DEPARTMENT

of HEALTH

and HUMAN

SERVICES

National Institute on Disability, 

Independent Living, and 

Rehabilitation Research (NIDILRR)

2019 Report to Congress

Prepared by

ADMINISTRATION FOR COMMUNITY LIVING
2

Table of Contents

Acronyms..................................................................................................................................3

Executive Summary...................................................................................................................4

Funding and Grants Management.........................................................................................4

Productivity and Accomplishments.......................................................................................4

Research Capacity Building ...................................................................................................5

Training and Technical Assistance on the Americans with Disabilities Act (ADA)..................5

Knowledge Translation..........................................................................................................6

Ongoing Activities .................................................................................................................6

Introduction ..............................................................................................................................7

Grant Competitions – Year in Review........................................................................................9

Grant Competition and Peer Review Process........................................................................9

Grant Competitions...............................................................................................................9

Monitoring and Oversight...................................................................................................10

Funding Overview ...............................................................................................................11

Grantee Activities and Progress..........................................................................................14

Sampling of Key Accomplishments by Funded Researchers................................................16
3

Abbreviations

AAC Augmentative and Alternative Communication

AAC-RERC Augmentative and Alternative Communication Rehabilitation 

Engineering Research Center

ABI Acquired Brain Injury

ACL Administration for Community Living 

ADA Americans with Disabilities Act 

APR Annual Performance Reporting System

ARRT Advanced Rehabilitation Research Training Project 

ASTM American Society for Testing and Materials

CL&P Community Living & Participation

CHRIL-F Collaborative on Health Reform and Independent Living 

Fellowship

DRRP Disability and Rehabilitation Research Project

EMP Employment

FCC Federal Communications Commission

FIP Field-Initiated Project 

FY Fiscal Year

GM General Motors

H&F Health & Function

HHS Department of Health and Human Services 

ICDR Interagency Committee on Disability Research 

IDD Intellectual and Developmental Disabilities 

KT Knowledge Translation 

MSI Minority-Serving Institution 

NIDILRR National Institute on Disability, Independent Living, and 

Rehabilitation Research

NRTC National Research and Training Center on Blindness and Low 

Vision 

PE Progressive Employment

RERC Rehabilitation Engineering Research Center

RRTC Rehabilitation Research and Training Center

RTT Real-Time Text

SBIR Small Business Innovation Research 

SCI Spinal Cord Injury 

STI Strategies, Techniques, and Interventions

TBI Traumatic Brain Injury 

VR Vocational Rehabilitation

VSD Visual Scene Display

WSU Washington State University
4 

Executive Summary

The mission of the Administration for Community Living’s (ACL) National Institute on Disability, 

Independent Living, and Rehabilitation Research (NIDILRR) is to generate new knowledge and 

to promote its effective use to maximize the full inclusion and integration into society, 

employment, independent living, family support, and economic and social self-sufficiency of 

individuals with disabilities of all ages. 

NIDILRR programs address a wide range of disabilities and impairments — across all age groups

— and promote health and function, community living and participation, and employment. To 

accomplish these goals, ACL invests in research, knowledge translation, and capacity-building 

activities through its discretionary grant-funding mechanisms.

Funding and Grants Management

ACL funded a total of $100,935,565 to NIDILRR program grantees in FY 2019. In addition, ACL

awarded $8,034,435 in contracts and other support activities in FY 2019. These funds 

supported 220 grant awards in 2019. 

The peer review process for NIDILRR program grant competitions is highly rigorous, with 14 

percent of applicants receiving new grant funding during FY 2019 (see Table 1). 

Productivity and Accomplishments

ACL funds research toward the development of new knowledge and innovative technological 

devices, prototypes, measurement tools, interventions, and informational products to enhance 

community living, health and function, and employment among people with disabilities.

Grantees employ advanced methodologies to conduct research, including randomized 

controlled trials, longitudinal studies, and qualitative studies. These investments produce peerreviewed publications, intervention protocols, software, databases, and a wide range of other 

outputs and outcomes. Selected examples of grantee accomplishments in FY 2019 include: 

FIRST CLINICAL PRACTICE GUIDELINE FOR MANAGING CARDIOMETABOLIC RISK AFTER SPINAL 

CORD INJURY (SCI)

Cardiometabolic risk factors are known to affect people with or without disabilities. 

Cardiometabolic risk factors are often termed the “silent killer” because individuals may never 

know they carry these risk factors. Despite the presence of these risk factors following SCI, no 

clinical practice guidelines on this topic are available for use by physicians and other health care 

providers. As a result of their hard work, Dr. Mark Nash and his colleagues at the University of 

Miami have produced the first clinical practice guideline for managing cardiometabolic risk 

after SCI. A description and discussion of this guideline can be found in the Sampling of Key 

Accomplishments Funded Researchers section of this report.
5 

MANUFACTURERS AND DEVELOPERS OF AUGMENTATIVE AND ALTERNATIVE 

COMMUNICATION (AAC) HAVE ADOPTED VISUAL SCENE DISPLAYS (VSD)

Prior to the development of VSDs funded by a grant to the Augmentative and Alternative 

Communication Rehabilitation Engineering Research Center (AAC-RERC), the only AAC option 

was traditional grid displays with isolated symbols presented in rows and columns. Therefore, it 

was difficult for many adults with disabilities to use these traditional grid displays, resulting in 

significant language and cognitive limitations.

