TONY SANTI AND THE BAKERY
THE ROLES OF FACILITATION, ACCOMMODATION, AND INTERPRETATION

Zana Marie Lutfiyya
February 1991


TONY SANTI AND THE BAKERY

I first met Tony Santi at my office. He came on Monday afternoons, delivering bread. He helped Patti, who was in charge of the operation, by carrying up the boxes of bread from her car. He stood off to one side as she greeted people, exchanged gossip, and sold the bread. Tony is a short, slight man, usually wearing blue jeans and a t-shirt or a flannel shirt. He would nod, smile, and respond if someone talked to him, but generally he stayed in the background.

I had heard of the Bakery where he and Patti worked. It is not strictly a commercial enterprise. Founded about twenty years ago as an outgrowth of the Catholic Worker Movement, it was meant to provide employment to individuals who had been involved in the criminal justice system. Patti is a social and political activist, well known locally for her efforts in a number of peace and justice causes. Tony has a slight speech impediment. From his manner, and by chatting with him, I assumed that he had a mild impairment of some sort. I learned from a colleague who had met him before that he had once been in a state developmental center. I was intrigued with Tony and wanted to learn more about him and his background.

My interest in Tony was inspired by my participation in the Community Study. The Community Study is a five year project during which time a group of about ten researchers plan to meet and follow along about two dozen individuals with mental retardation/developmental disabilities. We want to learn about their place in the community, and who they know. This includes learning about the people with whom they are connected and the meaning of these connections and personal relationships to the individuals with disabilities.

This interest in what has been characterized as the informal, unpaid, or "natural" relationships of individuals with mental retardation has come directly out of the concern for the community integration of such individuals. In the past few years or so, there has been more of an emphasis on learning about, and facilitating the personal social integration of individuals with disabilities (O'Brien & Lyle O'Brien, in press; Wolfensberger & Glenn, 1973). A commonly held assumption is that many individuals with mental retardation and other developmental disabilities are isolated from their community, and do not know many people other than those who are paid to be with them in some capacity (Wolfensberger, 1987). This has resulted in efforts to establish regular contacts between people with disabilities and typical community members (Bridge & Hutchison, 1988; Cormier, Grant, Hutchison, Johnson, & Martin, 1986). The goal of these interactions is to promote close ties between disabled and nondisabled individuals and rests on the belief that such freely given relationships will lead to a more complete participation of individuals with mental retardation in society (Johnson, 1985; O'Brien, 1987; Taylor, Racino, Knoll, & Lutfiyya, 1987).

In establishing this research project, we gave ourselves the challenge to identify and contact individuals with disabilities outside of or with little contact with the formal human service system. We wanted to pursue the possibility that there were at least some individuals with developmental disabilities who had made a life for themselves, or who had been assisted to make a life for themselves, outside of the traditional community based service network of group homes/residential facilities and sheltered workshops/supported employment programs.

And that was one reason why Tony Santi intrigued me. As I chatted with him for a few minutes each Monday afternoon in the fall of 1989, I learned that he worked part time at the Bakery and lived in his own apartment. He had once lived in a large, notorious state institution for the mentally retarded, but had "escaped" (his term) and had moved back to his hometown of Syracuse. In the late fall, I asked him if I could interview him, starting early in the new year. He readily agreed, and added one proviso: that I would spend time at the Bakery. For as Tony said to me, "you can't learn about me without spending some time at the Bakery." This paper is an initial description of Tony, his background, and his life today, a large part of which is the Bakery and the people who work there.

TONY SANTI: HIS BACKGROUND

Tony is not very good at remembering dates or how old he was at the time any given event. But at his most recent birthday party celebrated at the Bakery, I found out that he was 37 years old. The lack of clarity of specific dates makes compiling a personal history of this man somewhat difficult. But after talking to Tony and others, it is clear that there are some distinct "chapters" of his life: his early days in Syracuse; the "institutional school"; living on the streets; the prison; and living on his own.

The Early Days in Syracuse

Tony grew up on the North side of Syracuse until he was about 8 or 9 years old. The North Side is a working class, blue collar neighborhood of mostly German and Italian American families. Tony lived here as a small child with his parents, brothers and sister.

