Ординатура / Офтальмология / Английские материалы / The Encyclopedia of Blindness and Vision Impairment_Sardegna, Shelly, Shelly, Steidl_2002

often treated with vasoconstricting agents such as ergotamine. These drugs constrict the blood vessels of the scalp to reduce the ßow of blood. Ergotamine must be taken during the early stages of the headache and cannot be taken in conjunction with drugs for hypertension.

Migraines may recur. Patients may reduce recurrences by avoiding triggering factors and managing stress and tension. Drugs to prevent migraine attacks may be prescribed in cases in which the severity or frequency of migraine attacks has not been affected by the elimination of triggering factors. The drugs, such as Bellergal, Pizotyline, Propranolol, Elavil, and Sansert, have varying degrees of effectiveness, side effects, and safety. New treatments for migraines are being developed and tested.

Migraines can be very upsetting and distressing to those who suffer from them and to their families and friends. Also, there are many misconceptions about migraines, including the theory that a migraine is not a bona Þde physical illness.

Joel R. Saper, M.D., director of the Michigan Head-Pain & Neurological Institute, explained the problem of misconception as it relates to migraines. ÒThere is no condition of such magnitude that is shrouded in myth, misinformation, and mistreatment as is this condition, and there are few conditions which are as disabling during the acute attack,Ó Saper said.

There is a support group for migraine sufferers called Migraine Awareness Group: A National Understanding for Migraineurs, or M.A.G.N.U.M.

Contact:

M.A.G.N.U.M., Inc.

113 South Saint Asaph, Suite 300 Alexandria, VA 22314 703-739-9384 www.migraines.org

mobility See ORIENTATION AND MOBILITY.

Mowat Sensor The Mowat Sensor is a mobility aid designed for use by visually impaired persons and developed by HUMANWARE. The device uses high-frequency sound waves to detect objects in

the userÕs path. The sensor vibrates if an object is present and increases the vibration rate as the user nears the object. The sensor has a short range for objects less than one meter away and a longer range for objects up to four meters away.

Approximately the size of a ßashlight, the device may be hand held or carried in a pocket or purse. A model for those with poor tactual sensation produces an audible signal heard through an earphone attachment. Other similar devices are manufactured under various names, including the Bliss Passive Detector.

The device is designed to be used with a long cane or dog guide. Several hours of practice and/or training with a qualiÞed instructor are required for proÞcient use. (See ELECTRONIC TRAVEL AIDS.)

multiple sclerosis (MS) A chronic disease of the central nervous system. According to the National Multiple Sclerosis Society, approximately 333,000 Americans have been diagnosed with MS or MS-related diseases, and approximately 200 new cases are diagnosed each week.

The disease attacks the bodyÕs myelin, a fatty substance that coats and insulates nerve Þbers of the brain and spinal cord. As the myelin is damaged, sclerosed or hardened tissue, called plaques, form. The plaques interrupt or obstruct the impulses transmitted along the nerves.

Symptoms of MS include tingling in the limbs or extremities, numbness, blurred or double vision, nystagmus, impaired sensation, fatigue, weakness, dizziness, slurred speech, tremor, spasticity, and bladder, bowel, or sexual function problems.

Half of all those who are diagnosed with MS may experience visual disturbances. The three most common disorders are optic neuritis, DIPLOPIA, and NYSTAGMUS.

Optic neuritis, or inßammation of the OPTIC NERVE, often results in a condition termed retrobulbar neuritis. It may Þrst appear as a loss of vision in one eye, blurring of vision, color blindness, or blind spots. The disruption of vision usually Þrst occurs in the central Þeld of vision and progresses to peripheral Þelds.

Optic neuritis may be treated with steroids or the drug ACTH. Recurrence is possible, but remis-

sion of the visual impairment is good. Most cases respond to treatment in three months.

Diplopia, or double vision, may occur if the eyes do not move together to focus on an object. Diplopia occurs when the myelin along nerve Þbers controlling coordination of the eye movement is damaged. Diplopia is treated with steroids and ACTH or by patching one eye. The condition usually improves within several weeks but may recur.

Nystagmus is an involuntary, jerky movement of the eyes that makes focusing difÞcult. It may cause dizziness and blurred vision. The condition is treated with steroids, ACTH, and Meclizine for symptoms of dizziness. Within a few weeks the symptoms may subside, although recurrences are possible.

The symptoms and progression of MS are unique to the individual. Although an initial attack may never be followed by a recurring incident, most people experience periods of exacerbation, in which symptoms of the disease are most pronounced, and remission, symptom-free periods.

