HB II DB (1). Week 6

People with Disabilities and Social Work: Historical and Contemporary Issues

Romel W. Mackelprang and Richard O. Salsgiver

From the earliest recorded history, people with disabilities have been ostracized, rejected, and discriminated against in society. Although social work has a history rich in advocacy for oppressed people, the

profession has been hesitant to become involved with people with disabilities. This article addresses historical and contemporary issues

concerning disability. Recent developments in the disability movement, including independent living, are discussed and compared to social work's approaches to disability. Finally, a plea is made to the

social work profession and the disability movement to combine efforts to enhance the lives of people with disabilities.

Key words: disability; disability movement; independent living; minority model; strengths perspective

T he Americans with Disabilities Act (ADA) of 1990 (P.L. 101-336) was a civil rights land- mark for people with disabilities. With the

passage of the ADA, Congress acknowledged that the 43,000,000 Americans with disabilities have been subjected to serious and pervasive discrimi- nation. Congress also acknowledged that unlike other populations who have experienced discrimi- nation, people with disabilities have had "no legal recourse to redress such discrimination." From the beginning, social work has viewed itself as the profession with primar)' responsibility toward people who are subjected to discrimination and oppression. However, the profession has not em- braced the causes of people with disabilities as it has other oppressed groups. Consequently, rela- tively few social workers work with people with disabilities, few people with disabilities enter the profession, and the profession has done little to promote disability rights (Mackelprang, 1993; Mackelprang & Santos, 1992).

This article examines the history of societal values and attitudes about people with disabilities

and the rise of the disability' movement. Social work and independent living approaches to work- ing with people with disabilities are compared and contrasted, and suggestions for integrating both approaches are provided. Finally, a plea is made for social work to re-evaluate its commitment to people with disabilities.

History of Treatment of People with Disabilities

Throughout the history of humankind people with disabilities have been a part of society; ar- chaeologists have repeatedly uncovered evidence of people with disabilities dating as far back as the Neanderthal Period. Societies treated and re- sponded to people with disabilities based on their cultural belief systems.

Ancient Beliefs

Neolithic tribes perceived people with disabilities as possessed by spirits. When the spirits were per- ceived as evil, escape routes were fashioned by drilling holes in the skulls of people who were

CCX CIKJC: 0037-8046/96 S.1.00 O 19S6 ional AssiKialion orS<Kial Workers. Inc.

thought to be possessed (Albrecht, 1992). The Spartans, with their rugged individualism, aban- doned young and old people with disabilities in the countryside to die. Plato (1991), to whom Western culture owes much of its ethical frame- work, viewed people with disabilities as standing in the way of a perfect world: "the offspring ofthe inferior, or ofthe better when they chance to be deformed, will be put away in some mysterious, unknown place, as they should be" (p. 183). The Romans, who borrowed the concept of reciprocity from the Greeks, gave assistance to adult people with disabilities with the expectation that they would demonstrate thanks by not rioting. How- ever, like the Greeks the Romans also abandoned disabled or deformed children to die (Morris, 1986).

Judeo-Christian Beliefs

Judeo-Ghristian tradition, prevalent among Euro- peans during and after the Middle Ages, taught that people with disabilities were expressions of God's displeasure (Livneh, 1982). Although Judeo-Ghristian philosophy did not advocate kill- ing, people with disabilities were ostracized and stereotyped. Disability signified "sinner" to the ancient Hebrews, and people with disabilities were thought to be possessed by evil demons. People who were deformed, "crippled," or of short stat- ure were forbidden to become priests. The Old Testament forbade people who were blind or lame from entering the houses of believers (Wright, 1960). In the New Testament, people with mental disorders were believed to be possessed. It was thought that people with disabilities had them because of their own or their parents' sins. Treat- ment centered on spiritual redemption (Albrecht, 1992),

Judeo-Ghristian thought, on which much of Western culture is based, has also taught that hu- mans are made in God's image and are different from and superior to the rest ofthe animal king- dom. Livneh (1980) contended that people with disabilities remind those without disabilities of humankind's link with the rest ofthe animal king- dom and of their own fallibility.

