inclusion) identified the same three supports more often than other supports.

The perceptions of fourteen teachers from fourteen different public schools about their changing roles and responsibilities as they moved into inclusive settings with students with severe disabilities were explored in this qualitative study. It discusses their experiences of cultural dissonance as they left the segregated culture of special education and attempted to assimilate themselves into general education classrooms, grades K-8. Their dilemmas, doubts, and hopes for the future are discussed as well as the challenges that attempted cultural assimilation presents for special educators.

This investigation analyzed the effectiveness of an intervention designed to facilitate the social inclusion of three students who experienced significant physical and intellectual challenges and, for two students, dual sensory impairments. The children were full-time members of two first-grade and one fourth-grade classrooms. The individualized intervention package included three major components: (a) provision of ongoing information to classmates about the communication system, adaptive equipment, and educational activities of the students with disabilities in the context of naturally occurring interactions between the students and their classmates or during "club" meetings; (b) identification and utilization of various media that could serve as the basis for interactive exchanges between the focus students and others; and (c) ongoing facilitation by educational staff of social exchanges between students and their classmates through the establishment of a "buddy" system, arrangement of interactive activities across the day, and prompting and interpreting communicative exchanges when necessary. All aspects of intervention were implemented by educational staff including general education and inclusion support teachers, paraprofessionals, and related service personnel. An analysis of the interactive patterns between the focus students and others indicated that when the intervention was fully implemented, there were increases in (a) reciprocal interactions with peers, (b) focus student-initiated interactions, and (c) focus student-initiated interactions that were comments (with no increase in requests or protests). In addition, there were decreases in assistive interactions with paraprofessionals. The social validation of changes in interactive patterns between the focus students and their classmates was established through interviews with the student' friends and their teachers.

This study investigated the way teachers in five elementary classrooms used peer interactions to facilitate the inclusion of a student with moderate or severe disabilities. Four themes describing the strategies used to encourage and shape interactions between students with and without disabilities were identified: new rules about helping, "just another student," age appropriateness, and "backing off." The discussion focuses on the complexity of facilitating peer helping roles without encroaching on the social reciprocity found in friendships. The development of inclusion practices based on cooperation and mutual assistance for all students, rather than only for students with identified disabilities, is recommended.

This commentary responds to a previous article questioning school inclusion published in Mental Retardation. The author discusses the meaning of inclusion, describes the impact of inclusion programs, and questions negative portrayals of parents by professionals.

These two articles are a point-counterpoint exchange on school inclusion of students with severe disabilities. Sandler takes issue with a previous commentary published by Kliewer in Mental Retardation, suggesting that Kliewer overstated the benefits of inclusion. Sandler argues that there is little empirical evidence supporting inclusion in areas other than socialization. Kliewer responds to Sandler by arguing that both sides in the inclusion debate can cite evidence in their favor. However, according to Kliewer, inclusion versus segregation is fundamentally a moral issue. Further, Kliewer argues that it is meaningless to clinically dissect a human being in functional, intellectual, and social domains.

This paper explores the experiences of nine students with disabilities pursuing degrees at a large Canadian university. An ethnographic approach was followed using face-to-face, unstructured interviews and a focus group to generate data. The analysis focuses on how these students negotiate disabled and non-disabled identities while negotiating the physical environment of the university campus. Low argues that these negotiatory processes are necessarily interconnected and inherently contradictory.

The social preferences of children who are typically developing towards peers with special needs in inclusive preschool classrooms were examined. Children with special needs received few positive playmate preference nominations, but not a significant number of negative nominations. Children were disliked if they were aggressive, irrespective of disability status. Interventions need to be focused on improving the social skills of children with special needs and teaching preschool age children who are typically developing to understand the behaviors of classmates with special needs.

While there has been a recent trend toward inclusive educational placements for students with significant cognitive disabilities, little information exists regarding parent perceptions of such practices. This article reviews the construction and analysis of a scale designed to encourage research in this area. An examination of three dimensions of perceptions assessed by the scale found that parents were more positive regarding the impact of inclusion on mutual social benefits, acceptance, and treatment of their child and more apprehensive regarding the impact of inclusion on the quality of educational services their child receives. Discussion includes how these findings may offer insight into reasoning used by some parents when considering the benefits of more inclusive educational placements for their own children.

The perceptions of 21 nonhandicapped high school students were investigated in regard to the benefits they had experienced as a result of developing relationships with peers who had moderate or severe disabilities. Semi-structured interviews with the nonhandicapped students indicated their experiences resulted in six types of benefits: (a) improvements in self-concept, (b) growth in social cognition, (c) increased tolerance of other people, (d) reduced fear of human differences, (e) development of personal principles, and (f) interpersonal acceptance and friendship. Students also identified areas of difficulty they had experienced in their relationships with peers having disabilities. Results are discussed in terms of implications for policy analysis and research on social integration.

Part-time integration of students with moderate and severe disabilities into regular classes has become a common feature of special education programs. How regular education students think about their school experience, including part-time mainstreaming, can be a source of information for integration efforts, but these perceptions have received little attention in the special education literature. Participant observation and indepth interviews were employed over a 7-month period to study a first grade class in which a student described as "moderately mentally retarded" participated on a part-time basis. This student spent most of his school day in a self-contained special education class. The findings reveal that these first graders had a common framework for defining their school experience. Their descriptions centered around themes of "where you belong," "what you do," and "with whom you play." Data collected about Peter, the part-time mainstream student, are interpreted according to this student framework. Findings indicate significant discrepancies between the student's definition of what it means to be part of first grade and the focus of the teacher's efforts to include Peter and present him as a member of the class.