Most of what Tony recalls from his childhood are stories and big events. Like the time his father took the whole family apple picking one fall. The family, busy filling up their baskets, didn't notice the owner approach and warn them off. The farmer chased the Santi family off his land, firing his shot gun into the air for effect. Instead of paying for the privilege of picking the fruit, a typical practice in Central New York, Mr. Santi had simply pulled up to an available field and had his family help themselves. Tony laughs heartily when he remembers how his father got his family into the car to drive off--with the apples. Tony missed the car and was running after it, trying to hold on, yelling, until his dad stopped to let him in.

Tony recalls his school days with much less relish. He went to a parochial Catholic school for kindergarten and the first grade, while going with his brothers and sister to catechism classes, or what he calls "church school." He had a difficult time in school, a hard time learning how to read and keep up with the classwork. According to Tony, the teachers at the parochial school told his family that he was a "hard case" who needed to be sent to the institutional school in order to receive an education.

The Institutional School

It may be hard for some readers to think of a state institution for the mentally retarded as a boarding school, but that is how these facilities seem to have been described to families in the 1950s in this country. It is undoubtedly more palatable to think of the facility where one's child is living as a boarding school where s/he will receive a useful education. However, it is clear from Tony that he does not regard the Empire State School (as it was then called) or the Empire Developmental Center (today's name) as anything but a prison.

The state institution to which Tony was sent once housed thousands of residents. It was extremely difficult for Tony to try to describe and talk about his years in the institution, except to say what a bad place it was. As he told me in our first interview:

Recently, I read in the paper where they were making that place into a prison, like up at Kingstown. And I said to myself, well at least they got that right. That's what it is, a prison, and no school. At least now they are being honest with the name. It is a bad place.

When I told him that at least some of the original residents were still living on the same grounds, adjacent to the new prison, albeit in new cottages, Tony shook his head and replied, " Well, then I feel sorry for the poor bastards that are still in there. No one should have to live like that, nobody, no way."

Tony's father did not have the heart to take him to the institution, so he got Tony's brother to do so. When asked to describe how the institutional school was bad, Tony told about being mistreated and abused by both the staff members and some of the other residents. Tony, a small child, recalled often being picked on because of his size. He soon developed a reputation as a "runner," and became known for his various escape attempts.

The first time that he ran away was during a visit from his father. His father had taken him to a nearby town for an ice cream cone. The stand did not have a bathroom, so Tony told his father that he was going across the street to use the facilities there. Tony walked away, using the gas station as cover. It took his father a few minutes to realize what had happened, and then he got into his car and started back down the highway, searching for Tony. Tony, already on the road trying to hitch a ride, saw his father's car. He jumped into the ditch until his dad's old Chevy had passed him by. After the car had passed, Tony got out of the ditch and waved goodbye to his father.

As Tony tells the story, it was here that he made his first mistake. He hitched a ride back into Syracuse and returned to his neighborhood. He did this even though he had been warned not to by an experienced friend, also a runner, who had told him that one's home is the first place where the officials came looking for one. In those days, as today, institutions in New York state are patrolled by security guards who wear official looking uniforms with badges and drive patrol cars painted to resemble police cars. These security people are referred to as the "state school police," or the "institution police." After returning to his neighborhood, but not to his parental home, Tony learned that it had been his parents who had called state officials and informed on him.

Tony spent several years at the institutional school, nominally attending classes, and working, typically in a variety of janitorial positions. He was moved to several different buildings, and these moves came right after he had run away and then been returned to the institution. When Tony turned 21, he was "paroled." On yet another escape, Tony had returned to his neighborhood. There a friend of the family who apparently kept in touch with Tony and knew his whereabouts, told Tony to go look up his father, who had just gotten word that Tony was to be paroled. Tony and his father returned to the institution and Tony picked up his discharge papers. To his surprise and dismay, Tony now learned that his father was not prepared to let Tony return home. Tony was now on his own.

On the Streets

After being discharged from Empire in 1974, Tony lived "on the streets." He moved into a halfway house in Syracuse, but only stayed there until early 1975. He then lived in a series of apartments, on the street, and in other people's homes. During this time he spent a year in jail for theft, and then a couple of years later, he was sentenced to serve two concurrent two-year sentences in the prison at Kingstown.

