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Help for
Women

U. S. D E P A R T M E N T OF L A B O R
James P. Mitchell, Secretary
W O M E N ' S BUREAU
Mrs. Alice K . Leopold, Director

in cooperation

with

U. S. D E P A R T M E N T OF HEALTH, E D U C A T I O N , A N D WELFARE




Arthur S. Flemming, Secretary
OFFICE OF V O C A T I O N A L

REHABILITATION

Mary E. Switzer, Director

WOMEN'S

BUREAU

PAMPHLET

FIVE : 1958

Until every American "is given full opportunity to
display and utilize all the capacities he has, considering
his physical condition, we still have more work to do."
—PRESIDENT DWIGHT

D.

EISENHOWER,

addressing the President's Committee on Employment
of the Physically Handicapped, May 23, 1957.

U. S . GOVERNMENT PRINTING O F F I C E : 1 9 5 8

Tor sale by the Superintendent of Documents, U. S. Government Printing Office
Washington 25, L). C. - Price 40 cents




FOREWORD
Thousands of women in this country, handicapped by crippling injuries and illnesses, are leading active and useful lives today as a result of vocational rehabilitation.
The rehabilitation program is rooted in the idea that modern developments in medicine, education, psychology, and vocational planning can be fused into a concentrated
effort to restore the handicapped.
As rehabilitation services for the American people have improved, and as voluntary agencies and the State-Federal program of vocational rehabilitation have expanded, an increasing amount of attention has been given to disabled women. From
20,000 to 25,000 handicapped women are being restored to usefulness each year
through the public program ; other thousands are being helped by private agencies.
These women are now performing jobs in a wide variety of occupations—in offices, in
industrial production, in the professions, as homemakers, and in many other pursuits.
At the same time, many women—whether handicapped or not—will find job
opportunities in the field of rehabilitation. For the girl interested in preparing for a
professional career, the rehabilitation program offers a life of constructive service to
people.
In this pamphlet, directed primarily to restorative services for disabled women
through the vocational rehabilitation program, a full and informative description of
the widespread work of the United States Employment Service and the State Employment Services has not been attempted. A brief description of the program as it
relates to rehabilitation is included. It should be noted, however, that the Employment
Services place thousands of handicapped women in employment each year and that
each Federal, State, and local office has one or more staff members who specialize in
job counseling and placement for the handicapped.
The agencies of the Federal Government primarily concerned with vocational
rehabilitation and with women workers have joined in the preparation of this pamphlet explaining the importance to women of present-day rehabilitation programs,
particularly the State-Federal program of vocational rehabilitation. Here is the story
of how handicapped women can be aided to make full use of their remaining abilities;
how those who are handicapped or have a handicapped member of the family can
manage their homes and take care of their children; and how those who want paid
employment can be helped to become wage earners. Here, too, is the story of what
women in all the communities of America can do by mobilizing their energies and
their influence toward restoring the disabled to lives of usefulness.
MARY

E.

SWITZER

Director of Vocational Rehabilitation
Department of Health, Education, and
Welfare




ALICE K .

LEOPOLD

Director of the Women's Bureau
Department of Labor

ACKNOWLEDGMENTS
This pamphlet is made available through the joint efforts of the Office of V o c a tional Rehabilitation of the Department of Health, Education, and Welfare, and the
Women's Bureau of the Department of Labor. The writing was done by Miriam
Keeler of the Division of Program Planning, Analysis, and Reports in the Women's
Bureau. The manuscript was reviewed by Russell J. N. Dean and members of the
technical staff of the Office of Vocational Rehabilitation.
Grateful acknowledgment is made to the directors and staff members of the
many agencies which cooperated in the preparation of the pamphlet by providing
printed materials, interviews, and photographs. Special mention should be given to
the following: Mr. K. Vernon Banta, Deputy Executive Secretary, Office of the
President's Committee on Employment of the Physically Handicapped; Dr. James S.
Peters, II, Chief, Connecticut Bureau of Vocational Rehabilitation, Hartford, Conn.;
Dr. Elizabeth Eckhardt May, Dean, and Mrs. Neva R. Waggoner, Research Assistant,
School of Home Economics, University of Connecticut, Storrs, Conn.; Dr. Donald A
Covalt, Associate Director, Dr. Leonard Diller, Coordinator, Clinical Training and
Research in Psychology, and Mrs. Joan B. Spencer, Homemaking Counselor, of the
Institute of Physical Medicine and Rehabilitation, New York University-Bellevue
Medical Center, New York City; Miss Cele Dengrove, Coordinator, and Dr. Leo Stein,
Chief of Rehabilitation Counseling, Bellevue Rehabilitation Service, New York City;
Mr. Willis C. Gorthy, Director, The Institute for the Crippled and Disabled, New York
City, and Miss Eunice Agar, of the Public Relations Department of the Institute.
The photographs were made possible by the courtesy of the following:
Institute of Physical Medicine and Rehabilitation, New York University-Bellevue Medical Center
(New York, N. Y . ) , figs. 8B, 14B.
Institute for the Crippled and Disabled (New York, N. Y . ) , figs. 3B, 7, 15, 16.
Massachusetts Department of Education, Division of the Blind, fig. 5.
National Society for Crippled Children and Adults (Chicago, 111.), fig. 13.
Office of Vocational Rehabilitation, Department of Health, Education, and Welfare (Washington,
D. C . ) , figs. 1, 3C, 4, 14A.
Oklahoma City Times (Oklahoma City, Okla.), fig. 3A.

Performance,figs.2, 3A, 5, 6.
Rusk, Howard A., M. D., et al., in " A Manual for Training the Disabled Homemaker," Rehabilitation Monograph V I I I (The Institute of Physical Medicine and Rehabilitation, New York
University-Bellevue Medical Center, New York, N. Y . ) , fig. 14B.
United Cerebral Palsy Industrial Production Workshop (Los Angeles, Calif.), fig. 6.
University of Connecticut, School of Home Economics (Storrs, Conn.), figs. 8A, 9A, 9B, 9C,

10, 11, 12.
University of Oklahoma Medical Center (Norman, Okla.), fig. 2.
Woodrow Wilson Rehabilitation Center (Fishersville, W. V a . ) , fig. 17.

iv



CONTENTS
Page

A new outlook
The vocational rehabilitation program
How to secure vocational rehabilitation services
Number of women helped by the program
Occupations of women after rehabilitation
Wage earners
Ho me makers
Easing the financial burden
For the family
For the community as a whole
Community resources for the handicapped
Activities of women's groups
The employment service program
Activities of cooperating groups
Research and demonstration projects
Careers in rehabilitation
Traineeship grants in rehabilitation subjects
Professions for which traineeships are available
Other professions in rehabilitation
Appendix
References on vocational rehabilitation
Addresses of State and Territorial offices

Figure

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.

Illustrations

Patient and ex-patient
A television panel on the handicapped woman at work
Clerical workers
Hospital worker
In the photographer's darkroom
Industrial production in a sheltered workshop
A sheltered workshop operated as part of a comprehensive rehabilitation
program
Household devices for the handicapped
Child-care procedures used by handicapped mothers
Family cooperation
Lynn, modeling skirt and blouse
Bobbie, modeling a shirt with big buttons
Transportation of crippled children—a vital service of volunteers . . .
Careers in rehabilitation for the professional woman
Speech correctionist, using mirror and tape recorder to improve a
patient's speech
Occupational therapist, teaching prevocational skills
Physical therapist, teaching a patient to walk with braces




1
3
3
5
7
7
18
27
27
28
30
30
32
33
35
38
40
41
48
50
50
51

vi
6
9
12
14
15
16
18
22
25
26
26
31
39
43
45
47

Figure 1.- •Patient and Ex-Patient.




Brunette Grace Ann tries on a cast with the enthusiasm of a girl shopping for new shoes, while blond Margie, a wheel-chair "graduate" of
vocational rehabilitation, takes notes for the official medical record.

A New
Outlook
Of the many changes that the 20th century has brought, one of the most promising
is the changing attitude toward physical
handicaps and other disabling conditions.
For centuries, people have accepted as
inevitable the crippling that so often results
from injury and illness and from congenital
defects. Today, there is a growing conviction that something can be done about it;
in fact, something is being done about it.
This change in attitude is reinforced by
knowledge—by new medical procedures to
eliminate or reduce the disability itself, by
new understanding of the emotional and
family problems which so often are involved in disability, by recognition of educational and job needs of many disabled
persons—in short, by combining the knowledge of many professions into an individual
plan to overcome the problems of a disabled
person.
This is rehabilitation. It is not a cureall, nor does it restore all people with disabling conditions. Rehabilitation has, however, transformed the lives of hundreds of
thousands of Americans, both women and
men. As new knowledge is developed, it




offers hope to more and more of our people
who are disabled.
For women with a handicap, many specialized rehabilitation methods have been
developed, which not only help them become physically stronger and more active,
but also give practical aid in preparing for
their chosen work, whether it be in a salaried job or in managing a home.
Most American communities, except the
smallest, have one or more agencies that
provide some type of rehabilitation service.
The voluntary agencies are widely known—
the Easter Seal societies for crippled children and adults, the National Foundation
for Infantile Paralysis and its March of
Dimes, the national and local Goodwill
Industries, the National Tuberculosis Association, and many others.
A public program of vocational rehabilitation services for the disabled is provided
in every State, with most States having district and local offices spread through the
major cities and reaching out to all communities. This program is jointly financed
by the Federal Government and the States,
with the State agencies providing services to
1

disabled persons and the Federal Government furnishing technical and professional
help and national leadership for the total
program. Under a Federal law enacted by
the Congress and signed by the President on
August 4, 1954,1 this Federal-State program
is expanding, both in the number of disabled persons it serves and in the variety
and effectiveness of services provided.
This booklet deals principally with the
1

Public Law 565, 83d Cong.. 2d sess. A Federal pro-

gram for rehabilitation of the physically handicapped has
existed since 1920 and was expanded by Congress in 1943.
A 1936 act first provided for State agencies to license blind
persons to operate vending stands in Federal and other
buildings.


http://fraser.stlouisfed.org/
2
Federal Reserve Bank of St. Louis

services and activities of the vocational rehabilitation program as they affect women.
Rehabilitation service is provided by
State agencies in all 48 States and in the
District of Columbia, Alaska, Puerto Rico,
Hawaii, and the Virgin Islands. In the majority of States there is a separate agency
to serve blind persons, but in some, the Division of Vocational Rehabilitation serves
persons with all types of disability, including
blindness.
Applications for service may be made by
letter or by visiting the nearest vocational
rehabilitation office. The addresses of the
State agency headquarters are listed on
pages 51 and 52 of this pamphlet.

The Vocational
Rehabilitation Program
HOW TO SECURE VOCATIONAL REHABILITATION SERVICES
Kach year, thousands of disabled men
and women are being restored to useful
activity through the State-Federal partnership program of vocational rehabilitation.
Many others could be helped. If you arc
one of these—or if there is in your family or
your community a handicapped person who
wants to be able to work—you will find in
this chapter information on the kinds of
service offered.
Who Is Eligible for Service?
To be eligible for service, a person must
(1) be of working age, or near it, (2) have
a disability which interferes with employment, and (3) have a reasonable prospect
of being employable when services are completed. (In some States, a person must be
a resident of the State for at least 1 year or
meet other residence requirements.) Both
men and women are eligible, whether or
not they have veteran status or have ever
worked before.1
1 Veterans with a service-connected disability, however,
ordinarily are eligible for rehabilitation through the Veterans' Administration. Children not yet of working age
may be eligible for the crippled children's program administered by the Children's Bureau of the Department of
Health, Education, and Welfare.

