Traumatic Brain Injury: A NARIC Resource Guide for People with TBI and their Families. From the National Rehabilitation Information Center. Introduction to TBI Resources This guide contains information that traumatic brain injury (TBI) survivors, their families, and friends can use to adjust to life after TBI. It includes resources to enhance your knowledge of TBI, your coping and caregiving skills, and the general quality of life for the person with TBI. The resources listed are in a variety of forms, including telephone hotlines, magazines, newsletters, pamphlets, booklets, and books. Resources were selected based on their usefulness to people without medical backgrounds, and their availability through clearinghouses, libraries, or publishers. For your convenience, most of the listings include a phone number. In some cases you will be routed when you call; you may be put on hold, and you may have to explain what you want more than once. Please be patient and persistent. Some of the organizations have answering machines that will record messages when staff members are not available. National Resources The organizations listed below provide resources in one or more of the following ways: they answer requests for information over the phone; they direct TBI survivors and their families to services and support groups; or they distribute printed publications such as brochures, booklets, or books. Some are membership organizations, some are not. All hours listed are for Monday to Friday. National Head Injury Foundation. 1140 Connecticut Avenue NW, Suite 812, Washington, DC 20036. 800/444-6443 (hotline). Hours: 8 A.M. to 4 P.M. eastern time. Also: 202/296-6443 (office). Hours: 9 A.M. to 5 P.M. eastern time. NHIF is an organization that provides information on medical and legal aspects of TBI; provides referrals from The National Directory of Head Injury Rehabilitation Services, a listing of acute, intermediate, and long-term care facilities; and provides contact information for state Head Injury Foundation chapters. A free catalog is available that describes the many publications NHIF produces or distributes. Among the listings are About Head Injury (15 pages, CEM 87-019, $1.35 plus shipping and handling), Comprehensive Rehabilitation of the Head-Injured Person: A Family Education Manual (75 pages, CEM 86-008, $3 plus S&H), and What to Look for When Selecting a Rehabilitation Facility: A Working Guide (9 pages, CEM 85-011, $2 plus S&H). NHIF also publishes a quarterly newsletter, and compiles TBI statistics. (NHIF plans to relocate in July 1992, to 1776 Massachusetts Avenue NW, Suite 100, Washington, DC 20036. Phone numbers will remain the same.) Family Survival Project. 425 Bush Street, Suite 500, San Francisco, CA 94108. 415/434-3388. Hours: 9 A.M. to 5 P.M. pacific time. This organization provides direct services (including legal and financial consulting) to families in California, and distributes information nationally about how people can care for family members with neurological disabilities. Publications include their newsletter, Family Survival Project Update, workshop materials, fact sheets, research reports, directories, and training manuals. A publications list is available upon request. Other services include a speakers bureau and technical assistance in establishing support groups. Phoenix Project. Box 8451, Seattle, WA 98124. 206/329-1371; 206/621-8558. Hours: vary. Provides information and referral services and publishes From the Ashes, a book on TBI (see publication listings below for more information). This organization is not affiliated with the Phoenix Society for burn survivors. Coma Recovery Association. 377 Jerusalem Avenue, Hempstead, NY 11550. 516/486-2847. Hours: 10 A.M. to 3 P.M. eastern time. Provides information relating to coma, including information on treatment techniques. Offers legal consulting services. A Chance to Grow. 3700 Bryant Avenue North, Minneapolis, MN 55412. 612/521-2266. Legal information hotline: 612/339-1290. Hours: 8 A.M. to 5:30 P.M. central time. A self-help group for parents of people with brain injury. Maintains a library on TBI, which includes legal information. Operates the Sandler rehabilitation program, which uses physical movement, an exercise regimen, spinal fluid regulation, and proper nutrition to improve the physical and cognitive skills of TBI survivors. Publishes a newsletter called Growing Times (quarterly). National Aphasia Association. P.O. Box 1887, Murray Hill Station, New York, NY 10156-0611. At this time requests by mail are preferred to phone calls. NAA provides information on aphasia through a newsletter, fact sheets, and bibliographies. The newsletter lists names and addresses of NAA regional representatives, who can provide information about local aphasia support groups. The National Institute of Neurological Disorders and Stroke. Office of Information and Scientific Health Reports, Building 31, Room 8A-16, Bethesda, MD 20892. 