It was during these years on the street that Tony met up with and became connected to the individuals with whom he now associates. These are folks who are loosely affiliated with the Catholic Worker Movement and/or some of its projects in the Syracuse area. It was also at this time that Tony got involved with a number of individuals who had shady pasts and careers. Tony admits to selling stolen property, and getting mixed up in some unusual land and house sales. Throughout this period he would get into minor trouble after making threats by telephone or in person to his "business partners." He also talks about destroying and vandalizing property (houses and cars) of some of these individuals. He was up before a judge for a number of these offenses.

On the other hand, Tony became connected to a number of welfare agencies and human service workers. He went to a soup kitchen for his meals. Someone at the kitchen helped Tony to apply for welfare. This soup kitchen was also operated by Catholic Workers and their affiliates. Carla, a woman who was working at the soup kitchen and living in the halfway house, helped Tony move in there. It was at the halfway house that Tony met Father Bryan who was living there himself. The primary mission of this place was to serve men who had been in jail or in trouble with the law. According to Tony, Father Bryan thought that the halfway house was not a suitable place for Tony, so he helped Tony locate a series of small apartments to live in. Gradually, Tony became adept at doing this himself. But he continued to move constantly every few months or so. Father Bryan also employed Tony to clean the halfway house, and accompanied him on his various court appearances.

Tony told me a few stories about these days. He had gone over to a business partner's house, and had broken a window with a large stick, calling to the man to come out and face him directly. The man called the police. As Tony saw the cruiser turn down the street in answer to the call, he headed out, and:

I was cutting through the weeds and all that to get down by a mall. The cop was chasing me, and then he tripped. His face went into the mud. And then I walked over to him to make sure he was okay. So I reached my hand out to him and I says, "Do you want me to help you up?" And he says, "Are you one little son of a gun." And then I am looking at him, at his face, and I just couldn't help laughing, I was laughing so hard I just couldn't run anymore, and I said, "Okay, you got me." And then he said to me, "I got to admit that you are a fast runner." And I said, "Well, you would have caught up if you hadn't of tripped."

Tony was in and out of the municipal jail for thirty or sixty days at a time for a variety of these petty misdemeanors. When Tony runs into the lawyers and court officials from that period, they remind him of several incidents like the one above. Tony tells most of these stories now, chuckling, able to laugh at himself. But he can still get angry. He recounts a number of incidents with his court appointed attorney which left him feeling unrepresented, and disappointment over the betrayal he experienced at the hands of his numerous business partners. Today, Tony explains his past run- ins with the law as the result of a bad influence in his life. "It was like some kind of an evil thing that I had in me to do that."

Throughout this period, Father Bryan remained in contact with Tony. He accompanied Tony to all of his court appearances, often wearing his clerical collar for effect. Father Bryan became well known as an advocate and friend of Tony's. As Tony said, "Judges knew there was a slight problem whenever Father Bryan came to court." Their relationship has endured over the years, and today Tony says that Father Bryan is, "one of my best friends. We go way back."

Before going to jail, Tony belonged to two different but related worlds. The first was the world of petty crime, theft, and selling stolen objects. The other was the world of those committed to trying to help out people who were poor, living on the street, and having difficulties with alcohol or the law. On the scale of things, Tony's forays into crime were not "big-time," but as what was once known as a "bum," he had been inducted into a street society that included both of these groups of individuals and networks.

Doing Time

When Tony was finally sentenced for a longer term jail sentence, it was Father Bryan who convinced the judge to let Tony serve the four year sentence in two separate terms, concurrently. This allowed Tony the opportunity to do his time in a medium security facility nearby, rather than being sent to another part of the state. Father Bryan visited him regularly in jail.

According to Tony, it was around the time of his incarceration that Father Bryan became Tony's representative payee. This meant the Father Bryan controlled Tony's welfare monies and disbursed the monies to Tony every month as he needed them. So Father Bryan took care of Tony's financial affairs, such as they were, while Tony was in jail. He also visited Tony once a week, and made sure that Tony received some of the amenities that only outsiders can provide to inmates (like extra snacks and cigarettes).

On His Own

Tony acknowledged that being incarcerated was very tough, and it is definitely a period of his life that he prefers not to talk about. When Tony was released, he resolved to stay out of trouble. He planned to do this by living alone and staying away from housemates (originally, it was some housemates whom he went into business with). He also decided not to get a telephone, and thus avoid the people with whom he had gotten into trouble before. Father Bryan remained his representative payee, and stayed in close touch with Tony.