4V>W ' o —2
. _: O
K




Homemaking is recognized as useful
work, and a woman who is needed as homemaker for her own family may be accepted
for rehabilitation just as is the employed or
self-employed person.
It docs not matter whether the handicap is physical or mental, visible or invisible. It does not matter whether it was
caused by a work injury, an accident (at
home, in traffic, or elsewhere), or by a disease, or is a condition present from birth.
But it is important that the person could
be—and wants to be—restored to usefulness.
What Services Are Available?
If a disabled woman wants to work and is
eligible for service, the vocational rehabilitation agency will give her all the help it
can. Some persons receive all the various
services offered; others may need only one
or two. The following arc the principal
services:
1. Counseling. The key to successful rehabilitation is good counseling. The disabled person and the
rehabilitation counselor go over the situation, considering all the problems and deciding what can be
done. Specialist advice is secured when needed. A
3

rehabilitation plan is drawn up. The counselor arranges appointments for medical, educational, psychological, or other services required to carry out
the plan.
2. Medical services. Medical treatment and, in
some cases, an operation, may be needed to help a
disabled person become physically able to work.
Treatment may be given in a hospital or clinic, at
a rehabilitation center, at home, or in the doctor's
office. Physical therapy and other procedures are
provided for those who need to strengthen and retrain muscles, to learn to walk, to perform self-care
activities, or to master the use of artificial limbs and
appliances..
3. Physical aids. Sometimes an artificial arm, a
brace, a hearing device or other appliance is required. The counselor, in planning the individual's
program, finds out what is needed, sees that the
item is obtained, and arranges for training in its use
when necessary.
4. Job training. If a disabled person needs educational or other special job training to carry out the
rehabilitation plan, the vocational rehabilitation
agency will arrange for it. The training may be
given in a trade or technical school, university,
special school or workshop, or through on-the-job
training or home study courses.
5. Living expenses and travel costs during training and hospitalization. This covers the additional
costs involved when the disabled person must be
away from home to secure hospital care, or the
specialized services of a rehabilitation center, or to
carry out educational or other job training instruction.
6. Tools and licenses. In some occupations special
tools, or licensing, or both are required (for
beauty operators, commercial artists, physical therapists, for example). In these instances such aids
may be furnished as part of the rehabilitation plan.
7. Job finding. The rehabilitation counselor is an
expert in the local employment situation. Working
with the State employment service, with representatives of the Governor's Committee on Employment of the Physically Handicapped, and through

4




direct contacts with many employers, the counselor
arranges for a suitable job.
8. Help on the job. Frequently, a disabled person
needs advice or help in adjusting to new working
conditions. The counselor keeps in touch during the
early stages, to make certain things are going well
and to help if needed.

For a person so severely disabled that
planning for employment is impracticable,
a rehabilitation goal of self-sufficiency
within the home may be recommended. To
be as nearly self-sufficient as possible within the home means being able to perform
the activities of daily living, such as feeding and dressing oneself and moving about
in a wheelchair. The rehabilitation counselor who is familiar with the services and
resources of many community agencies can
sometimes arrange for a disabled person
to obtain rehabilitation services of this type
through a voluntary agency.
Who Pays for the Services?
Certain services are free to everyone, regardless of financial situation. These include medical examination, diagnosis, and
other evaluation to determine eligibility;
rehabilitation counseling and guidance;
training for a job (furnished without cost
in nearly all States); job placement service; and followup on the job.
For other services—medical service, artificial limbs and appliances, living expense
and travel, tools, equipment and licenses—
the rehabilitation agency pays the costs if
the disabled person is not financially able
to bear such expense. This is decided by
the counselor after discussing the facts with
the individual.

NUMBER OF WOMEN HELPED BY THE PROGRAM
Nearly 90,000 women have been rehabilitated through the State-Federal program in the last 4 years. This represents
more than a third of the total number of
persons rehabilitated through the program
during that time.

Year ended June 30

Number of persons
rehabilitated
Total

1957
1956
1955
1954

70,
65,
57,
55,

940
640
981
825

Women rehabilitated
in 1956
Occupational group
Number

Percent
distribution

Women
24,
22,
21,
20,

750
900
310
553

The average age of the persons rehabilitated in 1956 was 35 years, but among
them were girls and boys 15 to 19 years
of age and adults of all ages up to 65 and
over.
The time required for rehabilitation varied from 1 month or less to 3 years or
more. Half of the total were rehabilitated
within a year (30 percent within 6 months)
from the time their cases were accepted.
Of the women rehabilitated in 1956, 70
percent were placed in jobs in which they
earned wages and, of these, half received
$35 a week or more. The other 30 percent
were unpaid family workers or housewives
caring for their own homes.




The occupational grouping of the women
rehabilitated in 1956 is shown in the accompanying list:

Total

22, 900

100. 0

Paid occupations

16, 109

70. 4

4, 842
2, 769

21. 1
12. 1

2, 533

11. 1

2, 466

10. 8

1,405
706
611

6. 1
3. 1
2.7

541

2.4

236

1.0

6, 790
1

29. 6

Clerical and kindred. . .
Private household
Service, except private
household
Crafts and other manual (skilled and semiskilled)
Professional and semiprofessional
Sales and kindred
Unskilled labor
Agricultural (farmers,
farm managers, farm
laborers)
Managerial (except
farm)
Housewives and unpaid
family workers
Occupation not reported.

5

Figure 2.—A Television Panel on the Handicapped Woman at Work.

! t g h U A r e s e a r c h a s s i s t a " t (paraplegic from birth) at the University
of Oklahoma School of Medicine; a social worker (industrially blind) with the
Oklahoma Department of Public Welfare; a head bookkeeper (born without
hands) employed by Oklahoma Goodwill Industries; a personnel director (crippled
by poliomyelitis at the age of 2) with Oklahoma Goodwill Industries

6




Occupations of Women
After Rehabilitation
WAGE EARNERS
Women with a physical handicap are
working in a great variety of occupations,
carefully selected with the individual's
abilities in mind. Many of them received
their vocational training through the rehabilitation program. Some arc doing more
highly skilled work, and receiving higher
pay, than before they were disabled. Some
who had never held a paid job before are
now supporting themselves through useful
work.
Professional and Technical Work
Many professional jobs are well suited to
handicapped women who are qualified for
them by training and experience. It is entirely possible, for example, for a woman
with certain types of physical handicap to
be a highly competent librarian, pharmacist, laboratory technologist, or designer.
The leading profession for handicapped
women, as for all women, is teaching.
A woman who has training and experience in a professional field before she becomes disabled is likely to continue in that




general field after rehabilitation. For example, a professional nurse crippled by arthritis, took advanced training and became
a teacher of nurses.
Some women without professional training, on the other hand, have been enabled
to enter a professional field through training received as part of the vocational rehabilitation program. This is the case with
a woman psychologist in a large eastern
rehabilitation center.
The need for professional workers who
understand how to deal with disabled persons is increasing as the State-Federal vocational rehabilitation program expands.
This creates attractive opportunities in hospitals, medical centers, rehabilitation
agencies, and clinics all over the country
for women qualified as nurses, teachers,
medical or psy chiatric social workers, physical, occupational, or speech therapists, vocational counselors, and home economists.
All four of the young women shown in
figure 2 were disabled from birth or from
early childhood. 'Three of them arc professional workers, and the fourth a skilled
7

clcrical worker. They appeared on a panel
discussion of "The Handicapped Woman at
Work," in connection with an industrial
nursing workshop held at the University of
Oklahoma Medical Center.

Over a thousand of the women

rehabilitated

through the State-Federal vocational rehabilitation program in 1956 were doing professional
work. They included—
623 teachers
182 nurses
94 social workers

37 musicians
23 accountants
8 scientists

6 physicians and surgeons
There were also a dentist, a chemical engineer,
and an actress.
Among the 324 technical workers rehabilitated
in 1956 were—
167 laboratory technicians and assistants
37 commercial artists
14 draftsmen and
a radio operator.
The proportion of women wage earners who
entered professional and technical occupations
after rehabilitation was nearly as high as the proportion of all employed women in these occupations in 1956 (9 percent compared with 11 percent as reported by the Bureau of the Census).

Another young woman, who prepared for
professional work through the cooperation
of several rehabilitation agencies, is Mrs. J,
disabled by rheumatoid arthritis. Mrs. J
was referred to the Arkansas Division of
Vocational Rehabilitation by the District
Office of Social Security. After medical
treatment which somewhat stabilized her
condition, Mrs. J started a course in junior
accounting. When she completed the course
successfully, the State Employment Service
placed her in a job with a hardware
company.
8



Clerical Work
In the country as a whole, more women
arc employed in clerical work than in any
other occupational group; and still there
is a shortage of well-qualified workers, especially for secretarial and stenographic
jobs. Because this is the leading occupation for women, and also because the sedentary nature of many clcrical jobs makes
them possible for a person using a wheelchair or crutches, disabled women who
want a paid job are likely to turn to clcrical
work if they have the educational background for it.
The decennial census of 1950 reported
that one-fourth of all women secretaries,
stenographers, and typists had had at least
1 year of college, and that most of the
others were high-school graduates. Training in secretarial work, stenography, and
typing is available in high schools and business schools throughout the country, and
is provided for women in many cases as
a part of a vocational rehabilitation plan.
In many other kinds of clerical work,
high-school graduation may not be required. For the operation of sorting, keypunch, and certain other office machines,
for example, the amount of formal education is less important than finger dexterity,
attention to detail, and accuracy. Although
the large telephone companies prefer highschool graduates as operators, less schooling may be acceptable for the switchboard
operator in a business firm. For other clcrical jobs, such as file clerk and stock clerk,
the amount of education required depends
on the way the job is set up.
Handicapped women who are qualified
for clerical work may be employed in the
offices of rehabilitation centers or of other
health and social agcncies; or they may be

Figure 3
Clerical Workers

A . Because they are completely deaf, the noise and
confusion of a brokerage office do not distract these two
board markers.

B. Training in switchboard
operation has provided ready
e m p l o y m e n t for disabled
women. Here, Frieda, her
crutches parked within reach,
operates a switchboard with
smiling competence.

C. W h e n her employer says
"'take a letter," Gwen wheels
to his desk, pen poised. A secretary's notebook rests on a
light board across the arms of
the wheelchair.




placcd in private business offices or industrial firms.
The frontispiece shows a stenographer in
a rehabilitation agency taking down notes
for a patient's medical record. Connie,
whose story is given on page 11, docs general clerical work in a photographer's shop.

Nearly 5,000 of the women rehabilitated through
the State-Federal program in 1956 were clerical
workers. They included—
1,232 stenographers and typists
1,062 general office workers
814 secretaries
544 bookkeepers and 30 bookkeeping machine operators
251 office-machine

operators

(other

than

bookkeeping)
169 telephone operators
Most of the others worked as clerks in banks,
insurance companies, printing and publishing
firms, hotels, trade, and general industry. Some
were file clerks and stock clerks, payroll clerks
and timekeepers, shipping and receiving clerks,
vending-stand clerks or checkers.

A few were

assistants in libraries or in the offices of physicians
and dentists, and a very few worked in the post
office.
The percentage of women in paid occupations
who were clerical workers was about the same
as the percentage of all employed women who
were in clerical and kindred occupations in 1956
as estimated by the Bureau of the Census (29
percent).

These jobs are typical. On the other hand,
some of the clerical jobs in which handicapped women are placed are highly unusual. For example, figure 3A shows two
deaf girls employed in a brokerage office as
boardmarkcrs. They enjoy the work, and
10



as they do not hear the hubbub around
them, they arc not disturbed by it. The office
manager, who hired them at the suggestion of the Oklahoma Division of Vocational Rehabilitation, hopes that his problem of replacing boardmarkcrs who quit
because of the noise is now solved.
Women with serious physical disabilities
have sometimes succeeded, with the help of
vocational rehabilitation services, in completing stenographic training and supporting themselves through secretarial jobs.
One such success story follows:
In her first year after high school, Janet
was severely crippled by poliomyelitis.
Both legs and her left arm were paralyzed,
and the use of her right arm was somewhat
impaired. Through the New York State
Division of Rehabilitation, she was given
business school training and succeeded in
passing the Federal Civil Service examination in stenography. Seven times Janet was
called for a job interview, and seven times
she was turned down by an employer unwilling to give her a trial. An opening then
occurred as secretary to a vocational counselor in the rehabilitation agency. A few
minor arrangements had to be made in the
office: Janet must have space enough to
maneuver her wheelchair in and out; she
can reach only the second and third file
drawers in the cabinet; she uses a headphone in telephoning. Janet does her typing
with one hand on an electric typewriter provided for her use by the State Division of
Vocational Rehabilitation. Her enthusiasm
for the work makes it easy for her to memorize the facts about each individual accepted
for vocational counseling. Moreover, Janet's
example gives new courage to many a handicapped person afraid to undertake a job.