Responding to a previous article published in the journal, the author provides a parent's perspective on inclusion. The author discusses the importance of helping students with developmental disabilities to make social gains in school and advocates for increased diversity in all school programs.

The effectiveness of a multi-element approach derived from factors to increase self-determination of middle- and high-school-age students with physical and multiple disabilities was examined. The approach includes equipment and performance adaptations, brief in-school simulation training, and instruction and support for parents and home assistance providers. The intervention was instituted with three students; a multiple baseline design was used. Student participation and independence dramatically increased after the intervention. Results suggests that this approach may be one solution to providing students with both inclusive education and community skill and activity instruction. The impact of the intervention on student self-determination was discussed.

Qualitative research methods were used to conduct a study of an inclusion program at a junior high school in which typically developing students assisted and supported students with moderate and severe disabilities as they attended general education classrooms. There were two purposes for conducting this case study: first, to provide a description of how one school, with limited resources available, successfully included students with disabilities in general education classrooms; and second, to describe outcomes perceived to be associated with the student aide program for the students with disabilities and the student aides. Data were gathered over 2 years and included ethnographic field notes and interviews. The perceived outcomes that emerged from an analysis of these data are discussed in terms of their implications for future practice and research.

The perspectives and experiences of 20 paraeducators working with inclusion students with disabilities who also present significant behavioral challenges were investigated in this research. The inclusion students were in Grades K through 8 and represented a range of disability categories (e.g., autism spectrum disorder, serious emotional disturbance [SED], learning disability, attention deficit/hyperactivity disorder [AD/HD]). Findings from this study indicate that paraeducators tend to assume high levels of responsibility for managing the academic and behavioral needs for special education students in inclusive settings. This tendency appears to be due to the nature of the job, which can create conflicting roles in meeting both the needs of inclusion students as well as those of general education teachers.

The McGill Action Planning System (MAPS) is a planning process that places primary emphasis on the integral involvement of learners with disabilities in the school community (i.e., regular classes and other typical school environments and activities). The seven key questions that comprise the MAPS process provide a structure that assists teams of adults and children to creatively dream, scheme, plan, and produce results that will further the inclusion of individual children with labels into the activities, routines, and environments of their same-age peers in their school community. This article provides a detailed description of the MAPS process, including the structure used, content covered, and the underlying assumptions of the process. An example of MAPS planning for an elementary age child with severe disabilities is provided, along with suggested modifications that have been used for secondary age students. The final discussion addresses practical considerations for using MAPS, including how it complements an ecological approach to curriculum development and areas requiring further development and evaluation.

The purpose of this qualitative research study was to explore the characteristics of classroom membership as perceived by middle school students themselves and for their classmates with severe disabilities. A total of 51 middle school students of whom 4 students had severe disabilities participated in the main study. Multiple focus group interviews and individual interviews were conducted to obtain an in-depth understanding of the phenomenon of membership and belonging. Following qualitative data analysis procedures, findings indicated that middle school students thought that having friends in class, peer interactions, actively participating in class activities, and obtaining good grades indicated membership. Students attributed teachers with helping them feel like members of the class. Students also associated certain class activities with classroom membership; they felt part of the class when class work was fun, active, interesting, and meaningful. Students perceived similar indicators of membership for their classmates with severe disabilities. In conclusion, findings provided implications for teachers to facilitate membership and a sense of belonging for middle school students with and without disabilities in their inclusive classrooms.

Appropriate education guaranteed to children with disabilities under P.L. 94-142 has been translated by the courts to mean more than 180 days of education. There is now a strong legal precedent establishing the right to an extended school year (summer school) for students with severe disabilities. The courts have left open to interpretation, however, issues related to the program implementation. Descriptions of extended school year programs vary widely and include respite for parents, continuations of the regular school year curriculum, and remediation in skill areas. The only consensus seems to be that these programs should be tailored to individual needs. In the present article a systematic approach to curriculum development for students with severe disabilities enrolled in extended school year programs was described. This approach is (a) community driven, (b) consistent with each student's IEP objectives for the regular school year, (c) tailored to the individual student, and (d) consistent with current best practices of teaching functional skills performed by individuals without disabilities in a variety of integrated nonschool settings. Student progress data were presented.

Parents and professionals have increasingly rejected aversive intervention strategies that rely on their punishing effect to decrease occurrences of challenging behavior. As a result, positive behavioral intervention strategies have emerged as a viable alternative. Students with disabilities, however, continue to be at risk for exposure to aversive interventions. This article identifies legal boundaries and protections for students through a review of the case law on aversive interventions in five categories: electric shock, noxious substances, corporal punishment, restraints, and timeout. Despite the emergence of positive interventions, qualified support for the use of aversive interventions continues to exist. The article discusses IDEA amendment language supporting positive behavioral interventions and makes recommendations for continued advocacy on behalf of students with disabilities.

Educational reform has had a significant impact on the structure of public education over the last decade. However, the needs of children with severe disabilities have essentially been ignored in this process. This paper explores the relationship between third-wave educational reforms and the development of public educational programs for students with severe disabilities. This examination highlights the striking similarities in focus and approach between these two initiatives. Issues which are preventing the inclusion of children with severe disabilities in reform efforts are identified and discussed.

