A r c h i v e d I n f o r m a t i o n
[Federal Register: March 16, 2000 (Volume 65, Number 52)]
[Notices]
[Page 14345-14355]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr16mr00-133]
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Part II
Department of Education
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National Institute on Disability and Rehabilitation Research; Final
Funding Priorities for Fiscal Years 2000-2001; Invitation for
Applications for Model Spinal Cord Injury Centers and Research Centers;
Notice
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DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research
AGENCY: Department of Education.
ACTION: Notice of Final Funding Priorities for Fiscal Years 2000-2001
for Certain Centers.
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SUMMARY: The Assistant Secretary for the Office of Special Education
and Rehabilitative Services announces final funding priorities for
fifteen Model Spinal Cord Injury Centers and two Rehabilitation
Engineering Research Centers (RERCs) under the National Institute on
Disability and Rehabilitation Research (NIDRR) for fiscal years 2000-
2001. The Assistant Secretary takes this action to focus research
attention on areas of national need. These priorities are intended to
improve rehabilitation services and outcomes for individuals with
disabilities.
DATES: These priorities take effect on April 17, 2000.
FOR FURTHER INFORMATION CONTACT: Donna Nangle. Telephone: (202) 205-
5880. Individuals who use a telecommunications device for the deaf
(TDD) may call the TDD number at (202) 205-4475. Internet: Donna--
Nangle@ed.gov
Individuals with disabilities may obtain this document in an
alternate format (e.g., Braille, large print, audiotape, or computer
diskette) on request to the contact person listed in the preceding
paragraph.
SUPPLEMENTARY INFORMATION: This notice contains final priorities under
the Special Projects and Demonstrations for Spinal Cord Injuries (SCI)
Program and two RERCs related to Low Vision and Blindness and Children
with Orthopedic Disabilities. The final priorities refer to NIDRR's
Long-Range Plan (the Plan). The Plan can be accessed on the World Wide
Web at: http://www.ed.gov/legislation/FedRegister/other/1999-12/
68576.html.
These final priorities support the National Education Goal that
calls for every adult American to possess the skills necessary to
compete in a global economy.
The authority for the Secretary to establish research priorities by
reserving funds to support particular research activities is contained
in sections 202(g) and 204 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. 762(g) and 764).
Note: This notice of final priorities does not solicit
applications. A notice inviting applications is published elsewhere
in this issue of the Federal Register.
Analysis of Comments and Changes
On December 9, 1999 the Assistant Secretary published a notice of
proposed priorities for the Model Spinal Cord Injury Centers in the
Federal Register (64 FR 69154). The Department of Education received 25
letters commenting on the notice of proposed priorities by the deadline
date. On December 17, 1999 the Assistant Secretary published a notice
of proposed priorities for two Rehabilitation Engineering Research
Centers in the Federal Register (64 FR 70956). The Department of
Education received 8 letters commenting on the notice of proposed
priorities by the deadline date. Technical and other minor changes--and
suggested changes the Assistant Secretary is not legally authorized to
make under statutory authority--are not addressed.
Model Spinal Cord Injury Centers
Priority 1: Model Spinal Cord Injury Centers
Comment: Several commenters discussed the issue of the national
database, with a range of questions and recommendations. Some asked
whether it was a given that the national database would be continued as
is, or whether the requirement might be to contribute to a national
database not yet configured. Many commenters asked whether the number
or type of variables in the current database (MSCIS) would be
maintained or altered for the next five-year period. One commenter
suggested that only large Centers should be required to contribute to
the database. Several commenters asked whether there would be changes
in the selection criteria or funding levels related to database
participation.
Discussion: All Centers will be required to contribute to the
national database as designated by the Secretary. The database has
evolved over its entire existence, and will continue to evolve to meet
current needs. NIDRR intends to evaluate the existing database within
the next twelve months, and prescribe modifications as necessary. These
modifications may include changes in the number and type of variables
or limits on follow-up samples. However, for the purpose of responding
to this notice, prospective applicants should base their proposals on
the database as currently configured. If those modifications require
changes to the proposed scope of work or budget of any funded Center,
these changes can be negotiated with the funding agency.
Changes: None.
Comment: A number of commenters stated that the proposed research
priority areas were either unclear or too limiting. Several questioned
whether the Centers were to be limited to one area or topic. Some
questioned why the Associated Research Areas section of the Plan, as
well as other specific priorities in the Plan, were not referenced, and
others proposed that each Center be encouraged to undertake one
research project addressing Health and Function and one project
addressing a second chapter of the Plan.
Discussion: This priority encourages focused, cohesive, and
integrated research programs that will make a substantial contribution
to the knowledge base in SCI rehabilitation, while simultaneously
discouraging fragmented programs with numerous discrete and disparate
projects. The Plan presents an integrated approach to research. NIDRR
recognizes that disability and rehabilitation are both holistic
phenomena. Investigations of major issues in one area, for example
Health and Function, may involve issues of technology or independent
living. Applicants have the freedom to investigate any issues
prioritized in the Plan, including those in the associated areas
chapter and issues that cut across areas of the Plan. The priority
encourages studies that will capitalize on each Center's population and
programmatic characteristics to make significant contributions to SCI
rehabilitation. Applicants should carefully justify the likelihood of
achieving the proposed research objectives.
Changes: The list of priorities for the research projects has been
modified to include the associated areas chapter of the Plan, and to
incorporate investigation of any long-range plan priority areas,
including cross-cutting issues.
Comment: Several commenters discussed the mechanism of running a
separate competition for collaborative research projects. Most
commenters supported this idea, although one contended that large
Centers should be funded to do site-specific research, while Centers
with smaller patient loads could collaborate on research projects.
Discussion: A major advantage of supporting a Model Systems program
is the ability to conduct studies with large samples on populations
that are geographically, ethnically, culturally, and otherwise diverse.
This is an important justification for the common data collection
system. In the past, Centers have been required to propose both
collaborative and site-specific research. This was an administrative
problem, because applicants would have to propose collaborations with
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other applicants who might not be chosen for funding. After the Centers
were funded, many had to drop or alter proposed collaborative studies
because some of the partners did not receive funding. Also, the peer
review process in the past did not give adequate attention to the
research proposals, as they were focused on evaluating the
comprehensiveness and quality of the systems of care. A separate
competition for collaborative research projects in Fiscal Year 1998 for
the NIDRR Traumatic Brain Injury program led to awards of substantial
and meaningful research projects. It should be noted that collaboration
is not precluded in the current competition. Applicants can form
collaborative relationships with any appropriate entity as required to
address their particular research.
NIDRR acknowledges the concerns of Centers that are tracking large
patient populations. Projects will be funded at varying amounts up to
the maximum allowed based on individual factors in proposals. Proposed
budgets should reflect costs associated with data collection, proposed
research, and administration. Funding will be determined individually
for each successful applicant up to the maximum allowed based upon
documented workload, the peer review process, and the overall budgetary
limits of the program.