The degree of disability varies by individual but two thirds of all those with MS remain ambulatory over their lifetimes. The disease is rarely fatal and studies indicate that life expectancy is only reduced by 15 percent or less.

MS usually Þrst appears between the ages of 20 and 40. Women, whites, and those who live in colder climates are more likely to develop the disease. Twice as many women as men have MS. Studies suggest that where one was born and lived for the Þrst 15 years of life affect the risk of developing the disease more than later places of residence.

The cause of MS is unknown. It is not contagious or inherited, although certain genetic conditions within individuals may make them more receptive to MS. These factors include exogenous (outside the environment) factors such as viruses and endogenous (inside the environment) factors such as body immunity.

Because families tend to share similar exogenous and endogenous factors, susceptibility to the disease may run in families. Four percent of all families with an incidence of MS have an additional case of MS.

Although there is no cure for MS, it may be treated with medications to reduce the symptoms. Muscle relaxants may reduce spasticity and medications may be prescribed to reduce pain, tension, bowel and urinary distress.

The drug ACTH or steroids such as prednisone may shorten the duration and lessen the intensity of exacerbations. ACTH is usually administered by injection and monitored for effects on the body in the hospital. Steroids are given orally or by injection but also require monitoring. Side effects of these medications may include weight increase, ßuid retention, mood alteration, and tendency toward the development of ulcers. Since 1993, three new medications to treat relapsing forms of MS have been approved by the Food and Drug Administration. They are: Betaserona, Copaxonea, and Avonexa. These medicines have been shown to lessen the severity and frequency of MS attacks. They also help to reduce accumulations of lesions on the brain and to slow the progression of disability.

Since increasing evidence links MS to disorders within the bodyÕs immune system stemming from a viral infection, current areas of research include virology and immunology. Some researchers believe that MS is associated with physical trauma, but that theory is controversial.

Frames, Robin. ÒInsight into Eyesight.Ó MS: Facts and Issues. New York: National Multiple Sclerosis Society, 1985.

National Multiple Sclerosis Society. Living with MS. HealthNet Library, CompuServe, 1988.

National Multiple Sclerosis Society. What Is Multiple Sclerosis? New York: NMSS, 2001.

myasthenia gravis Myasthenia gravis is an autoimmune disease in which abnormal antibodies in the blood disrupt transmission of impulses from the nerve endings to muscle tissue. This condition results in severe or fatal (in the case of respiratory failure) fatigue of the muscle. It is estimated that there are about 36,000 cases of the disease in the United States, with a prevalence of 14 in every 100,000 people. Women are affected more often and earlier in life than men.

The disease may affect one group of muscles or those of the entire body. Approximately 75 percent

of all initial myasthenia cases involve the ocular muscles, and nearly 90 percent develop some ocular involvement over time. Those cases that involve only the ocular muscles for a period of two years will probably be limited to the ocular muscles and not progress systemically. Ocular myasthenia cases account for approximately 20 percent of all cases.

Ocular symptoms of the disease include PTOSIS (drooping eyelid), lid twitch or quiver, and NYSTAG- MUS (uncontrollable movement of the eyes). Ptosis may be absent at the start of the day but becomes more pronounced as the day progresses.

Myasthenia gravis is diagnosed with a Tensilon test. The drug Tensilon is injected to stimulate nerve transmission. Muscle strength is measured before and after the injection. Those who show a temporary gain in strength or improvement of symptoms after the injection test positively for myasthenia gravis.

Myasthenia gravis is generally treated by a neurologist. Treatment may consist of oral drugs and corticosteroids. Removal of the thymus gland may produce an improvement in symptoms.

myopia Nearsightedness, occurring when the refractive power of the eyes is too great in relation to the length of the eyes. Myopic eyes are too ÒlongÓ for their refracting capabilities. Myopic people see close objects more clearly than distant objects. Corrective concave lenses in the form of contacts or eyeglasses are prescribed to correct the problem.

High myopia is a condition in which the eye is extremely long or large, producing extreme nearsightedness. In very large eyes, the structures within them are stretched, causing the retina to become thin and weak. Tears or detachments that impair vision can develop as a result.

Myopia usually occurs from the preteen to teenage years. As the child grows, the myopia may worsen with each growth spurt. Once the child reaches maturity, it generally levels off and stabilizes for many years.

myths Myths about blindness have existed for centuries and grew from ignorance about the condition and nature of blindness. Myths are perpetu-

ated by modern attitudes toward, and stereotypes of, blindness.