Neither P.L. 94-142 nor its amendments, the Individuals With Disabilities Education Act (IDEA) of 1990, refers to the terms "inclusion" or "mainstreaming," addressing only the issue of placement in the "least restrictive environment" (LRE) for students with disabilities. Beginning in 1989, the federal courts began to address the issue of the inclusion of students with disabilities into the regular education classroom as a method for meeting the least restrictive environment mandate of federal legislation. As a result, functional definitions of LRE and its impact on the issue of inclusion have emerged in case law decisions during the decade. These decisions have provided educators and administrators with guidelines concerning appropriate placements, use of records from other school districts for program and placement decisions, and types of required documentation. As litigation concerning inclusion increases, it is imperative that educators be aware of and understand the implications of these legal decisions. The authors review federal and circuit court cases related to the issue of inclusion and interpret the impact these decisions are having on the special education process as well as the effect this controversy and subsequent legal decisions are having on the educators who are involved.

Developments in recent years have shown an increasing interest in the educational needs and aspirations of disabled adults. There is still, however, limited research information representing the disabled person's voice. This paper describes the outcomes from a survey of the educational experiences of 44 physically disabled adults in the North West of England. The findings indicated that, usually, the earlier someone had acquired a disability, the less likely they were, as adults, to have achieved professional or higher qualifications, and that the level of qualifications reached among women being surveyed was particularly low. Barriers to course attendance reflect both attitudinal and practical access issues, with underachievement often the result of oppression from a variety of sources. Both positive and negative experiences from disabled adults form the basis of recommendations for an equal opportunities approach to adult education for disabled people around the themes of integration, self-worth, empowerment and consultation.

Although adults with severe mental retardation were one of the primary target groups intended to benefit from supported employment when it first emerged, the vast majority continue to be served in segregated sheltered work or non-work settings. To change this picture, many have believed that resources currently invested in day activity and sheltered employment programs must be redirected to supported employment. Recent studies suggest, however, that most rehabilitation organizations are adding supported employment to their existing array of services, rather than pursuing total changeover from facility-based to community-based employment support. If these data reflect the national experience, the anticipated and necessary shift of resources from segregated to community employment services is not occurring. To supplement existing data, a telephone survey was conducted of eight rehabilitation organizations pursuing changeover. This paper provides information on the experience of these eight organizations related to their reinvestment and agency changeover to supported employment, and offers recommendations for the future.

Although there is a growing consensus that including natural supports in the employment process in an important goal, there is considerable debate about the definition and appropriate role of these supports. This manuscript clarifies and extends current definitions of natural supports and proposes a working model to guide future research and practice. Primary emphasis is placed on natural supports as a desired outcome of successful employment rather than a distinct model for support and as a contributing factor to higher level outcomes such as quality of life. From both a researcher's and a practitioner's perspective there is a need to shift emphasis from competing models of employment support to developing a better understanding of the relationship between specific job coach interventions and the desired outcome of effective natural supports.

The relations between cost-efficiency (from the perspective of worker, taxpayer, and society) and personal characteristics of supported employees (i.e., IQ, level of mental retardation, multiple disabilities, gender, ethnicity, and age) were examined. Results suggest that when sheltered workshops were used as alternative placements, supported employees with high IQs benefited more from employment within the community than did supported employees with lower IQs. From society's perspective, African American and male supported employees were more cost-efficient than were European American and female supported employees. Further, regardless of the severity or number of disabilities, all individuals were cost-efficient from each perspective (i.e., worker, taxpayer, and society) and time period (i.e., 1990, 1994, and projected lifelong).

People with learning difficulties who had access to day services were invited to talk about their work placement or employment. Focus groups were used to gather information on type of work placement opportunities and the participants' experiences. The majority liked their job as it offered purposeful activity and opportunities to meet people. Many individuals wished to increase the number of hours worked, but several were relatively dissatisfied with their wages and negative interactions with workmates. The study identified that in spite of high motivation to work many individuals were unclear about their future occupational prospects. They did not have many opportunities to systematically explore and discuss their work related interests, range of placement options and how they could be accessed. Participants had not been involved in the search for their current placements. These omissions could result in increased reliance on day centers even for skilled individuals who might otherwise be employed in community settings.

This article reports the findings of a qualitative research study utilizing focus groups which obtained the perspectives of people with significant disabilities and family members about their overall employment experiences, concerns, and expectations. Focus group participants responding to questions about job outcomes and satisfaction, work relationships, support at work, job obstacles, and job expectations. Theis paper summarizes the key themes which emerged in response to the focus group questions and highlights the similarities and differences among consumer and family perspectives on these issues. The implications of these findings for professionals working with individuals with disabilities and their families are summarized.

The purpose of this article is to examine some aspects of the traditional job coach model of supported employment that ignore or impede the formation of social relationships between supported employees and their co-workers and supervisors. Alternative strategies are offered, using a support consultant approach, in order to maximize the social inclusion of supported employees and the development of natural support systems. The strategies discussed include (a) using typical strategies to secure jobs, (b) building opportunities for interaction into the design of supported jobs, (c) adopting a consultant role with business, (d) working with established procedures for employee training, (e) learning the informal culture of workplaces, and (f) assisting in the identification of common interests among workers. Specific examples of each strategy are offered.