The Story of Connie
Connie shares her family's interest in art and the theater. In high school, she acted
in school plays and made posters for dances and concerts. But the courses she chose did
not give her much in the way of specific job skills, and after graduation she went to
work as file clerk in a large department store.

This job offered little challenge. Connie grew more and more bored and dissatisfied
with her job, but she was still there when, at the age of 20, she was stricken with poliomyelitis. She recovered, but was paralyzed from the waist down—a paraplegic.

After Connie left the hospital, she spent several months at home feeling sorry for herself. She became overweight and developed serious emotional problems. Finally, her
doctor referred her to the Institute of Physical Medicine and Rehabilitation of the
New York University-Bellevue Medical Center, where she was accepted for rehabilitation, with the State Division of Rehabilitation paying the bills.

After evaluation there, Connie received physical therapy which strengthened weak
muscles, slimmed her down to normal weight and taught her to care for her personal
needs. She learned to get about well, mostly in a wheel chair, and to drive a specially
equipped car. Her appearance improved and her self-confidence returned.

Through vocational counseling, a job was found for Connie in a photographer's studio.
She is the receptionist, answers the telephone, and assists in mounting and framing
photographs. She earns $10 a week more than she did before she was disabled, and has
the satisfaction of feeling that she is working in a field related to her artistic interests.

The Speech Department of the Institute arranged for Connie to coach the drama
group of the Federation of the Handicapped. This gives her an outlet for her love of
the theater, and an opportunity to make new friends and have some social life.

Connie—who now owns a car and drives it herself—has emerged as a busy, useful, and
reasonably happy member of society.

452330°—58




3

11

Household Service
Nineteen out of every 20 persons employed in private households are women.
Until World War II, household service employed more women than any other occupational group. But the number of women
so employed is somewhat smaller now than
it was in 1940, although the number of
women employed in all occupations has increased by 60 percent. T o some extent the
adoption of labor-saving and automatic devices has enabled more homemakers to do
their own work without the assistance of
paid workers. On the other hand, the increasing number of married women who
hold jobs outside the home has created a
great and unsatisfied demand for dependable and competent household workers, especially in families where there are young
children or invalids.

the few types of employment where jobs
can be found for workers who wish to live
where they work.

Other Service Occupations
In addition to household service, the
broad group of service occupations includes
personal service occupations, protective
services, and building services. Of these, the
personal service group is by far the most
important for women. It includes women
who work in restaurants, hotels, boarding
and lodging houses, hospitals and other institutions (see fig. 4 ) . It also includes
beauty service.
Figure 4.—Hospital Worker.

This is a situation which operates to the
advantage of women with a physical handicap who need to earn their living but who
may not be able to work in a factory, store,
or office, or who cannot travel to a job.
Private families can usually be found by
vocational rehabilitation counselors where
a handicapped worker will be welcomed
and where special consideration will be
given to her needs. Moreover, this is one of
About one-eighth of the women rehabilitated in
1956 were household workers. They included—
1,158
539
344
332
182
99

general maids
housekeepers
day workers
nursemaids and baby sitters
cooks
laundresses

Of all employed women, about one-tenth were
private household workers in 1956, according to
the Bureau of the Census.


12


Born without legs, Hattie has learned to use artificial legs provided by the Virginia Division of
Vocational Rehabilitation. She is employed by
the Anderson Orthopedic Hospital in Arlington,
Va., where she makes surgical dressings as she
was taught to do, and helps in other ways.

Of the women rehabilitated in 1956, a total of
2,363
Those

were

in

personal

employed

in

service

hotels,

occupations.

restaurants,

etc.,

included—
587
240
122
160
84

waitresses
kitchen workers
maids
cooks
housekeepers, stewardesses, and hostesses

Those in hospitals included—
363 nurse aides, practical nurses, etc.
237 attendants

Figure 5 shows a blind woman working
in a photographer's darkroom. Until she
was over 40 and was left a widow, this
woman had never been employed. She
could hardly believe her luck, when the
counselor of the Massachusetts Division of
the Blind suggested that a certain photographer who cooperates with the Governor's
Committee on Employment of the Handicapped was willing to hire her. She decided
to try to learn the work, but was frightened

Also in this group were—
448 beauticians and manicurists, and,
70 keepers of boarding and lodging houses
Building service workers among the women rehabilitated in 1956 included—

Over 900 of the women rehabilitated in 1956 were
skilled workers—half of them, dressmakers and
seamstresses.
Other women classed as skilled workers were—

78 charwomen and cleaners

37 weavers and 70 other textile workers

37 elevator operators
32 janitors

56 employed in the manufacture of television,

6 porters and hall maids in motels, etc.

radios, and other electrical equipment
23 in machine-shop and metalworking occupations

Only 17 of the women were in protective services. This included 7 who were Armed Forces
personnel, and a few watchmen, guards, and
detectives.

31 in photographic process occupations
This group also included a few lithographers
and photoengravers, compositors and typesetters,
jewelers and watchmakers, upholsterers, furni-

Crafts and Operative Occupations
Dressmaking, tailoring, and millinery are
traditional crafts of women, and about
half of all the women who enter a skilled
trade after rehabilitation choose one of
these specialties. In some other crafts where
individual women have shown great aptitude there is a demand for skilled workers—
in the grinding of lenses, for example. However, most crafts are learned through apprentice training which may take several
years. Therefore, handicapped women usually prefer an occupation that can be
learned more quickly, unless they are young
or have already acquired some degree of
skill. There are exceptions, however.



ture makers, as well as leather craft workers, glass
and pottery decorators, ceramics workers, and so
forth.
Over 1,500 of the women rehabilitated in 1956
were semiskilled workers. Many of these were
doing light bench assembly work or were engaged
in packing, filling, and labelling in various industrial establishments. Others worked in laundries.
Some were in the same occupations as the skilled
workers but doing less skilled work.
Over 100 of the women rehabilitated in 1956
(12 skilled workers and 94 semiskilled workers)
were employed in sheltered workshops.
Of the women in paid occupations 10.8 percent were skilled or semiskilled.

This is much

smaller than the corresponding percentage of all
employed women who were in craft and operative occupations in 1956 (18 percent).

13

by the speed of the automatic developing
machine. At first she spoiled much of the
work and was highly nervous. But the photographer encouraged her to keep on try-

14




ing, and personally helped her until she
gained confidence. Eventually, she was able
to operate the machine expertly and was
working an 8-hour day.

Industrial production workers are often
called "operatives." Most of the work they
do is semiskilled and can be learned in a
relatively short period. Many handicapped
workers can perform semiskilled jobs successfully, even under competitive factory

Figure 5.—In the Photographer's Darkroom.
Every 45 seconds, as the automatic developing machine completes its cycle, this blind worker attaches 10 rolls of films to the frame of the machine
and weights each roll to keep it from rolling up
as it goes through the developing process.

conditions. Others can do good work, but
not at the speed or under the pressure of
factory conditions.

Sheltered Workshops
The sheltered workshop provides a protective, noncompetitive environment where
seriously disabled persons can begin training for industrial work, can gradually build
up good work habits and work tolerance,
and can earn money by useful work. The
work performed in a sheltered workshop
iin n

HHMHiifiHiliiHI

Figure 6.—Industrial Production in a Sheltered
Workshop.
This young
c e r e b r a l - p a l s i e d woman,
with disabled left hand,
does aircraft small-parts assembly work at the Los
Angeles County
United
Cerebral Palsy Workshop.




15

Figure 7.—A Sheltered Workshop Operated as Part of a Comprehensive Rehabilitation Program. Job demands are geared to the individual's capacity, in this
workshop where disabled women and men earn their own income by stitching
paper slippers for use in hospital and clinic.

may be on contract from private industry;
or it may be the production of articles
used in hospitals, rehabilitation centers, or
public institutions. In many instances, the
work is to turn discarded household articles
into salable merchandise.
In some cases, a person may start to work
in a sheltered workshop at piecework rates,
and when she is able to earn the legal minimum wage, may be graduated to a regular job in private industry. Some may be
able to work only a few hours a day at first,
and must build up strength and good work
16




habits gradually until they can put in a
full 8-hour day. Disabled persons who cannot hold a regular job sometimes stay on
indefinitely in the sheltered workshop.
One example of the training and employment of handicapped persons in a sheltered workshop is the United Cerebral
Palsy Industrial Production Workshop in
Los Angeles County. Training for industrial production is one of the free services
offered at the workshop (see fig. 6 ) . Payment by the piece-rate system gives the
trainees incentive to improve their skills

and speed. When it had been in operation
a year, the 48 on-the-job trainees—who
were all young men and women with cerebral palsy—had earned a total of $30,000
through contract jobs for 12 Southern California industries. The participating industries include major aircraft companies, and
novelty, toy, and plastic products manufacturers.
In New York City, the Institute for the
Crippled and Disabled operates a sheltered
workshop as part of its complete rehabilitation service (see fig. 7). Women or men,
while receiving physical therapy, training
in the use of an artificial limb, or other
restorative services may be able to start
work there and learn a semiskilled, or even
a skilled job. The Institute considers that
the workshop, with its therapy of useful
work and its incentive of the pay envelope,
is often an important factor in successful
rehabilitation.

by women who have training and experience in them.
Women who need a wage-earning occupation but who have no specific skills are
sometimes placed by rehabilitation agencies as unskilled workers in various industries or agriculture, according to whether
they live in urban areas or rural sections.

Among the women rehabilitated in 1956 were
about 700 in sales occupations. Most of these
were listed as salesclerks or salespersons, but—
62 were doing canvassing and soliciting
11 were demonstrators
10 were selling insurance or real estate
More than 500 women were in agricultural occupations. In this group were 176 farmers engaged in general farming or in raising cotton,
in dairy, livestock, or poultry farming, or in some
other farming specialty. Another 12 were members of farm couples, and 2 were farm managers.
A few were nursery and landscaping workers, or
flower growers. A small number of women engaged in fishing occupations or hatchery work

Other Occupations
Some handicapped women are employed
in sales occupations, in agriculture, and in
managerial work. The managerial group
includes operators of vending stands—an
important occupation for blind persons.
Agriculture offers opportunities for outdoor
employment, which may be essential for
persons with certain types of disability.
Agricultural specialties, such as poultry
farming or seed growing, can be developed




were also included in this group. Over half of
the total were farm hands.
Over 200 women were working as managers
or officials (exclusive of farm managers). They
included—
74 operators of vending stands
73 managers, department heads, floormen in
retail stores
The percentage of rehabilitated women workers who entered these occupations was much
smaller than the percentage of all employed
women who were in them in 1956 (9 percent
compared with 19 percent).

17

Figure 8.—Household Devices for the Handicapped.
A, A d j u s t a b l e
ironing
board; B, Wheelchair tray.

HOMEMAKERS

keeper, or at least a helper, especially
if there are young children.

How does a family manage when the
homemaker is disabled?

When the homemaker is dependent on
others for her daily needs, it may be
necessary to have a nurse or attendant
for her.

Perhaps another member of the family—who otherwise could be earning
or in school—stays at home to serve
as homemaker.
If there is no one who can do this, it
may be necessary to employ a house18




The burden—in terms of energy output, emotional strain, financial adjustments—is often more than the family
can carry unaided, except on an emergency basis.