Some commonly held myths surrounding blindness include the concept of all forms of blindness as darkness, the concept of blind as dependent, the connection between blindness and punishment as in the Oedipal legend, the belief that the other senses compensate for a loss of sight, and that people who have a vision loss have ESP or musical talent.

Being blind does not necessarily mean seeing nothing, or being in darkness. Of the half million people who are legally blind in the United States, most retain some usable vision. Only a fraction have no light perception or usable vision. Because darkness is so closely associated in society with ignorance, evil, and fear, the concept of blindness as darkness also links it to these negative traits.

The lack of understanding about visual abilities of the blind fosters the perception of blind persons as dependent. Throughout history, blind persons have been seen as liabilities to the social group, wards of society, or beggars. This myth disregards the abilities of blind individuals to work and be self-supporting and exists today in the unwillingness of employers to hire blind persons.

The evil-eye myth stems from ancient times when blindness was perceived as a sign of evil or a punishment from God for some evil-doing or sin. Those with the evil eye were thought to be able to kill with it, and were therefore shunned.

The Oedipal legend supports the myth that blindness is equated with evil. Oedipus blinded himself as a punishment for wrong-doing. The legend supports blindness as a just punishment for sins and suggests that blind persons may have brought the condition on themselves.

A commonly held myth about blindness concerns the compensation of senses. It is falsely believed that once eyesight is gone, nature heightens the other senses to compensate for the lack of sight. In reality, the blind person may learn to use the other senses in more efÞcient ways to gather information, but the senses remain unchanged.

Blind persons are often believed to have extraordinary abilities or talents, as well. It is commonly held that blind individuals develop extrasensory powers, or ESP, as a compensation for the sight

loss. Perhaps because of some popular blind performers, the myth exists that blind persons are innately musically talented.

Curiously, the reverse situation is also widely believed. It is held that blind persons lose sense abilities, especially hearing, with the loss of sight. This myth prompts people to shout questions to a blind person with normal hearing.

As blind and visually impaired persons become more widely integrated into social, vocational, and education situations, myths may dissipate. Through personal experiences, society can discover that blind persons are not condemned or blessed as a group, but rather, are individual members of soci-

ety who happen to lack some degree of sight. (See

ATTITUDES, EMPLOYMENT.)

Carroll, Thomas J. Blindness, What It Is, What It Does, and How to Live With It. Boston: Little, Brown, 1961.

Goldberg, Maxwell H., and John R. Swinton. Blindness Research: The Expanding Frontiers. University Park: Pennsylvania State University Press, 1969.

Haskins, James. Who Are the Handicapped? New York: Doubleday, 1978.

Jernigan, Kenneth. Disability and Visibility: Uncle Tom, Blind Tom, and Tiny Tim. Baltimore: National Federation of the Blind, 1970.

Mitchell, Joyce Slayton. See Me More Clearly. New York: Harcourt, Brace, Jovanovich, 1980.

National Alliance for Eye and Vision Research (NAEVR) A nonprofit advocacy organization made up of a coalition of professional, consumer, and industry organizations involved in research in eye and vision disorders. The organization works to provide the best vision possible for all Americans through education, advocacy, and vision research. Its goals are supported by the National Institutes of Health, the National Eye Institute, and other federal research organizations.

NAEVR was founded in 1997 as an afÞliated organization of the ALLIANCE FOR EYE AND VISION RESEARCH. Its purpose is to carry out the advocacy activities of that coalition. It is particularly concerned about maintaining federal funding for the NATIONAL EYE INSTITUTE to allow the NEI to carry out its extensive research programs. NAEVR actively lobbies for NEI funding. It also is working to raise government awareness of the connections between tobacco use and eye disease, and the devastating effects of macular degeneration on many elderly people. NAEVR hopes to convince Congress of the need for intensive, focused research in these areas.

Contact:

National Alliance for Eye and Vision Research 426 C Street, NE

Washington, DC 20002 202-544-1880 (ph) 202-543-2565 (fax) www.eyeresearch.org

National Association for Parents of the Visually Impaired (NAPVI) An association that serves as a source of support, information, and service to families of the visually impaired. Founded in 1980, the association membership consists of parents and families of the visually impaired, agencies and

N

community groups, and individuals interested or affected by visual impairment.

The organization offers encouragement and emotional support to families and provides information to parents on care, treatment, education, and services available to visually impaired children. NAPVI communicates its expectations to service agencies at the local, state, and federal levels to obtain and ensure quality services to visually impaired and blind children.

