Rehabilitation Act Amendments and the Helen Keller National Center Act of 1992: implications for consumers with hearing loss.

Since 1920, rehabilitation legislation in the United States has provided for vocational and related education services, financial support, civil rights protection, and related programs for citizens with disabilities (Jenkins, Patterson, &Szymanski, 1992). This legislation has expanded and evolved over its 73-year history from a narrowly focused jobs program primarily for industrially injured workers to a broad-based tapestry of programs serving people with physical, mental, or emotional disabilities. The pre-eminent philosophical paradigm influencing rehabilitation legislation in recent years has been that of consumer involvement and empowerment. This recognizes the right of people with disabilities to full participation in all aspects of community life.

This article will summarize major issues regarding full and equitable inclusion for persons with hearing loss in rehabilitation programs and services authorized through the Rehabilitation Act of 1973, review recommendations made by the Commission on Education of the Deaf (COED) and the Council of Organizational Representatives (COR)--a coalition of organizations serving people who have hearing loss--and identify changes in the 1992 Rehabilitation Act Amendments that hold promise for continued improvement in services to rehabilitation consumers with hearing loss.

Background and Context

People who are deaf or hard of hearing represent diverse populations with frequently disparate rehabilitation needs. This diversity cannot be emphasized too often or too much. The impact of hearing loss on any one person will be contingent upon many individual and environmental factors, including severity of loss, age at onset of the hearing loss, progression of the loss, innate personal characteristics and reaction to the hearing loss, family and social support systems, potential to benefit from assistive technology, current or potential educational interventions, potential to benefit from vocational training or retraining, identification with the Deaf(1) community, and a host of other factors. Although the needs of individuals with hearing loss are diverse, there are also many characteristics and needs that they have in common.

In general, persons with hearing loss have benefited over the years from improved accommodations and accessibility in most programs authorized under rehabilitation and related legislation. In some instances, however, well-intentioned efforts to provide all-inclusive programs and services have overlooked or inadvertently neglected the needs of this population.

In 1988, the Introduction to the Commission on Education of the Deaf Report noted that, as a nation, we have the knowledge to improve the circumstances of individuals who are deaf, "significantly, even dramatically." It added, "But can we afford to do what's necessary? Indeed, we can't afford not to. Maintenance of the status quo represents an unwarranted extravagance--especially when we consider that a clearer understanding of the needs of persons who are deaf, coupled with the re-direction of some existing funding and priorities, and a modest amount of new funding could result in impressive long-term savings" (p. viii).

Although directed primarily to the education needs of deaf youth, the COED report made several legislative and policy recommendations for improving conditions for adults who are deaf and, to a more limited extent, adults who are hard of hearing. It expressed concern for the lack of rehabilitation services and resources for noncollege bound youth with hearing loss who make up an overlooked and underserved population at high risk for unemployment and underemployment. It noted there are no large federally funded rehabilitation centers to serve the needs of this population. Because local funding is costly and because people with deafness represent a low-incidence population, it recommended establishing 10 federally funded comprehensive service centers to meet the school-to-community transition as well as the employment and independent living needs of this population. It emphasized the severe shortage of qualified interpreters for persons who are deaf, noted the varying qualifications of persons who provide interpreting services, and recommended that the Department of Education develop standards for interpreters in rehabilitation and human service settings.

The COED report also stressed that unqualified personnel are frequently employed to work with clients who are deaf and noted that "on-the-job training (for such personnel) is unacceptable and... can only delay effective rehabilitation of deaf clients" (p. 107). And, finally, it made several recommendations about the development and maintenance of assistive devices and technology.