Help can be given to enable handicapped homemakers to manage their own
households and take care of their children
with a minimum of assistance. The contribution of the homemaker to family maintenance is fully recognized by the vocational rehabilitation program. Nearly
18,000 homemakers have been rehabilitated in the past 3 years.
Like any worker accepted for rehabilitation, a disabled homemaker may receive
452330°—58
4



needed medical services, prosthetic appliances, training in daily activities and vocational skills, and other services. For the
homemaker, training may include home
management and child care as well as the
development of other needed skills. Not all
disabled housewives are eligible for rehabilitation, however; those are eligible
who are substantially handicapped and yet
offer promise of successful resumption of
the duties of homemaker, at least part time.
19

A young girl who is handicapped may
learn to take limited household responsibility—perhaps to care for her own clothing.
Men with housekeeping responsibilities are
also eligible for rehabilitation.
The homemaker program is a relatively
new aspect of vocational rehabilitation. Research projects are under way in universities and medical centers in various parts
of the country to build up resources of information, techniques, and devices (see fig.
8). For example, one project is selecting
and designing simplified clothing and
equipment for children; another has analyzed housekeeping activities in order to
find the easiest ways of performing them;
a third has brought together an extensive
collection of simplified work devices; others
have designed kitchens for the use of
women with cardiac, orthopedic or other
defects.
Incidentally, a number of these devices
have interesting possibilities for commercial production and use by the general population. Many a busy housewife would like
to be able to break an egg with one hand
while holding the baby with the other arm.
Most mothers welcome attractive and durable garments that young children can put
on without help. Energy-saving kitchens
are proving popular among married
women who work part time or full time
outside the home.
Home

Management

A handicapped homemaker must learn
to plan everything she does in advance in
order to conserve time and energy; she soon
develops a new sense of values in determining which tasks are necessary and which
can be omitted or postponed.
20



A study of home management for the
handicapped, made by the Institute of
Physical Medicine and Rehabilitation of
the New York University-Bellevue Medical
Center shows that one of the most important ways to save energy is to sit for as many
jobs as possible, in a relaxed position. This
means having a chair or stool of the right
shape and height and a convenient work
surface.
Special equipment is not usually recommended by the Institute. Most women find
that with some suggestions as to arranging
utensils within reach, they can use a standard stove, sink, and washing machine.
Other devices can be bought inexpensively
or made at home. For example, a woman
who can use only one hand needs a wooden
board with a nail or spike which will hold
the vegetable she is peeling or the meat she
is slicing.
Some ironing remains, even when paper
napkins, plastic table cloths, and "miracle"
fabrics are used. An adjustable ironing
board (8A) is necessary for the wheelchair
housewife, important for any woman who
is not strong enough to stand while ironing,
and desirable for every homemaker. It can
also be used as a convenient work surface
in cooking, preparing vegetables, or writing.
A wheelchair tray (8B) has multiple uses
as a work surface or for moving utensils,
dishes, groceries, and laundry. The tray may
be made at home but should be carefully
fitted and securely fastened.
Instruction may be obtained in the use
of kitchen appliances through a demonstration kitchen. At the Institute, groups of
patients use the kitchen during the last part
of their hospitalization. If possible they
take over the laundering of their own clothing in an automatic washer. They learn

about keeping much-used utensils within
easy reach, not piling dishes of various sizes
on top of each other, and using a wall can
opener with one hand (see fig. 14B).
A planning unit is important for any
busy housewife. It is doubly important, the
Institute considers, for the woman with a
disability. Usually the planning unit contains a desk or shelf of the right height for
chair or wheelchair, a telephone, writing
pad and pen; cookbook and recipe file, address book, and whatever else is needed to
plan and order the meals, write checks, and
keep accounts.
Child Care
A pilot study of 100 handicapped mothers made by the School of Home Economics,
University of Connecticut, showed that dis-




cipline and supervision of play are the aspects of child care most likely to raise problems for the "wheelchair mother."
One of the mothers in the survey is Mrs. E, who
contracted poliomyelitis 4 years ago, when her children ranged from 2 to 5 years of age. She is fortunate in having space enough for play equipment in
the yard; a play room in the attic; and a play corner
near the basement laundry. She encourages the children to bring their friends home with them and
keeps an eye on them while doing the laundry.

The care of babies and preschool children
offers special difficulties for mothers who are
unable to walk, to lift a baby, or to use both
hands. Each mother has to work out methods that fit her own situation—she is fortunate if she has the help of an experienced
homemaking counselor. Figure 9 shows
how three mothers cope with specific problems of child care.

21

Figure 9.—Child-Care Procedures Used by Handicapped Mothers,


22


A. This young mother, paralyzed by poliomyelitis, assembles everything needed
for bathing and dressing her baby, before starting his bath.
B. The baby's bath poses problems for the one-handed mother, too.
finds that a kitchen sink is convenient and offers baby firm support.

This woman

C. Unable to lift her 2-year-old daughter into a high chair, this mother has invented
a substitute. June loves the child's auto seat, mounted firmly on an ordinary
wooden chair, and can climb into it without help.




Mrs. M Does an "Impossible" Job
Competent Mrs. M was able to take care of her home, husband, and four small children,
and still found time to supplement the family income by typing for an insurance
company. In 1956, when she was 29, she was found to have cancer and had to undergo
extensive surgery, which involved the loss of her left arm.
Mrs. M made a good recovery and by Christmas was ready to return to her job—the
job of rearing her children and doing the cooking, cleaning, and laundry for her family
of six. But, with one hand, she could not even manage to braid the little girl's hair, or to
cut meat into bite-sized pieces for the youngest child. Her husband's take-home pay, as
night-shift worker in a factory, was $260 a month; one-fourth of this went for rent on
their 3 bedroom apartment. They could not afford to hire household help.
The local rehabilitation center told the School of Home Economics at Connecticut
University about Mrs. M, and asked if she could be included in a study they were making of the problems of handicapped homemakers with small children. With the project
director's consent the homemaking consultant visited Mrs. M bringing some gadgets
that other one-handed women had found useful—a cutting board with a spike to hold
vegetables or meat firmly in place; a flour sifter; an asbestos mitt to protect her remaining hand.
Between December and May, the homemaking consultant made 12 visits to Mrs. M ,
encouraging and instructing her. The Society for Crippled Children and Adults agreed
to pay for a vacuum cleaner which Mrs. M selected with the consultant's advice. The
Motor Vehicle Bureau provided a teacher to help Mrs. M get the driving license she
longed for, and to advise on fitting a car to her needs.
With the consultant's help, Mrs. M mastered most of the housekeeping jobs that can
be done with one hand. She developed the cooperation of the whole family, and learned
to plan ahead so as to use to best advantage any offers of assistance from relatives or
neighbors. Mr. M was glad to do the marketing and help with the heaviest tasks in
the afternoons, before leaving for work (see fig. 10). The children washed dishes under
their mother's supervision. Mrs. M had more time to spend with the children than
formerly, and they all enjoyed doing "numbers" and "rhymes" together.
By spring, Mrs. M was typing the church weekly bulletin with one hand. She hoped
soon to drive the children to Sunday school. With a very limited amount of assistance
from rehabilitation services in the community, she was managing her own demanding
job of homemaking and was ready to assume a useful role in church and community.







Figure 10.—Family Cooperation. Since Mrs. M lost an arm, her husband and
children have learned to help with some of the household tasks. Here, Mr. M
adjusts slip covers on the livingroom chairs.

25

Figure 11.—Lynn, Modeling Skirt and Blouse.

Figure 12.—Bobbie, Modeling a Shirt With Big

The "blouse-slip" and skirt have proved popular

Buttons. For small boys, two shirts were de-

with both children and mothers. The skirt has

signed—one that opens in front and one that pulls

adjustable shoulder straps and a control slot to

on over the head. Bobby wears the shirt that opens

keep the straps from slipping. Buttons are few

in front and has an action pleat in back. The

and large—at least as large as a nickel. Three

cuffs are wide enough to slip on without unfasten-

other dresses for little girls were designed—a

ing, and there are only three buttons. Bobby likes

jumper dress, a yoke dress, and a coat dress.

the shirt because it is comfortable and easy to put
on; mother likes it because it launders easily and
allows for growth.

Children's clothing presents many difficulties for handicapped mothers—the putting on, the taking off, the laundering,
mending, and altering. The University of
Connecticut project included a study of
simplified clothing for children.
Children of 3 and 4 years, and in some
cases even 2-year-olds, were able to put

26


these garments on with little or no help.
Outdoor garments that are simple and practical in design (also clothing for infants too
young to help dress themselves) can be
bought, the study showed, if mothers know
what to ask for.

Easing the
Financial Burden
FOR THE FAMILY
When either the wage earner or the
homemakcr is disabled, the family faces
greatly increased costs, not only for medical
care, but for family maintenance. At the
same time, earning capacity may be drastically reduced.
If the husband is disabled, the wife may
have to support the family by obtaining
outside employment. The Bureau of the
Census estimates that there are half a million married couples where the wife is in
the labor force and the husband is not.
Many of these, doubtless, are families
where the husband is disabled. In other
cases, the wife may have to stay at home to
take care of her disabled husband and, perhaps, of young children.
On the other hand, if the wife is disabled, the husband may find it necessary
to employ a housekeeper or a nurse, or possibly both; or to assume their duties in addition to his regular day's work.
In all likelihood, severe and prolonged
disability of either husband or wife results
in less money available for household needs




and lower standards of living for the family. When neither husband nor wife is
earning an income, the family must draw
on other resources for support.
To case the financial impact of disability on the family, Congress has enacted special legal provisions.
Aid to Dependent Children
The most widely known and long established of these provisions is aid to dependent children. This system, jointly financed
by the States and the Federal Government,
was set up in 1936 under the Social Security Act and has been gradually liberalized. It provides monthly benefits for children under 16 (or under 18 if in school) in
families where the wage earner is dead, absent, or disabled. Its primary purpose is to
enable the mother to stay at home with the
children and keep the family together. Information about aid to dependent children
can be obtained from the local department
of public welfare.
27

Old-Age, Survivors, and
Disability Insurance
If a disabled worker is 50 years of age or
over and is protected by old age, surviv ors,
and disability insurance under the Social Security Act, he or she may be eligible for
benefits. A disabled child, and the mother
who cares for him, may also be entitled to
benefits if he is the dependent or the survivor of an insured worker. These benefits,
under a recent amendment, may continue
even after the disabled child reaches the
age of 18 years.
When an insured worker under 50 is
found to have a severe and prolonged disability, he or she may be eligible for what
is called the "disability freeze" which
means that his benefits, when he becomes
eligible for them at retirement, will be
based on his earnings before disability.
It is important, therefore, for a disabled
worker who has been paying social security
taxes to ask the district social security office about his eligibility for benefits under
old-age, survivors, and disability insurance.

Income-Tax

Deductions

Blind persons (and also persons 65 years
of age and over) are entitled to a double
exemption in the amount of income not subject to Federal income tax—$1,200 per person instead of $600.
A deduction not to exceed $600 from taxable income is allowed (under conditions
which arc explained in the instructions for
preparing income-tax returns) for expenses
paid for care of dependents to enable the
taxpayer to hold a job. In general, a woman
may claim the deduction, but in the case of
a married woman she must file a joint return with her husband, and the deduction
is reduced by the amount that their joint
income exceeds $4,500. However, these limitations do not apply if the husband is incapable of self-support because physically or
mentally defective. A man may claim the
deduction only if he is a widower or is divorced or legally separated and has not remarried. The dependent may be a child or
stepchild under 12 years of age or a person
who is physically or mentally incapable of
caring for himself, regardless of age.