As a paradigm for human services, the concept of empowerment is coming of age. This article examines the history and philosophy of vocational rehabilitation (VR) in the public sector as a way of understanding VR's capacity to implement empowering services for people with disabilities.

This article explores the nature of disability employment policy drawing on evidence from fifteen countries. In line with earlier sociological approaches to disability it describes two ways of framing policy in the area. These two paradigms are developed and used to critically evaluate employment policy under the headings: legislative measures, open employment-financial measures, employment support services and sheltered/supported provision. The dilemmas that may arise during implementation of policy are discussed and the consequence for the construction of an emancipatory employment policy. Finally, the article suggests some themes or dimensions that a coherent disability policy should have.

A review of the status of the national supported employment initiative shows that thousands of individuals are benefiting from the initiative and that supported employment is offered by community programs in every state in the nation. Yet despite these successes, access to supported employment is severely limited, the quality of the outcomes is challenged, and the investment in change appears to be dwindling. If supported employment for persons with severe disabilities is to expand and improve to meet the growing demand, then communities and government alike must analyze both the successes and the problems of the supported employment initiative and create a new path to change. The purpose of this paper is to review the status of the supported employment initiative, explore the perception of its underachievement, and provide recommendations for recapturing the momentum of the initiative.

Increasingly, supported employment is discussed in tandem with the notion of natural supports. Natural supports, emphasizing the use of existing supports typically found in the workplace, has become a commonly used strategy for improving economic and integration outcomes valued by people with disabilities, their families, and their advocates. This study is the second in a series of focused on features of employment as they relate to economic and integration outcomes. As analysis of data collected from 462 people in 8 states was provided. Results suggest that understanding and incorporating "typical" employment features in workplaces is associated with better wage and integration outcomes. Data were discussed in relation to potential implications for job development and workplace analyses.

Supported employment began with a focus on those individuals deemed less likely to secure a job in the community: those with severe mental retardation, behavioral challenges, and multiple disabilities. The creation of supported employment resulted, in part, because of demonstrations of the competence and capabilities of these same people previously thought to be unemployable in any meaningful sense of the word. However, as supported employment has unfolded, those with the most severe disabilities appear to be underrepresented in the ranks of those benefiting from supported employment. Although the limited access to supported employment by individuals with such labels appears clear, little is known about how the employment of those with more severe disabilities compares with others in supported employment. This report provides analyses of the employment features, support patterns, and outcomes for persons with more severe disabilities in supported employment.

Monetary costs and benefits of supported employment to individuals, taxpayers, and society were assessed as was the cost-effectiveness of the nonmonetary benefit, namely, quality of life of employees, as a result of supported employment. Participants were 20 individuals from two Central Illinois agencies serving clients with developmental disabilities. Costs and effects were evaluated using benefit-cost-effectiveness analyses. Supported employment was found to be cost-beneficial from the perspectives of the supported employee, the taxpayer, and society over a 5-year period as programs move from sheltered employment. In addition, supported employment was also more cost-effective with regard to quality of life than was sheltered employment.

This paper presents an analysis of 7,189 complaints of disability-based discrimination in employment filed with New York State and open between 1984-1994. The characteristics of the complainants, the employers, the complaints, and the resolutions are presented. The data show that the majority of disability discrimination complainants were not persons seeking jobs, but those who had jobs or were terminated from jobs. Approximately 40% of cases closed with a positive outcome for the complainant, with no discernible differences by type of disability. The New York State data are of interest not only because they indicate how a state civil rights law for disability operated before the American with Disabilities Act (ADA), but because they can suggest what the experience and the challenges may be in the enforcement of the ADA over time.

We evaluated a pre-work assessment for predicting task preferences during supported work with an individual who has profound mental retardation as well as deafness and blindness. The assessment method included specific components for familiarizing an individual with visual and auditory impairment with available work tasks. The individual's task selections were compared for three work tasks drawn from his future job duties. Results of the worker's choices, once he began his supported job in a publishing company, indicated the pre-work assessment predicted tasks that the worker preferred to perform during his routine job. Results are discussed regarding the benefits of determining work preferences prior to beginning supported work. Areas for future research are also noted, focusing on developing additional procedures for matching individuals with deaf-blindness with preferred work activities.

Ongoing employment supports are critical for persons in supported employment. This study obtained detailed information regarding types of ongoing employment supports available in programs and ongoing supports used with specific individuals. Results of the study indicated that ongoing support is an important issue that is not being adequately addressed. On the one hand, funding for extended job coach services and availability of case management services that focus on employment are limited. On the other hand, ongoing employment supports tend to focus on services provided primarily by human service personnel. Human service personnel in the study do not focus on linking employees with co-workers, employers, family, and community members who might provide assistance. The degree to which human service personnel provided supports to such natural supports was also limited. This study illustrates the present state-of-art and the need to redefine the roles and relationships of human service personnel, persons with disabilities, and naturally supportive relationships.

Supported employment, by definition, assumes the need for ongoing support. Despite this, assumptions inherent within regulations and policies of federal and state rehabilitation systems appear to be at variance with this definition: Job placement is viewed as final and support is temporary. Consequently, retraining and replacement services following the termination of a job are an afterthought, job change is equated with failure, and retraining is a reaction to this failure. In contrast, models of career development for the general population assume that changing jobs is an integral part of career development. In this paper we have applied this more normative view of career development to the rehabilitation system and the provision of supported employment.