VSDs offer an easier alternative to traditional grid displays. They go beyond standard pictures 

and symbols organized in rows and columns by providing information on the situation or 

context. As a result of the continued efforts of the AAC-RERC and their partners, this VSD 

technology has been successfully transferred to a wide range of major AAC manufacturers and 

app developers.

“YOUDESCRIBE” IS CREATING UNPRECEDENTED ACCESS TO VIDEO MATERIALS FOR BLIND 

STUDENTS AND ADULTS

Currently, blind individuals have virtually no access to video materials unless they pay for a 

professional service, which can be extremely expensive and a cost burden on the individual. 

Researchers and engineers at the Smith-Kettlewell Eye Research Institute have created a better, 

more cost-effective solution to this problem called “YouDescribe.” Since blind individuals are 

limited with experiencing a visual experience with videos, they must rely on audio descriptions. 

Audio description is an extra soundtrack added by a describer so that the blind viewer is aware 

of what is occurring on the screen. Family members, educators, friends, and service providers 

volunteer to develop the audio descriptions. For more information on how “YouDescribe”, visit 

their support and user information page at https://youdescribe.org/.

Research Capacity Building 

Research capacity-building efforts under the Advanced Rehabilitation Research Training 

Projects, Switzer Fellowship Program, and Disability and Rehabilitation Research Center grant 

efforts, develop a diverse cadre of emerging disability and rehabilitation researchers. In 

addition, ACL directs targeted resources to minority-serving institutions, such as Historically 

Black Colleges and Universities and Tribal Colleges and Universities, to develop and implement 

programs to build disability and rehabilitation research capacity.

Training and Technical Assistance on the Americans with Disabilities Act 

(ADA)

ACL sponsors the ADA National Network, which delivers training, technical assistance, and 

dissemination of materials to stakeholders with rights and responsibilities under the ADA. The 

ADA Participatory Action Research Consortium complements the Network’s activities through 
6

research on factors influencing the community living of individuals with disabilities at regional, 

state, and community levels.

Knowledge Translation

ACL is committed to ensuring that the products of its sponsored research and development are 

used to promote the independent living, health and function, employment, and community 

living outcomes of individuals with disabilities. Through its Knowledge Translation Centers, ACL

ensures that new knowledge and products gained through research and development are 

effectively communicated to stakeholders and used to improve the lives of individuals with 

disabilities.

Ongoing Activities

In March 2019, ACL published NIDILRR’s FY 2018–2023 Long-Range Plan, which outlines the 

vision and research agenda for NIDILRR programs for the coming years. The ACL Administrator 

has identified five pillars: Connecting People to Resources, Supporting Families and Caregivers, 

Strengthening the Networks, Protecting Rights and Preventing Abuse, and Expanding 

Employment Opportunities. These pillars encompass both aging and disability, and NIDILRR’s

research and subject matter expertise will support planning and implementation efforts in all

five areas.

Strategic partnerships with other agencies in the Department of Health and Human Services

(HHS) and across the federal government are also instrumental in advancing the research and 

impact of ACL’s NIDILRR. ACL will continue to enhance its existing partnerships and seek out 

new collaborative opportunities within HHS and more broadly across the federal disability and 

rehabilitation research communities. ACL’s Director of NIDILRR serves as the delegated Chair of 

the Interagency Committee on Disability Research (ICDR). Under the ICDR Chair’s leadership, 

efforts will focus on building upon the ongoing work of the ICDR and the achievement of goals 

set forth in the recently drafted government-wide disability and rehabilitation research 

strategic plan.
7

2019 Report to Congress

Introduction

The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 

is committed to improving independent living and community participation among people with 

disabilities by funding research and development in the areas of community living and 

participation, health and function, and employment. This Annual Report to Congress will 

describe activities and accomplishments during the 2019 fiscal year. It begins with a summary 

of the organization’s historical foundation, provides a description of its funding process and 

fiscal allocations, and follows with descriptions of programmatic outcomes impacting the 

community. This report concludes by describing ongoing initiatives and directions within the 

organization.

NIDILRR was established by Congress to conduct research that would lead to improved health 

and function, employment, and community living outcomes of individuals with disabilities. First 

constituted as the National Institute on Handicapped Research by the Rehabilitation, 

Comprehensive Services, and Developmental Disabilities Amendments of 1978 (P.L. 95–602), 

amending the Rehabilitation Act of 1973, the organization was originally housed in the 

Department of Health, Education, and Welfare, and later the Department of Education. The 

1986 amendments to the Rehabilitation Act changed the agency’s name to the National 

Institute on Disability and Rehabilitation Research. On July 22, 2014, the agency was renamed 

the National Institute on Disability, Independent Living, and Rehabilitation Research and 

transferred from the Department of Education to the Administration for Community Living 

(ACL) within the Department of Health and Human Services (HHS). This change occurred with 

the passage of P.L. 113–128, the Workforce Innovation and Opportunity Act. Thereafter, 

NIDILRR personnel officially became HHS/ACL employees in February 2015.