FOR THE COMMUNITY AS A WHOLE
Disability of the wage earner accounts
for thousands of families who are maintained by the community on welfare rolls.
Nearly half a billion dollars of local, State,
and Federal funds arc being paid out annually in public assistance to support some
1,000,000 persons, including 325,000 dependent children, because of prolonged disability of the family breadwinner. Every
taxpayer shares that cost, which is only a
part of the total loss to society caused by
disabling illnesses and injuries.
28



Among the disabled individuals receiving public assistance are several thousands
who could be rehabilitated—some to activity and employment, some to self-care at
home. The potential savings of public funds
are enormous. The benefits to the family, in
terms of stability and independence, are
incalculable.
Mr. H had a wife and six children, and when,
after a fight of 2 years against a circulatory ailment,
he had to have one leg amputated, the family had
used up all its savings and was being supported by

aid to dependent children funds. The Rhode Island
Division of Vocational Rehabilitation undertook to
provide a well-fitted artificial leg and to give Mr. H
training in its use. While he was learning to walk
again, the rehabilitation agency and the State employment service located a job for him as bench
worker in a machine shop; this pays $10 a week
more than his former job as a textile worker. During
the years this family received public assistance the
cost to the taxpayers totaled $6,500. Mr. H still has
to have periodic clinic checkups, but the rehabilitation program has given him the satisfaction of being
once more able to support his family.

Thousands of disabled persons—many of
them heads of families—remain economically unproductive today, simply because
they have never had the benefit of a thorough evaluation by a trained team of rehabilitation experts, followed by specialized
services planned to meet their individual
needs. The nationwide vocational rehabilitation program is aimed at bringing existing knowledge and vocational rehabilitation




services within the reach of all who want
and can profit by them.
As expressed by the President's Committee on Employment of the Physically Handicapped, the aims of community organization for rehabilitation include the following:
T o increase community understanding of the
value of rehabilitation and employment of the
handicapped;
T o perfect community organizations so that the
handicapped are better served through early rehabilitation and job placement;
T o study community needs of the handicapped
and facilities and opportunities for meeting these
needs for the future.

The pattern followed in any locality depends, of course, on local needs and local
facilities, on the interests and resources of
the group, and on the development of leadership and teamwork among the agencies
and individuals cooperating in the program.

29

Community Resources
for the Handicapped
ACTIVITIES OF WOMEN'S GROUPS
There arc a multitude of activities in support of the rehabilitation services that can
be carried on by nonprofessional groups,
and it would probably be safe to say that
every one of them is being carried on by
some women's organization, somewhere in
the country. However, there is probably no
community where all is being done that
could be done for the rehabilitation of disabled persons in the community.
Some women's organizations support and
promote all phases of the rehabilitation
program through a special committee or
department. Others concentrate on disabilities of a certain type, such as blindness
or cerebral palsy, or on volunteer services
to disabled individuals.
Illustrative of broad rehabilitation programs are the following:
T h e General Federation of Women's Clubs has

ranging transportation for the handicapped to
providing employment opportunities (such as
typing manuscripts, telephone-answering service,
insurance and real estate brokerage, hand sewing,
and so on) for the homebound. Special rehabilitation projects sponsored by women's clubs include the
provision of fellowships and scholarships for the
study of physical and occupational therapy and
other professions related to rehabilitation. Clubs are
encouraged to include the subject of rehabilitation
in their regular programs through guest speakers,
tours, films, and demonstrations.
-x- *
Members of the women's auxiliary to the North
Dakota State Medical Association have worked on
rehabilitation committees, taken part in educational
activities, and assisted with the program for crippled
children. In the coming year, the auxiliary was
planning a more extensive rehabilitation program
which would include locating persons in need of
rehabilitation, and developing a volunteer service
for the new rehabilitation center under construction
at the State Medical School.

established a rehabilitation division in its Community AiTairs Department. The division works to develop

volunteer

services

to

assist

community

rehabilitation teams headed by physicians. Suggested activities for the volunteers range from ar30




Figure 13.—Transportation of Crippled Children—a Vital Service of Volunteers.
—»




Women's auxiliaries of veterans' organizations also plan programs to educate the
public in regard to rehabilitation aims,
raise funds for local rehabilitation projects,
stimulate volunteer activities to assist disabled persons, and interest employers in
hiring the handicapped. Especially active
in this field are the Disabled American Veterans' Auxiliary, the Ladies' Auxiliary of
the Veterans of Foreign Wars, and the
American Legion Auxiliary.
Specific rehabilitation activities undertaken by women's organizations vary
widely. Typical are the following:

In one State the garden club undertook to landscape the dormitory and swimming pool at a camp
for crippled boys and girls, which was sponsored by
the State Easter Seal Society. Members of the Easter
Seal Guild in various cities give volunteer service to
drive crippled children to school, or to give wheelchair patients an airing (fig 13).

The Council of Jewish Women in a Wisconsin
city, in cooperation with the State rehabilitation
agency, operates a work adjustment center for mentally retarded adults. About 40 persons were trained
for employment in the first year of operation, and
half of these were placed in jobs paying from $20 to
$75 a week. In a New Jersey city, the council cooperates with the State Association for Retarded
Children and the United Cerebral Palsy organization to provide a special vocational rehabilitation
program for children who are mentally retarded or
have cerebral palsy.

Members of two national sororities, in cooperation with the National Society for Crippled Children
and Adults, help to raise standards for professional
workers in the cerebral palsy program by raising
funds for scholarships to provide advanced training
and for a manual on cerebral palsy equipment designed for professional workers and used in 42
countries.

Quite a different type of work is done by the Girl
Scouts and Campfire Girls, who encourage participation of physically handicapped girls in their organizations. The Girl Scouts offer their program as
a bridge to carry the child with a handicap into "a
world which does not set him apart * * * but
which welcomes him exactly as it welcomes every
child, which offers him identical privileges and
identical responsibilities."

Various women's groups transcribe reading materials into Braille and carry on other projects for the
blind, such as providing transportation to and from
work, and giving personal and reading service.

THE EMPLOYMENT SERVICE PROGRAM
When a handicapped worker who could
benefit by vocational rehabilitation services
comes to the public employment office looking for a job, the person is referred to the
State rehabilitation agency. Many hundreds of handicapped persons are given this
service in a year's time. The public employment offices also cooperate with the
State-Federal vocational
rehabilitation
program by working with the rehabilitation counselor to place in the right job persons who have been rehabilitated and are
ready for employment.
32



In addition to this two-way cooperation
with the vocational rehabilitation program,
however, the employment service finds
work for many thousands of handicapped
workers who are ready for employment and
not in need of rehabilitation. In the year
ended June 30, 1957, the number of handicapped persons placed in nonagricultural
jobs by the public employment service was
296,703. Of these, 54,982 ( 1 8 / 2 percent)
were women.

Selective Job Placement
Specialized job counseling and placement services for handicapped workers are
provided through the State and local employment offices affiliated with the United
States Employment Service of the Department of Labor. There were 1,750 of these
public employment offices by the end of
1957. They are situated in every major city
in the country, and in many smaller cities,
and can be found in the local telephone directory under "Employment Service."
These agencies are tax supported, and their
services are given to both workers and employers without charge.
Developing Employer Cooperation
The public employment service has since
1933 been charged by Congress with responsibility for placing handicapped workers, but the program was greatly expanded

through the 1954 amendments to the vocational rehabilitation act (Public Law 565)
which provided funds for these specialized
services.
In order to place job applicants, whether
handicapped or not, the employment offices must develop contacts with local employers in every possible way. The State
agencies have job analysts who can, by arrangement with an employer, study a business establishment and recommend job readjustments and modifications that increase
the efficiency of the personnel, ease labor
shortages, and, in many cases, provide work
for handicapped persons in need of selective placement.
The State and local Committees on Employment of the Physically Handicapped
also provide a channel of employer cooperation. The public employment offices work
closely with the committees, and often serve
as focal points for local and regional meetings and programs of the committees.

ACTIVITIES OF COOPERATING GROUPS
Government Agencies
State health and welfare departments
cooperate with the rehabilitation division by
referring to it clients in need of rehabilitation service. A substantial proportion of disabled persons rehabilitated by State agencies are heads of families receiving public
assistance. By enabling the handicapped
workers to support themselves and their
families again, the rehabilitation program
saves large sums for the taxpayers. The
health and welfare departments also, in
many instances, make surveys, furnish information on community needs, and keep



the public informed of the services available.
The division of the State labor department dealing with workmen's compensation cases works closely with the State Division of Rehabilitation. In fact, restoration
of workers injured in industrial accidents
is one of the oldest functions of rehabilitation.
One of the newest aspects of rehabilitation, on the other hand, is the task of deciding whether persons applying for disability benefits or the disability "freeze" on
their earnings record under social security
are disabled under terms of the law, and
33

whether such individuals could be successfully rehabilitated for employment. The social security office and the rehabilitation
division work together on all such cases.

connected with observance of National Employ the Physically Handicapped Week,
these efforts are increasingly being spread
throughout the year and coordinated with
daily services for the handicapped.

Committees on Employment of the
Physically Handicapped
The President's Committee on Employment of the Physically Handicapped with
headquarters at the United States Department of Labor in Washington, D. C., is composed of 400 citizen organizations and individuals representing labor, business, industry, medicine, civic, women's, veterans',
religious, professional, and other groups, as
well as the major Federal officials who are
associate members. The chairman, General
Melvin J. Maas, points out that
Major accent in the national program to hire the
handicapped has always been placed on employer
acceptance of the principle that such action is good
business.

The President's Committee promotes the
cooperation of employers in hiring handicapped workers. For this purpose it holds
national and regional meetings, assists State
and local groups in program planning, and
coordinates informational plans throughout
the country.
Working with the President's Committee
in each State is a Governor's Committee,
and many communities have organized local
committees to cooperate with the Governor's and President's Committee. Pennsylvania claims the largest number of local
committees—more than 80 in 1956. Typically, these Committees provide leadership
for the promotional efforts of all the agencies and individuals cooperating with the
State Division of Rehabilitation. Originally
34



Employers
The most important way in which employers cooperating with the President's
Committee help the handicapped, of course,
is by being willing to employ them on jobs
within their physical capacity. Vocational
rehabilitation is not complete until the
handicapped person is earning his way.
Except for women who are homemakers,
this means, in the majority of cases, finding
an employer who will hire them.
From Policy Declarations Adopted by Members
of the Chamber of Commerce of the United States,
Washington, D. C., 1957—
Many employers throughout the Nation are
giving increased recognition to the competence
of physically impaired workers when properly
selected and placed on suitable jobs. The experience of employers with these workers has demonstrated that their job performance records
compare favorably with those of the ablebodied, with respect to productive efficiency,
accident rates, and absenteeism.

There are many other ways in which employers further the vocational rehabilitation program. For instance, public utility
companies have helped to furnish demonstration kitchens with equipment suitable
for use by cardiac or orthopedic patients.
Some manufacturers have become interested in producing self-help devices and
other specialties for the handicapped. Retail stores sometimes market products which

have been made by handicapped workers at
home or in sheltered workshops. For example, Christmas tree decorations made in the
Denver Goodwill Industries Sheltered
Workshop were placed on sale by a large department store in Denver. At least one enterprising woman proprietor of an exclusive
shop for women's wear has featured fashionable clothes for women who use a wheelchair. In addition, there is probably a large
potential market with the general public for
some products designed for use by the handicapped—for example, simplified clothing
for children (see p. 26).
An employers' guide to employing the
handicapped was published in 1957 by the
National Industrial Conference Board.1
Unions
Labor organizations have for many years
recognized the right of a worker disabled by
1 The Company and the Physically Impaired Worker.
Studies in Personnel Policy, No. 163. National Industrial
Conference Board (460 Park Avenue, New York, N. Y . ) .
1957. $2.50. While distribution of Conference Board re-

accident on or off the job to an opportunity to earn a living. They worked for workmen's compensation legislation, which is
now in operation in all States, and have promoted second injury funds to protect the
worker who suffers injury in employment.
The policy of the American Federation
of Labor and Congress of Industrial Organizations since their merger is to use every
practical means to insure equal opportunity
in employment for all physically handicapped workers. It calls for opening more
jobs for the handicapped through collective
bargaining agreements and union-management cooperation. The program is outlined
in detail in an AFL-CIO booklet entitled
"Cooperation— . . the key to Jobs for the
Handicapped."
Some large unions maintain health and
welfare funds which can be drawn on to
finance vocational rehabilitation services for
members and their families.
ports is generally limited to members and associates, exception is made in the case of schools, colleges, and government agencies.