Changes: None.
Comment: Many practitioners and researchers in SCI rehabilitation
point out that the individuals with SCI of non-traumatic origins now
comprise a large portion of the individuals treated in rehabilitation
units. There have been strong arguments for expanding the scope of the
SCI Model Systems beyond traumatic SCI.
Discussion: This is an important change to consider. However, there
has not been sufficient examination of the ramifications of changing
the inclusion criteria of the database. NIDRR requires more data
concerning the populations to be considered, proposed inclusion
criteria such as time of onset and extent of lesion, and comparison of
characteristics of traumatic vs. the non-traumatic SCI populations,
including natural course, coexisting conditions, and socio-demographic
variables. Applicants remain free to treat non-traumatic SCI in
clinical settings and to include these patients in research projects.
However, the parameters of the MSCIS will not be expanded at this time
to include these non-traumatic patients. The peer review process will
evaluate the merits of each proposal.
Changes: None.
Comment: Some respondents were concerned that there were too few
points being awarded to adequacy of facilities, as the new selection
criteria award a large number of points for project design. Respondents
were unclear as to whether project design refers only to the design of
the research portion. Other commenters objected to the inclusion of
additional points for employment of individuals with disabilities on
the project, arguing that applicants would tend to give pro forma
responses, that the requirement is antithetical to the direction of
current affirmative action practices, or that institutions may be
forced into a bidding war for the relatively few qualified disabled
researchers.
Discussion: The new thrust of the model systems program is to
emphasize research. NIDRR believes there are sufficient points allowed
for a comprehensive, integrated system of care to supplement the
importance of high quality facilities. The Project Design criteria
refer to the research project, and the Service Comprehensiveness
criteria refer to the model demonstration.
NIDRR encourages employment of persons with disabilities on
research projects not only as a measure of equal opportunity, but
because individuals with disabilities bring important perspectives and
concerns to research. The disability research field is also encouraged
to find innovative ways to build research capacity among persons with
disabilities.
Changes: The Project Design criteria section has been renamed
Research Project Design.
Comment: Several commenters discussed the need for a specified
minimum number of new injuries to be considered for inclusion in this
program.
Discussion: NIDRR agrees that a ``critical mass'' of new injuries
is important for an SCI Center of Excellence. This is important for
maintaining a high level of clinical skill and for having enough
subjects to perform meaningful research. However, NIDRR views this
requirement as contextual. It is expected that applicants will document
their history of new patients, and the likelihood of obtaining
sufficient numbers to maintain a center of excellence for SCI care and
to conduct research. It is the responsibility of the applicants to
demonstrate that they have sufficient admissions to maintain a clinical
Center of excellence and to conduct significant research.
Changes: None.
Comments: Two commenters were concerned that the priority did not
discuss the geographic distribution of the Centers.
Discussion: When making funding determination, both the legislation
(Section 204(b)(4) of Rehabilitation Act of 1973, as amended (29 USC
764(b)(4)) and the regulations (34 CFR Part 359) specify that the
Director must take into account the location of any proposed SCI Center
and the appropriate geographical and regional allocation of such
Centers. This geographic distribution is considered in making the final
determination of the awards.
Changes: None.
Rehabilitation Engineering Research Centers--General
Comment: What criteria does NIDRR use for selection of RERCs?
Discussion: NIDRR publishes selection criteria in the Notice
Inviting Applications. The selection criteria are used by peer
reviewers to evaluate the proposals submitted to NIDRR under this
competition.
Changes: None.
Comment: Do RERCs have the authority to establish linkages with
other agencies in order to achieve the necessary outcomes?
Discussion: RERCs are required to collaborate with specific RERCs
and RRTCs as identified in each priority. In addition to these
requirements, an applicant could propose to coordinate with other
agencies or organizations. The peer review process will evaluate the
merits of each applicant's proposed activities.
Changes: None.
Comment: Are the proposed RERCs required to establish partnerships
between product manufacturers and practitioners to design and implement
innovative technologies?
Discussion: NIDRR encourages applicants to include manufacturers,
practitioners and consumers, as appropriate, in the design process.
Each RERC is required to develop and implement, in consultation with
the NIDRR-funded RERC on Technology Transfer, a utilization plan to
ensure that all new and improved technologies developed by the RERC are
successfully transferred to the marketplace. The peer review process
will evaluate the merits of each application.
Changes: None.
Priority 2: Low Vision and Blindness
Comment: Four commenters suggested that a new activity should be
added that requires the RERC to research and develop technologies that
address jobsite adaptation, employment and daily living problems among
the target population.
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Discussion: NIDRR agrees that unemployment for persons who are
blind or visually impaired is a very serious problem, as referenced in
the first paragraph of the background statement.
Changes: A new activity has been added requiring the RERC to
investigate, develop, and evaluate new vocational and daily living
technologies and approaches.
Comment: Two commenters expressed concern that the word
``screening'' in the first required activity may be interpreted to
imply merely the detection of a problem, whereas the real need is for
more detailed assessment and analysis of the complex problems.
Substituting ``assessment'', ``analysis'' or ``evaluation'' for
``screening'' would clarify and focus this priority.
Discussion: NIDRR agrees that ``assessment'' is a more appropriate
term.
Changes: The first required activity has been revised by
substituting the word ``assessment'' for ``screening.''
Comment: One individual commented that the main mandate of RERCs,
as stated in the Rehabilitation Act, as amended, is to focus on
research and development ``to produce new scientific knowledge, and new
or improved methods, equipment, and devices.'' This theme is very well
represented in the third required activity, which refers to
``technologies and approaches,'' but the other activities may be
somewhat limiting in their focus. This would easily be remedied by
inserting ``technologies and approaches'' or ``technologies and
methods'' in each activity where the word ``technologies'' appears.
Discussion: NIDRR agrees that the priority would be strengthened by
replacing ``technologies'' with ``technologies and approaches'' where
applicable.
Changes: Required activities 1, 2, and 4 have been revised by
replacing ``technologies'' with ``technologies and approaches.''
Comment: The third required activity does not accurately reflect
the background statement and the broad language used might suggest that
any and all studies of vision and aging apply.
Discussion: NIDRR believes that the background statement adequately
supports each activity. However, while NIDRR agrees with the commenter
that the third required activity would be strengthened by limiting the
number of potential vision screening and assessment technologies
investigated, NIDRR does not agree that the commenter's specific
language recommendations accomplish this purpose.
Changes: The third required activity 3 has been revised by adding
the words ``and practical'' after the word ``simple.''
Priority 3: Technologies for Children with Orthopedic Disabilities
Comment: Two goals for this RERC are to enable children to
negotiate their environment and to enhance interactive play and social
skill development. To accomplish these goals, the RERC must include
typically developing peers.
Discussion: An applicant could propose research methodologies that
include the use typically developing peers. NIDRR elects to leave the
choice of research methodologies to be proposed to the applicants. The
peer review process will evaluate the merits of each proposal.