The national proliferation of supported employment services for people with severe disabilities has governmental funders and regulators scrambling for standards upon which to judge the adequacy of these new services. The task is complicated by the variability in both employer needs and service requirements for supported employees as well as the community resources available to meet these needs. Conventional monitoring provides some safeguards against major abuses to persons receiving services, but does little to satisfy consumer, advocate, or policymaker interest in promoting quality assurance in service provision.

This article presents four case examples that illustrate various strategies used by agency personnel to promote job supports for employees with disabilities while minimizing the intrusion of supported employment personnel. Specific strategies include: (a) using personal connections to enhance social support, (b) matching individual preferences and attributes to work-site social climates, (c) collaborating with work-site personnel to develop adaptations and modifications, (d) facilitating and supporting the involvement of work-site personnel, and (e) providing general consultations focused on person-environment factors that promote both the success of the supported employee and the overall business. Each of these strategies is discussed within a natural support framework in relation to reexamining job coach roles. The implications of the four case examples are discussed and areas for further research are suggested.

Supported employment was conceptualized and developed according to several primary tenets and value-based assumptions. This article examines the current status of implementation in reference to these underlying premises: integrated work, long-term support, services to people with severe disabilities, and unconditional inclusion. Arguments supporting the need for sweeping changes in the federal-state vocational rehabilitation system to accommodate supported employment as it was originally intended are presented along with recommendations for such changes.

Career development of Hispanics with disabilities was the focal problem of the current study. Participants were seven Hispanic women and three Hispanic men. Twenty interviews were conducted and recorded. Additional data were collected through in-depth questionnaires including both demographic information and open ended questions. A grounded theory qualitative methodology was used to identify, categorize, and connect themes. Triangulation, field notes, memos, member checks, and peer debriefing were used to address issues of reliability. Two overriding themes emerged. The first, career motivation, was defined by experiences relating to developmental work motivation, the meaning of work, and the hierarchy of work needs. The second, vocational behavior, related to personal attributes, disability and work, and barriers and supports.

The authors identify expected trends in the type of employment that will be in demand during the next six years. They cite statistics for employment and unemployment for various categories of working-age people with disabilities, and identify basic skills that workers will need to be competitive in the future, including strong reading, writing, and computational skills. The authors also identify critical worker attributes such as task performance, teamwork, supervision, and socializing as important to job maintenance and advancement.

The Rehabilitation Act Amendments of 1992 mandate that state and federal public vocational rehabilitation extend efforts to further include "traditionally underserved" populations. Section 21 of the Rehabilitation Act Amendments specifies the Asian Pacific American population as an "underserved" group, and other data indicate that they are the fastest growing minority population in the United States. Yet, current data related to rehabilitation and disability at the national level are unavailable for Asian Pacific Americans. This article uses data taken from the Hawaii vocational rehabilitation program to illustrate the need for Asian Pacific American data to be reported, not only in aggregate form, but also for each ethnic group within the aggregate. It proposes a policy change for the way data are gathered and collected for the Asian Pacific American population.

What women with learning disabilities think and feel about their bodies should be of interest to those concerned with women's rights and disability rights. Yet scant attention appears to have paid to these issues. It has been suggested in the past that one of the "blessings" of having a learning disability is that one is free from many of the pressures society places on individuals to conform. However, the research presented here suggests that far from being immune to these pressures to conform, women with learning disabilities are, indeed, subject to strong influences, and overt and covert control mechanisms shape their bodies and minds towards achieving certain norms of femininity.

Pre-natal screening is a highly contentious ethical and political issue. The paper discusses aspects of the debate, and focuses on the context in which reproductive decisions are taken and the lack of a disabled voice is genetic policy. Eugenic aspects of the practice of genetics, particularly surrounding the role of professionals and the notion of consent, are explored. The paper concludes with recommendations on a disability equality approach to genetics and obstetrics.

The authors examined whether facilitated communication users, under controlled conditions, could transmit rudimentary information to a naive facilitator. Forty-three students across 10 classrooms were shown a single randomly selected word with their facilitator out of the room. The facilitator then entered the room and asked the student to type the word, which was recorded exactly as typed and later evaluated; approximately 3,800 attempts were conducted over a 6-week period. Results showed that (a) under controlled conditions, some facilitated communication users can pass accurate information and (b) measurement of facilitated communication under test conditions may be significantly benefited by extensive practice of the test protocol, which could partially account for the inability of several past studies to verify facilitated communication-user originated output.

This article explores the phenomenon of facilitated communication (FC), and the implications of excluding FC as a means of participating in the legal system. It traces the introduction and widespread use of FC in the U.S. and examines the clinical (psychological education, and scientific) debate surrounding FC; considers how the clinical debate affects the legal debate concerning the admissibility of FC testimony in court; examines whether currently-used standards for admissibility of scientific evidence should apply to FC; examines the rights of people with disabilities to access to the courts through FC pursuant to the ADA and Section 504 of the Rehabilitation Act; compares FC to interpretation or translation as an accommodation in court; and recommends protocols for the use of FC in court proceedings to ensure that rights of victims as well as defendants are protected. It develops a definition of FC as a "form of testimony that can be screened for outside influence by empirical means," rather than as a form of scientific evidence in itself, and argues for assessing on a case by case basis the use of FC to provide such testimony. It recommends validation of the FC user's ability to communicate and clarification of the statements that apparently suggest abuse, and points out that by implementing suitable protocols which permit the use of valid FC in court, the legal system will give individuals with disabilities a voice in the system and an opportunity to be heard consistent with the ADA and society's goal of equal access to justice.