RESEARCH AND DEMONSTRATION PROJECTS

All over the country, rehabilitation agencies, hospitals, universities, national health
organizations, foundations, and nonprofit
voluntary organizations are undertaking research and demonstration projects to further the rehabilitation program.



A university research project—the study
of handicapped mothers with preschool
children conducted by the School of Home
Economics of the University of Connecticut with the help of a grant from the Office
of Vocational Rehabilitation—is described
at length on pages 21-26.
35

Rehabilitation of the Homebound
No one really knows how many disabled individuals are confined to their beds, their homes,
and their wheelchairs indoors; a million is probably
a conservative estimate. This includes persons of all
ages, but excludes those in hospitals and other institutions.
How many of these men, women, and children,
remain confined to their homes needlessly is another unknown figure. From pilot studies completed
and others under way, it appears that thousands
could be removed from the "homebound" group if
every community were to make a determined effort
to help them.
In a report to Congress in February 1955, the
Office of Vocational Rehabilitation stated: "Many
individuals are homebound today not because they
are beyond help, but because help is beyond them.
It is not simply a case of the necessary funds being
out of reach, although this problem is all too familiar
among the homebound. It is equally—and perhaps
predominantly—a lack of understanding of what
modern methods of physical rehabilitation can contribute in freeing the person from confinement to
the home or making life in the home more active
and enjoyable." 2

A description of a hospital project, a
demonstration in vocational rehabilitation
of the homebound, follows:
The Bellevue Rehabilitation Service in New York
City undertook a study to learn how many homebound patients could be restored to regular employment, or to productive work within the home. For
this project, a rehabilitation team at Bellevue Hospital accepted cases referred from the State division
of Vocational Rehabilitation. The 25 patients (9
of whom were women) in the preliminary study

about 10 years. Their educational backgrounds
ranged from 15 years of schooling to none, with an
average of 9.3 years.
When the rehabilitation team made its first summary report, the results looked like this:
Seven of the 25 were no longer homebound. Five
of the 7 were in regular employment outside the
home and the other 2 were in training for jobs.
Thirteen of the 25 were employed—5 in regular
jobs and 8 in home employment. Another 4 had
completed training and were awaiting employment.
Three were in training in preparation for employment. Only 5 were still unable to perform any useful
work in or out of the home.
Of the 9 women in the group, 5 went into regular
employment following completion of rehabilitation
service. One woman, who was 65 years of age and
had a cardiac disability, found employment as a
power sewing-machine operator, a job in which she
had previous experience. Another woman, disabled
by a hip fracture, was placed in an office where she
does bookkeeping and handles telephone calls. A
job as telephone operator was found for an arthritic
woman, and 2 other women were placed in service
occupations.
Through a research grant from the Office of V o cational Rehabilitation, the Bellevue Rehabilitation
Service and the New York University-Bellevue
Medical Center of which it is a part, have undertaken a larger study of 100 homebound individuals,
in cooperation with the New York State Division
of Vocational Rehabilitation.

Research in other localities likewise is
producing new information, including better methods of restoring those who are
homebound.

were all certified by their physicians as being homebound but potentially capable of performing some
work within the home.
The 25 patients in the group averaged 44 years
of age and had been disabled, on the average, for
2 Study of Programs for Homebound Handicapped Individuals. H. Doc. 98, 84th Gong., 1st Sess. U. S. Government Printing Office, 1955.

36



Other Research Projects
More than 30 national nonprofit organizations are listed as concerned with the
problems of handicapped homemakers,
which is only one of the aspects of voca-

tional rehabilitation. Among these are the
great national health agencies, such as the
cancer, heart, arthritis, muscular dystrophy, epilepsy, multiple sclerosis, tuberculosis, and cerebral palsy associations and the
National Foundation for Infantile Paralysis; the American Foundation for the
Blind, the American Hearing Society, and
the American Speech and Hearing Association; service organizations such as the
American Federation of the Physically
Handicapped, the National Rehabilitation
Association, and the Family Service Association; the professional societies of home
economists, nurses, physical therapists,
occupational therapists, and architects, as
well as the American Medical Association,
the American Hospital Association, and the
American Red Cross.
Many of these agencies have funds available for research and training grants and
for financing rehabilitation services to individuals disabled by the disease which they
are fighting. Some undertake original research, organize community programs to
promote rehabilitation, or sponsor special
projects such as demonstration kitchens for
the physically handicapped.
The Office of Vocational Rehabilitation




awards research fellowship grants under
the act of 1954. The purpose is to develop
competent research workers in the various
fields concerned with rehabilitation. Grants
are made to graduate students or to those
who have completed work on their doctorates to assist them in securing advanced
training in research methods or to carry
out research in rehabilitation problems and
methods.
Among many local organizations and
agencies which received grants for special
projects in 1956 and 1957 are the John
Tracy Clinic, Los Angeles, Calif., for a
study of the intellectual and personality
factors associated with success in lipreading; and the Highland View Hospital,
Cleveland, Ohio, for a study of the vocational potential of patients hospitalized
with severe chronic disabilities.

Many unsolved problems remain. Some
are chiefly medical in nature; others are
vocational, or psychological. Progress is
achieved by simultaneous efforts of individuals and groups working in several sciences, and in many agencies and communities, to solve problems that concern us all.

37

Careers in
Rehabilitation
The aim of rehabilitation is to restore disabled persons to the greatest effectivenessphysical, emotional, social, and economic—
of which they are capable. This is a field
especially satisfying to women who are interested in giving care to the sick or injured,
in teaching, or in helping those in trouble.
Rehabilitation is an expanding field.
State programs are being strengthened.
Long-established voluntary agencies—such
as the crippled children's societies—are
growing, and new voluntary organizations
serving the handicapped are being established. All these developments create an increasing demand for well-trained personnel
who can help restore the disabled to activity
and usefulness.
Women workers are welcomed in any capacity for which they are qualified (fig. 14).
Especially great is the need for more women
workers trained in speech and hearing therapy, in social work, in physical or occupational therapy, and in rehabilitation counseling. A newer specialty now opening up is
that of homemaker counseling.
In a rehabilitation agency, the professional people who work with and for an in38




dividual patient make up the rehabilitation
"team." The membership of a team varies
according to the needs of the disabled person and the resources of the agency. The
team may include several of the following,
and sometimes other specialists:
physiatrist
psychologist
psychiatrist
orthopedic surgeon
neurologist
social worker

physical therapist
occupational therapist
speech and hearing
therapist
rehabilitation counselor
nurse
teacher

In addition, rehabilitation centers and
similar facilities often employ a medical records librarian, and perhaps a homemaking
counselor. Also needed are specialized personnel who make and fit artificial limbs and
braces. Many technicians and clerical workers are needed in rehabilitation centers and

Figure 14.—Careers in Rehabilitation for the
Professional Woman. A, Rehabilitation counselor
helping a patient plan her program; B, Homemaking
counselor,
demonstrating
kitchen
arrangement.
—»




agencies; service employees, such as elevator
operators, kitchen workers, building cleaners, are also employed.
There is, thus, a wide range of jobs in
rehabilitation which offer good opportunities for women, whether handicapped or
not.
Sometimes a woman with a physical
handicap becomes a highly successful rehabilitation worker. Her own experiences
give her insight into the difficulties others
are facing. Her example gives courage to
persons seeking help.

For the young woman in college, or the
high-school girl looking forward to college,
rehabilitation offers possibilities for interesting work, pleasant working relationships,
and an income comparable to what she
would receive for similar work elsewhere.
For women with professional training, work
in a rehabilitation program offers status,
economic security, the stimulation of a developing field, and opportunities for professional recognition and advancement.

TRAINEESHIP GRANTS IN REHABILITATION SUBJECTS
The shortage of professional personnel
trained in rehabilitation techniques is acute.
Because of this, the Congress has authorized
financial awards, called "traineeships," to
help college students meet the cost of becoming professional rehabilitation workers.
A special procedure has been set up for
these awards. The Office of Vocational Rehabilitation makes grants to universities,
colleges, and other institutions engaged in
teaching rehabilitation subjects.1 These institutions, in turn, make traineeship awards
to selected students. Information on the universities and other institutions making such
awards, the amounts, eligibility requirements, and so forth, may be obtained on request from the Division of Training, Office
of Vocational Rehabilitation, United States
1 Universities and colleges are establishing courses for
specialized training of professional personnel needed in
rehabilitation. To assist in this, Federal grants are available from the Office of Vocational Rehabilitation under
the act of 1954. For the year 1957-58, 168 teaching
grants were made to schools in 33 States and the District of Columbia.

40



Department of Health, Education, and
Welfare, Washington 25, D. C.
The awards are available for long-term
study in rehabilitation counseling, for residency training of physicians in physical
medicine and rehabilitation, and for training in occupational and physical therapy,
social work, speech and hearing therapy,
and rehabilitation aspects of nursing.
By "long-term study" is meant basic or
advanced academic preparation for a professional field. The awards are usually for
an academic or a calendar year. If progress
is satisfactory, the traineeship ordinarily
may be renewed for a second year upon application to the educational institution.
To be eligible for a traineeship award a
student must meet certain professional requirements which differ according to the
field selected, and must be eligible for study
at an educational institution which receives
traineeship grants under the O V R program. Certain requirements are alike for
all fields:

(1) The student must have applied to the educational institution or agency selected, and have met
the admission requirements.
(2) The student must be a citizen or a permanent
resident of the United States, or be in process of
becoming one.

(3) During the period of the Office of Vocational Rehabilitation traineeship, the student must
receive no other Federal educational benefits.

In 1958, the awards ranged from $2,000
to $3,700 a year, depending on the field
selected and the level of graduate training.

PROFESSIONS FOR WHICH TRAINEESHIPS
ARE AVAILABLE
Traineeship awards are made by educational institutions receiving grants for this
purpose through the program of the Office
of Vocational Rehabilitation. For the school
year 1957-58, traineeships were awarded in
the following fields: Rehabilitation counseling; speech and hearing; physical medicine and rehabilitation; nursing aspects of
rehabilitation; social work; physical therapy ; and occupational therapy.
Rehabilitation Counseling
The rehabilitation counselor has been a
key figure in the public program of vocational rehabilitation for many years. Some
1,150 were employed in State agencies in
1955, and the expectation was that as many
as 4,500 would be needed by 1959 to meet
the demand created by the expansion of
the State-Federal program. Private agencies, rehabilitation centers, and hospitals
also are employing an increasing number
of rehabilitation counselors as members of
rehabilitation teams (fig. 14A).
As friend and adviser to the disabled
person, the rehabilitation counselor helps
him to work out a plan that fits his needs,
using information furnished by him, by the
medical records, and by other members of



the rehabilitation team. The counselor
makes appointments for medical diagnosis
and treatment and arranges for prevocational or vocational training as needed.
When the individual is ready for a job, the
counselor aids him in obtaining work that
is consistent with his education, experience,
interests and physical capacity, and keeps
in touch until assured that both the disabled person and his employer are satisfied.
The rehabilitation counselor has a sustained and personal relationship to the individuals whom he counsels. The ability is
needed to understand, and be sensitive to,
all the factors that enter into the individual's total problem—medical, emotional,
educational, economic, social, vocational.
Maturity of judgment is important. In addition, the counselor needs the imagination,
resourcefulness, and initiative to deal with
problem situations.
As the assistance of private medical practitioners, hospitals, schools, and other agencies in the community is often needed, the
rehabilitation counselor must maintain cooperative relationships with community
agencies and have a knowledge of local resources. In addition, the counselor needs to
know the laws relating to the rehabilita41