800/352-9424; 301/496-5751. Contact Person: Norman Oliver, Information Specialist. Hours: 9 A.M. to 4:30 P.M. eastern time. This office, part of the National Institutes of Health, provides pamphlets written for nonprofessionals about various neurological disorders, including brain injury. One such publication is Head Injury: Hope Through Research (37 pages, free). They also publish fact sheets, special reports, and other documents. A list of free publications is available. The Well Spouse Foundation. P.O. Box 28876, San Diego, CA 92198-0876. 619/673-9043. Hours: 10 A.M. to 5 P.M. pacific time. Also: 914/357-8513, 10 A.M. to 5 P.M. eastern time. An organization that provides support for the husbands and wives of people who are chronically ill. They provide advocacy and publish the WSF Newsletter (quarterly), as well as the WSF Bulletin. There are around 50 Well Spouse regional support groups nationwide, and a pen pal system for people geographically distant from other members. Independent Living Centers. Independent living centers are local organizations administered and staffed by people with disabilities. They provide peer counseling, advocacy, and information about local services. Contact NARIC (800/346-2742 or 301/588-9284) for the name of the independent living center nearest you. NIDRR-Funded Projects The National Institute on Disability and Rehabilitation Research (NIDRR) funds projects called "model systems of care" and "research and training centers (RTCs)," which conduct research to improve the care of TBI survivors. While many projects focus on the training of professionals and the management of TBI care, some also provide direct services and information and referral for people with TBI and their families. This is particularly true when the project is located near where you live. As a repository for their newsletters, research results, and final reports, NARIC can provide more information about projects; for example, more information about model systems is available in "The Evolution of Model Systems of Care in Traumatic Brain Injury," by J. Paul Thomas. Journal of Head Trauma Rehabilitation, Vol. 3, No. 4, 1988, pp. 1-5. NARIC Accession Number: J10025. Model Systems of Care NIDRR currently funds five regional model TBI systems of care, located in New York City, Detroit, Houston, San Jose, CA, and Richmond, VA. The purpose of these facilities is to improve the treatment options for TBI. The objectives of the model systems include the following: -- To study the entire rehabilitation process, from admittance to the hospital onward, and determine what would make the process work better. -- To test and evaluate new ways of caring for TBI survivors, and put to use the ones that are effective. -- To establish a research program to develop a new database and conduct innovative analyses of TBI research data. -- To participate in national studies of the brain injury model system concept by contributing to a national TBI database as prescribed by the Secretary of Education. Model Project for Comprehensive Rehabilitation Services to Individuals with Traumatic Brain Injury. Mt. Sinai Medical Center, School of Medicine, One Gustave L. Levy Place, New York, NY 10029. 212/241-7917. Hours: 8 A.M. to 5 P.M. eastern time. Provides services for the New York metropolitan area, including information and referral. Traumatic Brain Injury Model System of Care. 2260 Clove Drive, San Jose, CA 95128. 408/295-9896. Hours: 8 A.M. to 5 P.M. pacific time. Provides services for the Bay area, including a once-weekly clinic and a monthly support group meeting on mild TBI. Conducts alcohol and drug education classes, and information and referral to the Bay area. Publishes the newsletter INTERACT (quarterly). A Model System for Minimizing Disability After Head Injury. The Institute for Rehabilitation and Research, 1333 Moursund Avenue, Houston, TX 77030. 713/666-7323. Hours: 8:30 A.M. to 5 P.M. central time. Provides services for the Houston area, including information and referral. Sponsors weekly support group meetings for TBI survivors and their families. Publications this project has helped to produce are Comprehensive Rehabilitation of the Head-Injured Person: A Family Education Manual (see the NHIF listing under "National Resources," above) and the Brain Injury Glossary (see the documents section below). The NHIF is the distribution point for these publications. A Comprehensive Model of Research and Rehabilitation for the Traumatically Brain Injured. Virginia Commonwealth University, Medical College of Virginia, Box 568, MCV Station, Richmond, VA 23298. 804/786-0200. Hours: 8:30 A.M. to 5 P.M. eastern time. Provides services for the Richmond area, including a support group for people with TBI through the University's RRTC on Supported Employment (804/367-1851). South Eastern Michigan Traumatic Brain Injury System. Wayne State University Medical Center, Rehabilitation Institute of Michigan, 261 Mack Boulevard, Detroit, MI 48201. 