NIDILRR'S mission is to generate new knowledge and promote its effective use to maximize the 

full inclusion and integration into society, employment, independent living, family support, and 

economic and social self-sufficiency of individuals with disabilities of all ages. To accomplish this 

mission, NIDILRR:

• Supports research, development, training, technical assistance, and related activities to build 

new knowledge.

• Promotes the transfer, use, and adoption of technology for individuals with disabilities to 

improve health and function, employment, and community living and participation outcomes.

• Provides for advanced research training to increase the number of qualified researchers, 

including researchers with disabilities and from minority backgrounds.
8

• Fosters widespread dissemination and use of scientific and technological information to advance 

policy, practice, and services that improve outcomes of people with disabilities.

NIDILRR programs address community living and participation, health and function, and 

employment outcomes of people with disabilities. Investments in research, development, 

knowledge translation, and capacity-building activities are carried out through the following 

discretionary grant-funding mechanisms: 

• Rehabilitation Research and Training Centers (RRTC) conduct advanced research and training 

on a wide variety of health, rehabilitation, employment, and community living topics.

• Rehabilitation Engineering Research Centers (RERC) conduct rehabilitation engineering 

research and development toward technological solutions to rehabilitation problems or 

environmental barriers.

• Disability and Rehabilitation Research Projects (DRRP) conduct research, development, 

technical assistance, training, and utilization activities related to health, rehabilitation, 

employment, and community living topics.

• Americans with Disabilities Act (ADA) National Network projects conduct research and provide 

information, training, and technical assistance to ADA stakeholders.

• Small Business Innovation Research (SBIR) projects support small businesses to explore the 

feasibility and develop or evaluate the commercialization potential of new technology products 

for people with disabilities.

• Knowledge Translation projects promote the use of research-based knowledge and products 

among the community of disability research stakeholders.

• Field-Initiated Projects (FIP) conduct 3-year studies on topics proposed by applicants to address 

a wide range of disability and rehabilitation topics.

• Model Systems programs in spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury 

conduct research on rehabilitation and long-term outcomes of individuals with these conditions. 

Research in these programs includes collaborative, multisite research and collection and analysis 

of longitudinal data.

• Advanced Rehabilitation Research Training Projects (ARRT) support institutions of higher 

education to provide advanced interdisciplinary research training to postdoctoral Fellows.

• Research Fellowship Programs, or Mary E. Switzer Fellowships, are awarded to qualified 

individuals to conduct 1-year independent research projects.

• Section 21 projects focus on research capacity building for minority-serving institutions, 

including Historically Black Colleges and Universities and other institutions with significant 

racial/ethnic minority student populations. Section 21 of the Rehabilitation Act requires that 

1 percent of NIDILRR program appropriations be invested to address traditionally underserved 

populations.
9 

Grant Competitions – Year in Review

Grant Competition and Peer Review Process

ACL’s NIDILRR sponsors disability and rehabilitation research and development in the outcome 

domains of community living and participation, health and function, and employment. Funding 

is provided to the research community through its funding mechanisms, with priorities within 

these mechanisms determined by the agency. A rigorous peer review process is utilized for all 

research grant competitions, as required by authorizing statute and federal regulation. Internal 

and external program evaluation is also critical in ensuring the quality of sponsored research 

and development activities. Subject matter experts, with the appropriate credentials and 

content knowledge, evaluate the scientific, technical, and management aspects of proposals

submitted in response to funding opportunity announcements. This approach generates an 

average score across reviewers, reducing bias and facilitating the ranking of projects by 

scientific merit, and only the highest-ranking proposals for funding.

Grant Competitions

Table 1 provides a snapshot of NIDILRR program FY 2019 grant competitions. The number of 

eligible applicants, review panels, reviewers, awards made, and percentage of applicants 

receiving funding are shown. A large percentage of applications receive high peer review scores 

that indicate strong technical merit and significant need. Due to the limited nature of program 

funds, only a small percentage of applicants receive grants each year. 