tion of disabled persons, the job elements
in a wide variety of occupations, and the
local employment market. Usually, the
counselor works closely with the local and
State employment service offices, for their
selective placement staffs often can arrange
prompt job placement.
The recommended training for a rehabilitation counselor is completion of a 4year liberal-arts course in college, followed
by 2 years of graduate work leading to a
master's degree in rehabilitation counseling. Additional training and experience are
usually needed by persons teaching on a
university faculty or assuming supervisory
or administrative responsibilities.
Traineeship awards for graduate study
in rehabilitation counseling are offered by
30 educational institutions.
Physical Medicine and Rehabilitation
The need for more physicians to specialize in the techniques of restoring the crippled and otherwise disabled has mounted
steadily in the last decade. A physiatrist
(physician trained in physical medicine and
rehabilitation) specializes in the medical
rehabilitation of the patient. A number of
other medical specialists also devote all or
a large part of their time to rehabilitation
work. As more women enter the medical
profession, the expanding rehabilitation
programs provide excellent opportunities
for those interested to specialize in physiatry
and take their American Board examinations in this field.
The physician in rehabilitation, as in
other medical specialties, may engage in
private practice, or in salaried work with
private or governmental agencies. Opportunities in teaching, research, consultant
42



work, and so on, are many and varied, according to the individual physician's interests, location and affiliations.
Traineeship awards under the Office of
Vocational Rehabilitation program are
available for graduates of schools of medicine or osteopathy approved by the American Medical Association. In 1957, 25 of
these schools were receiving grants.
Speech and Hearing Therapy
When a person is unable to speak and
be understood, or cannot hear, his communication with other people is shut off and
he faces a formidable barrier. Work, play,
family life, travel—all these call upon him
to speak with other people, to respond to
them and to the world in which he lives.
A child born with a cleft palate must have
speech training as well as surgical care if
he is to speak properly. A deaf person or a
person with impaired hearing may have
difficulty in talking—or may be unable to
talk—without special training (see fig. 15).
Speech and hearing therapists 2 in rehabilitation help patients overcome or reduce
speech or hearing impairments. They give
diagnostic tests to determine whether training in speech and hearing is indicated. They
use various specialized techniques to overcome deficiencies of speech and hearing
(fig. 15). Since speech problems may arise
from both physical and emotional conditions, the therapist must understand the
general physical nature of the different
types of speech impairments and have an
2 The
term "Speech and Hearing Therapist" is in
widespread popular use; however, the American Speech
and Hearing Association advises that there is a preference among many professional members for the terms,
"Speech Correctionist" and "Audiologist."

insight into the psychological reasons which
often affect the control of speech.
As some patients make very slow progress, the therapist must have great patience,
as well as responsiveness to the individual's
needs and ingenuity in meeting them.
This is a relatively new and fast-growing
profession. In 1957, the American Speech
and Hearing Association listed nearly 5,000
members and associates, more than half of
them women. The Association provides a
program of certification for its members in
speech correction and audiology.
For basic certification, at least 4 years
of college is required, with a degree of
bachelor of arts or bachelor of science. In
college, the student should specialize in
courses on the pathology of speech defects
and rehabilitation procedures. As a sequence of courses leading to certification
in speech and hearing therapy is not offered by all colleges, prospective students
are advised to consult the Association be-

Figure 15.—Speech correctionist, using mirror and
tape recorder to improve a
patient's speech.




fore deciding where to take their training.
In addition to having a college degree, a
person must be registered for a year of supervised professional experience before being certified. The same person may receive
basic certification in both areas. For advanced certification, a master's or doctor's
degree, with 4 years of registered supervised
experience is necessary.
Speech and hearing therapists are in
such demand that rehabilitation centers,
hospitals, clinics, and service agencies in
practically all large cities, and many smaller places, are recruiting constantly. The demand appears certain to exceed the supply
for several years, as rehabilitation

pro-

grams expand to serve more persons with
speech and hearing defects.
Five university schools of speech and
hearing received traineeship grants from the
Office of Vocational Rehabilitation for the
year 1957-58.

Nursing in Rehabilitation
The nursing profession, in which women
have excelled since its beginning, offers
special opportunities for those who wish to
specialize in helping the disabled. Graduate courses of 1 academic year are given to
prepare registered nurses and graduates of
collegiate nursing programs for work in rehabilitation. Short-term courses are also
available. Employment may be with rehabilitation centers or with the numerous hospitals which have rehabilitation departments.
The Office of Vocational Rehabilitation
made grants in 1957 to help six schools of
nursing to teach rehabilitation principles
and practices as a part of the basic nursing
curriculum. Three of the schools have
awarded traineeships for graduate study in
the rehabilitation aspects of nursing, to help
nurses prepare for teaching rehabilitation
or for key jobs in rehabilitation programs.
The purpose of the long-term grants is
to give enough nurses understanding and
skill in rehabilitation to make it possible for
every school of nursing to have one instructor who can teach rehabilitation principles
and methods; and for every hospital and
health agency to have one nurse able to
teach rehabilitation principles and methods
to other nurses.
Social Work

in Rehabilitation

When prolonged or severe disability occurs, it usually means financial strain, separation from family, loss of contact with
friends and community, emotional stress—
in short, a constellation of serious personal
problems surrounding the central fact of
disability.
44




The social worker in rehabilitation is a
specialist skilled in gathering facts about
the problem and how it affects the disabled
individual and his family, their finances,
and their mode of life. She works with doctors, nurses, therapists, rehabilitation counselors and many others to use this information in developing a plan for rehabilitation.
A social worker in rehabilitation needs
a strong and stubborn liking for people of
all sorts, and a desire to help them. She has
to put people at ease in situations that seem
strange or frightening to them; she must be
ready to recognize and consider their feelings. On the other hand, she must be able to
form and sustain good relationships with
specialists in various medical and physical
sciences or in other fields. She should have
flexibility, both emotional and intellectual.
The professional organization of social
workers is the National Association of Social Workers, with 20,000 members.
Within the Association are sections for social workers with particular fields of interest, such as group work, community
organization, social research, medical social
work, and psychiatric social work, providing opportunities for exchange of professional experiences.
Although only a small percentage of all
social workers are employed in rehabilitation agencies, the opportunities are excellent. Several hundred vacancies for social
workers in rehabilitation were reported in
1956.
The social work profession considers 2
years of graduate training in an approved
school of social work a desirable standard.
Undergraduate courses should be chosen to
give a sound foundation in the social sciences, especially psychology, anthropology,
sociology, and economics. The graduate

study includes both classroom study and
field work, and leads to the master's degree.
For teaching and research positions, it is
increasingly recognized that a doctorate in
social work is desirable.
Traineeships for college graduates interested in preparing for social work with the
physically or mentally handicapped are
available under the Office of Vocational
Rehabilitation program, for study at the
first or second graduate-year level. Applicants must be eligible for admission to a

Figure
16.—Occupational
Therapist, Teaching Prevocational Skills.




graduate school of social work to which the
Office of Vocational Rehabilitation has
made a teaching grant.

Occupational Therapy
The occupational therapist in rehabilitation helps disabled individuals take the important first steps toward recovery and usefulness by engaging in some type of purposeful activity. She uses the arts, crafts,
mechanical equipment, dramatics—nearly

any of the activities which combine functional purpose and an outlet for creative
expression. The activity program for a patient is selected especially to help overcome
his particular disability.
Occupational therapy is useful in both
physical and emotional illnesses and disability. Some therapists specialize in a certain type of patient—such as the amputee,
the cerebral palsied, the emotionally ill,
the tuberculous.
For selected patients, the therapist may
utilize certain prevocational activities to
help develop plans for employment which
will be suited to their physical limitations,
their individual interests and aptitudes (fig.

16).
The occupational therapist in rehabilitation must have a basic knowledge of human
anatomy and physiology, and the nature of
the major diseases and disabilities, along
with the technical skills necessary to give
instruction in arts, crafts, and other activity programs.
Some 5,500 occupational therapists—
most of them women—were registered with
the American Occupational Therapy Association in January 1957. About a fifth of all
occupational therapists work in special
workshops or in rehabilitation centers
where patients come for treatment. Openings exist in nearly all States and in a majority of the larger cities.
Graduates of an approved school of occupational therapy are eligible to take the
national registration examination given by
the American Occupational Therapy Association. For high-school graduates the
course consists of 4 years of college work
plus 9 months of supervised practice in a
hospital or clinic. This leads to a degree of
bachelor of science in occupational therapy.
46




College graduates can qualify for a certificate in occupational therapy in most of
these schools through 18 months of specialized training.
Traineeships for study in 22 schools of occupational therapy were available in 1957
for the junior, senior, advanced standing,
and clinical affiliation years.
Physical Therapy
The physical therapist provides treatment
and special types of training for a variety
of physical disabilities among both children
and adults.
She uses equipment such as diathermy,
ultraviolet rays, hydrotherapy; she examines
patients to determine muscle strength,
range of motion of joints, and functional
ability in self-care. She gives massage and
special exercises. In addition, she teaches
patients to walk with braces, crutches, etc.
(see fig. 16), and to perform the basic activities of daily living.
Physical therapists in rehabilitation ordinarily work in rehabilitation centers as a
member of the "team"; in rehabilitation
departments or services of hospitals, mobile
physical therapy and rehabilitation clinics;
or as consulting specialists on the staff of
community or State service organizations.
Figure

17.—Physical

Therapist,

Teaching

a

Patient to W a l k W i t h Braces.

The supply of physical therapists in rehabilitation is critically short of the need.
This situation apparently will continue for
several years. Openings exist in practically
all types of institutions and agencies which
furnish physical rehabilitation services—
and the need exists in practically every




State. For those with experience, opportunities for advancement to supervisory and
administrative responsibilitions are stated
to be excellent.
Through the Office of Vocational Rehabilitation, traineeships for graduate study
are available to experienced physical therapists interested in a teaching career.
Scholarship aid through the National Foundation for Infantile Paralysis is available to
students enrolled in approved physical therapy schools. Inquiries regarding scholarship assistance should be directed to the
American Physical Therapy Association
(1790 Broadway, New York 19, N. Y.).

Other Specialties
Prosthetists (specialists in making and
fitting artificial arms and legs) and orthotists (those who specialize in making and
fitting braces and certain other supports)
are important members of the rehabilitation team in cases where amputation or
paralysis of the limbs is involved. Training
for this work is based upon high-school
graduation, followed by apprenticeship
(usually 4 years) during which the trainee
earns and learns under certified members
of the profession, through a system of training established by the American Board for
Certification of the Prosthetic and Orthopedic Appliance Industry.

OTHER PROFESSIONS IN REHABILITATION
Women qualified in a number of other
professions will find that rehabilitation is
a promising field of employment. Three of
these professions—psychology, homemaker
counseling, and job counseling—are described briefly here.
Psychology
Psychologists are in demand by many
agencies, public and private, which carry
out rehabilitation programs for the disabled. Personality problems or emotional
factors often complicate the total picture
of disability. Psychological testing, evaluation, and other services frequently are key
elements in planning and carrying out a
rehabilitation program. This is an occupational field in which women already have
established themselves as able professional
workers.
48



Homemaker Counseling
A few large agencies offering complete
rehabilitation services have installed demonstration kitchens where a homemaker
counselor—usually a home economist—can
instruct patients while they are still receiving treatment (fig. 14B). One of these
has developed a large variety of devices to
simplify housekeeping tasks for the women
who cannot walk, who can use only one
hand, or who have heart trouble. At least
one research center is experimenting with
home visits by graduate home economists
trained in rehabilitation work.
This specialty is still on a small and
somewhat experimental basis, but it may
hold possibilities for the future, especially
for part-time employment of married
women who have suitable training and experience. The home economist, nurse, or

occupational therapist can be equipped for
this work by courses in home management
and in rehabilitation principles and
methods.
Job Counseling
In each State the Employment Service
has a supervising counselor in charge of the
statewide program for handicapped workers, Moreover, each of the 1,750 local offices
has a counselor designated to serve handicapped workers and make sure that they
have access to all available placement and
counseling service. Many have selective
placement interviewers to serve handicapped applicants.
Selective placement interviewers and
counselors are specially trained to understand the needs of handicapped workers
and to exercise ingenuity and imagination
in finding the right job for them. They must
have an extensive and detailed knowledge
of the local employment situation and maintain relationships of mutual helpfulness with
local employers. To assist them in determining what kind of job can be performed by
a person with a physical handicap, the
United States Employment Service has prepared a variety of technical aids, among
them special techniques for matching the
individual's physical capacities to the physi-




cal demands of particular jobs, guides for
interviewing job applicants who have
specific types of disability, and tests of aptitude for many occupations.
To enter this work, a woman should have
at least a bachelor's degree, with a major
in psychology or personnel administration
and a good foundation in other social sciences. A master's degree is desirable. She
will also need a year or more of experience
in employment counseling or personnel
work before specializing in placement of
the handicapped.
Up-to-date reports on the employment
outlook in several of the fields important
for rehabilitation are contained in the Occupational Outlook Handbook published by
the United States Department of Labor.
The section on health service occupations
contains material on professional nurses,
physicians, physical therapists, and occupational therapists; also dentists, osteopaths,
pharmacists, medical laboratory technicians, and medical record librarians. Another section is devoted to material on social
work. Earlier reports issued by the Women's
Bureau of the Department of Labor give
greater detail on the employment opportunities in nursing, occupational therapy,
physical therapy, dietetics, and social work
as they relate to women.