COR developed a position paper in September 1991 that supported many of the COED recommendations for adult service provision. The position paper recommended changes in the Rehabilitation Act of 1973 to improve access to services and programs authorized by the Act for persons with hearing loss. These recommendations include: modifying state plans to incorporate the needs of persons with hearing loss; strengthening transition services and programs; addressing the unique needs of "lower achieving" deaf and hard of hearing youth, particularly in supported employment and independent living programs; establishing 10 comprehensive service centers as recommended by the COED report; defining "qualified" personnel for persons with hearing loss; removing the "cap" on the number of authorized interpreter training programs; and establishing permanent authority for the Office of Deafness and Communicative Disorders in the Rehabilitation Services Administration (RSA), U.S. Department of Education.

On October 29, 1992, when former President Bush signed the Rehabilitation Act Amendments of 1992, many of these recommendations became a reality. The following sections will high-light changes in the Act that should provide added responsiveness of the system to consumers with hearing loss.

State Plans for Services to Persons Who Are Deaf or Hard ofHearing

The major activity funded under the Rehabilitation Act is the state-federal rehabilitation program that provides comprehensive vocational rehabilitation and independent living services to eligible individuals with disabilities through state vocational rehabilitation agencies. The key service providers in the state agencies are the rehabilitation counselors, who provide counseling and other services as identified in an individualized written rehabilitation program (IWRP).

States must submit a plan for services to the RSA Commissioner. This plan must include a designated state agency for the provision of vocational rehabilitation services, provide for financial participation by the state, and contain the policies and methods to be followed in carrying out the plan. Most states have agencies that serve all disability groups, although about half of all states have, in addition to the general agency, an agency that provides service only to people who are blind.

Because people who are deaf or hard of hearing may have trouble getting appropriate and equitable services from a qualified rehabilitation counselor in a general state agency, the COR recommended that states include with the submission of their state plans for vocational rehabilitation services a plan for the provision of such services to people who are deaf or hard of hearing. A model state plan for rehabilitation services to people who are deaf was originally published in 1973 (Schein, 1973), revised in 1977 and 1980, and completely updated with a section on services to people who are hard of hearing in 1990 (Watson, 1990). The adoption of comparable plans by states is now voluntary, resulting in a patchwork of policies and procedures for services to people with hearing loss across the nation. Although COR's recommendation for state plans was not incorporated into the amendments, some provisions were made in the amendments that require state plans to "ensure the availability of personnel within the designated State unit, to the maximum extent feasible, trained to communicate in the native language or mode of communication of the client" (Sec. 101 (a)(7)(C)); and design "outreach procedures to identify and serve individuals with disabilities... who have been unserved or underserved by the vocational rehabilitation system" (Sec.101 (a)(15)(D)). There were also notable changes to the policies and procedures for transition services under state plans. The next section will review these changes.

Transition Services

The transition from school to work, to postsecondary education, or to community life is a daunting developmental task for most youth in America today. It can present particular challenges for youth with disabilities, in general, and deaf or hard of hearing youth in particular. These students are at high risk of dropping out or "aging out" of special education without a diploma. Only 59 percent earn a diploma and 19 percent exit school without a diploma or certificate (Allen, Rawlings, & Schildroth, 1989).

Residential schools for deaf youth and the state-federal vocational rehabilitation system have historically maintained strong collaborative relationships. These relationships were based, in large part, on the low-incidence nature of early-onset deafness and the common bond of professionals who worked with persons who were deaf--teachers, administrators, and rehabilitation counselors--regardless of service setting (Danek & McCrone, 1989). The early cooperative relationships among systems for students who were deaf--the term "transition" was not yet coined--was, in many ways, a model for the transition initiatives of the 1980's. Over 40 years ago, a survey of working relationships between schools and rehabilitation agencies showed a very high percentage of verbal or written agreements for collaborative activities leading to appropriate vocational choice (Hoag, 1948). Residential schools for deaf students then concentrated heavily on vocational training. However, they recognized that, even in the early decades of this century, most individuals simply did not remain in the occupation that high school vocational education prepared them to enter (Martens, 1936; Walker, 1935). An established relationship with rehabilitation services was necessary to assure adequate vocational adjustment over an individual's lifetime.