Table 1. NIDILRR Peer Review Process Overview, FY 2019 

Grant Opportunity

# Eligible 

Applicants

# 

Panels

# 

Reviewers

# 

Awards 

Made

% of 

Applicants 

Receiving 

Funding

ARRT H&F 6 1 5 1 16.7%

ARRT CL&P 5 1 5 1 20%

ARRT EMP 6 -- -- 1 16.7%

SBIR Phase I 41 4 20 10 24.4%

SBIR Phase II 15 2 9 4 26.7%

Switzer Fellowship 44 4 16 6 13.4%

FIP 134 14 70 17 12.7%

FIP – MSI 12 1 5 1 8%

Field-Initiated DRRP in CL&P 40 4 20 2 5%

Field-Initiated DRRP in H&F 32 3 15 1 3%

DRRP AT 26 2 10 3 11.5%

DRRP KT 19 2 10 3 15.8%
10 

Grant Opportunity

# Eligible 

Applicants

# 

Panels

# 

Reviewers

# 

Awards 

Made

% of 

Applicants 

Receiving 

Funding

DRRP IL 5 1 5 1 20%

RERC Hearing 4 1 5 1 25%

RERC ICTA 2 1 5 1 50%

RERC – STI 7 1 5 1 14.3%

RERC Cognitive 5 1 5 1 20%

RRTC CL&P Youth SMI 1 1 5 0 0%

RRTC EMP Psychiatric 2 1 5 1 50%

RRTC Fam Support 7 1 5 1 14.3%

RRTC FI EMP Transition Youth 10 1 5 1 10%

RRTC FI EMP IDD 2 1 5 1 50%

RRTC HF PD 7 1 5 1 14.3%

RRTC Transition Youth EMP 

SMI 2 1 5 1 50%

Total 434 50 245 61 14%

Source: U.S. Department of Health and Human Services, Administration for Community Living, National Institute on 

Disability, Independent Living, and Rehabilitation Research. These figures do not include two employment-related 

FY 2019 awards made from 2018 funding decision memos. 

Monitoring and Oversight 

An Annual Performance Reporting (APR) System, formative review mechanisms, and close 

monitoring of grant activities provide rigorous oversight of its funded initiatives. The APR is a 

web-based grants performance system which allow grantees to provide data about goals and 

objectives, staffing, budget, research and development methods, progress, outputs, and 

accomplishments. Staff use this data to monitor grantees’ work and to determine whether 

continuation of funding should be provided. For most new grantees, the first reporting period 

begins on the start date of the award and extends until May 31 of the following year. 

Subsequent reporting periods begin June 1 and end May 31; however, grantees are required to 

submit their progress reports annually on July 1.

Formative evaluations of funded awards are used as supplemental oversight and technical 

assistance tools for grantees. Such reviews are conducted when program officers believe that a 

grantee could benefit from targeted technical assistance, in addition to technical assistance 

provided by the program officer. A panel of subject matter experts is chosen to provide the 

technical assistance and make recommendations for improvement if needed. 
11 

Staff, as experienced program administrators and researchers, are highly adept at maintaining 

ongoing, routine communication with and oversight of grantees to help inform their scientific 

programs and ensure that they are meeting goals and objectives. Program officers use the HHS 

Grants Policy Administration Manual to provide consistent oversight across projects. Risk 

assessments are conducted to identify grantees who are at risk for poor performance, however 

additional oversight and technical support can be provided as needed. Though rare, findings of 

ongoing poor performance can lead to a discontinuation of funding to a grantee.

Funding Overview

The allocation of FY 2019 grant funds for the 11 funding mechanisms discussed above is 

displayed in Table 2. For each funding mechanism, the table includes the number of new and 

continuation awards. The overall grant allocations across all 11 funding mechanisms totaled 

$100,935,565 for FY 2019.

Table 2. NIDILRR-Funded Centers and Projects: Funding and Awards, FY 2019 

Funding 

Mechanism 

(NIDILRRFunded 

Centers and 

Projects)

Award Type 

(NIDILRRFunded 

Centers and 

Projects) FY 2019 # of 

Awards

FY 2019

Total

Grant 

Amount in 

Thousands 

of $

Grant 

Amount 

Total

RRTC Continuations 14 20 11,949 17,198

RRTC New Awards 6 20 5,249 17,198

RERC Continuations 13 17 11,994 15,694

RERC New Awards 4 17 3,700 15,694

DRRP Continuations 21 32 10,946 18,103

DRRP New Awards 11 32 7,157 18,103

ADA 

Network 

Continuations

12 12 12,424 12,424

ADA 

Network 

New Awards

0 12 0 12,424

SBIR Continuations 3 17 844 2,930
12 

Funding 

Mechanism 

(NIDILRRFunded 

Centers and 

Projects)

Award Type 

(NIDILRRFunded 

Centers and 

Projects) FY 2019 # of 

Awards

FY 2019

Total

Grant 

Amount in 

Thousands 

of $

Grant 

Amount 

Total

SBIR New Awards 14 17 2,086 2,930

KT Continuations 7 10 3,416 4,004

KT New Awards 3 10 588 4,004

FIP Continuations 30 46 5,991 9,190

FIP New Awards 16 46 3,198 9,190

Model 

Systems SCI

Continuations 15 15 7,398 7,398

Model 

Systems SCI

New Awards 0 15 0 7,398

Model 

Systems TBI

Continuations 18 18 8,462 8,462

Model 

Systems TBI

New Awards 0 18 0 8,462

Model 

Systems 

Burn 

Continuations 5 5 1,850 1,850

Model 

Systems 

Burn 

New Awards 0 5 0 1,850

ARRT Continuations 15 18 2,178 2,628

ARRT New Awards 3 18 450 2,628
13 

Funding 

Mechanism 

(NIDILRRFunded 

Centers and 

Projects)

Award Type 

(NIDILRRFunded 

Centers and 

Projects) FY 2019 # of 

Awards

FY 2019

Total

Grant 

Amount in 

Thousands 

of $

Grant 

Amount 

Total

Switzer 

Fellowships 

(one-year 

grants)

Continuations 0 6 0 430

Switzer 

Fellowships 

(one-year 

grants)

New Awards 6 6 430 430

Section 21 Continuations 4 5 1,425 1,625

Section 21 New Awards 1 5 200 1,625

Total 220 101,936

Source: U.S. Department of Health and Human Services, Administration for Community Living, National Institute on 

Disability, Independent Living, and Rehabilitation Research. 