NAPVI awards the annual Outstanding Contribution Award to a Professional Working in the Field of Blindness. It publishes a quarterly newsletter called Awareness that provides resource information for parents.

The organization disburses fact sheets, brochures, and a publications list and holds a biennial National Parent Conference.

Contact:

National Association for Parents of the Visually Impaired

P.O. Box 317 Watertown, MA 02471 800-562-6265 (ph) 617-972-7441 (fax) www.spedex.com/NAPVI

National Association for Visually Handicapped (NAVH) A nonproÞt, national voluntary health agency. It serves the partially sighted, those not completely blind but who lack adequate vision even with the best possible corrective lenses. Founded in 1954, the organization was formerly known as Aid to the Visually Handicapped or National Aid to the Visually Handicapped.

NAVH produces and distributes large-print books, texts and reading materials free on request

to partially sighted persons. It serves as a largeprint consultant to commercial publishers and maintains a free, large-print lending library.

The organization offers counseling and advice services to young adults, seniors, and families of the partially sighted. It cooperates with senior citizen centers, hospitals, and institutions and offers adult discussion groups and teenage cultural, social, and educational group activities.

NAVH maintains public and professional education programs addressing the needs of the partially sighted. It serves as a public clearinghouse on services for the partially sighted and disseminates information on available commercial aids. It cooperates with commercial manufacturers of aids in Þeld testing. It offers a large variety of visual aids for sale. Visual-aid counseling is offered to all clients who visit a facility.

Publications include In Focus, an annual childrenÕs newsletter, Update, a large-print, quarterly newsletter, Seeing Clearly, an annual newsletter for adults, the Program Report Annual Bulletin, the biennial Catalog of Large Type Publications, and pamphlets, brochures, and manuals. NAVH holds an annual convention in New York City.

Contact:

National Association for Visually Handicapped 22 W. 21st Street

New York, NY 10010 212-889-3141 (ph) 212-727-2931 (fax)

Or, contact the San Francisco site of NAVH at:

3201 Balboa Street

San Francisco, CA 94121 415-221-3201 (ph) 415-221-8754 (fax) www.navh.org

National Braille Association (NBA) The National Braille Association (NBA), founded in 1945, is an organization that produces and distributes braille, large print, and taped reading materials for the visually impaired. The NBA offers transcription workshops and collects and studies improvements to transcription techniques.

The membership numbers over 2,500 and includes volunteers and professionals who produce

the materials, blind and visually impaired people, teachers, librarians, educators, publishers, professional workers and volunteers for the blind, and parents of the blind or visually impaired.

The organization maintains request registries for those seeking texts in braille, large print, or on tape. The Reader-Transcriber Registry receives requests for nontextbook or nontechnical material transcription. The Braille Textbook Assignment Service accepts requests for college textbooks and other technical materials.

In 1963, the NBA established the Braille Book Bank (BBB) in Rochester, New York. The BBB is a nonproÞt organization maintained by volunteers and is partially underwritten by donations. The Braille Book Bank is a major source of textbooks and career materials in braille for visually impaired college students. It maintains over 1,800 titles in master copies for immediate thermoform duplication. Each year, more than 36,000 volumes of paper braille are added to the collection as books are transcribed by request. The Braille Book Bank offers three catalogs for ordering material under the titles The Textbook Catalog, The Music Catalog and The General Interest Catalog. The catalogs are free on request to the Braille Book Bank, 422 South Clinton Avenue, Rochester, New York 14620.

The NBA established the Þrst volunteer electronic library in the United States. Volunteers transcribe materials with computers. The finished transcriptions are sent on diskettes to the NBA Braille Book Bank for storage or reproduction onto embossed paper braille or as paperless cassette braille. The transcriptions are available by request to individuals, schools, agencies or businesses. Electronic methods reduce costs allow the NBA to provide materials in braille comparable to the print cost. The NBA publishes the journal Bulletin four times a year. It holds a biennial national conference.

Contact:

National Braille Association 3 Townline Circle Rochester, NY 14623 716-427-8260 716-427-0263 (fax) www.nationalbraille.org

National Eye Institute (NEI) The National Eye Institute (NEI) was established by Congress in 1968 as a part of the federal governmentÕs National Institutes of Health. Funded by Congressional appropriations, the NEI funds approximately 80 percent of all vision research supported by the federal government agencies and national private philanthropic organizations.