The case of a 13-year-old boy with autism, severe mental retardation, and a seizure disorder who was able to demonstrate valid facilitated communication was described. In three independent trials, short stories were presented to him, followed by validation test procedures with an uninformed facilitator providing physical support to the subject's arm. In Trials 1 and 3, several specific answers were provided that clearly indicated that the young man, not the uninformed facilitator, was the source of the information. Moreover, some responses seemed to imply that the subject was employing simple inferential and abstract reasoning. This case study adds to the small, but growing number of demonstrations that facilitated communication can sometimes be a valid method for at least some individuals with developmental disabilities.

In this article, the authors present their perspectives on the implications of a study of facilitated communication they conducted. They argue that studies of the technique are too preliminary to conclude that it is not valid for all individuals and present a procedure to follow in continued validation on an individual level.

Due to the confusion and unexplained reported events unknown to facilitators, the authors list three main issues that need to be addressed. They include (a) the issue of authorship, (b) the complexity of communication, and (c) the nature of evidence. There are certainly many cases where authorship cannot be attributed to the facilitator, and they advocate both more studies and for facilitators to question their role in contribution to the messages portrayed. FC reminds us how interactive and dynamic communication is, and how very complicated. The need to provide clear and unequivocal proof challenges our way of thinking about communication. Although the ambiguities will continue, we need to work toward obtaining more information on FC.

Goode agrees with Levine et al.'s approach to a risk-benefit analysis, but not with their conclusion. The risks of not using FC includes the denial of a form of communication for a person who may be unable to communicate in any other way. Each individual needs to be assessed as to the decision of whether to use FC. FC cannot be scientifically proved or disproved by its very nature, and we need to make it available to people even as we sift through the ambiguities.

The author clearly states that the purpose of this paper is to evaluate the arguments put forth by Levine et al. as an independent but not uninterested onlooker. A critique of their paper is given that includes the argument that FC is unfairly given more scrutiny than other modes of communication, and that due to the questionably ethical dilemmas of putting FC to a controlled study, most likely the possible benefits far outweigh the risks. Users of educational materials, or people who make those decisions for others, need to be educated in consumerism, based on the students' needs and the available information on product use. A common solution to this controversy is remote, due in part to the possibility that those on both sides of the evaluation process may have differing world views.

Hitzing states that both sides of the controversy of FC view the findings of the other as unbelievable. More rational discourse needs to take place, and it is concluded that Levine et al.'s risk-benefit analysis is seriously flawed and serves as an emotional appeal to halt a practice that they are opposed to. Risk-benefit analyses are done for medications, and no other communication program has been subjected to this interrogation. They also spend very little time on the benefits, although they do cite the possible benefits as far-reaching. Their emotionally laden language ensures the continuation of misunderstandings.

The authors respond to the four commentaries written on Levine et al.'s first risk-benefit analysis. They showed how all of them concurred that more research needs to be done to demonstrate authorship. They continue to state that the potential serious concrete harm to individuals with developmental disabilities is of primary importance. Other types of communication do not carry these same risks, and therefore are not subject to such rigorous tests. Their goal is to prevent harm to individuals, families and the community.

The authors look at the risks of facilitated communication (FC), which include that if FC is found to be valid it would provide a means for people to express themselves effectively, and respect from others. They cite risks that are mostly based on the assumption that most communication originates with the facilitator, consciously or unconsciously. They include risks to individuals of the creation of a false persona, nonpreferred life changes, elimination of previously effective communication, and the delivery of inappropriate educational instruction. There are also risks to families and teachers, which include guilt around the previous interaction style, rejection of people who cannot facilitate, false abuse allegations, and guilt, confusion and anger of "debriefed" facilitators. They conclude that FC should only be used if and when validation studies have been done.

The editor of Mental Retardation comments on the decision to include a commentary on facilitated communication (FC) by Levine and Shane, followed by responses to their manuscript. The results provide thought-provoking positions that offer information for the readers. The article and the responses are included.

The focus of this article is to show that mental retardation is a concept constructed to account for selected events, behaviors, or phenomena. There are two views of mental retardation: the normative view and the competence view, and one's view defines one's research approach. Researchers who take the competence view carry out research in the tradition of ethnography or symbolic interaction, as opposed to the normative view which attempts to define the objective truths about various aspects of retardation. The conflict over FC can be seen in light of these two views of retardation, since one's definition of mental retardation, science and truth influences one's opinion on FC and authorship.

The most important issue in the debate of facilitated communication (FC) is to look at the evidence and methods used to answer the question of whether FC enables people with disabilities to demonstrate unexpected skills. The authors look at the research on the validity of FC and find it lacking. Even people who are purported to be typing on their own may be receiving subtle cues or prompts, and still lack objective evidence. FC is stated to be a practice unsubstantiated by scientific research and theory development. Large numbers of people with no training or credentials have been able to experiment on people with disabilities without safeguards. FC needs to be approved by human rights committees and the benefits demonstrated convincingly before it is used any more.

The editors invited papers from the most visible proponents of each side of the controversy of facilitated communication. In addition, four responses were assigned on the basis of their expertise on communication, research methodology, and the fact that they had not previously taken a public stand. A list of questions was provided as use for consideration in discussion.