Over time, broader events and growing complexity in the service delivery system diminished the strength and perceived importance of these school-rehabilitation partnerships. Now a much greater proportion of students who are deaf are served in mainstream programs (Schildroth & Karchmer, 1986). An even greater percentage of students who are hard of hearing are educated in these programs. Surprisingly, mainstreamed hard of hearing students earn lower grade point averages in high school and are more than twice as likely to fail a course when compared with their peers who are deaf (Wagner & Shaver, 1989). These unexpected findings have been attributed to large class size, lack of sensitivity to their needs, and the lack of support services for hard of hearing students in many mainstream programs (Nash, 1992). Many high school students--both deaf and hard of hearing--will be unidentified and unserved in the transition process unless a strong commitment is made by the systems involved and the personnel within these systems to expend professional energy and resources to meet their needs. However, competing demands on professional time, lack of clarity about when to begin transition services and who is responsible for them, the continuing lack of qualified personnel to serve persons who are deaf (Danek, 1987; Danek & McCrone, 1989), and the under-recognition of the unique needs of hard of hearing students can make such a commitment problematical.

Recent research (El-Khiami, 1991; Sendelbaugh & Bullis, 1988) reveals that transition agreements between special education and rehabilitation vary substantially across the nation. At least two studies (Allen, Rawlings, & Schildroth, 1989; Sendelbaugh & Bullis, 1988) show that less than half of all state rehabilitation agencies have a formal state level transition plan. Perhaps of greater concern is that most agreements target special education students in general with no mention of the needs of specific disability groups, such as students who are deaf or hard of hearing.

The Individuals with Disabilities Education Act Amendments of 1990 (IDEA) require cooperative transition planning by special education and rehabilitation. However, it recognizes that rehabilitation agencies may choose not to work with some students in special education programs. For these students, who still might not be served by rehabilitation or other adult service programs, IDEA states, "In the case where a participating agency, other than the educational agency, fails to provide agreed upon services, the educational agency shall reconvene the IEP [Individualized Education Plan] team to identify alternative strategies to meet the transition objectives" (Individuals with Disabilities Education Act, 1990, Sec. 602 (a)(20)).

The 1992 Amendments to the Rehabilitation Act provide greater specificity to the requirements for cooperative planning. They adopt the same definition for transition that is contained in IDEA: "...a coordinated set of activities for a student designed within an outcome-oriented process, that promotes movement from school to post school activities, including post secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation. The coordinated set of activities shall be based upon the individual student's needs, taking into account the student's preferences and interests, and shall include instruction, community experiences, the development of employment and other post school living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation" (Rehabilitation Act, Sec. 7 (35)).

The amendments also require that the state plan for rehabilitation services must now include, among other things, "plans, policies, and procedures" for formal cooperative arrangements with state education officials. These formalized arrangements must address: "provisions for determining State lead agencies and qualified personnel responsible for transition services; procedures for outreach to and identification of youth in need of such services; and a time-frame for evaluation and followup of youth who have received such services" (Rehabilitation Act, Sec. 101 (a)(24)(C)(i) through (iii). In addition, the state plan for rehabilitation services must now describe how nonspecial education students can access the system (Sec. 101(a)(30)). Transition services are also specifically added to the scope of vocational rehabilitation services that may be provided by the State rehabilitation agency and are identified as "transition services that promote or facilitate the accomplishment of long-term rehabilitation goals and intermediate rehabilitation objectives" (Sec. 103(a)(14)).

The level of specificity contained in the amendments should ensure that more students who are deaf or hard of hearing will be identified and referred by special education programs to rehabilitation services and will receive such services from qualified professionals. Similarly, hard of hearing students who are not in special education programs will be less likely to be overlooked in the transition process.