Changes: None.
Comment: Parental involvement should be a requirement in the design
and use of technologies developed by this RERC.
Discussion: NIDRR agrees that parental involvement is necessary for
an RERC such as this one. There is mention of parental expectations in
the first paragraph of the background statement. Furthermore, there is
a general requirement that all RERCs involve persons with disabilities
and their family representatives in planning and implementing their
research and development activities. The peer review process will
evaluate the merits of each applicant's proposed activities.
Changes: None.
Model Spinal Cord Injury Centers
The authority for Model Spinal Cord Injury Centers is contained in
section 204(b)(4) of the Rehabilitation Act of 1973, as amended (29
U.S.C. 764(b)(4)). The Secretary may make awards for up to 60 months
through grants or cooperative agreements. This program provides
assistance to establish innovative projects for the delivery,
demonstration, and evaluation of comprehensive medical, vocational, and
other rehabilitation services to meet the wide range of needs of
individuals with spinal cord injuries.
Description of Special Projects and Demonstrations for Spinal Cord
Injuries
This program provides assistance for projects that provide
comprehensive rehabilitation services to individuals with Spinal Cord
Injury (SCI) and conduct spinal cord research, including clinical
research and the analysis of standardized data in collaboration with
other related projects.
Each SCI Center funded under this program establishes a
multidisciplinary system of providing rehabilitation services,
specifically designed to meet the special needs of individuals with
spinal cord injuries. This includes acute care as well as periodic
inpatient or outpatient follow up and vocational services. Centers
demonstrate and evaluate the benefits and cost effectiveness of such a
system for the care of individuals with SCI and demonstrate and
evaluate existing, new, and improved methods and equipment essential to
the care, management, and rehabilitation of individuals with SCI.
Grantees demonstrate and evaluate methods of community outreach and
education for individuals with SCI in connection with the problems of
such individuals in areas such as housing, transportation, recreation,
employment, and community activities.
Projects funded under this program ensure widespread dissemination
of research findings to all SCI Centers, and to rehabilitation
practitioners, individuals with SCI, and the parents, family members,
guardians, advocates, or authorized representatives of such
individuals. They engage in initiatives and new approaches and maintain
close working relationships with other governmental and voluntary
institutions and organizations to unify and coordinate scientific
efforts, encourage joint planning, and promote the interchange of data
and reports among SCI researchers.
The Department is particularly interested in ensuring that the
expenditure of public funds is justified by the execution of intended
activities and the advancement of knowledge and, thus, has built this
accountability into the selection criteria. Not later than three years
after the establishment of any Center, NIDRR will conduct one or more
reviews of the activities and achievements of the Center. In accordance
with the provisions of 34 CFR 75.253(a), continued funding depends at
all times on satisfactory performance and accomplishment.
Priority
Under 34 CFR 75.105(c)(3) the Assistant Secretary gives an absolute
preference to applications that meet the following priority. The
Assistant Secretary will fund under this competition only applications
that meet this absolute priority.
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Priority 1: Model Spinal Cord Injury Centers
Background
Estimates of the number of people living with traumatic spinal cord
injury (SCI) range from 183,000 to 230,000, with an incidence of
approximately 10,000 new cases each year (``Spinal Cord Injury Facts
and Figures at a Glance,'' National Spinal Cord Injury Statistical
Center (NSCISC), University of Alabama at Birmingham). Although SCI
predominately affects young adults (56% of SCIs occur among people aged
16-30 years), there is an increasing proportion of new SCI cases in the
population over 60 years of age (NSCISC, ibid.). The true significance
of traumatic SCI lies not primarily in the numbers affected, but in the
substantial impact on individuals' lives and the associated substantial
health care costs and living expenses. A traumatic SCI has far-reaching
repercussions on the lives of the injured persons and their families
that can be devastating if not addressed effectively. According to a
report from the Agency for Health Care Policy and Research (Hospital
Inpatient Statistics, 1996, AHCPR Publication No. 99-0034), SCI is the
most expensive condition or diagnosis treated in U.S. hospitals. The
estimated lifetime costs for an individual injured at the age of 25
range from $365,000 for an incomplete injury to more than $1.7 million
for an individual with a high cervical injury (NSCISC, op cit).
The Model SCI program was developed in 1970 to demonstrate the
value of a comprehensive integrated continuum of care for SCI. Twenty-
six sites have been designated, at various times, as Model SCI Centers
through funding initially from the Rehabilitation Services
Administration, and subsequently from the National Institute on
Handicapped Research, and its successor, the National Institute on
Disability and Rehabilitation Research (NIDRR). For the period 1995-
2000 there are 18 funded Model SCI Centers. (Additional information is
available on the World Wide Web at http://www.ncddr.org/mscis/). The
clinical components of the Model Centers are specified in the program
regulations, and include ``* * * emergency medical services, acute
care, vocational and other rehabilitation services, community and job
placement, and long-term community follow up and health maintenance''
(34 CFR 359.11). In addition to demonstrating and evaluating the
benefits of such a system the centers are required to contribute data
on their patients to the National Spinal Cord Injury Database (NSCID),
and engage in research both within the center, and in collaboration
with other centers.
During the past 30 years, there have been substantial improvements
in outcomes following SCI (Stover, S.L., et al., Spinal Cord Injury:
Clinical Outcomes From the Model Systems, and Special Issue, Spinal
Cord Injury: Current Research Outcomes from the Model Spinal Cord
Injury Care Systems, Archives of Physical Medicine and Rehabilitation,
Vol. 80, No. 11, November, 1999). Enhanced emergency medical services
have led to increased preservation of neurologic function. Mortality
during the first year following injury has continuously declined. Life
expectancy, while still below that for those without SCI, has
significantly increased for all levels of injury. The ideal of a
comprehensive multi-disciplinary system of care for SCI has gained
widespread acceptance.
However, significant challenges and opportunities remain for SCI
rehabilitation. Recent statistics from the National Spinal Cord Injury
Statistical Center (NSCISC) suggest that as the length of stay in
rehabilitation settings has progressively decreased (1993-1998), there
has been an increase in re-hospitalization during the first year after
injury. In addition, mortality after the first anniversary of injury
declined continuously from 1973-1992, but now has increased for the
period 1993-1998. Secondary medical complications, including, but not
limited to, respiratory complications, pressure ulcers and autonomic
dysreflexia, continue to be significant problems. Injuries due to
interpersonal violence have increased as a proportion of the total SCI
incidence and are more likely to be neurologically complete injuries.
There is a need to identify, evaluate, and eliminate barriers in
the natural, built, cultural, and social environments to enable people
with SCI to achieve the goal of fully reintegrating into their
community. Particular focus is required to address the needs of
minority and underserved populations. Although employment for the U.S.
population is at historically high levels, employment for the SCI
population remains low. Individuals with SCI due to inter-personal
violence have an employment rate approximately half of the average for
all individuals with SCI (NSCISC, op cit).