Horner states that communication is the central process for choice making and individualization. Encouragement is given to not make the debate on FC primarily a research question, and to keep it focused on the practical issues that family members and teachers face. An emphasis is made to resolve the question of authorship. Until this is done, it is suggested that the facilitator's role should regularly be tested.

The focus of this paper is the meaning of the controversy over FC itself rather than the evidence supporting claims for and against the validity and replicability of FC. FC has arisen in a time of frustration from knowing too little about how to facilitate independence of persons with disabilities and being able to do less than we are able to know. Although we always seem to attempt to categorize, observe and improve the behavior of people with disabilities, we do not really know who they are. People with disabilities need to be seen from a more holistic perspective, and at the same time we need standards to evaluate new practices.

Facilitated communication, a technique that is said to enhance the communicative abilities of individuals with severe language impairments, has engendered much controversy. Biklen and Duchan (1994) and Green and Shane (1994) present two sides of this controversy. Biklen and Duchan argue that from a constructivist's perspective, the primary issue is the underlying cultural presuppositions regarding mental retardation and science rather than the efficacy of facilitated communication. Green and Shane present research evidence challenging the efficacy of facilitated communication within a positivist's framework. We present a brief review of science as viewed through positivists' and constructionists' lenses. Using the framework of social constructivism adopted by Biklen and Duchan, we disagree with them on three points: (a) even though the process of constructing scientific knowledge is strongly affected by human social, emotional, and cognitive processes, it also involves matters of fact that cannot be ignored; (b) social constructivists' accounts of science can be accepted as descriptive without being prescriptive; (c) although we cannot prove that belief systems, including positivism and social constructivism, are true or false in the larger sense, belief systems have differential consequences for technological changes of the type that are valued by persons with severe impairments of communication.

The author, who has been diagnosed with autism, states that there has been inappropriate testing techniques based on faulty assumptions, and misinformation of how FC works or doesn't work that undermines credibility. Many people with autism are treated as "broken" versions of the tester, which may result in a brick wall between them. Autism's self-other problem relating to poor systems integration cannot be reduced to a "movement" problem, and we don't have answers for why or how FC works.

In this short article the authors discuss the importance of the offering spiritual support by pastors and religious professionals to people with disabilities and their family members. Briefly described are past roles of pastors in this spiritual support and how this support differs from that offered by the medical community. A short list of resources is found at the end.

Ways were delineated in which group home employees can support individuals living n the home in the active expression of faith, both inside and outside the group home environment, and at the same time protect the freedom of others in the home who choose not to be involved in religious activities. After briefly reviewing some assumptions underlying the 1992 AAMR definition of mental retardation and describing the capability of religious expression for individuals with cognitive impairment, we presented several guidelines to assist group home staff members.

In this perspective, Hornstein provides a helpful insightful discussion based on her personal experiences with a son with a disability, on how a Jewish community can work to provide supports and assistance to families of children with disabilities as they work to make Jewish faith communities and agencies more inclusive.

This commentary discusses the potential benefits of natural supports for people with developmental disabilities through churches. The article concludes with a series of recommendations for professionals.

Owens, M. J. (1995). What does ADA mean to U.S. churches. Disability Studies Quarterly, 15(3), 58-73.

This article explains faith communities' responsibilities under the ADA and explores moral expectations. Also included is a list of organizations and annotations of resources that can help faith communities to be more inclusive of people with disabilities.

Rose, A. (1997). "Who causes the blind to see": Disability and quality of religious life. Disability & Society, 12(3), 395-405.

Persons with physical or mental disabilities often turn to religious institutions for comfort and belonging. They are not, however, always openly welcomed into religious circles. Many churches and synagogues fail to make the necessary accommodations for parishioners with disabilities and some show cover signs of hostility towards them. Possible reasons for this exclusion are examined, theorizing that they stem from the most ancient of beliefs about the nature of disability and its relationship to God. Sources within the Jewish and Christian faiths are examined and it is hypothesized that there are four central views inherent in these religions that act as barriers in those with disabilities. The beliefs must be challenged so that all may find fulfillment and inclusion within their religious faiths. Religious leaders and followers must also acknowledge and redress the fact that such beliefs have contributed to the establishment of disability and an oppressed political minority within Western society.

Religious belief and practice plays an important role in the lives of millions of people worldwide, and yet little it known of the spiritual lives of people with a disability. This review explores the realm of disability, religion and health, and draws together literature from a variety of sources to illustrate the diversity of the sparse research in the field. An historical, cross-cultural and religious textual overview of attitudes toward disability throughout the centuries is presented. Studies in religious orientation, health and well-being are reviewed, highlighting the potential of religion to effect the lives of people with a disability, their families and caregivers. Finally, the spiritual dimensions of disability are explored to gain some understanding of the spiritual lives and existential challenges of people with a disability, and a discussion ensues on the importance of further research into this new field of endeavour.

This article starts with a story of how faith communities can be less welcoming of people with disabilities--a baby is born with severe disabilities, loved very much by his family, but died at age three weeks. Although his parents' church hold a funeral for the baby, he is never mentioned again by the clergy, and a baptism of another child is held at the same time. Stiteler uses this story to talk about how faith communities do and do not celebrate and welcome people with disabilities in their congregations. Yet faith communities are called upon to be welcoming. She discusses ways that these communities are not welcoming and ways in which they can grow to become more welcoming.