313/745-9769. Hours: 9 A.M. to 4:30 P.M. central time. Provides services for the Detroit area, including information and referral. Research and Training Centers Research and Training Centers (RTCs) conduct research, offer training to professionals, and deliver services in various fields, including traumatic brain injury. Some provide direct services or information and referral for people with TBI and their families. They also publish newsletters, research results, and final reports, many of which are available from NARIC. RTC for Community Integration of Persons with Traumatic Brain Injury. State University of New York at Buffalo, 194 Farber Hall, 3435 Main Street, Buffalo, NY 14214. 716/831-2300. Hours: 8:30 A.M. to 5 P.M. eastern time. Disseminates information on TBI, searches the center's bibliographic database for specific topics, and provides document delivery. RTC on Head Trauma and Stroke. New York University Medical Center, Department of Physical Medicine, 400 East 34th Street, New York, NY 10016. 212/263-6161; 212/263-6185. Hours: 9 A.M. to 5 P.M. eastern time. Provides outpatient cognitive remediation and vocational services, consultants for family support groups, and information and referral services. RTC in Traumatic Brain Injury and Stroke. University of Washington, Department of Rehabilitation Medicine, BB-919 Health Sciences Building, Seattle, WA 98195. 206/685-3999 to reach an information specialist; 206/543-6766 for Dr. Lehmann, project director. Hours: 8 A.M. to 5 P.M. pacific time. Conducts clinical research and organizes support groups. RTC on Severe Traumatic Brain Injury. Virginia Commonwealth University, Medical College of Virginia, Box 434, Richmond, VA 23298-0434. 804/786-7290; 804/786-0956. Hours: 8:30 A.M. to 5 P.M. eastern time. Provides information and training on traumatic brain injury through workshops, conferences and training programs and through the RTC's National Information Clearinghouse, which disseminates RTC publications, audiovisual products, and evaluation/assessment tools, as well as the results of research projects ranging from coma to employment. Information and referral related to services is also provided. RTC in Rehabilitation and Childhood Trauma. Tufts-New England Medical Center, Department of Rehabilitation Medicine, 750 Washington Street, #387, Boston, MA 02111. 617/956-5036. Hours: 8:30 A.M. to 5 P.M. eastern time. This RTC produces materials such as the booklet When Your Child is Seriously Injured in an Accident (see the documents section, below), which offers support and assistance for families of injured children. Also publishes a free newsletter, Rehab Update, twice yearly, and provides information and referral. Other government-funded TBI projects The Rehabilitation Services Administration (RSA) has four regional projects that may be of interest to TBI survivors and their families. More information about the services of these projects can be obtained from NARIC. Periodicals The following publications may be of interest to TBI survivors and their families. All prices listed are for individuals living in the United States. This Brain Has a Mouth. This Brain Has a Mouth, Inc., 61 Brighton Street, Rochester, NY 14607. Fax: 716/442-2916. At this time requests by mail or fax are preferred to phone calls. A magazine by and for head-injury survivors. Examines the process of recovering from a head injury from the survivors' perspectives. Six issues per year. Cost: $12 per year and up. Cognitive Rehabilitation. NeuroScience Publishers, 6555 Carrollton Avenue, Indianapolis, IN 46220. 317/257-9672. A publication for therapists, families, and patients, designed to provide information relevant to the rehabilitation of impairment resulting from brain injury; includes techniques, programs, and new methods. Published six times per year. Cost: $35 per year. Exceptional Parent. Psych-Ed Corporation, 1170 Commonwealth Avenue, Boston, MA, 02134-4646. 617/730-5800. Publication for parents of children with disabilities. Articles provide ideas, guidance, personal experiences, and practical information. Published eight times a year. Cost: $18 per year. Journal of Head Injury. National Brain Injury Research Foundation, 1730 M Street NW, Suite 903, Washington, DC 20036. 800/447-8445. 202/331-8445. Subtitled "A Search for Understanding," this journal presents commentary and perspectives on head injury, often from the perspective of people with head injury. Quarterly. Cost: $20 per year (membership). NHIF Newsletter. National Head Injury Foundation, 1140 Connecticut Avenue NW, Suite 812, Washington, DC 20036. 202/296-6443. Contains news and articles for families and professionals concerned with head injury. Information on NHIF activities included. Quarterly. Cost: $35 per year (membership). Documents The NARIC library currently contains over 1100 documents pertaining to brain injuries. The following books and journal articles have been singled out as being useful for TBI survivors and their families. Copyright law prevents us from photocopying some documents; you may be able to find them in a local library, or the local library may be able to get them through the inter-library loan program. Purchasing information has been provided as well; many of the books are available by special order from book stores--others are available only from the publisher. From the Ashes: A Head Injury Self-Advocacy Guide. Miller, C., and Campbell, K. Seattle, WA: Phoenix Project, 1987. 