NIDRR shares the concerns of the rehabilitation community about the
impact of changes in health care delivery and financing upon the
continuum of care for SCI. People with SCI often have more difficulty
in obtaining adequate primary health care than non-disabled
individuals. The unique needs of women with SCI in cardiac
rehabilitation, reproductive health, and early cancer screening are
special issues that need to be addressed.
There are also new and developing opportunities for improving SCI
care. Medical and pharmacological therapies show promise for preserving
and enhancing function. There is a need to identify and evaluate
therapeutic interventions, including prevention and wellness programs,
and complementary and alternative therapies using evidence-based
evaluation protocols.
Advancing technology has the potential to enhance access and
function for individuals with SCI. There is a need to develop and
evaluate service delivery models incorporating telerehabilitation
strategies and technologies to provide services for people with SCI.
Assistive technologies may reduce the likelihood of secondary
complications in SCI. For example, improved wheelchair and seating
systems may reduce musculoskeletal trauma associated with long term
wheelchair use. Technological advancement has the promise of providing
greater accessibility to information, telecommunications, and
employment. The adoption of universal design methodologies will enhance
access to the built environment as well as rapidly developing
electronic and information technologies.
The development of strong collaborations by SCI centers with
community and social support organizations has the potential to impact
positively the independence and community integration for individuals
with SCI. Peer support beginning early in the rehabilitation process
may enhance return to participation in the community. The causes of
unemployment in SCI include lack of education and skills, lack of prior
work experience, and policy disincentives. Pending changes in
legislation and policy to permit retention of some medical insurance
during employment, together with the high demand for skilled
individuals in the workforce, represents an opportunity to foster
education and employment of individuals with SCI.
NIDRR has published the Plan that is based upon a new paradigm for
rehabilitation that identifies disability in terms of the relationship
between the individual and the natural, built, cultural, and social
environments (63 FR 57189-57219). The Plan focuses on both individual
and systemic factors that have an impact on the ability of people to
function. The elements of the Plan include employment outcomes,
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health and function, technology for access and function, and
independent living and community integration. As part of the Plan to
attain the goals in these areas, NIDRR is committed to capacity
building for research and training, and to ensure knowledge
dissemination and utilization. Each area of the Plan includes
objectives at both the individual and system levels. For example, the
health and function objectives include research to improve medical
rehabilitation interventions, as well as research to ensure access to
an integrated continuum of quality health care services that address
the unique needs of persons with disabilities. It is clear that the
challenges and opportunities for SCI care reflect all of the priority
areas of the Plan.
NIDRR has recently completed Program Reviews of all current Model
SCI Centers. Based upon presentations by the Centers, and discussion
with the external reviewers, NIDRR has concluded that the value of a
comprehensive integrated system of care for SCI has been demonstrated.
Because this conclusion is widely accepted, NIDRR is shifting the focus
of the program from demonstration, to place a greater emphasis upon
research. Participants in the Program Reviews observed that the
comprehensive continuum of quality care should continue to be a
requirement for participation in the Model SCI Centers Program. There
is significant diversity among the Centers, however, in research
interests and capacities. This diversity extends across the priority
areas of the Plan, and represents a strength of the program.
Reviewers noted that uniformly comprehensive, high quality care,
together with a common data collection system and administrative
infrastructure makes the Model SCI Centers Program a valuable platform
for various collaborative studies, including multi-center trials of
therapies and technologies. To further the enhancement of the research
mission, participants recommended a separate competition for the
collaborative research portion of the program. A separate competition
will facilitate focused, considered proposals, a higher level of
scientific review, and the development of significant research projects
in the Model SCI Centers. The competition for collaborative research
projects will be conducted subsequent to the identification of the
Model SCI Centers, and funds will be reserved for that purpose.
During the Program Reviews, there was considerable discussion of
the NSCID. It is clear that the database is a valuable resource and
that participation in the NSCID is an essential element for the Model
SCI Centers. For the purpose of the present competition, the data
collection activities will be maintained without change. NIDRR expects
that applicants will include historical documentation of numbers of
patients as well as expected new patients and expected annual follow-up
submissions based on current eligibility criteria for the NSCID.
However, it is anticipated that, through discussion among the newly
identified Model SCI Centers, NIDRR staff, and external reviewers,
details of data collection may be modified following the award. This
process should not result in increased data collection workloads above
current levels.
Priority 1
The Assistant Secretary will establish Model Spinal Cord Injury
Centers for the purpose of generating new knowledge through research,
development, or demonstration to improve outcomes for SCI through
improved interventions and service delivery models. A Model SCI Center
must:
(1) Establish a multidisciplinary system of providing
rehabilitation services specifically designed to meet the special needs
of individuals with SCI, including emergency medical services, acute
care, vocational and other rehabilitation services, community and job
placement, and long-term community follow up and health maintenance;
(2) Participate as directed by the Assistant Secretary in national
studies of SCI by contributing to a national database and by other
means as required by the Assistant Secretary; and
(3) Conduct a significant and substantial research program in SCI
that will contribute to the advancement of knowledge in accordance with
the Plan. Applicants may select from the following examples of research
objectives related to specific areas of the Plan or other research
objectives, including those that cut across areas of the Plan:
* (Chapter 3, Employment Outcomes): Either (1) Assess the
impact of legislative and policy changes on employment outcomes; or (2)
test direct intervention strategies for improving employment outcomes.
* (Chapter 4, Maintaining Health and Function): Either (1)
Study interventions to improve outcomes in the preservation or
restoration of function or the prevention and treatment of secondary
conditions; or (2) Design and test service delivery models that provide
quality care under constraints imposed by recent changes in the health
care financing system.
* (Chapter 5, Technology for Access and Function): Either
(1) Evaluate the impact of selected innovations in technology and
rehabilitation engineering on service delivery; or (2) Evaluate the
impact of selected innovations in technology and rehabilitation
engineering on outcomes such as function, independence, and employment.
* (Chapter 6, Independent Living and Community Integration):
Assess the value of peer support and early onset of services from
community and social support organizations to improve outcomes such as
independence and community integration, employment function, and health
maintenance.
* (Chapter 7, Associated): Either (1) Refine measures of
medical rehabilitation effectiveness in SCI to incorporate
environmental factors in the assessment function; or (2) Investigation
of the impact of national telecommunications and information policy on
the access of persons with SCI to related education, work, and other
opportunities.
(4) Provide for the widespread dissemination of research and
demonstration findings to other SCI centers, rehabilitation
practitioners, researchers, individuals with SCI and their families and
representatives, and other public and private organizations involved in
SCI care and rehabilitation. In carrying out these purposes, the SCI
center must:
* Incorporate culturally appropriate methods of community
outreach and education in areas such as health and wellness, housing,
transportation, recreation, employment, and other community activities
for individuals with diverse backgrounds with SCI;
* Demonstrate the research and clinical capacity to
participate in collaborative projects, clinical trials, or technology
transfer with other model SCI centers, other NIDRR grantees, and
similar programs of other public and private agencies and institutions;
and
* Demonstrate the likelihood of having a sufficient number
of individuals with SCI, including newly injured persons, to conduct
statistically significant research.
