Fredric K. Schroeder
This issue of American Rehabilitation concludes a three-part series on the subject of spinal cord injury, with the following topics covered: "Rural Healthcare Initiatives," "Independent Living," "Community Integration," "Prevention of Spinal Cord Injury," "Aging with SCI," and "Sexuality."
Today the state-federal vocational rehabilitation program provides services to many individuals with spinal cord injuries. As an example, in 1994 (1995 data are similar), approximately 13,000 individuals with spinal cord injury were served by the vocational rehabilitation system. Of these, over 5,500 were successfully rehabilitated. When entering vocational rehabilitation, 695 were competitively employed, 10 were in sheltered employment, 59 were self-employed, 72 were homemakers, 10 were unpaid family workers, and 4,337 were not working. Whereas, at closure from the VR system 4,808 of these same individuals were competitively employed, 39 were in sheltered employment, 333 were self-employed, 312 were homemakers, and 25 were unpaid family workers (there are data missing for 1 individual). During the rehabilitation process, 1,549 received college training, 1,538 received business training, 333 received on-the-job training, 2,048 received placement, and 2,293 received other services. People with spinal cord injury, when compared to all other individuals who are considered rehabilitated tend to be older at application (35.7 years of age vs. 34.4 years of age) and closure (38.1 years of age vs. 36.3 years of age), longer in service (29.2 months vs. 23.4 months), more costly to rehabilitate ($5,162 vs. $3,111) and more educated (11.74 years vs. 11.46 years).
Individuals with spinal cord injuries have dramatically benefitted from the rapid advances in computer related and other technologies. Electrically powered wheelchairs and devices permitting control of electronic devices at home are commonplace. Manual wheel-chairs have advanced from heavy clumsy devices to racing vehicles. Other advances have been made in pain management, biofeedback, and functional electronic stimulation.
Recently, modern medicine has begun exploring the possibility of finding a cure for spinal cord injury. This early research offers the prospect of looking beyond prevention to the possibility of reversing the consequences of spinal cord injury.
One of the most pressing issues for individuals with spinal cord injuries is a national comprehensive approach to the provision of personal assistance services. When such services become as commonplace as ramps and electric wheelchairs, individuals with spinal cord injuries will truly have full access to all the benefits that this great country offers its citizens.
The combination of community supports, increased availability of technology, civil rights, and access to education and employment provides a rich pallet for rehabilitation counselors to assist individuals with spinal cord injuries in obtaining the necessary skills, training, and encouragement to obtain employment.
I am hopeful that this series on spinal cord injury will serve as an important resource on the subject of spinal cord injury for many years to come. 
=> Rural Healthcare Initiatives in Spinal Cord Injury
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