102 p. Available from the Phoenix Foundation, P.O. Box 84151, Seattle, WA 98124. 206/329-1371; 206/621-8558. Cost: $20, plus $3 S&H. A handbook written by two women with brain injuries for fellow survivors. It addresses what happens functionally and psychologically when the brain is injured, recognizing the changes in behavior caused by head injury, ways to recognize what triggers reactions like a sense of separateness, irritability, headache, disorientation, and disinhibition, and self-management principles to help detect, analyze, correct, and adjust responses to the on-going problems people with TBI experience. Also discussed is finding the right doctor, medical tests, psychic losses, psychic pain, and life changes. Includes a glossary and bibliography. Helping Head Injury and Stroke Patients at Home: A Handbook for Families. Pi Lamba Theta National Honor and Professional Association in Education, San Jose Area Chapter. 1983. Available from Mary Ellen Dierks, 5266 Cribari Heights, San Jose, CA 95135. Cost: $20, CA residents add $1.65 sales tax. This self-help handbook gives specific examples of cognitive skills which injury may have impaired, and describes retraining techniques for cognitive skill improvement. Topics discussed include: memory, visual-spatial relationships, language-communication, slow responses, judgment-reasoning, planning-follow-through, rights, and do's and don'ts. Includes bibliography, glossary, suggested progress chart, and two resource sections. Educating Families of the Head Injured: A Guide to Medical, Cognitive, and Social Issues. DeBoskey, D. S., Hecht, J. S., and Calub, C. J. Gaithersburg, MD: Aspen Publishers, Inc. Available from Aspen Publishers, Inc., 7201 McKinney Circle, Fredrick, MD 21701. Cost: $70, plus postage. While the cost of this document may be prohibitive for individuals, its comprehensive scope may make it a useful reference tool for support groups and patient libraries. The topics covered include the medical issues in TBI, inpatient rehabilitation, preparing for home, outpatient options, mild-to-moderate head trauma, funding sources, how to choose an appropriate treatment facility, long-term placement considerations, cognitive and behavioral problems and how to manage them, emotional problems experienced by families, long-term medical and psychological problems, substance use/abuse and the TBI survivor, medications and side-effects, the family as educator, special considerations for children and the elderly, and community reintegration. Includes glossary, bibliography, and index. Brain Injury Glossary. Lehmkuhl, L. D., ed. Houston, TX: The Institute for Rehabilitation and Research (TIRR), 1991. 41 p. Available from the NHIF, 1140 Connecticut Avenue NW, Suite 812, Washington, DC 20036. 800/444-6443; 202/296-6443. Cost: $7.50. Ask for CEM Number 89-030. Subtitled "A Glossary of Terms and Definitions of Interest to Family Members and Survivors of Head Injury, Case Managers, Insurance Representatives, Staffs of Health Care Facilities, Staffs of Governmental Agencies, Local, State, Regional, and National Head Injury Associations." Compiled by the manager of the Head Injury Rehabilitation Research Project at TIRR, this glossary briefly defines approximately 400 terms. It was originally compiled to improve communication between researchers from the five model TBI systems of care mentioned above, but is accessible to readers without medical backgrounds. The Silent Epidemic: Rehabilitation of People with Traumatic Brain Injury. Rehab Brief, Vol. 9, No. 4, 1986. Washington, DC: National Institute on Disability and Rehabilitation Research. Prepared by PSI International, Arlington, VA. Available from NARIC at 800/346-2742. Single copies are free. Defines traumatic brain injury and describes the patterns of damage caused by closed head injury, specific brain functions that can be affected, residual deficits, myths of recovery versus factors in improvement, vocational rehabilitation intervention, and the role of head injury rehabilitation professionals. While this document provides good introductory information about TBI, a few of the listings in the resource section are no longer current. Aphasia. Rehab Brief, Vol 13, No. 5, 1991. Washington, DC: National Institute on Disability and Rehabilitation Research. Prepared by PSI International, Arlington, VA. Available from NARIC at 800/346-2742. Single copies are free. Contains a review of the clinical perspectives on aphasia and areas of concern in the delivery of services to people with aphasia. The first section examines changing views of the nature of aphasia and the implications for clinical practice. The second section explores issues