Final Selection Criteria
The Assistant Secretary will use these selection criteria to
evaluate applications under this program. The maximum score for all the
criteria is 100 points. The new emphasis on research and NIDRR's Plan,
plus the importance of the NSCID, require some
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modifications to the selection criteria for this program. The Secretary
will redistribute points to reflect the increased emphasis on research,
and to add references to the Plan and NSCID.
(a) Research Project design (30 points). The Secretary reviews each
application to determine to what degree--
(1) There is a clear description of how the objectives of the
project relate to the purpose of the program and the Plan;
(2) The research is likely to produce new and useful information;
(3) The need and target population are adequately defined and are
sufficient for meaningful research and demonstration;
(4) The outcomes are likely to benefit the defined target
population;
(5) The research hypotheses are sound; and
(6) The research methodology is sound in the sample design and
selection, the data collection plan, the measurement instruments, and
the data analysis plan.
(b) Service comprehensiveness (20 points). The Secretary reviews
each application to determine to what degree--
(1) The services to be provided within the project are
comprehensive in scope, and include emergency medical services,
intensive and acute medical care, rehabilitation management,
psychosocial and community reintegration, and follow up;
(2) A broad range of vocational and other rehabilitation services
will be available to individuals with severe disabilities within the
project; and
(3) Services will be coordinated with those services provided by
other appropriate community resources.
(c) Plan of operation (10 points). The Secretary reviews each
application to determine to what degree--
(1) There is an effective plan of operation that ensures proper and
efficient administration of the project;
(2) The applicant's planned use of its resources and personnel is
likely to achieve each objective;
(3) Collaboration between institutions, if proposed, is likely to
be effective;
(4) Participation in the National Spinal Cord Injury Database is
clearly and adequately described; and
(5) There is a clear description of how the applicant will include
eligible project participants who have been traditionally
underrepresented, such as--
(i) Members of racial or ethnic minority groups;
(ii) Women;
(iii) Individuals with disabilities; and
(iv) The elderly.
(d) Quality of key personnel (10 points). The Secretary reviews
each application to determine to what degree--
(1) The principal investigator and other key staff have adequate
training or experience, or both, in spinal cord injury care and
rehabilitation and demonstrate appropriate potential to conduct the
proposed research, demonstration, training, development, or
dissemination activity;
(2) The principal investigator and other key staff are familiar
with pertinent literature or methods, or both;
(3) All the disciplines necessary to establish the
multidisciplinary system described in Sec. 359.11(a) are effectively
represented;
(4) Commitments of staff time are adequate for the project; and
(5) The applicant is likely, as part of its non-discriminatory
employment practices, to encourage applications for employment from
persons who are members of groups that traditionally have been
underrepresented, such as--
(i) Members of racial or ethnic minority groups;
(ii) Women;
(iii) Individuals with disabilities; and
(iv) The elderly.
(e) Adequacy of resources (5 points). The Secretary reviews each
application to determine to what degree--
(1) The facilities planned for use are adequate;
(2) The equipment and supplies planned for use are adequate; and
(3) The commitment of the applicant to provide administrative and
other necessary support is evident.
(f) Budget/cost effectiveness (5 points). The Secretary reviews
each application to determine to what degree--
(1) The budget for the project is adequate to support the
activities;
(2) The costs are reasonable in relation to the objectives of the
project; and
(3) The budget for subcontracts (if required) is detailed and
appropriate.
(g) Dissemination/utilization (10 points). The Secretary reviews
each application to determine to what degree--
(1) There is a clearly defined plan for dissemination and
utilization of project findings;
(2) The research results are likely to become available to others
working in the field;
(3) The means to disseminate and promote utilization by others are
defined; and
(4) The utilization approach is likely to address the defined need.
(h) Evaluation plan (10 points). The Secretary reviews each
application to determine to what degree--
(1) There is a mechanism to evaluate plans, progress, and results;
(2) The evaluation methods and objectives are likely to produce
data that are quantifiable; and
(3) The evaluation results, where relevant, are likely to be
assessed in a service setting.
Final Additional Selection Criterion
The Assistant Secretary also will use the following criterion so
that up to an additional ten points may be earned by an applicant for a
total possible score of 110 points:
Within this absolute priority, we will give the following
competitive preference to applications that are otherwise eligible for
funding under this priority:
Up to ten (10) points based on the extent to which an application
includes effective strategies for employing and advancing in employment
qualified individuals with disabilities in projects awarded under these
absolute priorities. In determining the effectiveness of those
strategies, we will consider the applicant's success, as described in
the application, in employing and advancing in employment qualified
individuals with disabilities in the project.
For purposes of this competitive preference, applicants can be
awarded up to a total of 10 points in addition to those awarded under
the published selection criteria for this priority. That is, an
applicant meeting this competitive preference could earn a maximum
total of 110 points.
Rehabilitation Engineering Research Centers
The authority for RERCs is contained in section 204(b)(3) of the
Rehabilitation Act of 1973, as amended (29 U.S.C. 762(b)(3)). The
Secretary may make awards for up to 60 months through grants or
cooperative agreements to public and private agencies and
organizations, including institutions of higher education, Indian
tribes, and tribal organizations, to conduct research, demonstration,
and training activities regarding rehabilitation technology in order to
enhance opportunities for meeting the needs of, and addressing the
barriers confronted by, individuals with disabilities in all aspects of
their lives. An RERC must be operated by or in collaboration with an
institution of higher education or a nonprofit organization.
Description of Rehabilitation Engineering Research Centers
RERCs carry out research or demonstration activities by:
[[Page 14352]]
(a) Developing and disseminating innovative methods of applying
advanced technology, scientific achievement, and psychological and
social knowledge to (1) solve rehabilitation problems and remove
environmental barriers, and (2) study new or emerging technologies,
products, or environments;
(b) Demonstrating and disseminating (1) innovative models for the
delivery of cost-effective rehabilitation technology services to rural
and urban areas, and (2) other scientific research to assist in meeting
the employment and independent living needs of individuals with severe
disabilities; or
(c) Facilitating service delivery systems change through (1) the
development, evaluation, and dissemination of consumer-responsive and
individual and family-centered innovative models for the delivery to
both rural and urban areas of innovative cost-effective rehabilitation
technology services, and (2) other scientific research to assist in
meeting the employment and independent needs of individuals with severe
disabilities.
Each RERC must provide training opportunities to individuals,
including individuals with disabilities, to become researchers of
rehabilitation technology and practitioners of rehabilitation
technology in conjunction with institutions of higher education and
nonprofit organizations.