Programs For Individuals Who Are Deaf or Hard Of Hearing and Lower Achieving

A logical corollary to the need for transition services for youth who are deaf or hard of hearing is to ask, "transition to what?" Formalized agreements, outreach, and other services for the coordination of special education and rehabilitation will only work if there are adult service programs available to meet the continuum of needs of this population. In this respect, college-bound deaf and hard of hearing students fare reasonably well. The number of programs accessible specifically to this population has increased over the past two decades and is now approximately 150 (Rawlings, Karchmer & DeCaro, 1988). Deaf high school graduates who go on to earn an associate or bachelors degree have higher earnings and much lower unemployment rates 10 years after graduation than those who do not earn such a degree (Macleod-Gallinger, 1992). However, only a small percentage of deaf youth complete associate or bachelors degree programs.

A population that is particularly at risk for unemployment and continued dependence on adult service programs is the so-called "lower achieving" individual who is also deaf or hard of hearing. These individuals will have problems in multiple life areas: independent living; academic skills, particularly reading and language skills; and social and vocational adjustment. They may also have additional disabilities (including substance abuse) and may experience many environmental obstacles in attaining satisfactory life adjustment.

The COED report (1988) highlighted the needs of this often overlooked population (whom it termed "lower functioning") and noted that the lack of accessible and appropriate rehabilitation training is a growing problem for these individuals. The COED report recommended the establishment of one comprehensive service center in each of the 10 federal regions of the United States to meet the needs of deaf people who are "lower functioning." COR noted the difficulty for many people who are deaf or hard of hearing and also "lower functioning" or "lower achieving" in accessing services from cross-disability community rehabilitation programs, most notably supported employment and independent living programs. This lack of access is not due to deliberate exclusion but rather to the lack of qualified personnel and programmatic inadequacies in many of these programs. COR recommended mandating communicative accessibility in these programs, the provision of assistive listening devices and technology, needs assessments of the deaf and hard of hearing population within each state, and involvement of consumers and consumer organizations in program development and service provision. COR also supported the COED recommendation for comprehensive service centers, noting that such centers also should serve the needs of hard of hearing youth.

Regrettably, the Rehabilitation Act Amendments of 1992 did not establish comprehensive service centers specifically for deaf and hard of hearing individuals who are also "lower achieving." However, many assurances of accessibility and program accommodation for these individuals were realized in the amendments.

Client assistance projects are now charged with providing advocacy to facilitate access to services "especially with regard to individuals who have traditionally been unserved or underserved by vocational rehabilitation programs" (Sec. 112 (a)). Under innovation and expansion grants, funds may be made available to carry out "programs or activities to improve the provision of, and expand, employment services in integrated settings to individuals with sensory... impairments who have traditionally not been served by the State vocational rehabilitation agency (Sec. 123 (2)). Under Title III (Training and Demonstration Projects) grants may be authorized for "special projects and demonstrations which hold promise of expanding or otherwise improving rehabilitation services to individuals with disabilities, including...individuals who are deaf whose maximum vocational potential has not been reached" (Sec. 301 (2)).

The identification of underserved individuals in these initiatives is a good beginning for the expansion of services to people who historically have been neglected and overlooked.

Supported Employment

Supported employment is defined as competitive employment in integrated settings for workers with severe disabilities who require ongoing support in order to maintain employment (President's Committee for Employment of People with Disabilities, 1987). It is defined in the Rehabilitation Act as "... ongoing support services and other appropriate services needed to support and maintain an individual with the most severe disability in supported employment, that (A) are provided singly or in combination and are organized and made available in such a way to assist an eligible individual in entering or maintaining integrated, competitive employment; (B) are based on a determination of the needs of an eligible individual, as specified in an individualized written rehabilitation program; and (C) are provided by the designated State unit for a period of time not to extend beyond 18 months, unless under special circumstances ..." (Sec. 7 (34) (A) through (C)).

Supported employment represents a major paradigm shift in rehabilitation (Szymanski, Shafer, Danek, & Schiro-Geist, 1990). It recognizes that community integration for persons with severe disabilities will depend on integrated work environments that provide support to acquire and maintain work-related skills. Although originally conceptualized for persons with mental retardation, supported employment is effective for a wide range of people with severe disabilities (Rusch & Hughes, 1989), including those who are deaf (Danek, Seay, & Collier, 1989). However, access to appropriate supported employment provided by qualified personnel has been lacking for most deaf and many hard of hearing youth who could benefit from it.

