contributions. The members, officers, and board of directors serve without con.pensation of any kind. Its national headquarters are at 369 Lexington Avenue, New York City. United Cerebral Palsy comprises 200 affiliates, State and local organizations throughout the United States dedicated to making it possible for the cerebral palsied to take their proper places as participating members of the community. The term "cerebral palsy" denotes a complex and highly variable disturbance of function which is the outward reflection of damage to the brain. The most prominent reflection is disturbance of motion, although other functions mediated in the brain may also be affected, depending upon the location of the damage, the number of cells destroyed, and other complex factors. Such damage can be caused by any type of injury, or by failure of the brain to develop before birth. Most adults have learned as children to eat, walk, talk, and perform countless functions of everyday living quite naturally and almost automatically. This is possible because normal people, early in childhood establish delicately balanced control of their muscles so that they work together smoothly and efficiently. A person with cerebral palsy has suffered damage to the mechanisms which provide this delicate control. The appearance of a person so afflicted had often led the uninformed observer to the conclusion that the cerebral palsied individual is feebleminded. This affords an unthinkable injustice to the large numbers of cerebral palsied individuals who are intellectually normal or superior. It is true, however, that others suffering from cerebral palsy have also sustained the additional handicap of impaired intellectual ability. One of the most difficult parts of the cerebral palsy problem is that of helping adults to become self-sufficient members of industry and society. Estimates indicate that there are some 550,000 persons in the United States who are suffering from cerebral palsy. With unrelenting regularity about 10,000 babies are born with cerebral palsy annually, 1 every 53 minutes. The caselad of cerebral palsy persons is growing steadily as attention is directed to the problem. According to the most authoritative evidence available there are approximately 350.000 adults with cerebral palsy in the United States. A spot check leads us to believe that about 50,000 cerebral palsied adults are engaged in some sort of remunerative occupation. The responsibility for the employment rehabilitation of the cerebral palsied was assumed by the Federal Government but the Federal Government found itself incapable of meeting the need. In 1953 with the corporate income of the United States at the highest level in history and the total income of the Nation at a correspondingly high level, we were able to provide opportunities for only one-fourth of 1 percent for the adult cerebral palsied. These people needed work, wanted work, and many could be adjusted to the condition in their communities only by means of work. The most prosperous nation in the world at full industrial and economic capacity could provide employment for only 800 adult cerebral palsied through its governmental machinery. This record of providing employment rehabilitation to victims of cerebral palsy should give us pause and demands that vigorous, constructive action be taken to prevent its recurrence. We are, therefore, asking the Congress through this committee, to step into the breach and do something constructive for these truly forgotten men and Women. As a physician, my primary medical background has been in pediatrics, which deals in the care of children. This is necessarily a forward-looking branch of medicine since what we are, in effect, doing, is helping to prepare children to be as effective adults as their health and their Nation will permit. Therefore, I am deeply concerned by one of the final stages of this whole process of growth and development of an individual, which is, of course, the ultimate fulfillment of his potential as a useful adult. This whole problem of vocational rehabilitation is very nearly the final phase of his preparation which we physicians begin in infancy and early childhood. It is disturbing to me to see this field receiving so little attention that it may well become a bottleneck which renders all that has gone before rather pointless. Employment problems of cerebral palsied stems from three major sources: (1) Limitations imposed on these people as a result of their physical and/or mental disabilities and emotional problems: (2) inadequate functional guidance and preparation for job placement: (3) resistance of employers to hiring the cerebral palsied because of their lack of knowledge of the true nature of the condition, their prejudice, or fear. While the physical disability of other handicapped persons interferes with their prospects, guidance, and training, the situation for the cerebral palsied is intensified because the multiple complexity of their involvement produces multiple disabilities in the same individual. The present limitations in the act in effect exclude the cerebral palsied from the benefits which Congress clearly intended for all the handicapped. It has been said, "Employment is Nature's best physician-it is essential to human happiness.' To a person who has never known success but has been categorical as atypical and looked upon by his family, his friends, and the community as grossly unfit, and perhaps, unjustly, as feebleminded, a job assumes even greater importance than to the physically able. We know how destructive it is to a person to find he is rejected or pitied by his family and his peers, and finally to find his hopes and ambitions shattered when he discovers the sign "No Help Wanted" displayed for him without benefit of a fair trial. From the standpoint of national economy, it is far less costly to habilitate an individual and prepare him for even partial