The Department is particularly interested in ensuring that the
expenditure of public funds is justified by the execution of intended
activities and the advancement of knowledge and, thus, has built this
accountability into the selection criteria. Not later than three years
after the establishment of any RERC, NIDRR will conduct one or more
reviews of the activities and achievements of the Center. In accordance
with the provisions of 34 CFR 75.253(a), continued funding depends at
all times on satisfactory performance and accomplishment.
General RERC Requirements
The following requirements apply to these RERCs pursuant to these
absolute priorities unless noted otherwise. An applicant's proposal to
fulfill these requirements will be assessed using applicable selection
criteria in the peer review process.
The RERC must have the capability to design, build, and test
prototype devices and assist in the transfer of successful solutions to
relevant production and service delivery settings.
The RERC must evaluate the efficacy and safety of its new products,
instrumentation, or assistive devices.
The RERC must involve individuals with disabilities and, if
appropriate, their representatives, in planning and implementing its
research, development, training, and dissemination activities, and in
evaluating the Center.
Priorities
Under an absolute priority we consider only applications that meet
one of these absolute priorities (34 CFR 75.105(c)(3)).
Priority 2: Low Vision and Blindness
Background
According to recent estimates there are more than 3 million
Americans with low vision, and almost one million who are legally blind
(National Eye Institute, ``Vision research: A national plan 1999-
2003,'' A report of the National Advisory Eye Council, National
Institutes of Health, 1999). Approximately 7.8% of persons over 65
cannot see well enough to read newspaper print (Nelson, K.A.,
``Statistical brief #35: Visual impairment among elderly Americans:
statistics in transition,'' Journal of Visual Impairment and Blindness,
vol. 81, pgs. 331-334, 1987), and the number of persons in this age
group is projected to increase twice as fast as the population as a
whole (Schmeidler, E. and Halfman, D., ``Statistics on visual
impairment on older persons, disability in children, life expectancy,''
Journal of Visual Impairment and Blindness, vol. 91, pgs. 602-606,
1997). Blind and visually impaired individuals face major barriers in
information access and handling, orientation and mobility, and access
to jobsites and public facilities, resulting in very high rates of
unemployment (Kirchner, C. and Schmeidler, E., ``Prevalence and
employment of people in the United States who are blind or visually
impaired,'' Journal of Visual Impairment and Blindness, vol. 91, pgs.
508-511, 1997; Hagemoser, S.D., ``The relationship of personality
traits to the employment status of persons who are blind,'' Journal of
Visual Impairment and Blindness, vol. 90, pgs. 134-144, 1996). There is
also a growing and underserved group of individuals with a combination
of multiple sensory, physical, and cognitive impairments (Malakpa, S.,
``Job placement of blind and visually impaired people with additional
disabilities'' RE:View, vol. 26, pgs. 69-77, 1994).
The leading causes of vision impairment in children in the U.S. are
cortical visual impairment (35%), retinopathy of prematurity (ROP),
optic nerve hypoplasia, and other retinal conditions (Murphy, D. and
Good, W.V., ``The epidemiology of blindness in children in
California,'' American Academy of Opthalmology, pg. 157, 1997; Oxford
Register of Early Childhood Impairments Annual Report, The National
Perinatal Epidemiology Unit, Ratcliffe Infirmary, pgs. 32-36, 1998). As
a result of improvements in medical diagnosis, treatment and
technologies, more premature infants are surviving birth. However, a
significant number of newborn infants experience traumatic conditions
that include blindness and cognitive and motor deficits. New approaches
and technologies are needed to identify and separate the sensory and
cognitive deficits so that habilitation can be planned and monitored
more effectively (Good, W.V., Jan, J.E., deSa, L., Barkovich, A.J.,
Groenveld, M. and Hoyt, C.S., ``Cortical visual impairment in children:
A major review,'' Survey of Opthalmology, vol. 38, pgs. 351-364, 1994).
Intervention in the very young age groups offers maximum promise of
cost effectiveness and independent functioning throughout life.
Wayfinding refers to the techniques used by persons who are blind
or visually impaired as they move from place to place independently.
Wayfinding is commonly divided into orientation and mobility skills.
Orientation refers to the ability to monitor one's position in relation
to the environment. Mobility refers to one's ability to move safely,
from one location to the next with a limited amount of veering.
Orientation and mobility are prerequisites to success at school, on the
job, and in daily living. Various electronic devices and environmental
modifications have been used in attempts to improve wayfinding and to
reduce veering. Current technologies, including clear-path and drop-off
detectors, do little to prevent veering.
Low vision or blindness frequently coexists with other disabilities
including hearing loss, cognitive impairments and mobility limitations.
Individuals with multiple disabilities present technological challenges
and require complex adjustments to achieve functionality in and across
environments (Greenbaum, M.G., Fernandes, S. and Wainapel, S.F., ``Use
of a motorized wheelchair in conjunction with a guide dog for the
legally blind and physically disabled,'' Archives of Physical Medicine
and Rehabilitation, vol. 79(2), pgs. 216-217, 1998).
The most common cause of visual impairment among the aging
population is Age Related Maculopathy (ARM) (Fletcher, D.C. and
Schucard, R.A.,
[[Page 14353]]
``Preferred retinal loci relationship to macular scotomas in a low-
vision population,'' Opthalmology, vol. 104, pgs. 632-638, 1997).
Visual impairments among this population impact a wide variety of
activities of daily living. Further, visual impairment is often
accompanied by hearing loss, cognitive deficits, and motor dysfunction.
Many older individuals reside in congregate care settings (i.e.,
nursing homes) where the prevalence of eye disorders can be as high as
90% (Marx, M.S., Werner, P., Feldman, R. and Cohen-Mansfield, J., ``The
eye disorders of residents of a nursing home,'' Journal of Visual
Impairment and Blindness, vol. 88(5), pgs. 462-468, 1994; Whitmore,
W.G., ``Eye disease in a geriatric nursing home population,''
Opthalmology, vol. 96, pgs. 393-398, 1989; Horowitz, A., ``Vision
impairment and functional disability among nursing home residents,''
The Gerontologist, vol. 34, pgs. 316-323, 1994). These facilities could
be a platform for reaching many consumers with simple vision screening
technologies that would permit non-clinical personnel to rapidly screen
residents for visual impairments and make appropriate referrals.
Currently, methods for assessing ARM include, but are not limited to,
residual visual function and identifying optimal locations on the
retina for reading and other tasks (Fletcher, D.C. and Schucard, R.A.,
op. cit., 1997). These methods address one eye at a time, and the
advantages of binocular vision are often lost (Paul, W., ``The role of
computer assistive technology in rehabilitation of the visually
impaired: A personal perspective,'' American Journal of Opthalmology,
vol. 127(1), pgs. 75-76, 1999; Schuchard, R.A. and Kuo, K., ``Retinal
correspondence and binocular perception characteristics in low vision
people with binocular eccentric PRLs,'' Investigative Opthalmology and
Vision Science, vol. 91, pgs. 602-606, 1999).