Exhibits 1 and 2 illustrate the distribution of funded research and development grant projects in 

FY 2019 across the three domains of NIDILRR programs: health and function, community living 

and participation, and employment. “Cross-cutting” is a composite category used in the Annual 

Performance Report to describe projects that reflect two or more domains. Roughly 49 percent 

of development projects and about 31 percent of research projects were described as crosscutting. “Research projects” are defined as “an intensive systematic study, based on a clear 

hypothesis or research question that is directed toward producing new scientific knowledge 

about the subject or problem being studied.” “Development projects” are defined as “the use 

of knowledge and understanding gained from research to create materials, devices, systems, or 

methods beneficial to the target population, including design and development of prototypes 

and processes.” 
14

Exhibit 1. Research Grant Projects by Domain, FY 2019

Source: U.S. Department of Health and Human Services, Administration for Community Living, National Institute on 

Disability, Independent Living, and Rehabilitation Research. 2019 Annual Performance Reports. “Program 

Performance Report Table 9.”

Exhibit 2. Development Grant Projects by Domain, FY 2019

Source: U.S. Department of Health and Human Services, Administration for Community Living, National Institute on 

Disability, Independent Living, and Rehabilitation Research. 2019 Annual Performance Reports. “Program 

Performance Report Table 11.”

Grantee Activities and Progress

ACL collects output data through the APR. Grantees are required to report each output from 

their funded activities in one of four categories: publications; tools, measures, and intervention 

protocols; technology products and devices; and informational products. A brief description of 

each category of output type follows:

• Publications are documents directly funded by a grantee’s current award. Publications include 

journal articles, periodicals, web journals, proceedings from meetings and symposia, books or 
15

book chapters, monographs, abstracts, technical or research reports, and reviews. Within this 

output category are peer-reviewed and non-peer-reviewed publications.

• Tools, measures, and intervention protocols include instruments or processes created to 

acquire quantitative or qualitative information, knowledge, or data on a specific disability or 

rehabilitation issue as well as research-based protocols for delivering interventions to specific 

target populations of people with disabilities.

• Technology products and devices are developed, modified, tested, or evaluated by the grantee. 

This category refers to any technology product or device developed under the award that the 

grantee disseminated or delivered to external audiences during the current reporting period. 

• Information products refer to items such as training manuals/curricula, fact sheets, newsletters, 

audiovisual materials, marketing tools, educational aids, websites, presentations, and other 

forms of disseminated information.

Exhibit 3 compares the number of output products produced by grantees within each category 

type in FY 2019. Additional detail has been provided for the category of publications, with peerreviewed and non-peer-reviewed publications being reported separately. 

Exhibit 3. Total Outputs Produced by All Grantees across All Program Mechanisms, by Product 

Type, FY 2019

Source: U.S. Department of Health and Human Services, Administration for Community Living, National Institute on 

Disability, Independent Living, and Rehabilitation Research. 2019 Annual Performance Reports. “Program 

Performance Report Tables 18–22.”

Data obtained through the 2019 APR show that ACL supported 220 grantees during FY 2019, 

totaling $100,935,565 across all program mechanisms. These projects reflect the breadth of 

disability and rehabilitation research within the agency’s outcome domains of community living 

and participation, health and function, and employment. The knowledge and products that are 

generated by research and development grants have a wide variety of important impacts in the 

field. The summaries that follow provide examples of the outcomes and impacts resulting from 
16 

NIDILRR program investments. Additional information concerning these projects is available 

through the National Rehabilitation Information Center website (http://www.naric.com/). 

Sampling of Key Accomplishments by Funded Researchers

NIDILRR program grantees conduct coordinated, integrated, and advanced programs of 

research, development, training, and knowledge translation. 

The following are examples of accomplishments reported by grantees in FY 2019. 

First Clinical Practice Guideline for Managing Cardiometabolic Risk After SCI

Cardiometabolic risk factors affect people without disabilities and people with disabilities. In 

both people with and without disabilities, cardiometabolic risk factors are often termed the 

“silent killer;” anyone may have these risk factors and never know it. People with spinal cord 

injuries are different – supporting the need for specific guidelines to manage cardiometabolic 

disease risk in people with SCI. 