employment than it is to keep him as a public charge for a lifetime. Some cerebral palsied individuals have, through their performance, adequately demonstrated their ability to become self-supporting, contributing members of society. We are convinced that many more could, with additional preparation and opportunity, take their places in industry and enjoy, not only the benefit of economic status, but also the attainment of social acceptance and a personal satisfaction which comes from a sense of "belonging"-of "contributing." For his happiness and self-respect, every individual must have significant work to do, fitted to his individual capacity. The latest published statistics from the Department of Health, Education, and Welfare indicate that 892 cerebral palsied were rehabilitated in 1949; 819 in 1950; 881 in 1951, and 809 in 1952. The Office of Vocational Rehabilitation of the Department of Health, Education, and Welfare has graciously cooperated by compiling for us two sets of figures which will vividly illustrate the plight of the cerebral palsied in his quest for aid. These figures, copies of which have been submitted, show first the number of cerebral palsied rehabilitated from 1945 to 1953, and second, the number of persons with cerebral palsy who have been rehabilitated and placed in jobs by States. The jobs filled range from unskilled to highly technical and professional. These statistics indicate that when the cerebral palsied has the opportunity for training and proper guidance through proper job placement, there is no doubt that he can make his contribution to society, not only in service, but incidentally, as a taxpayer rather than a public ward. Industrialist Louis C. Whiton, president of the Prat-Daniel Corp. of South Norwalk, Conn., who, as the first voluntary chairman of United Cerebral Palsy's Vocational guidance program, has pioneered in this field, maintains that we are not properly utilizing these hidden human resources of our society. He points out that among America's cerebral palsied adults there exists an undeveloped potential asset to the industrial, business, and cultural life of the Nation. According to a letter received from Mr. D. H. Dabelstein, Assistant Director at the Office of Vocational Rehabilitation, dated December 16, 1953, a copy of which has been submitted to your committee, "the State rehabilitation agencies have also been shifting program emphasis toward serving larger numbers of the severely disabled." He continues by saying: "As you know, rehabilitation of the severely disabled is very costly and difficult." A pamphlet issued by the California State Department of Education, Bureau of Vocational Rehabilitation, says: "Many physical or mental handicaps can be removed through vocational rehabilitation services. Many others can be reduced to the point where they do not interfere with the work demands of a properly selected job. When the disability has been properly treated and the person properly trained for and placed in the right job, he can do that job as well as anybody. It's not what a man has lost, but what he has left that's important." We are concerned with a serious disability which is much more difficult and expensive to approach with rehabilitation techniques than is the case with many other handicaps. It is obvious to us that a program inadequately financed will never reach down deeply enough into the reservoir of the handicaps to do much about cerebral palsy, but rather will be expended on the easier and more rewarding problems. Therefore, as we view it, the amount suggested by the President for vocational rehabilitation of $28 million is not enough. It certainly should be closer to $50 million and perhaps $75 million. According to an article by Dr. Howard A. Rusk that appeared in the New York Times on Sunday, January 10, 1953, the Nation paid more than $430 million in 1952 for the disabled persons on public assistance rolls. In the same article Miss Mary E. Switzer, Director of the Office of Vocational Rehabilitation, noted that "if a proper program of rehabilitation is instituted, these workers will, during their working years, pay back in Federal income taxes $10 for every $1 the Federal Government invested in them. I cannot overemphasize the importance of training of personnel for a wellrounded rehabilitation program. Certainly $1 million for training people to work with the cerebral palsied is necessary. It is difficult to arrive at figures for the support of productive research, However, we suggest that $5 million should be invested in much needed research in the field of rehabilitation of the cerebral palsied. This was the amount that was determined as applicable in the case of research rehabilitation of persons afflicted with poliomyelitis. Cerebral palsy is as common a cause of disability and far more complex. We know firsthand that the cerebral palsied can be rehabilitated provided they are placed under the supervision of trained personnel. One of our affiliates, United Cerebral Palsy of New York City, has, with its limited facilities and only one person in charge of the program, placed 56 cerebral palsied persons in paying jobs in about a year and a half. That interesting record is submitted for your consideration. It is called Vocational Placement of the Cerebral Palsied, a brief Experience in Dealing with the Vocational Problems of 200 Cerebral Palsied Adults, and was prepared by Linn W. Curtis, vocational supervisor for United Cerebral Palsy for New York City. Some most interesting and informative pamphlets about vocational guidance for the cerebral palsied have been prepared by Dr. Frederick A. Whitehouse, former director of vocational rehabilitation for the Institute of Crippled and Disabled, and with your kind permission, I would like to submit them as part of this record. In his health message to Congress in January of this year, President Eisenhower said: "Working with only