Persons with disabilities are at significant risk for additional or secondary disabilities. Because of this increased risk, especially for persons suffering from the "disuse syndrome," it is important that a comprehensive health promotion component is included in the rehabilitation program for disabled individuals. Current concepts of disability are discussed as well as the distinctions between primary and secondary disabilities. Specific types and causes of disabilities are identified and described. Each type of secondary disability is assessed in terms of its "preventability." Examples and characteristics of quality programs for health promotion for disabled persons are presented. Recommendations for further research and study are discussed to include the need for determining effective components of successful programs and ways to encourage the field of rehabilitation to incorporate health promotion into the rehabilitation process for its disabled clients.

While some recent studies that apply epidural spinal cord stimulation (SCS) have demonstrated a breakthrough in improvement of the health and quality of the life of persons with spinal cord injury (SCI), the numbers of people who have received SCS are small. This is in sharp contrast to the thousands of persons worldwide living with SCI who have no practical recourse or hope of recovery of lost functions. Thus, the vision is to understand the full potential of this new intervention and to determine if it is safe and effective in a larger cohort, and if it is scalable so that it can be made available to all those who might benefit. To achieve this vision, the National Institute of Biomedical Imaging and Bioengineering (NIBIB) called for and organized a consortium of multiple stakeholder groups: foundations addressing paralysis, Federal and public agencies, industrial partners, academicians and researchers, all interested in the same goal. Based on input from consortium participants, we have reasoned that a first step is to define a scalable SCS approach that is effective in restoring lost autonomic physiology, specifically bladder, bowel and sexual function. These functions are most critical for improving the quality of life of persons living with SCI. This report outlines a framework for conducting the research needed to define such an effective SCS procedure that might seek FDA approval and be implemented at the population level.

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The investigation reported here was concerned with the application of the factor analytic method to identify the factors which define oral communication abilities in older children. A study population of 143 preadolescent subjects was evaluated on 40 speech and language measures by classroom teachers and by speech specialists. An intercorrelation matrix of the 40 measures was computed and submitted to a factor analysis by means of the principal axes method. Seven factors were extracted which represent the human abilities underlying the dimensions of speech and language behavior studied. The factors were identified as follows: Factor 1—General Speaking Ability as Assessed by Speech Specialists; Factor 2—Motor Skill in Speaking; Factor 3—Speech Dominance; Factor 4—Non-distracting Speech Behavior; Factor 5—Voice Quality; Factor 6— Language Maturity; and Factor 7—General Speaking Ability as Assessed by Teachers.