Thanks to a grant entitled A Lifestyle Intervention Targeting Enhanced Health and Function for 

Persons with Chronic SCI in Caregiver/Care-Receiver Relationships: Effects of Caregiver CoTreatment, Dr. Mark Nash and his colleagues at the University of Miami and Medstar 

Rehabilitation Hospital at Georgetown University are working on this problem.

As a result of their hard work, Dr. Nash and his colleagues have produced the first clinical 

practice guideline for managing cardiometabolic risk after SCI. A description and discussion of 

this guideline can be found in the following publication:

Nash, M. S., Groah, S. L., Gater, D. R., Dyson-Hudson, T. A., Lieberman, J. A., Myers, J., 

Sabharwal, S., & Taylor A. J. (2018). Identification and management of cardiometabolic risk 

after spinal cord injury: Clinical practice guideline for health care providers. Topics in Spinal 

Cord Injury Rehabilitation, 24, 379–423. Full text of the clinical practice guideline: 

(HTML format) (PDF format).

Physicians and health care professionals, responsible for identifying and treating secondary 

health conditions occurring after SCI, will now have access to, and be able to use, this clinical 

practice guideline to provide better care to patients with SCI. Persons with SCI and their families 

can also bring this guideline to their health care providers and engage in a discussion with their 

health care providers about how to incorporate the recommendations into their plans of care.

Manufacturers and Developers of Augmentative and Alternative Communication (AAC) Have 

Adopted Visual Scene Displays (VSDs)

Prior to the development of VSDs by the grant awarded to the Augmentative and Alternative 

Communication Rehabilitation Engineering Research Center (AAC-RERC), the only AAC option 
17

was traditional grid displays with isolated symbols presented in rows and columns. It was 

difficult for many adults with disabilities resulting in significant language and cognitive 

limitations to use these traditional grid displays.

VSDs offer an easier alternative to traditional grid displays. They go beyond standard pictures 

and symbols organized in rows and columns by providing information on the situation or 

context. Put more simply, VSDs are photos or pictures that people can use to communicate 

messages to others. These images depict familiar scenes, objects, or people, and users can 

touch “hot spots” on the photo to speak messages that relate to the pictured scene or object. 

For example, a person with aphasia might touch a hot spot on a picture of a sibling and say,

“this is my sister.” This additional information on the situation and context makes it easier for 

persons with complex communication needs to express their wants and needs and therefore 

enhances their ability to interact and participate with others in the community. Research from 

the AAC-RERC and external researchers demonstrates the effectiveness of VSDs with adults 

with severe chronic aphasia, primary progressive aphasia, dementia, and other conditions.

Due to the continued efforts of the AAC-RERC and their partners, this VSD technology has been 

successfully transferred to major AAC manufacturers and app developers. 

The widespread integration of VSD technology into AAC devices by these manufacturers and 

developers offers speech-language clinicians and practitioners effective and easier-to-use 

options to help their clients. With appropriate guidance from speech-language clinicians and 

practitioners, individuals and families with complex communication needs can use these VSDenhanced AAC devices and software applications to improve their ability to communicate with 

much less effort.

Information on the availability, effectiveness, and use of VSD technology in AAC is also much 

more commonplace in the scholarly literature. Examples of publications that discuss it include 

but are not limited to:

Mooney, A., Bedrick, S., Noethe, G., Spaulding, S., & Fried-Oken, M. (2018). Mobile 

technology to support lexical retrieval during activity retell in primary progressive aphasia. 

Aphasiology, 32, 666–692.

Taylor, S., & Wallace, S. (2019). High technology AAC in post-stroke aphasia. Perspectives of 

the ASHA Special Interest Groups, 4, 464–473. 

Thiessen, A., Brown, J., Freeland, T., & Brewer, C. H. (2019). Identification and expression of 

themes depicted in visual scene and grid displays by adults with traumatic brain injury. 

American Journal of Speech-Language Pathology, 28, 664–675.
18 

Waller, A. (2019). Telling tales: Unlocking the potential of AAC technologies. International 

Journal of Language & Communication Disorders, 54, 159–169.

Childes, J. M., Palmer, A. D., & Fried-Oken, M. B. (2019). Communication support before, 

during, and after treatment for head and neck cancer. In P. C. Doyle (Ed.), Clinical care and 

rehabilitation in head and neck cancer (pp. 247–264). Springer. 

General Motors (GM) Withdraws its Federal Communications Commission (FCC) Petition for 

an Exemption to Certain Real-Time Text (RTT) Regulations

RTT is an important technology for many persons with disabilities, especially those with 

communication or hearing difficulties, because it allows instant text transmission and receipt 

without having to press a “Send” button. Instant text transmission is similar to the 

instantaneous exchange of information that happens during a voice telephone conversation. 

This instant text transmission is particularly important in emergency situations. The FCC 

recognized the importance of RTT by adopting a set of federal RTT regulations found in 47 CFR 

Part 67. 

In December 2018, GM submitted a request for a waiver to some of the FCC RTT requirements

with respect to its new autonomous vehicle ride-hailing service but then requested and 

received approval to withdraw this request. The withdrawal of this request was due in large 

part to the comments and ongoing consultation with researchers and consumer groups at the 

RERC on Universal Interface and Information Technology Access. 