The 1992 Amendments to the Rehabilitation Act now partially address the lack of programmatic options for these individuals. Under special demonstration programs, grants are authorized to establish "programs for providing vocational rehabilitation services which hold promise of expanding or otherwise improving services to individuals with disabilities (especially those with the most severe disabilities), including...individuals who are deaf" (Sec. 311(a)(1)). "The Commissioner [of the Rehabilitation Services Administration] may make grants...provding supported employment, including continuation of determinations of the effectiveness of natural supports or other alternatives to providing extended employment services" (Sec. 311 (c) (1) (A). "Not less than two such grants shall serve individuals who either are lowfunctioning and deaf or low-functioning and hard of hearing" (Sec. 311(c)(1)(C)). In addition, "The Commissioner may make grants to public or private institutions to pay for the cost of developing special projects and demonstrations to address the general education, counseling, vocational training, work transition, supported employment, job placement, followup and community outreach needs of individuals who are either low-functioning and deaf or low functioning and hard of hearing. Such projects shall provide educational and vocational rehabilitation services that are not otherwise available in the region involved and shall maximize the potential of such individuals, including individuals who are deaf and have additional severe disabilities" (Sec. 311(e)(1)).

These changes should make a difference. Authorization and funding for demonstration grants in supported employment will begin to address the service needs of this population while providing models for best practices in supported employment programs for deaf and hard of hearing individuals.

Independent Living

The independent living philosophy, as defined by the 1992 amendments, encompasses "consumer control, peer support, self-help, self-determination, equal access, and individual and system advocacy, in order to maximize the leadership, empowerment, independence, and productivity of individuals with disabilities, and the integration and full inclusion of individuals with disabilities into the mainstream of American society" (Sec. 701). Persons who are deaf and, to a lesser extent, persons who are hard of hearing are notoriously underserved by independent living programs that typically have a philosophy of full inclusion but are abysmally unaware of the needs of deaf people. Unless these programs make a deliberate and sustained effort to include people who are deaf, they are inadvertently excluding this population.

The Rehabilitation Act amendments may offer some amelioration of these circumstances. The Act now requires that plans for independent living services from states "set forth steps to be taken regarding outreach to populations that are unserved or underserved by programs..." (Sec. 704 (1)). Centers for independent living must similarly provide "aggressive outreach ... to reach populations of individuals with severe disabilities that are unserved or underserved by programs under this title" (Sec. 725(c)(10)) and "staff at centers for independent living will receive training on how to serve such unserved and underserved populations" (Sec. 725(c)(11)).

Qualified Personnel

The qualifications of service providers are a crucial element in the success of any rehabilitation program. There is an ongoing shortage of qualified interpreters, counselors, and other personnel to work with deaf and hard of hearing individuals in education and rehabilitation settings (COED, 1988; Danek, 1987).

The Rehabilitation Act has funded training programs for rehabilitation personnel since 1954 and has required that personnel serving individuals with disabilities be "qualified" since 1984 (Danek, 1992). However, there has never been a definition of "qualified" in the legislation, a situation that has resulted in varying hiring standards across the nation and no consumer assurance of personnel competency in state agencies and other public programs serving individuals with disabilities. An unevenness of standards also exists across systems serving people who are disabled. For example, while special education programs have uniform standards for personnel as specified in IDEA and private rehabilitation programs almost uniformly require specific educational or certification credentials, public rehabilitation programs hold lower standards than these other systems, thus creating a two-tier adult service system and confusion for consumers and families who assume comparable standards exist in public rehabilitation and special education.