Like the earlier time when he lived on the street, Tony found himself a series of apartments to live in. He describes all of them as having been small, cheap places that he could afford on his own. He initially worked for Father Bryan, running errands for men who were in the local detention center waiting to be tried or to be bailed out. This meant that he would purchase the cigarettes and snacks that these men could receive, take down bail money for the low bails (e.g., fifty dollars), mail letters and so on.

Tony met the people at the Bakery when he helped Father Bryan deliver their bread once a week. Eventually, he got himself a job in the Bakery. In the beginning, Tony started out by bagging the bread, that is putting the cooled loaves into plastic bags, labelling them and then sealing them. But his role quickly expanded. As Tony tells it:

One guy broke me in on the cinnamon buns, and how to seal them packages tight. And then from that I was doing the dishwashing and from the dishwashing it extended into a lot more heavier work.

Today, his official job title is "Jack of all trades." He is proud of that title, which is printed in the brochure about the Bakery. He cleans but also helps with all aspects of the bread production, and is one of the few people who can easily lift the heavy, wet dough. The Bakery closes during the summer for three months. During this time, Tony tries to earn money as a janitor, mowing lawns, and other odd jobs which are generally arranged by others at the Bakery.

THE BAKERY

The Bakery was first started by two Catholic workers who wanted to create an economic enterprise that employed people often excluded from the world of work. Father Bryan became involved in the early days. As part of the "crowd" associated with Father Bryan and the halfway house, Tony visited the Bakery on a number of occasions. Tony, along with about a dozen others, works at the Bakery two of the three days that it is open, on Mondays and Fridays.

The Work

As its name implies, the Bakery is just that, a bakery that produces a couple thousand loaves of bread each week, which are then sold. It is a small operation, run by a dozen workers and volunteers. Workers range in age from their early twenties to their late eighties. And because of its ties to the Catholic Worker Movement, the Bakery claims a mission that is more than merely baking bread. The work of the Bakery includes both the baking and selling of bread, and an attendant activity that is spiritual in nature: the rebuilding of individual lives as well as creating a community life.

This dual nature of the work in the Bakery is reflected in the language that the people use there. First are the terms that deal with the actual preparation of the bread itself: making the dough, cutting it, rolling it out, the first and second rise, and so on. But many of the workers at the Bakery are also aware of and consciously use the metaphor of making bread in additional ways. When classes of schoolchildren come to spend a morning at the Bakery, they are told that the yeast is alive, a living organism, and that this causes the bread to rise. This is compared to the actions of humans who through a small effort in the right place and right time, can cause ferment, and some positive change to occur.

In this paper, while I will not go into any detail describing the physical work of baking, I do want to describe this second aspect of the work that takes place at the Bakery.

The People

Individuals with different backgrounds and experiences work at the Bakery. The "core members" of the Bakery are Carla, Liza, Olivia, and Father Bryan. Carla has worked at the Bakery since it first opened, and lives in the Halfway House that Tony stayed in many years ago when he left the institution. Carla packs the bread for delivery. Liza, now the manager, has also worked at the Bakery since the early days. Although Liza maintains that her main concern is bread production and running the Bakery as a business, she carefully orchestrates the work and involvement of individuals like Tony. Liza's eldest daughter, Pam, married and with a family of her own, works at the Bakery once a week.

Olivia is the matriarch of a large family that is involved in many of the activities of the parish where the Bakery is located. Olivia is the assistant manager, and is in charge when Liza is away. Father Bryan is responsible for much of the distribution of the bread.

Tony and Danny are the youngest of the regulars who work at the Bakery. Danny is a quiet man who keeps to himself. He bags the bread. He occasionally misses work, due, it is believed, to his glue sniffing. When this happens, Father Bryan is dispatched by Carla to seek him out and make sure that he is okay.

In addition to these regular workers, the Bakery hosts many visitors. Most are schoolchildren who take a field trip to spend the day. Some individuals volunteer their services at the Bakery for a number of years, as many of the drivers who deliver the bread do. All visitors are taught the philosophy of the Bakery: that baking bread is both a practical and symbolic activity.

BAKING BREAD: BUILDING CONNECTIONS

The important work of the Bakery is not simply baking bread, it is also how the baking is done. All of the workers have valid and valuable roles in this work and everyone's contribution is necessary. The bread is baked by individuals who could not do their work without the presence of the others. Baking bread is one way to establish and maintain a small community of people bound by common purpose and work, at least for two days a week. Involving everyone in a valid way is an unspoken and not highly visible effort at the Bakery and can be a real challenge. Many of the workers would not generally be viewed as highly skilled or capable on the open job market. While many of the examples presented here are taken from Tony's experience, the efforts at facilitation, interpretation, and accommodation are extended to everyone at the Bakery.