a small portion of the disabled among our people, Federal and State Governments and voluntary organizations and institutions have proved the advantage to our Nation of restoring handicapped persons to full and productive lives. "There are now 2 million disabled persons who could be rehabilitated and thus returned to productive work. Under the present rehabilitation programs only 60,000 of these disabled individuals are returned each year to full and productive lives. "Rehabilitated persons as a group pay back in Federal income taxes many times the cost of their rehabilitation. "Our goal in 1955 is to restore 70,000 disabled persons to productive lives. Our goal for 1956 should be 100,000 rehabilitated persons, or 40,000 persons more than those restored in 1953. In 1956, also, the States should begin to contribute from their own funds to the cost of rehabilitating these additional persons. By 1959, with gradually increasing State participation to the point of equal sharing with the Federal Government, we should reach the goal of 200,000 rehabilitated persons each year." Our reasons for appearing before your committee are twofold: (1) To ask that sufficient money be appropriated to provide for the rehabilitation of the cerebral palsied; (2) That some sort of provision be included in the law to make sure that each State be required to develop a rehabilitation program not only for those who can be placed in employment within a short period but also for those whose rehabilitation will take a longer period and cost more money. I should like to conclude our presentation by pointing out that failure on the part of our Government to provide adequately for the rehabilitation of the cerebral palsied cannot be blamed on any public official. It can perhaps he traced to the fact that until recently public awareness of the magnitude of seriousness of the problem of cerebral palsy has not been sufficiently aroused. The growth of United Cerebral Palsy, whose sole concern is with the problems of this group of people, is evidence that the public is now beginning to face the deplorable facts which we have presented to you and further evidenced by the fact that we are here as a national organization, the first time that such a group has come before you to plead the cause of the cerebral palsied. OFFICE OF VOCATIONAL REHABILITATION Number of persons with cerebral palsy rehabilitated, fiscal years 1945–53 Source: Prepared by Division of Research and Statistics, Mar. 30, 1954. Number of persons with cerebral palsy rehabilitated, by State, fiscal years ended DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Mr. HARRY LYONS, Legislative Director, United Cerebral Palsy, New York, N. Y. DEAR MR. LYONS: This will acknowledge your letter of November 30, 1953, requesting information about the accomplishments of the Federal-State vocational rehabilitation program during 1951 and 1952. The total number of disabled persons served under the program decreased from 231,544 during 1951 to 228,481 in 1952. The number of persons reported as rehabilitated decreased from 66,193 in 1951 to 63,632 in 1952. The proportion of cerebral palsied among the rehabilitated group remained constant during this 2-year period-1.3 percent. The Federal appropriation for the program was $20.6 million in 1951 and $21.5 million in 1952, or an increase of $900,000. There are several reasons for the slight decrease in the number of persons rehabilitated. The inflationary costs of "cost-of-living." salary adjustments for State agency personnel, and services purchased for disabled persons-such as hospitalization-more than offset the $900,000 increase in Federal appropriation. The cost of maintaining the national program per person rehabilitated was $514 in 1952 in contrast to $457 in 1951. Then, too, the State rehabilitation agencies have been shifting program emphasis toward serving larger numbers of the severely disabled. As you know, rehabilitation of the severely disabled is more costly and difficult. At the request of your Washington representative, we are sending you copies of our recent publications, under separate cover. If there is any further information you desire, please do not hesitate to call upon us. Sincerely yours, D. H. DABELSTEIN, Assistant Director. Dr. BROOKS. Thank you, Mr. Chairman and members of the committee. Mr. Chairman and members of the committee. I am Dr. Glidden L. Brooks of New York City, N. Y., medical director of United Cerebral Palsy Associations, Inc. We appreciate this opportunity to present testimony on behalf of the cerebral palsied. United Cerebral Palsy Associations is a nonprofit membership corporation founded in 1948-the only nationwide organization devoted exclusively to a united attack on cerebral palsy. Its humanitarian work is supported by voluntary contributions. The members, officers, and board of directors serve without compensation of any kind. Its national headquarters are at 369 Lexington Avenue, New York City. United Cerebral Palsy comprises 200 affiliates, State and local organizationus throughout the United States dedicated to making it possible for the cerebral palsied to take their proper places as participating members of the community. The term "cerebral palsy" denotes a complex and highly variable disturbance of function which is the outward reflection of damage to the brain. The most prominent reflection is disturbance of motion, although other functions mediated in the brain may also be affected, depending upon the location of the damage, the number of cells destroved, and other complext factors. The brain is a highly complex organ and anything that happens in it is apt not to have simple readily definable results. Such damage can be caused by any type of injury, or by failure of the brain to develop before birth. Most adults have learned as children to eat, walk, talk, and perform countless functions of everyday living quite naturally and almost |