in regular classrooms in 1986-1987 (U.S. Department of Education, 1989b). Special resource rooms were provided for another 43 percent, 25 percent were placed in separate classes, and 4 percent were placed in separate schools. Less than 2 percent of special educational services were provided in homes, hospitals, residential facilities, or correctional facilities.

Sixty percent of "handicapped students" aged 16 to 21 graduated with a diploma or certificate. Twenty-five percent dropped out. The highest dropout rates were reported among the "emotionally disturbed" (42 percent) and the "learning disabled" (26 percent) (U.S. Department of Education, 1989a).

In 1986, amendments to the 1975 legislation (P.L. 99-457) encouraged states to identify children with disabling conditions as early as possible and provide early intervention services (Smith, 1976; DeGraw et al., 1988). States are now discussing how to implement these programs.

Environmental Interventions

Environmental Control

Environmental control programs are designed to protect children from exposure to toxicants such as lead and asbestos. With respect to lead, prevention strategies focus on efforts to identify major environmental sources of lead exposure (such as house paint, automobile emissions, and water) and to identify children with elevated blood levels of lead (Centers for Disease Control, 1985). Federal, state, and local regulations are directed at keeping environmental exposures at safe levels.

Childhood lead exposure is an important cause of preventable developmental disability, and screening programs in high-risk areas should be expanded. Surveillance also should be established to monitor childhood lead poisoning more closely, and governmental health, housing, and environmental agencies should work together to increase the removal of lead paint and dust in high-risk areas.

Accessibility and Adaptation

Methods of adaptive assistance that reduce secondary conditions are evolving, including personal care attendants, respite care, and a vast array of assistive technology. Communication devices, feeder plates, computers, and electric wheelchairs are among the most widely used assistive technologies, but devices also can be customized for individuals with unique needs. The impact of some environmental obstacles, such as curbs and buildings, has been lessened, but many obstacles remain, including inadequate transportation in rural areas.



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