Facilitation

The word facilitation is used here to refer to those activities that help to bring people together. This might involve teaching either a disabled or nondisabled individual a particular skill or response. The things that are learned may be used in an actual interaction with another individual or simply to increase the opportunities for people to get together. Facilitation can be used to smooth over ruffled interactions between people. The use of facilitation is not restricted only to people with disabilities. But when it is planned, the effort is in making a particular interaction or relationship go well. The purpose of this activity is not to teach people with disabilities certain skills that they can then generalize to other situations.

The continual and ongoing effort of both Liza and Olivia in trying to involve Tony in a number of "wholesome" social activities falls into the category of facilitation. These include invitations to monthly suppers that are held at the parish, coming to mass, and other occasional social activities and events that take place.

Olivia tries to facilitate certain interactions between me and Tony. On several occasions, she tries to get me to assume another role than that of a researcher with Tony. She calls me his friend (despite my corrections otherwise) and at least twice asks me to "reinforce" something with him, typically something that she thinks would be good for him. For example, she approached me on a few occasions and openly wondered about where Tony should live, and could I help him find a group home to live in, so that he wouldn't have to be alone.

Interpretation

Interpretation is used here to refer to those occasions where a person is presented in a positive and a enhancing way to others (Wolfensberger, 1972; Wolfensberger & Glenn, 1973; Wolfensberger & Thomas, 1983). To interpret someone in an enhancing way is not only nice for the person, but it can indirectly promote further positive interactions between individuals with and without disabilities. The individual with a disability is portrayed to others as being interesting; both worthy and capable of establishing a relationship.

One day, Tony was being teased by others at the Bakery. Olivia interrupted and asks if people knew that Tony had saved a man's life. His next door neighbor tried to commit suicide by turning on the gas in his apartment, and then starting a fire. Tony smelled it, and tried to enter the man's apartment. He then called the police and got the caretaker. The two of them broke down the door and rescued the man. As he was telling the story, Olivia suggested what he should tell next, so that no details would be missed. By the end of the story, Tony was downplaying his role, but others contradicted him and told him how brave he had been to act on another's behalf with little or no thought to his own safety.

Accommodation

Accommodation refers to the actual changes in the physical or social environment that makes it easier to involve an individual in some way. The most obvious case of making an accommodation would be to add a ramp and renovate washrooms. It is typically this act of making a physical accommodation that gets defined as the essence of integration and helping someone to fit in. Physical accommodations result in physical integration, but the interpretation, facilitation and accommodation in the social environment of a person's social integration, lead to the valued participation in a typical activity or interaction.

An example of this occurred when Liza arranged a part time job for Tony. The church where the Bakery is located needed someone to clean up after the congregation's monthly community suppers. Olivia and Liza thought that Tony would be an excellent and obvious choice to take on this role. The suppers end at nine p.m., so the two women thought that Tony could come in first thing Wednesday mornings to clean up the hall. Tony refused the job regretfully, because he could have used the money. But he did not want to be in the church on Wednesday as he didn't get along with a couple of the people who would be there.

Liza devised a plan whereby Tony would come in towards the end of the supper, have something to eat (he generally avoids these suppers too), and then stay to clean up. It would be late, 9:30, but he was close to his own home and would not be at risk to walk the few blocks at that time of night. Tony agreed to the idea of coming in the evening, and then Liza convinced Father Bryan of the scheme. Tony is not allowed a key to the church, but Father Bryan could lock up, leaving one door that Tony could exit the church from, with the door locking itself behind him. As Liza reasoned with Father Bryan about the change in schedule to suit Tony, she suggested that this would be one way to get Tony back to the community suppers and with people. Both Tony and Father Bryan agreed to Liza's plan although they had different reasons for doing so.

CONCLUSION

The Bakery fills more than one function in the lives of the people involved with it. It is a place of work, and of meaningful occupation. It is a place to get together with other people for companionship. It is a place for like minded people to get together: activists in the peace and social justice movement, those involved in their local parishes and individuals who have faced a variety of difficulties (e.g., substance abuse, incarceration, poverty, homelessness, unemployment).