The RERC worked with consumer groups on the development of these formal comments to the 

FCC, pointing out that a waiver was unnecessary since the law and regulations as written 

already exempted the technology for which GM was looking for an exemption and that instead 

the FCC should simply respond that an exemption was not needed since the regulation did not 

cover GM's use case.

Issuing an exemption would have created a loophole for other covered organizations to avoid 

compliance with the federal RTT regulations. Consulting directly with GM over a period of time 

resulted in GM realizing they did not need an exemption. Additionally, GM cited the RERC and 

consumer group comments as evidence supporting the withdrawal of their waiver request.

Factsheet Entitled “The ADA, Addiction and Recovery” Helps Addiction Professionals 

Many people in recovery from addiction are unaware of their civil rights under the ADA. The 

ADA applies to addiction to alcohol, and to the illegal use of drugs differently. To address this 

situation, the New England ADA Center, as well as expert members from the ADA National 

Network Knowledge Translation Center , developed a factsheet in PDF format entitled The ADA, 

Addiction and Recovery. 
19 

News of the availability of this factsheet spread and Kristin Hamilton, Director of 

Communication for the National Association for Alcoholism and Drug Abuse Counselors, 

decided to include the factsheet in the May 2019 issue of their national association’s online 

newsletter. This is an important step for dissemination of ADA addiction-related information 

because the Association’s membership represents the professional interests of more than 

100,000 addiction counselors, educators, and other addiction-focused health care professionals 

in the United States, Canada, and abroad.

Free Short Courses on Blindness and Visual Impairment Provide New Knowledge to Those 

Who Take Them

The National Research and Training Center on Blindness and Low Vision (NRTC) offers free-ofcharge short online courses to everyone, with the purpose of increasing knowledge about 

blindness/low vision, employment of people who are blind/visually impaired, and center

research results. 

Based on current 2019 information reported by NRTC, 769 people accessed these online 

courses and completed 1,712 courses with a passing grade. Most of the users were VR

professionals, but users also included educators, individuals with who are blind/visually 

impaired, friends and family members of these individuals, and VR administrators.

These courses are quite popular with state VR agencies. Virginia Department for the Blind and 

Vision Impaired and South Carolina Commission for the Blind use these courses for training of 

their new staff. Georgia Vocational Rehabilitation Agency uses these courses as a component of 

trainings that they provide to their staff. Individual users are also taking the courses on NRTC’s

website.

“I took multiple courses from the NRTC Continuing Education page. I found that the 

information on employer relations and use of Business Relations employees in VR agencies 

to be particularly helpful in describing to VR Counselors in my agency the importance of 

opening up to the employer/business side of our work. This has been useful to help them 

understand that when we reduce stigma, fears, etc. of employers our participants can 

have greater success.”

“With this course, I was better able to understand the different causes of low vision and 

how the different types of low vision create barriers. I also learn about resources to help 

people with low vision and blindness. Learning to read an eye report was also very 

helpful.”

“Assisting my father who has macular degeneration and has low vision.”
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Standards Developed by NIDILRR Program Grantee are Foundational to New Proposed 

Federal Legislation on Accessible Fitness 

Little information on accessible fitness equipment, exercise or fitness classes, and instruction is 

available to individuals with disabilities. Dr. Jim Rimmer and his colleagues at the RERC on 

Exercise and Recreational Technologies for People with Disabilities have been working to solve 

this problem for several years. 

Through ongoing research and development efforts led by Dr. Rimmer and his colleagues, an 

American Society for Testing and Materials (ASTM) standard entitled Standard Specification for 

Universal Design of Fitness Equipment for Inclusive Use by Persons with Functional Limitations 

and Impairments (ASTM F3021–17) has been developed. The first of its kind, this specification 

establishes the requirements for the design and manufacturing of fitness equipment intended 

for use by persons with functional limitations and impairments. It aims to assist designers and 

manufacturers in reducing the possibility of injury when these products are used in accordance 

with the manufacturer’s operational instructions. It covers assistive technologies such as 

wheelchairs, walkers, crutches, canes, prosthetics, alternative communication devices, and cell 

phones, as well as requirements for color contrast.

These standards have been used by Federal legislators to help define “accessible exercise or 

fitness equipment” in S.3728, the Exercise and Fitness for All Act, which was introduced in the 

115th Congress in December 2018. The act was reintroduced in the 116th Congress as S.1244

on April 30, 2019. The act will require the Access Board to create guidelines regarding the 

provision of universally designed and inclusive fitness equipment, programming, and staff 

trained in working with people with impairments. As of April 2019, 30 advocacy organizations 

had pledged support of the bill.

A related bill (H.R.4561) with the same name was introduced in the House of Representatives 

on September 27, 2019.

“YouDescribe” is Creating Unprecedented Access to Video Materials for Blind Students and 

Adults

Individuals who are blind have virtually no access to video materials unless they pay for a 

professional service, which is extremely expensive. Researchers and engineers at the SmithKettlewell Eye Research Institute have come up with a better, more cost-effective solution to 

this problem.