Chapter 5 of the Plan (64 FR 68575) discusses the importance of
directing research and development activities toward the problems faced
by individuals who have significant visual, hearing, and communication
impairments. The number of individuals with both severe hearing and
visual impairments (deaf-blind) is small but increasing. The greatest
challenges persons with multiple sensory impairments face are
communication and access to information technology (Engelman, M.D.,
Griffin, H.C. and Wheeler, L., ``Deaf-blindness and communication:
Practical knowledge and strategies,'' Journal of Visual Impairments and
Blindness, vol. 92(11), pgs. 783-798, 1999). Individuals who are deaf-
blind rarely use Braille for communication purposes. To date,
technologies for individuals who are deaf-blind have focused primarily
on tactile interpreting for face-to-face communication.
In today's complex and multifaceted electronic world, access to
graphical and spatial information is critical for persons who are blind
or visually impaired to be successful in school and work (Kent, D.,
``Book review: Let's learn shapes with Shapely-Cal,'' Journal of Visual
Impairment and Blindness, vol. 92(4), pgs. 245-247, 1998). Tactile
graphical information and spatial and geometric concepts are difficult
to represent for persons who are blind. Converting pictures or signs
into raised tactile form has proven to be costly and time-consuming
(Horsfall, B., ``Photopolymers, computer-aided design, and tactile
signs,'' Journal of Visual Impairment and Blindness, vol. 92(11), pgs.
823-826, 1998). Audio and audio-tactile methods of graphics
presentation and spatial and geometric concepts may promote parity
between individuals who are blind or visually impaired and others in a
variety of environments including school, work, and recreation.
Priority 2
The Assistant Secretary will establish an RERC that will identify
and develop technologies that will improve assessment of vision
impairments and promote independence for individuals with low vision
and blindness. The RERC must:
(1) Investigate, develop, and evaluate new assessment technologies
and approaches that will identify and differentiate between vision and
cognitive impairments in infants;
(2) Develop and evaluate new wayfinding technologies and approaches
that can be used by persons with coexisting disabilities;
(3) Investigate, develop, and evaluate simple and practical vision
screening and assessment technologies and approaches for identifying
visual impairments associated with aging;
(4) Investigate, develop, and evaluate new technologies and
approaches to facilitate face-to-face communication for individuals who
are deaf-blind and methods that will enable individuals who are blind
or deaf-blind to navigate and interpret graphical, spatial and
geometric information;
(5) Investigate, develop, and evaluate new technologies and
approaches that will assist individuals who are blind or visually
impaired in vocational and daily living environments; and
(6) Develop and implement, in consultation with the NIDRR-funded
RERC on Technology Transfer, a utilization plan for ensuring that all
new and improved technologies developed by this RERC are successfully
transferred to the marketplace.
In carrying out the above required activities, the RERC must:
* Develop and implement, during the first year of the grant
and in consultation with the NIDRR-funded National Center for the
Dissemination of Disability Research (NCDDR), a plan to effectively
disseminate the RERC's research outcomes to all appropriate target
audiences including: clinicians, engineers, manufacturers, individuals
with disabilities, families, disability organizations, technology
service providers, businesses, journals, organizations representing
minorities and other underrepresented groups;
* In the third year of the grant, conduct a state-of-the-
science conference on technologies for individuals with low vision and
blindness and publish a comprehensive report in the fourth year of the
grant;
* Collaborate on research projects of mutual interest with
NIDRR-funded RERCs on Information Technology Access and
Telecommunications Access, RRTCs on visual disabilities and appropriate
professional organizations; and
* Address the needs of children with vision disabilities
from minority backgrounds and cultures.
Priority 3: Technologies for Children with Orthopedic Disabilities
Background
It is estimated that 6 million children, age 18 and younger, in the
United States have some type of disability. The prevalence of children
with orthopedic impairments in the U.S., including paralysis and
congenital anomalies, is roughly 420,000 (8.4 percent) (LaPlante, M.
and Carlson, D., ``Disability in the United States: Prevalence and
Causes,'' 1992 Report of the Disability Statistics Rehabilitation
Research and Training Center, NIDRR, U.S. Department of Education,
1995). The majority of these children are unable to perform a major
activity or are limited in the amount or types of major activities,
including education and play, they can perform (Wenger, B.L., Kaye,
H.S. and LaPlante, M.P., ``Disabilities among children,'' Disability
Statistics Abstract (No. 15), NIDRR, U.S. Department of Education,
1996). Children with disabilities present unique challenges for health
care
[[Page 14354]]
professionals when compared to adults with similar disabilities. For
example: children experience periods of accelerated growth affecting
shape, strength and body alignment; their body sizes are
disproportionate to adults, they are not scaled-down adults; they
experience developmental stages that affect their fine and gross motor
skills; their capabilities change as they mature and as they learn to
control their bodies and their environment; and parental expectations
about their child's disability can influence medical treatment and
therapeutic interventions.
Chapter 5 of the Plan (64 FR 45766) discusses the importance of
research and development activities that will enhance mobility and
improve manipulation for individuals with orthopedic impairments.
Children with orthopedic impairments present unique challenges for
rehabilitation specialists. The technology to `replace' a child's
missing limb does not exist today. It is possible, however, to restore
considerable function with a prosthesis. The usefulness of such a
device depends largely upon its weight, how well it fits, how easy it
is to control and its durability, reliability and aesthetics. Continual
developmental changes, including physical, emotional, and social
growth, make it difficult to fit a child with a prosthesis and to
determine the most appropriate time for introducing a prosthesis to a
child. For example, the importance of fitting a child early with a
prosthesis is well cited. However, there continues to be discussion
about which developmental milestones to consider when determining the
most suitable prosthesis for a child (Patton, J.G., ``Development
approach to pediatric upper-limb prosthetic training,'' Atlas of Limb
Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles,
Mosby, St. Louis, pgs. 778-793, 1992).
In addition to congenital and acquired amputations there are other
conditions that can cause orthopedic impairments in children. Cerebral
palsy (CP) is a motor disorder originating from a central nervous
system injury that occurs before, during or shortly after birth.
Children under the age of five who sustain brain injuries are also
classified as having CP. The disability ranks third among childhood
disabilities (LaPlante, M.P., Disability risks of chronic illness and
impairments, Disability Statistics Program, San Francisco, CA., 1989)
and is the most common cause of paralysis in children (Wenger, B.L.,
Kaye, H.S. and LaPlante, M.P., op. cit., 1996). The reported prevalence
of CP in the U.S. is two per thousand and the incidence is
approximately one per thousand live births (Turk, M.A., ``Early
development-related conditions,'' Assessing Medical Rehabilitation
Practices: The Promise of Outcomes Research, Marcus J. Fuhrer, ed.,
pgs. 371-372, 1997). Individuals with CP typically have abnormal muscle
tone, muscle weakness, primitive reflexes, or uncoordinated movements
requiring seating and orthotic interventions for postural control and
alignment (Cook, A.M. and Hussy, S.M., Assistive Technologies:
Principles and Practice, Mosby, St. Louis, pg. 237, 1995). Spina bifida
is a congenital anomaly in which the neural tube that forms the spinal
cord does not fully develop, leading to a number of lower extremity
problems, including muscle paralysis, hip dislocations, knee
hypertension, and club feet. The reported incidence of spina bifida is
between 0.5 and 1 per thousand (Turk, M.A., op. cit., pgs. 378-379,
1997).