of concern in service delivery, including support for aphasic people and their families, specialized personnel trained to meet the needs of aphasic people, service delivery in rural areas, cultural and linguistic diversity, and responses to needs in service delivery. Family Guide to Evaluating Transitional Living Programs For Head-Injured Adults. Sachs, P. R. Cognitive Rehabilitation, Vol. 4, No. 6, November- December 1986. Indianapolis, IN: NeuroScience Publishers. pp. 6-9. NARIC Accession Number: XJ7246. Tells how family members can evaluate transitional living programs. These programs generally include speech, cognitive memory, and behavioral therapies for people with TBI and are often an essential step between inpatient treatment for the injury and living independently after the medical problems have diminished. Differentiates transitional living from other types of head injury treatment. Getting Our Heads Together: A Helpful Handbook for Families of Head Injury Patients. Mebane, W. M., Jr., ed. Asheville, NC: Thoms Rehabilitation Hospital, 1991 (revised). 52 p. Available from Thoms Rehabilitation Hospital, Inc. of WNC, One Rotary Drive, Asheville, NC 28803. 800/522-4083; 704/274-2400. Cost: $4. This booklet was originally designed for the families of patients in Thoms Rehabilitation Hospital. It briefly covers 11 topics, including information about how a hospital's head injury unit functions, 15 professionals that may constitute the rehab team (for example, the physiatrist, primary nurse, social worker, cognitive retrainer, etc.), team meetings, the hospital, eight levels of recovery, and 31 things to remember when working with a person with a brain injury. Also discusses the impact of the injury on the family, planning and preparing for discharge from the hospital, sources of financial help, and legal concerns. Includes glossary. This booklet is also available in Spanish. Traumatic Brain Injury: Discharge and Beyond: The Discharge and Recovery Process. Aronow, H. U., Desimone, B. S., and Wood, R. L. Continuing Care, Vol. 6, No. 3, March 1987. North Hollywood, CA: Coordinator Publications. pp. 26-29. NARIC Accession Number: XJ7526. Discusses factors involved in rehabilitation of TBI survivors, focusing on the person's reactions following discharge, early emotional and behavioral obstacles, issues surrounding early discharge to the community versus transitional programs, factors that influence the speed of recovery, and effects of rehabilitation. Describes the benefits of early rehabilitation. Training Family Members to Work with the Head Injured Patient. Anderson, J., and Parente, F. Cognitive Rehabilitation, Vol. 3, No. 4. Indianapolis, IN: B & B Publishing. pp. 12-15. NARIC Accession Number: XJ4632. Describes exercises that families of people with brain injuries can use to assist in the person's cognitive rehabilitation. The exercises included are designed to increase the person's attention span, and to help the person remember information by organizing it for better retention. Topics discussed include verbal mediation, mnemonics, and imagery. Discusses the relationship between memory and attention, types of organizational strategies, methods to remember disassociated information using mnemonics, and teaching the concept of mental imagery as a precursor to memory training. Includes references. Problems and Coping Strategies of Individuals with Traumatic Brain Injury and Their Spouses. Willer, B. S., Allen, K. M., Liss, M., and Zicht, M. S. Archives of Physical Medicine and Rehabilitation, Vol. 72, No. 7, June 1991. Chicago: American Congress of Rehabilitation Medicine and American Academy of Physical Medicine and Rehabilitation. pp. 460-464. NARIC Accession Number: XJ20398. This document examines the problems and coping strategies of people with TBI and their uninjured spouses. Researchers gathered information from 20 men and 11 women, at least one and a half years after the injury. The report discusses the resulting list of the top five or six problems and coping strategies of wives with TBI, wives whose husbands have TBI, husbands with TBI, and husbands whose wives have TBI. The Head Injury Survivor on Campus: Issues and Resources. Author/publisher: HEATH Resource Center, A Program of the American Council on Education, Washington, DC, 1988. 11 p. Available from Heath Resource Center, One Dupont Circle NW, Washington, DC 20036-1193. 