The people at the Bakery try to reach out to people in the community in order to provide food and sustenance. One day a week, free bread is available from the Bakery to local soup kitchens and food pantries as well as anyone who happens to stop by. As one worker said, "On free day, you get the bread for free. It's a statement. We all need bread to eat, and when we eat the same bread, it's a statement that we are all the same."

Another example of this attitude was demonstrated the day a high school student came in and asked how much bread he could buy for 47 cents. Liza told him to put away his money and help himself to a couple of slices of bread and butter. As she said, "we have bread to share."

But there is a tension at the Bakery between the efforts at reaching out into the community and maintaining a level of bread production and sales in order to keep the Bakery going. This dilemma was articulated by a long-time baker, who is disappointed in what she sees as commercialism overtaking the real purpose of the Bakery as a place for people to come together and associate with each other.

That's what people today need. Boy, I wish we were more like that here. No, its just not the way I had envisioned it. The commercial has won out. We are so commercial here. I had planned a bakery with a full time day care. Women could come and leave their kids, help out here, or just bring lunch and visit with each other. I knew a couple of women like that, they would have come. But our production has driven out all this kind of stuff.

On the other hand, several of the people working at the Bakery want to earn the minimum wage or better. This means that a certain amount of bread must be made and sold. As Father Bryan stated:

We have introduced much more of an economic thing...than used to be the case. People get a stipend for bread baking which is probably more than minimum wage. [To do this] you have to...get enough production...and distribution...to meet the overhead. It changes the atmosphere.

This dilemma will not be easily resolved as those at the Bakery wish to provide a workplace and a place where often forgotten individuals would be welcomed. But for Tony and others, working the Bakery provides both meaningful employment and meaningful association with others.

REFERENCES

Bridge, N. J., & Hutchison, P. (1988). Leisure, integration and community. Leisurability, 15(1), 3-15.

Cormier, L., Grant, C., Hutchison, P., Johnson, N., & Martin, L. (1986). Facilitating friendship and integration for adults. Leisurability, 13(1), 22-26.

Johnson, T. (1985). Belonging to the community. Madison, WI: Options in Community Living and Wisconsin Council on Developmental Disabilities.

O'Brien, J. (1984). A guide to life-style planning: Using the activities catalog to integrate services and natural support systems. In B. Wilcox & G. T. Bellamy (Eds.), A comprehensive guide to the activities catalog (175-189). Baltimore: Paul H. Brookes Publishing Co.

O'Brien, J., & Lyle O'Brien, C. (in press). Members of each other: Perspectives on social supports for people with severe disabilities. In J. Nisbet (Ed.), Natural supports. Baltimore: Paul H. Brookes Publishing Co.

Traustadottir, R. (1990). Supports for community living [Unpublished case study].

Taylor, S. J., Racino, J. A., Knoll, J. A. & Lutfiyya, Z. (1987). The nonrestrictive environment: On community integration for people with the most severe disabilities. Syracuse, NY: Human Policy Press.

Wolfensberger, W. (1972). Normalization. Toronto: The Canadian Association for the Mentally Retarded.

Wolfensberger, W. (1987). The new genocide of handicapped and afflicted people. Syracuse, NY: Author.

Wolfensberger, W., & Glenn, L. (1973). Program analysis of service systems, PASS (3rd ed.). Toronto: National Institute on Mental Retardation.

Wolfensberger, W., & Thomas, S. (1983). Program analysis of service systems' implementation of normalization goals (PASSING). Toronto: National Institute on Mental Retardation.

NOTES

  1. Unless stated otherwise, all names of individuals, facilities, and agencies in this report are pseudonyms.

  2. The author acknowledges Rannveig Traustadottir and her (so far) unpublished analysis on the facilitation that some personal assistants perform on behalf of the individual with disabilities whom they are working for.

  3. Preparation of this case study was supported in part through a subcontract to the Center on Human Policy, Syracuse University, from the Research and Training Center on Community Living at the University of Minnesota. The Research and Training Center on Community Living is funded by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (Cooperative Agreement #H133B80048). The opinion expressed herein are solely those of the author and no endorsement by the U.S. Department of Education should be inferred.

  4. The author wishes to acknowledge Rannveig Traustadottir, John O'Brien, Bonnie Shoultz, Steven Taylor, and Janet Duncan for their comments and insights.


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