system must permit flexibility at the community level. The community is the appropriate site for making decisions on what services an individual needs and how best to provide them. Independent living centers are discussed below as an example of effective community-based programs that assist people with disabling conditions.

Independent Living Centers

Independent living centers provide one model of how to address the multiple needs of people with disabling conditions. These community-based centers, which usually are staffed by persons with disabling conditions who live independently, offer a variety of services and act as resource and referral centers, achieving linkages among the disparate elements of the health care and social service system.

Services offered by independent living centers typically include the following:

  • organizing and coordinating family support for people with disabling conditions;

  • organizing coalitions among people with different types of disabling conditions;

  • peer counseling;

  • long-term monitoring and follow-up of referred clients;

  • computerized information and referral system;

  • health maintenance programs, often developed in conjunction with local rehabilitation centers;

  • transportation;

  • housing assistance; and

  • advocacy, including participation in the development of policies that foster integration of people with disabling conditions into the community.

Collectively, these services and activities constitute a comprehensive, rational approach to the prevention of secondary conditions, addressing not only health concerns but also issues related to the quality of life. Indeed, the aim of the independent-living movement—to foster "control over one's life based on the choice of acceptable options that minimize reliance on others in making decisions and in performing everyday activities" (Texas Institute for Rehabilitation and Research, 1978)—is an appropriate goal for guiding the development, organization, and coordination of disability prevention programs.

Assistive Technologies

Assistive technologies are devices and techniques that can eliminate, ameliorate, or compensate for functional limitations. Essentially enabling tools, assistive technologies help people with disabling conditions interact



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