800/544-3284; 202/939-9320. Free. Many brain injuries occur in people who are college-age; also, TBI survivors sometimes need retraining or remedial job training. This publication offers encouragement and information resources to college students with head injuries, their families, school administrators, and faculty members. Included is information about the types of programs that are available, tips for setting up a program, and questions that should guide program planning (for students, family members, and professionals). Includes descriptions of successful programs, including addresses and phone numbers of people to contact for more information. School Reentry Following Head Injury: Managing the Transition from Hospital to School. Ylvisaker, M., Hartwick, P., and Stevens, M. Journal of Head Trauma Rehabilitation, Vol. 6, No. 1, March 1991. Gaithersburg, MD: Aspen Publishers. pp. 10-22. NARIC Accession Number: XJ19408. This journal article examines elements involved in the successful return to school for children and youth following TBI. Topics discussed include goals of school reentry programming, the initial steps in reentry planning, activities during rehabilitation admission that are directed toward reentry into the school system, reentry activities undertaken shortly before discharge from rehabilitation, transitional classrooms, TBI consultants, and special school reentry problems such as summer discharge, children unable to attend school, mild injuries with good recovery, preschoolers, transportation, and funding. Sisters and Brothers, Brothers and Sisters in the Family Affected by Traumatic Brain Injury. Pieper, B. Albany, NY: New York State Head Injury Association, under a grant from NIDRR, 1991. 14 p. Available from: New York State Head Injury Association, 855 Central Avenue, Albany, NY 12206. 518/459-7911. Cost: shipping and handling charge. This paper discusses the family stress that often accompanies TBI, how parents can identify the unspoken concerns of uninjured brothers and sisters, and methods parents have used to reduce the concerns. The methods included are strengthening communications, finding people who can provide emotional support, and arranging sibling support group meetings guided by a professional. Includes resource listing. Meeting the Challenge of Disability or Chronic Illness: A Family Guide. Goldfarb, L. A., Brotherson, J. M., Summers, J. A., and Turnbull, A. P. Baltimore, MD: Paul H. Brookes, 1986. 225 p. Available by request from bookstores, or directly from Brookes Publishing, 800/638-3775 (orders only). Cost: $21. Discusses how families can collect and focus their strengths to meet needs and solve problems that sometimes arise with the onset of disability or illness. Part one helps the reader take stock of resources, such as social support and professional support, and family values. Part two presents a step- by-step problem-solving process that includes opening communication, defining the problems, brainstorming for solutions, evaluating and choosing alternatives, and taking action. Includes work sheets and exercises for a step-by-step approach to problem resolution. Also includes resources, references, and exercises. When Your Child is Seriously Injured in an Accident. Boston: Tufts University/New England Medical School, RTC in Rehabilitation and Childhood Trauma, in collaboration with the Kiwanis Pediatric Trauma Institute. 1990. 40 p. Available from the RTC in Rehabilitation and Childhood Trauma, Department of Rehabilitation Medicine, Tufts-New England Medical Center, 750 Washington Street, #75K-R, Boston, MA 02111. 617/956-5036. (Ask for B. Saunders in the publications department.) Free. This booklet offers support and assistance for families of injured children, including information about the hospital stay, loss and what it means for you and your child, helping brothers and sisters, getting help and coping, and planning for discharge from the hospital. Also included is a Parents' Bill of Rights, samples of a family log or notebook, resources, and suggested reading. ABOUT THIS DOCUMENT This document is available in several forms: as a text file (this document), on disk, on cassette, in braille, and in printed form (formatted with a desktop publishing program). This guide is part of a series of resource guides produced by NARIC. Those interested in distributing the *Guide* in printed form are encouraged to contact NARIC at the above address, and we will arrange to send you a limited number of copies of the document free of charge. This document is in the public domain. You are free to upload it to appropriate online services, so that it reaches as many people as possible, provided that you leave the information unaltered. If you use this information in new publications, please verify prices and document availability. NARIC guides are updated occasionally, so you may wish to contact NARIC to receive the latest copy (check date of release, below). The National Rehabilitation Information Center invites your comments and recommendations on this resource guide; corrections, information about publications and resource information that is not included here, and other suggestions are welcome. Please address your remarks to NARIC, 8455 Colesville Road, Suite 935, Silver Spring, MD 20910-3319. NARIC's phone numbers: 800/34-NARIC (800/346-2742), or in Maryland, 301/588-9284 (both are voice/TDD); Our fax number is 301/587-1967. Date of print document release (revised edition): April 1992 Date of electronic document release (revised edition): May 1992 Released by: Daniel L. Wendling, NARIC Media Specialist: Internet: danlw@well.sf.ca.us