49

Appendix
REFERENCES ON VOCATIONAL REHABILITATION
A few of the many valuable sources of further
information on vocational rehabilitation are listed
below. For reasons of space the list is limited to publications of the Department of Health, Education,
and Welfare and the Department of Labor. Those
for which prices are listed may be purchased from
the Superintendent of Documents, Government
Printing Office, Washington 25, D. G.
U. S. D E P A R T M E N T OF H E A L T H ,
A N D WELFARE

EDUCATION,

Office of Vocational Rehabilitation:
Annual Reports of the Office of Vocational Rehabilitation.
Doing Something for the Disabled, by Mary E.
Switzer and Howard A. Rusk. Public Affairs Pamphlet No. 197. (Single copies available free from
Office of Vocational Rehabilitation.)
New Hope for the Disabled—Public Law 565. V R ISC-13. 1956. 15 cents.
Psychological Aspects of Physical Disability. Rehabilitation Service Series Number 210.
1952. 45
cents.
Self-Employment. Explanation of opportunities for
self-employment of disabled. (Limited quantity.)
1948.
Workshops for the Disabled—A Vocational Rehabilitation Resource. 1956. 60 cents.
Social Security Administration:
If You Are Disabled. O A S I - 2 9 . April 1957.
Public Programs for Crippled Children, 1955. Children's Bureau Statistical Series, No. 40. 1957.
Processed.
Office of Education:
Education for the Professions. 1955. $1.75 (paper).
U. S. D E P A R T M E N T OF LABOR
Bureau of Employment Security: Interviewing Guides
for Specific Disabilities. 1954. 5 cents each.
Pulmonary Tuberculosis (No. E - 1 1 5 ) .
Heart Disease (No. E - 1 1 6 ) .
Epilepsy (No. E - 1 1 7 ) .

50



U. S. D E P A R T M E N T OF LABOR—Continued
Bureau of Employment
Security—Continued
Diabetes (No. E - 1 1 8 ) .
Arthritis and Nonarticular Rheumatism
(No.
E-119).
Orthopedic Disabilities (No. E - 1 2 0 ) .
Suggestions for Using Interviewing Guides for
Specific Disabilities (No. E - 1 1 4 ) .
Bureau of Labor Statistics: Occupational Outlook Handbook. 1957 edition. Bull. 1215. $4. Reprints are*
available of the following sections: Teaching (15$),
Health Service Occupations (35$), Dietitians and
Home Economists (10$), Psychologists (5$), Social
Workers (5$).
Women's Bureau: The Outlook for Women—
As Occupational Therapists. Bull. 203-2, Revised
1952. 20 cents.
As Physical Therapists. Bull. 203-1, Revised 1952.
25 cents.
In Professional Nursing Occupations, Bull. 203-3, Revised 1953. 30 cents.
In Dietetics. Bull. 234-1. 1950. (Out of print.)
In Social Case Work in a Medical Setting. Bull.
235-1. 1950. 25 cents.
In Social Case Work in a Psychiatric Setting. Bull.
235-2. 1950. 25 cents.
PRESIDENT'S C O M M I T T E E O N E M P L O Y M E N T
OF T H E PHYSICALLY HANDICAPPED
Employment of the Physically Handicapped: A Bibliography. 1957. Contains nearly 550 entries with
annotations, including bulletins, articles, leaflets,
and legislative documents, published from 1950 to
1957 (with a few earlier works of special importance). Arranged by subject, with an alphabetical
index by author. Also contains a list of rehabilitation agencies and organizations, and a list of films.
Handbook for State and Community Committees,
1956-1957.
Handbook for Regional Meetings.
Performance—The Story of the

Handicapped.

Monthly periodical.
Spotlight on Ability—Guide to Action,
Processed.

1956-1957.

ADDRESSES OF STATE
VOCATIONAL REHABILITATION AGENCIES

In States where a single address is listed, this
agency conducts the rehabilitation program both for
the blind and for the disabled who can see. The
word "blind" in parentheses after an address means
that the agency deals only with those who are handicapped in seeing.
ALABAMA :

416 State Office Bldg., Montgomery (17 local offices).
ALASKA:

P. O. Box 2568, Alaska Office Bldg., Juneau (3 local
offices).
ARIZONA :

1704 West Adams St., Phoenix (4 local offices).
1632 West Adams St., Phoenix (blind).
ARKANSAS :

303 Education Bldg., Little Rock (15 local offices).
CALIFORNIA:

721 Capital Ave., Sacramento (26 local offices).
COLORADO:

510 State Office Bldg., Denver (7 local offices).
100 West Seventh Ave., Denver (blind).
CONNECTICUT:

33 Garden St., Hartford (11 local offices.
State Office Bldg., Hartford (blind).
DELAWARE :

11 Concord Ave., Wilmington.
305-307 West Eighth St., Wilmington (blind).
D I S T R I C T OE C O L U M B I A :

819 Ninth St. NW., Washington, D. C.
FLORIDA :

105 Knott Bldg., Tallahassee (12 local offices).
416 South Tampania St., P. O. Box 1229, Tampa
(blind, one local office).
GEORGIA:

129 State Office Bldg., Atlanta (22 local offices).
GUAM :

Department of Education, Agana.
HAWAII :

P. O. Box 2360, Honolulu (3 local offices).
1390 Miller St., Honolulu (blind).




IDAHO:

State House, Boise (2 local offices).
103 9th St., Box 1189, Boise (blind).
ILLINOIS :

Rm.

400

State Office Bldg., Springfield

(22

local

offices).
INDIANA :

145 West Washington St., Indianapolis (12 local offices).
536 West 30th St., Indianapolis (blind).
IOWA:

415 Bankers Trust Bldg., Des Moines (9 local offices).
State Office Bldg., Des Moines (blind).
KANSAS:

State Office Bldg., Topeka (8 local offices).
State Office Bldg., Topeka (blind, 5 local offices).
KENTUCKY:

State Office Bldg., High Street, Frankfort (11 local
offices).
LOUISIANA :

2655 Plank Road, Baton Rouge (16 local offices).
State Dept. of Public Welfare, Capitol Annex, P. O.
Box 4065, Baton Rouge (blind, 4 local offices).
MAINE:

32 Winthrop St., Augusta (5 local offices).
State House, Augusta (blind, 2 local offices).
MARYLAND:

2 West Redwood St., Baltimore (11 local offices).
MASSACHUSETTS :

37 Court Square, Boston (8 local offices).
14 Court Square, Boston (blind).
MICHIGAN :

900 Bauch Bldg., Lansing (10 local offices).
4th Floor, Lewis Cass Bldg., Lansing (blind, 4 local
offices).
MINNESOTA:

517 Commerce Bldg., St. Paul (14 local offices).
117 University Ave., St. Paul (blind).
MISSISSIPPI:

316 Woolfolk State Office Bldg., Jackson (13 local
offices).
614 State Office Bldg., P. O. Box 1669, Jackson (blind,
7 local offices).

51

PENNSYLVANIA:

MISSOURI:

Labor and Industry Bldg., 1st Floor West Wing, 7th and
Forster Sts., Harrisburg (10 local offices).
Health and Welfare Bldg., Seventh and Forster Sts.,
Harrisburg (blind, 6 local offices).

Jefferson Bldg., 7th Floor, Jefferson City (8 local
offices).
State Office Bldg., Jefferson City (blind, 2 local offices).
MONTANA:

PUERTO RICO :

508 Power Block, Helena (2 local offices).
10th and Ewing St., Helena (blind).

Edificio Zequeira, Stop 3 4 / 2 , P. O. Box 757, Hato Rey
(10 local offices).

NEBRASKA:

RHODE

State Capitol Bldg., 10th Floor, Lincoln (6 local offices).
State Capitol Bldg., Lincoln (blind, 2 local offices).
NEVADA :

SOUTH

103 State Capitol Bldg., Annex, Carson City (1 local
140 No. Virginia St., Reno

SOUTH

(blind, 1 local office).
NEW

HAMPSHIRE:

TENNESSEE:

State House Annex, Concord (blind).

1717 West End, Room 615, Nashville (10 local offices).
303 State Office Bldg., Nashville (blind, 6 local offices).

JERSEY:

38 South Clinton Ave., P. O. Box 845, Trenton (12

TEXAS :

local offices).

Capitol Station, Austin (26 local offices).
1306 San Jacinto, Austin (blind, 5 local offices).

1100 Raymond Blvd., Newark (blind, 1 local office).
NEW

MEXICO:

UTAH :

119 South Castillo, P. O. Box 881, Santa Fe (3 local

400 Atlas Bldg., 36 West 2nd South, Salt Lake City
(3 local offices).

offices).
P. O. Box 1391, Santa Fe (blind).
NEW

VERMONT:

16 Langdon St., Montpelier (3 local offices).
Dept. of Social Welfare, 128 State St., Montpelier
(blind).

YORK :

42 North Pearl St., Albany (11 local offices).
112 State St., Albany (blind, 6 local offices).
NORTH

VIRGIN

CAROLINA:

VIRGINIA:

Mansion Park Bldg., P. O. Box 2658, Raleigh (blind,

State Dept. of Education, Richmond (13 local offices).
3003 Parkwood Ave., Richmond (blind).

7 local offices).
DAKOTA:

WASHINGTON :

University Station, Grand Forks (3 local offices).

Old Capitol Bldg., P. O. Box 688, Olympia (14 local
offices).
P. O. Box 1162, Olympia (blind, 3 local offices).

OHIO:

79 East State St., Room 309, Columbus (10 local offices) .

WEST

85 South Washington Ave., Columbus (blind, 8 local

(18 local

WISCONSIN :

OKLAHOMA :

14 North Carroll St., Madison (10 local offices).
311 State St., Madison (blind, 5 local offices).

1212 North Hudson, Oklahoma City (11 local offices).
OREGON:

WYOMING:

1178 Chemeketa St. NE., Salem (5 local officcs).

123 State Capitol Bldg., Cheyenne (3 local offices).

535 Southeast 12th Ave., Portland (blind).

O

52

VIRGINIA:

State Capitol Bldg., Rm. 673, Charleston
offices).

offices).




ISLANDS:

Dept. of Education, St. Thomas.

Dept. of Public Instruction, Raleigh (11 local offices).

NORTH

DAKOTA:

State Capitol Bldg., Pierre (3 local offices).
New State Office Bldg., Pierre (blind).

18 School St., Concord.
NEW

CAROLINA:

Rm. 217, 1015 Main St., Columbia (15 local offices).
State Dept. of Public Welfare, Columbia (blind).

office).
304 Clay Peters Bldg.,

ISLAND:

205 Benefit St., Providence (1 local office).
24 Exchange Place, 7th Floor, Providence (blind).





Federal Reserve Bank of St. Louis, One Federal Reserve Bank Plaza, St. Louis, MO 63102