Changes in the Rehabilitation Act now move closer to quality assurance in service provision from state rehabilitation agencies by requiring that state plans must set forth policies and procedures relating to "(i) the establishment and maintenance of standards that are consistent with any national or State approved or recognized certification, licensing, registration, or other comparable requirements that apply to the area in which such personnel are providing vocational rehabilitation services; and (ii) to the extent such standards are not based on the highest requirements in the State applicable to a specific profession or discipline, the steps the State is taking to require the retraining or hiring of personnel within the designated State unit that meet appropriate professional requirements in the State" (Sec. 101 (a)(7)(B)(i) and (ii)).

These changes are virtually the same as existing personnel standards under IDEA. Although they hold promise for greater consumer protection in general, no specialized certification or licensure standards currently exist (beyond discipline-specific certification and licensure) for most personnel who work with deaf or hard of hearing consumers. The Rehabilitation Act amendments address this issue, but only partially, by mandating regulations to assure that rehabilitation providers "comply with State guarantees such as ... minimum standards to ensure the availability of personnel, to the maximum extent feasible, trained to communicate in the native language or mode of communication of the client" (Rehabilitation Act, Sec. 12(e)(2)(D)(iii)).

Communication competency is necessary but not sufficient for adequate service provision for consumers who are deaf or hard of hearing. However, recognition of this need is an important first step toward the professionalism of counselors and other service providers for persons who are deaf or hard of hearing.

Interpreter Training

The requirements under the Americans with Disabilities Act of 1990 (ADA) for "reasonable accommodations" will certainly exacerbate the current shortage of qualified interpreters. Unlike other accommodations under ADA, the provision of interpreters is a recurring need that must be continuously met. Full implementation of ADA will require accommodations for deaf or hard of hearing persons at the worksite and in community programs and services not covered under Section 504 of the Rehabilitation Act of 1973.

The Rehabilitation Act authorizes and funds training programs for interpreters. However, until the 1992 amendments, only 12 programs were permitted to be funded. The amendments remove this restriction on the number of training programs "... for the purpose of training a sufficient number of interpreters to meet the communications needs of individuals who are deaf, the secretary, through the Office of Deafness and Communicative Disorders, may award grants under this section to any public or private nonprofit agency or organization to establish interpreter training programs or to provide financial assistance for ongoing interpreter training programs" (Sec. 302(f)(1)).

Office of Deafness and Commnicative Disorders

The Office of Deafness and Communicative Disorders has provided a centralized focus in RSA for many years regarding rehabilitation services to persons who are deaf or hard of hearing. However, this office never had statutory authority or responsibility for managing training programs related to serving deaf or hard of hearing persons. COR strongly advocated for a permanent legislative base for the office and the amendments have finally reflected such statutory authority (Sec. 302(f)(1)). The intent of these amendments is, additionally, to elevate that office within the Department of Education to a level above its current branch status, a recommendation that was also supported by COR.

Services to Deaf-Blind Individuals

Individuals who are deaf and blind have a dual sensory disability and cannot typically access generic programs for hearing persons with disabilities, nor programs for persons who are deaf or blind, due to communication and other barriers. Because appropriate services are usually not available locally, the Helen Keller National Center for Deaf-Blind Youth and Adults (HKNC) offers a program of evaluation and training in independent living, communication, mobility, and job skills to individuals who are deaf-blind and operates a national network of affiliated agencies to identify and serve deaf-blind persons in their communities.

The Helen Keller National Center Act of 1992 defines an individual who is deaf-blind as an individual "who has a central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual field subtends an angular distance no greater than 20 degrees, or a progressive visualloss having a prognosis leading to one or both of these conditions; who has a chronic hearing impairment so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; and for whom the combination of impairments ... cause extreme difficulty in attaining independence in daily life activities, achieving psychosocial adjustment, or obtaining a vocation; who despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints, or both, can be determined through functional and performance assessment to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psycho-social adjustment, or obtaining vocational objectives; or meets other such requirements as the Secretary may prescribe in regulation" (Sec. 206(2)(A) (i) through (iii), (B), and (C)).