The 60s social movements of normalization and deinstitutionalization and the 90s ADA passage resulted in people with disabilities living increasingly in the community, including places of worship. In response to increased presence, both Jewish and Christian educators have attempted to create religious instructional material for people with disabilities. Most of these curricula are based on the instructional techniques of secular special education programs, that is, "special" or segregated Sunday or Sabbath school programs. Here inclusive and non-interventionist approaches as discussed are alternatives to segregated programs.

Over the past two decades, our response to children with developmental disabilities and their families has shifted dramatically, moving from an historical awareness of disability based in segregation and exclusion to one that favors the integration of people with disabilities into the mainstream of community life. Over this period, nearly all states have developed initiatives to provide families with a variety of supportive goods and services. This article explores the current status of family support in the United States, summarizing essential program features, program effects, and outstanding issues that must be addressed if the present momentum for family support is to be sustained.

This study is a companion to our 4-year study (Birenbaum, Guyot, & Cohen, 1990) on financing health care for individuals with autism or severe mental retardation. We reported on nonmedical expenditures and opportunity costs pertaining to maintaining a child or young adult with serious developmental disabilities in the home or in residential care and discussed policy implications for assisting their families. We proposed that (a) personal care and family support should be included in health care requirements, (b) family-centered care should be promoted, (c) appropriate programs and care should be provided for young adults no longer in school, (d) financing and organizing of family supports and subsidies should be administratively simple, (e) Medicaid should be expanded to increase use of home-and community-based services, and (f) financial support should be provided to families.

This article addresses the issue of how best to provide families of children who have severe disabilities with the support services they need to maintain their well-being. Relevant federal and state programs for family-related services are analyzed, and current service themes are discussed. Principles for program design are presented and recommendations for policy are offered.

This paper reviews evaluation studies of family placement schemes offering long-term care for adults with learning disabilities in Britain. The model is widely used, but there is very little research describing such schemes. It is suggested that evaluation is made difficult because the goals of placement schemes for people with learning disabilities are not made clear in the literature. A theoretical structure for evaluation based upon an ecological view of quality of life is suggested and research is reviewed within this model. Where possible, comparisons are made to American literature on similar models of care.

Thirty pairs of fathers and mothers who had school-age children with mental retardation and other disabilities were compared with each other and with 32 father and mother pairs of parents of children without disabilities. Responses to family scales indicated that fathers and mothers of children with developmental disabilities did not differ from each other nor from fathers and mothers of children without disabilities in parental stress, family social support, or family functioning. However, parents of children with disabilities experienced a disproportionately greater level of stress relating to their children than did those of children without disabilities. Fathers' and mothers' stress was associated with aspects of family functioning as perceived by themselves and their spouses.

Although educators and other professionals acknowledge the importance of involving parents in their children's' education, few researchers have investigated parental perceptions of educational and related services. This qualitative study identified four major themes during interviews with 28 families whose children have dual sensory impairments. These concerns clustered around parental perceptions of a "good life" for their children, as well as their experiences with fear, frustration, and change. Implications from the analysis may assist teachers, related service professionals, and administrators working with families to understand more fully parental perspectives.

In most studies positive outcomes for families who have adopted children with developmental disabilities have been described. In this previous research, however, investigators have examined primarily short-term adjustment. In contrast, in the current longitudinal investigation 9 years after an initial interview, we assessed the adjustment and functioning of families who have adopted children with developmental disabilities. Results indicate that nearly 12 years after their adoptions, families remaining in the study reported generally positive outcomes and good adjustment to their adopted children. Whereas there were changes in these families, especially as the children approached adolescence and early adulthood, these changes were perceived as potential sources of reward as well as sources of stress.

Relations between service and support utilization, problem-solving/coping strategies, and level of personal burden experienced by younger and older caregivers were examined. Overall, there were no differences in the number of support services received. However, younger caregivers reported significantly more unmet service needs and rate significantly more of them as a critical or an emergency need. Both groups had highly developed effective problem-solving skills. However, older caregivers were more likely to seek spiritual support and the younger caregivers more apt to mobilize their families to acquire and accept help. Older caregivers experienced significantly less personal burden. Results suggest that younger caregivers are more predisposed toward seeking outside help and have higher expectations of the service system.

This study was conducted to determine whether support provided to caregivers by their adult children with mental retardation would influence caregiving appraisals. We also examined how severity of disability of the adult child, personal and social resources of the caregiver, and amount of caregiver assistance to the adult with mental retardation influenced caregiving appraisals. Using surveys and interviews we collected information from 80 primary caregivers on caregiving burden and satisfaction and six predictors or burden and satisfaction. Findings indicate that great support from the adult child to the caregiver resulted in greater satisfaction and less burden. Adaptive and maladaptive behaviors and caregiving assistance all predicted caregiving satisfaction but only maladaptive behaviors predicted caregiving burden.

The authors show that although family support spending has increased dramatically over the past eight years, the percentage for MR/DD services is still very small. They look at the cash subsidies, respite care, and other family support for each state, with the total dollars spent on family support.

From the professional perspective, parenting by people with mental retardation, or intellectual disability, is regarded with concern. Little attention has been paid to what constitutes social support for these parents. A qualitative design was used to explore views of parents with intellectual disability about their relationship and social support for their parenting. Most emphasis was placed on the support received from and given to their spouses or partners. S