The goal of the NEI is to conduct and support research relating to ocular disease and disorder treatments and cures, training concerning blinding eye diseases and disorders, research and training in health concerns and requirements of the blind, and clinical sciences regarding the mechanisms of visual function and sight preservation.

The NEI funds grants for research concerning the prevention, diagnosis, and treatment of blinding and visually disabling disorders and diseases. All research is classiÞed under one of Þve major programs: retinal and choroidal diseases; corneal diseases; cataract, glaucoma, and strabismus; amblyopia; and visual processing. Special consideration is given to projects relating to visual impairment and the rehabilitation process that can be related to the major programs.

The NEI distributes its plan, which outlines the major needs and opportunities within the vision research Þeld, to members of the vision research community, scientists, government ofÞcials, and the public. It encourages coordination among private and governmental agencies that support vision research.

The NEI works with individual investigators to encourage submission of grant applications in targeted priority areas, presents plan recommendations to scientiÞc meetings, organizes workshops and symposia on plan-identiÞed topics, and establishes research resources, such as animal colonies.

In January 2001, Dr. Paul A. Sieving was named director of the NEI, replacing acting director Dr. Ruth L. Kirschstein. Sieving was with the Kellogg Eye Center of the University of Michigan before joining the NEI.

The NEI compiles and publishes research results in the National Advisory Eye Council Report, entitled Vision Research.

It also offers a variety of free brochures, posters, Spanish-language materials, and a school program

publication. These and other publications can be ordered on-line at www.nei.nih.gov/publications.

Contact:

National Eye Institute National Institute of Health 2020 Vision Place Bethesda, MD 20892 301-496-5248 www.nei.nih.gov

National Federation of the Blind (NFB) The National Federation of the Blind (NFB), founded in 1940, is the largest organization of the blind in the United States. Membership includes more than 10 percent of the nationÕs blind persons. The organization is dedicated to the complete, equal integration of blind persons into society.

The NFB serves as a public clearinghouse on information concerning blindness, directs and conducts research, produces and disseminates information to blind persons, and researches and monitors legislation concerning the blind.

It advises and refers blind individuals to services, provides assistance to blind persons with discrimination concerns, consults with congressional committees and state legislatures, serves as an advocate for the rights of blind individuals, and evaluates and promotes new technology. NFB offers over 26 scholarships to blind students and grants an award for the greatest contribution to welfare of the blind.

With the United States Department of Labor, NFB developed Job Opportunities for the Blind (JOB), a program that matches qualiÞed blind workers with employers. JOB directs seminars on career planning for unemployed blind people and educational seminars concerning blindness for employers.

In 1990, the NFB opened the International Braille and Technology Center at the National Center for the Blind in Baltimore, Maryland. The center is a comprehensive facility, offering training, evaluation, and demonstration of various technology.

Staff at the International Braille and Technology Center is available to answer any kind of question

about assistive technology for the blind. The center can be accessed through the NFBÕs phone number, which is listed below.

Publications include The Braille Monitor, a monthly journal, Future Reflections, a bimonthly magazine and numerous pamphlets, brochures and materials in print, braille, and on records and cassettes. NFB holds an annual conference.

Contact:

National Federation of the Blind 1800 Johnson Street

Baltimore, MD 21230 410-659-9314 (ph) 410-685-5653 (fax) www.nfb.org

National Industries for the Blind (NIB) A private, nonproÞt organization that develops industrial employment for blind and multihandicapped blind Americans. It includes 108 associated industries in 36 states, Puerto Rico and the District of Columbia.

NIB allocates federal government orders and offers grant programs, management training programs, technical expertise in new product and service development, industrial engineering, contract administration, purchasing, quality assurance, and production maintenance to its associated industries.

The organization was developed in 1938 following the passage of the Wagner-OÕDay Act, which mandated that federal agencies purchase products from workshops for the blind meeting speciÞc qualiÞcations. In 1971, the Wagner-OÕDay Act was renamed the Javits-Wagner-OÕDay Act and amended to include severely disabled workers and services as well as products. The products for sale to the federal government are approved by the Committee for Purchase from the Blind and other Severely Handicapped, a presidentially appointed committee.

The Þrst products included mops and brooms but have since expanded to include 1,300 quality blind-made products such as components for the ArmyÕs Kevlar helmet, tracheotomy kits, and various kitchen gadgets stocked in commissaries for sale to military families worldwide.