In recent years, family roles and interventions in rehabilitation have received legislative support and expanded recognition (Szymanski, Hershenson, & Power, 1988). The Helen Keller National Center Act emphasizes the importance of services to family members of individuals who are deaf-blind. Specifically, it authorizes services to "train family members of individuals who are deaf-blind, at the (Helen Keller) Center or anywhere else in the United States, in order to assist family members in providing and obtaining appropriate services for the individual who is deaf-blind" (Sec. 203(b)(2)).

Assistive Technology

There has been a virtual explosion of technological advances for persons with disabilities over the past decade. This has been particularly true for both deaf and hard of hearing persons who now have access to assistive listening devices, telecommunications devices, alerting systems, and other technology designed to improve communication and provide awareness of environmental sounds (Compton & Kaplan, 1988). Persons with hearing loss report a high level of usage of TV decoders, TDD's, flashing lights for telephones, alarm clocks, and doorbells and a moderate level of usage of smoke detector lights, alarm clock vibrators, and baby cry lights (Harkins & Jensema, 1988).

Title IV of ADA now requires common carrier telephone companies to provide telecommunication relay services 24 hours a day 7 days a week to persons with hearing loss. This provision and expanded usage of assistive technology for those who can benefit from it should assure greater independence for persons who are deaf or hard of hearing in employment and related community activities (McCrone, 1990).

The Rehabilitation Act amendments of 1992 recognize the pivotal role technology assumes in removing or minimizing environmental barriers to persons with disabilities. The term, rehabilitation technology, is defined in the amendments as "the systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of and address the barriers confronted by individuals with disabilities in areas which include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services" (Sec. 7(13). The amendments require that state plans describe how assistive technology will be used for the consumer with a disability at each stage of the rehabilitation process and how it will be used on a statewide level. They also require that, in the determination of client eligibility and rehabilitation needs, assistive technology devices and services or worksite assessment will become part of the assessment process.

The new Rehabilitation Amendment requirements assume that service providers, including rehabilitation counselors, job coaches, job development specialists, and related personnel have sufficient knowledge of appropriate technology for persons with hearing loss to be able to assist consumers with choices and utilization of the technology. Training programs in these fields and in audiology will need to include this information in their curriculum. For example, the rehabilitation counselor education program at Gallaudet University now includes knowledge of assistive technology through cooperative curricular efforts with the Assistive Devices Center at Gallaudet. This is a beginning. In order to meet the needs of all persons with hearing loss--deaf and hard of hearing--all rehabilitation counselor and related programs training professionals to work with adults with hearing loss will need to modify their curriculum to include state-of-the art information about assistive technology.

Summary

Public rehabilitation services have expanded enormously in the more than 70 years of their legislated existence. The new Rehabilitation Act amendments maintain previous initiatives for consumer involvement and civil rights protection while responding more sensitively to consumer needs and choices, providing increased access for underserved populations to programs funded under the Act, and insuring quality control in programs and personnel.

Note

1. The term, "deaf" (lower case "d"), refers to any person with hearing loss so severe that communication and learning is primarily by visual methods. The capital "D" Deaf indicates a cultural identification with members of the Deaf community and the use of American Sign Language as the primary communication method.

People who are "hard of hearing" have some degree of hearing loss ranging from mild to profound, as defined by audiological measurement; can benefit to some extent from the use of hearing aids or other assistive listening devices; depend primarily upon spoken or written English in communicating with others (do not rely on any form of sign language as their primary means of communication); and may or may not have taken steps to deal with their hearing loss (i.e., audiological assessment, use of hearing aids or other technology).

The above definitions are from Rehabilitation of Individuals Who Are Hard of Hearing and Late Deafened: A Guide for Rehabilitation Practitioners, developed by the Region VI Rehabilitation Continuing Education Program at the University of Arkansas and produced under a grant (H246A20002) from the Rehabilitation Services Administration, U.S. Department of Education.

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