They have developed “YouDescribe.” Since individuals who are blind cannot see videos, they 

must rely on audio description. Audio description is basically an extra soundtrack added by a 

describer so that a viewer who is blind knows what is happening on the screen. Family 
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members, educators, friends, and service providers volunteer to do the descriptions. For more 

information on how YouDescribe works, visit their support and user information page. 

YouDescribe is generating a lot of excitement. In the past 6 months alone nearly 900 people 

have opened YouDescribe accounts, bringing the total to close to 2,500 subscribers, and 600 

new, high-quality videos have been posted. An interesting short YouDescribe video is the 2017 

Solar Eclipse. Currently approximately 15 videos are being described per day. Center staff are 

very active on the YouDescribe twitter account, keeping YouDescribe viewers abreast of 

exceptional content from volunteers.

Center staff also maintain a YouDescribe Facebook page, which highlights great audio 

description, presents mini tutorials, and posts articles about audio description in general. This 

structure creates a community of practice for teachers and keeps them growing as audio 

describers in and out of the classroom. One volunteer describer recently used YouDescribe to 

hone her skills and build a portfolio of excellent described videos, which she was then able to 

use to apply for and obtain a job as a professional describer for CaptionMax. This is one of the 

largest providers of closed captioning and media access in the U.S., whose clients include 

Warner Brothers Television, NBC Universal, and Sony Pictures Entertainment.

Finally, third-party websites are citing and talking about YouDescribe. Examples include but are 

not limited to:

• Perkins School for the Blind Review of YouDescribe

• Media Access of Australia — How to Audio Describe a YouTube Video

Progressive Employment (PE) Fidelity of Implementation Toolkit May Help States Correctly 

Implement PE

There is a critical need for innovation to ensure that persons with disabilities who have multiple 

work barriers, limited work skills or educational credentials, and who may have a need for 

intensive work experience opportunities are not left out of a system-wide initiative to align 

public employment services with business needs.

One potentially innovative model that can address this critical situation is known as the PE 

Model. Researchers wrote the first peer-previewed publication on PE. The citation for this 

publication is below:

Moore, D., Haines, K., Bradshaw, H., Porter, A., Smith, J., & Foley, S. (2018). Development of 

the Progressive Employment dual customer model for vocational rehabilitation. Journal of 

Vocational Rehabilitation, 49(2), 149–160. View abstract. 

Moreover, Researchers at the University of Massachusetts at Boston, working on a 3-year grant 

entitled Progressive Employment for Individuals with the Most Significant Disabilities, have 
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developed a Progressive Employment Fidelity of Implementation Toolkit. The Toolkit provides: 

(1) an overview of the PE Model; (2) definition of terms; (3) key principles of PE; (4) 

prerequisites for operationalizing PE; and (5) the revised Fidelity of Implementation 

Measurement Tool (version 4.3). This Toolkit is important because it can be used to guide 

implementation of the PE Model in a variety of settings and provide a quantitative 

measurement (score) of fidelity to the key model components to inform research and practice.

The PE Learning Collaborative has informed the development of the Toolkit through site visits, 

Learning Collaborative meetings, and by direct input.

This fidelity of implementation toolkit is not widely available yet. However, the Toolkit has been 

shared with researchers at the American Institutes for Research (under Maine’s Work-Based 

Learning grant) as well as Mathematica Policy Research current and former staff. It was also 

shared with state VR agencies implementing PE. Examples of states implementing PE include 

but are not limited to Maine and Vermont. 

In Maine, a contractor is using the Toolkit to inform the current evaluation of PE expansion

within the state. VR agencies may use the tool to assess fidelity of implementation across area 

offices/statewide. VR agencies can review measurement indicators and provide or request 

additional training in content areas related to PE implementation strategies. 

These examples of current uses of the Toolkit, as well as other future uses, will help to ensure 

that the PE Model is being implemented as intended. Ultimately, implementing PE as intended 

will help maximize employment outcomes among people with disabilities who face multiple 

work barriers, have a limited set of work skills, and limited educational credentials.

Anti-Stigma Curriculum Helps Veterans with Psychiatric Disabilities in California and 

Massachusetts

NIDILRR-funded researchers at Boston University’s Center for Psychiatric Rehabilitation have 

been working on interventions to reduce feelings of stigma among people with psychiatric 

disabilities. 

In a previous funding cycle, these researchers developed and tested the Anti-Stigma Photovoice 

Curriculum with individuals with psychiatric disabilities. News of this anti-stigma curriculum has

spread, and clinicians in the Department of Veterans Affairs (VA) health systems in 

Massachusetts and California are currently using it to treat stigma and internalized stigma 

among veterans. For more information on how the curriculum is being used by the VA Palo Alto

health care system in California, email Dr. DiAnn Aiello, psychologist and local recovery 

coordinator. For more information on how the curriculum is being used by the VA health care 

system in Massachusetts and other states, email Dr. Zlatka Russinova, a staff member at Boston 

University’s Center for Psychiatric Rehabilitation.