Contact:

National Industries for the Blind 1901 N. Beauregard Street, Suite 200 Alexandria, VA 22311

703-998-0770 (ph)

703-998-8268 (fax) www.nib.org

National Keratoconus Foundation (NKCF) A nonproÞt agency founded in 1986 to increase awareness and understanding about KERATOCONUS and support research concerning the disorder. The organization began with a grant from Jane Neely and her husband, Norman, who had keratoconus and was frustrated by how little information was available.

The mission of NKCF is to provide information and support about the condition to patients, their families, and eye care professionals, and to encourage research and new technology for treatment of the disorder.

NKFC provides educational materials, support groups and programs, a newsletter, links to other keratoconus-related sites, a patient registry, an outreach program, a referral service, and patient education seminars. It also oversees a research program and a corneal tissue collection program.

Contact:

National Keratoconus Foundation 8733 Beverly Boulevard, Suite 201 Los Angeles, CA 90048 800-521-2524

www.nkcf.org

National Library Service for the Blind and Physically Handicapped This act was originally legislated in 1904 by Congress to permit free braille books to be mailed to blind adults. The Pratt-Smoot Act of 1931, and further amendments in 1934, authorized the Library of Congress to establish a national library service that provided free braille and talking books to blind adults.

In 1952, an amendment to the act deleted the word Òadult,Ó thus allowing the service to expand and include visually impaired children. Further amendments in 1962 extended the program to include braille musical scores, textbooks, and

related music instructional information. In 1966, the act was amended to include other physically limited people among those who qualify for the service. These may include people with paralysis, missing limbs, chronic weakness, or muscle-coordi- nation problems.

Currently, the Library of Congress offers free braille and recorded matter under the Books for the Blind and Physically Impaired Program. Full-length braille books and magazines and cassettes, records, or discs (talking books) are distributed through a nationwide cooperative library system. Books, materials, and play-back machines are sent and returned through the mail, postage-free.

The network began serving 19 libraries. In 2000 it has expanded to 56 regional and 81 subregional libraries throughout the United States. In 1999 more than 22 million recorded and braille books and magazines were circulated to more than 764,000 readers. The program is funded by Congress. In the 2000 Þscal year it received $47,984,000.

The service is available at no cost to patrons who cannot read or use conventional print materials due to permanent or temporary physical or visual impairments.

Contact:

National Library Service for the Blind and Physically Handicapped

The Library of Congress

1291 Taylor Street NW

Washington, DC 20542 202-707-5100 (ph) 202-707-0712 (fax) 202-707-0744 (TDD) nls@loc.gov (e-mail) www.loc.gov/nls

National School Lunch Act As amended, the National School Lunch Act of 1946 offers assistance to public and private institutions, schools, camps, and day-care centers, including those that serve handicapped or mentally retarded students, to provide meals to eligible children. The assistance outlined in the act includes grants, reimbursements, and commodity donations.

The School Lunch Program, as authorized under Section 4 of the act, provides institutions with the

funding and food donations necessary to serve free or reduced fee lunches to eligible children. Children qualify according to their family income and the number of children participating in the program.

The participating schools, child-care centers, and residential-care centers are reimbursed for the lunches that must meet nutritional guidelines determined by the Department of Agriculture. The rate of reimbursement is set by the states according to Þgures in the Consumer Price Index.

The Commodity Distribution Program, as outlined in Section 6 of the act, allows donations of food bought by the federal government under price-support or surplus-removal programs. Formula grants to state agencies are used to distribute the food to eligible schools, institutions, child and elderly nutrition programs, nonprofit summer camps, families, and individuals.

Section 13 of the act provides for the Summer Food Service Program, a nonproÞt summer meal program for children in summer camps or institutions, including those that serve the disabled. The program awards formula grants to states that introduce, support, or extend the program and pay according to the number of meals served. The meals must meet nutritional criteria set by the Department of Agriculture.

The Child-Care Food Program, Section 17 of the Act, provides grants-in-aid to states maintaining nonproÞt meal programs for children in nonresidential day care. The programs serve meals, including breakfast, lunch, snack, and dinner, to eligible children. QualiÞed nondisabled children under 12 years of age or disabled children of any age are entitled to two meals and one snack per day under the program. The meals must meet the Department of AgricultureÕs nutritional requirements.

The states distribute the funds to facilities such as public or private nonproÞt institutions or organizations, day-care and recreation centers, and other day-care services. Grants are awarded according to how many meals are served based on reimbursement rates set by the federal government.

U.S. Department of Education. Summary of Existing Legislation Affecting Persons with Disabilities. Washington, D.C.: USDE, 1988.