The most common management strategy for motor impairments caused by
cerebral palsy and spina bifida is developmental therapy (i.e.,
physical, occupational, speech and language therapies). However,
orthotics, specific spasticity-reducing regimens (Baclofen pumps,
botulinum toxin injections), orthopedic surgery, and adaptive equipment
also are used in intervention. Orthotics are used on both upper and
lower extremities to improve function, to prevent or compensate for
anomalies, and to control muscle weakness, spasticity and structural
instability. Most orthotic devices (e.g., ankle-foot orthoses) are
designed to be rigid. Dynamic orthoses and splints for gait, spasticity
and contracture management may have significant application.
Adaptive equipment is used to improve functional independence in
mobility, self-care, communication, environmental control, and school
activities. There is no definitive study on how to make the best choice
among all the options or which improves function the most (Turk, M.A.,
op. cit., pg. 376, 1997).
Composite materials have much to offer in prosthetic and orthotic
design. They are strong, lightweight, and durable. However, these
materials require different and more costly manufacturing techniques
than those used with traditional materials such as metal and
thermoplastics. A problem associated with composite materials is that
they are difficult to postform, a process whereby prosthetic or
orthotic devices are adjusted slightly during final fittings (White,
M., ``Development of an advanced lightweight composite orthosis,''
Presented at ASM International--Aeromat 1992, New Trends in Advanced
Composites, Anaheim, CA., May 20, 1992).
Leisure time is critical to a child's well-being and development.
Play is one means for children to master developmental tasks and learn
important behavioral and social skills. The ability to interact
effectively with the environment through play can affect a child's
self-esteem, behavior, self-awareness, confidence, and competency
(Masten, A.S., ``The development of competence in favorable and
unfavorable environments: Lessons from research on successful
children,'' American Psychologist, vol. 53, pgs. 205-220, 1998).
Children with disabilities, including those with amputations, cerebral
palsy and spina bifida, encounter many challenges in their attempts to
engage in learning and play activities. Often sensory and motor
impairments severely limit the degree to which they are able to
negotiate their environment and interact with others. Facilitating play
for these children involves adapting the environment and providing
appropriate technologies that will enhance interactive play and social
skill development. The product market is challenged to meet the demands
of millions of children with disabilities and their families who need
alternative strategies in order to engage in recreation and social
activities.
Priority 3
The Assistant Secretary will establish a RERC on technologies for
children with orthopedic disabilities to identify and develop
technologies that will help children with orthopedic disabilities to
overcome functional deficits and to support their ability to learn,
play and interact socially. The RERC must:
(1) Develop and evaluate new, lightweight upper and lower limb
prosthetic and orthotic devices for children;
(2) Investigate the use of dynamic orthoses for controlling
spasticity and contractures for children with orthopedic impairments
including those with cerebral palsy and spina bifida;
(3) Identify, develop, and evaluate models for determining when
during children's development to introduce assistive technologies and
prosthetic and orthotic devices;
(4) Investigate, develop, and evaluate technologies, and strategies
for their use, that will enable young children, including children with
cerebral palsy and spina bifida, to participate in interactive play and
socialization activities; and
(5) Develop and implement, in consultation with the NIDRR-funded
RERC on Technology Transfer, a
[[Page 14355]]
utilization plan for ensuring that all new and improved technologies
developed by this RERC are successfully transferred to the marketplace.
In carrying out the above required activities, the RERC must:
* Develop and implement, during the first year of the grant
and in consultation with the NIDRR-funded National Center for the
Dissemination of Disability Research (NCDDR), a plan to effectively
disseminate the RERC's research outcomes to all appropriate target
audiences including: clinicians, engineers, manufacturers, individuals
with disabilities, families, disability organizations, technology
service providers, businesses, and journals;
* In the third year of the grant, conduct a state-of-the-
science conference on technologies for children with orthopedic
disabilities and publish a comprehensive report in the fourth year of
the grant;
* Collaborate on research projects of mutual interest with
the RERC on Prosthetics and Orthotics, the RERC on Wheeled Mobility,
and the RRTC on Children with Special Health Care Needs; and
* Address the needs of children with orthopedic disabilities
from minority backgrounds and cultures.
Final Additional Selection Criterion
The Assistant Secretary will use the selection criteria in 34 CFR
350.54 to evaluate applications under this program. The maximum score
for all the criteria is 100 points; however, the Assistant Secretary
also will use the following criterion so that up to an additional ten
points may be earned by an applicant for a total possible score of 110
points:
Within these absolute priorities, we will give the following
competitive preference to applications that are otherwise eligible for
funding under these priorities:
Up to ten (10) points based on the extent to which an application
includes effective strategies for employing and advancing in employment
qualified individuals with disabilities in projects awarded under these
absolute priorities. In determining the effectiveness of those
strategies, we will consider the applicant's success, as described in
the application, in employing and advancing in employment qualified
individuals with disabilities in the project.
For purposes of this competitive preference, applicants can be
awarded up to a total of 10 points in addition to those awarded under
the published selection criteria for these priorities. That is, an
applicant meeting this competitive preference could earn a maximum
total of 110 points.
Electronic Access to This Document
You may view this document, as well as all other Department of
Education documents published in the Federal Register, in text or
Portable Document Format (PDF) on the Internet at either of the
following sites:
http://ocfo.ed.gov/fedreg.
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To use the PDF you must have the Adobe Acrobat Reader Program with
Search, which is available free at either of the preceding sites. If
you have questions about using the PDF, call the U.S. Government
Printing Office (GPO), toll free, at 1-888-293-6498; or in the
Washington, D.C., area at (202) 512-1530.
Note: The official version of this document is the document
published in the Federal Register. Free Internet access to the
official edition of the Federal Register and the Code of Federal
Regulations is available on GPO Access at: http://
www.access.gpo.gov/nara/index.html.
Applicable Program Regulations: 34 CFR Part 350.
Program Authority: 29 U.S.C. 760-762.
(Catalog of Federal Domestic Assistance Number 84.133N, Model Spinal
Cord Injury Centers and 84.133E, Rehabilitation Engineering Research
Centers)
Dated: March 8, 2000.
Judith E. Heumann,
Assistant Secretary for Special Education and Rehabilitative Services.
[FR Doc. 00-6140 Filed 3-15-00; 8:45 am]
BILLING CODE 4000-01-U