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You have created the field, now we need to people it with the resources necessary to move it from a dream to a reality. Thank you for you time this morning.

[The statement follows:]


Good morning, Senator Harkin, my name is Alfred Healy and I

am the director of the Division of Developmental Disabilities at the University of Iowa. In brief the time available to me, I will discuss the programmatic priorities of the University Affiliated Programs supported through the Assistance and Bill of Rights Act and how those priorities relate to the broader issues facing persons with disabilities today.



UAPS are engaged in interdisciplinary training of physicians and allied health professionals, exemplary service provision to infants and young children with severe developmental disabilities and technical assistance to community-based residential, vocational and educational service programs. Over four years ago, Mr. Chairman, you initiated a vigorous expansion of the national network with the objective of assuring that every state in the Union has a UAP capacity. While universities in 9 states joined the UAP system during that period, Maine, Rhode Island, Delaware, Wyoming, Alaska, Oklahoma and the territory of Puerto Rico remain unserved.

In addition, the last two reauthorizations of the Developmental Disabilities Act added a series of specific training initiatives to the UAP authority. These initiatives, which were selected in close consultation with primary consumer organizations represented in the Consortium for Citizens with Disabilities (CCD), address a panoply of pressing issues including early intervention, aging, paraprofessional personnel preparation, behavior management and assistive technology.

Yet, in this era of tight fiscal constraints, why is it important to complete the UAP national network? How will the new training initiatives improve the lives of persons with developmental disabilities?

Unfortunately, the

answer to those

questions can often be found in the extremely


circumstances confronting many of our Nation's children today. For example, the incidence of Fetal Alcohol Syndrome among infants born on Native American reservations in Nevada and Wyoming is twice as high as the national average. San Juan, Puerto Rico has a strikingly large pediatric AIDS population for a city of its size. The crack epidemic sweeping Our Nation's cities has reached Providence, Rhode Island, Wilmington, Delware, and Oklahoma City, Oklahoma. In their wake, these national trends leave infants with retardation, children with severe cerebral palsy and


youngsters with seemingly intractable learning disabilities.

You have been active Mr. Chairman, in addressing these issues. Specifically, through the passage of Part H of the Education of the Handicapped Act, you have sought to provide these children with multidisciplinary early intervention services that will give them a real chance to live independently, hold a job and have a family of their own. At the same time, you are one of the leaders in Congress who recognize that the developmental needs of these infants and children cannot be dealt with by the erection of direct service programs alone.

As an

More than ever before, we must expand our interdisciplinary training and exemplary service capacity --represented in part by the UAP system-- to meet burgeoning national demands. illustration, many of my colleagues in the UAP system believe that between 250,000 and 300,000 infants will be eligible to receive Part H services in 1992. However, over 80% of the states report a lack of trained personnel in almost every critical early intervention service discipline.

Whether the population of children in need of developmental assistance is the result of advances in medical technology, or improved diagnostic techniques, or drug and alcohol abuse or other factors is largely irrelevant to us. The fact remains that


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the United States must produce a substantially larger number of pediatricians, occupational therapists, physical therapists and speech language pathologists specifically trained to meet the needs children with developmental disabilities.


Providing an appropriation of $16.9 million for the UAP system, or an increase of roughly $3 million, is a step in the right direction. While this may seem like an insignificant expenditure in view of the scale of personnel shortages we face, the history of the UAP program shows that limited DD Act funds can have an extraordinary impact on institutions of higher education.

Thank you for taking the time to listen to our concerns.

UAPS Not Receiving Funding for Training Initiative Projects:

Mental Retardation & Developmental Disability Program (UCLA)
Los Angeles, California

Center for Child Development & Developmental Disorders
University Affiliated Training Program (USC) Los Angeles
Hawaii UAP for DD Honolulu, Hawaii

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Sparks Center Birmingham, Alabama







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New Hampshire UAP Organization
Mental Retardation Institute/UAP

Durham, New Hampshire
Valhalla, New York

University Affiliated Cincinnati Center for Developmental

The Nisonger Center Columbus, Ohio

Cincinnati, Ohio

Philadelphia, Pennsylvania
Austin, Texas

Developmental Center for Handicapped Persons
Vermont Center for DD Burlington, Vermont

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Child Development and Mental Retardation Center

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Senator HARKIN. Thank you very much. Is it safe to say these States that still do not have a program, probably would not be able to start one with the level of funding requested by the administration?

Dr. HEALY. Absolutely would not be able to do, sir.

Senator HARKIN. Well, we do have budget constraints, but this is one area in which we are going to need this program, especially with the passage of ADA.

Dr. HEALY. Exactly. We totally concur.

Senator HARKIN. Thank you very much, Dr. Healy.

Dr. HEALY. Thank you for hearing me.


Senator HARKIN. Next we will hear from Dr. John Folkins, the American Speech, Language, and Hearing Association. And might I just say that Dr. Folkins is professor and chair of the Department of Speech, Pathology, and Audiology at the University of Iowa.

Dr. FOLKINS. Thank you, Mr. Chairman. It is an honor to appear before the subcommittee on behalf of the American Speech, Language, and Hearing Association. That is ASHA.

ASHA has already joined with other professional and disability organizations in the Consortium for Citizens With Disabilities in making recommendations for numerous programs in education, rehabilitation, and health in fiscal year 1992. Therefore, my testimony today will focus on a single program, special education personnel development.

Communication disorders form one of the largest categories of disabilities in the United States. Approximately 1 in 10 Americans have some kind of speech, language, or hearing disorder. Nearly one-quarter of the children served under Public Law 94-142 have primary disorders of speech and/or language. The Special Education Personnel Development Program assists institutions of higher education in producing an adequate supply of qualified providers of special education and related services. It is difficult to envision a successful implementation of appropriate education under Public Law 94-142 without properly trained personnel.

An important achievement of Public Law 99-457, was the enactment of a provision requiring all individuals covered by the special education mandate to receive services from qualified providers. The provision requires that education personnel standards are based on the highest requirement in the State for personnel in a specific profession. In this way, Congress has effectively abolished dual standards for service delivery in which children with communication disorders received inferior services in many States.

The Department of Education reports that in the 1987-88 school year, there were nearly 30,000 additional special education teachers needed for students 6 to 21 years old. This included 3,500 speech language pathologists, or 13 percent of the positions needed. In addition, over 15,000 additional related services personnel were needed. Both the number of related services personnel and the shortfall have increased steadily during the past decade.

Incidentally, the State of Iowa does not train nearly enough speech language pathologists to fill its needs. In the past 10

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