Similarly, Western culture has engaged in a collective denial of aging and death. People with serious or terminal illnesses challenge that denial and thus tend to be avoided (Becker, 1966), a de- nial that generalizes to those with disabilities. Livneh (1982) believed that the segregation of

people with disabilities decreases the chances of association, allowing people to deny the eventual loss of physical integrity and ultimately death. Livneh also contended that people with disabili- ties threaten those without disabilities with the knowledge that their limber walk, strong muscles, and sexual prowess are temporary.

17th-century Beliefs

The rise of capitalism during the Industrial Era presented unprecedented labor needs and social problems. With the codification ofthe Elizabe- than Poor Laws in 1601, England endeavored to deal with the dilemma of caring for needy people while maintaining a labor force for its developing industries. Stone (1984) suggested that the Poor Laws were England's attempt to reconcile this di- lemma by creating a "system of categorical ex- emption" (p. 51) by classifying poor people into deserving and nondeserving categories. Or- phaned, blind, and "crippled" people were deemed deserving and received charity less be- grudgingly than so-called nondeserving poor people.

18th-century Beliefs

By the mid-1770s, a new perspective on the hu- man situation, the Enlightenment, was making its impact on Europeans and Americans. Out ofthe tenets ofthe era came the idea that perhaps hu- mans could be perfected. Within this environ- ment, a model of treatment began to emerge that defined people with disabilities by their biological inadequacies. In the United States, institutions dedicated to perfecting the imperfect sprang up (Rothman, 1971) with the hope that professional intervention could cure these inadequacies. When a cure was not possible, people with disabilities could at least be trained to become functional enough to "perform socially or vocationally in an acceptable manner" (Longmore, 1987b, p. 355).

19th-century Beliefs

The 1800s began with the continuing belief that humans could change. Professionals held great hope that "deviants," which included people with disabilities, could be molded into assimilated, less threatening, more acceptable people (Rothman, 1971).

However, by the end ofthe 19th century, the ominous philosophy of social Darwinism and eu- genics came to prominence. Deutsch (1949)

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quoted Darwin's cousin Frances Faltin, who de- scribed eugenics as "the study of the agencies un- der social control that may improve or impair the racial qualities of future generations either physically or mentally" (p. 358). Rhodes (1993) concluded, "the movement emphasized the dominance of heredity and sought to encourage the reproduction of socially desirable individuals (positive eugenics) and discourage the repro- duction of the undesirable (negative eugenics)" (p. 6).

Eugenics became a convenient explanation for the ills of society and cast people with disabilities in a frightening light, making them extremely vul- nerable. Professionals lost confidence in their ability to perfect people with disabilities, conclud- ing that they were innately un- productive and thus endemi- ^ ^ ^ ^ cally without worth. No inter- vention could bring about change because the laws of na- ture deemed people with dis- abilities unfit (Longmore, 1987a). People with disabilities were to be prevented from mar- rying or having children for fear of propagating their imperfec- ^ ^ ^ ^ tions. As the 19th century pro- gressed, institutions to deal with the threat and nuisance of people with disabilities increased dramatically, and they were increasingly isolated and institutionalized, sometimes in sub- human conditions.

20th-century Beliefs

Early 20th-century America offered little attitudi- nal progress. People with disabilities were objects of shame and disgrace. Parents, often on the ad- vice of professionals, hid disabled children from society in their homes or in institutions. Gallagher (1985) recounted the prevailing attitudes of the time in the experiences of President Franklin D. Roosevelt as a person with a disability. Roosevelt was continually forced to compensate for society's attitudes and to hide his disability from the public.

World War I and World War II marked super- ficial advancement for people with disabilities. Federal rehabilitation legislation produced money for treatment of veterans disabled by war. How- ever, the stereotype of people with disabilities as nonproductive and socially abject was prominent

The stereotype of people with disabilities as

nonproductive and socially abject was prominent

through the / 950s.

through the 1950s (Longmore, 1987b). During the second half of the 20th century the ideas of past eras continued to influence professional practice.

Mental health practice has focused on indi- vidual weakness and pathology. The DSM-IV (American Psychological Association, 1994), the major diagnostic tool of mental health practition- ers, is devoted to the diagnosis of pathology, with almost no attention given to strengths. Similarly, medical evaluations measure pathology and the lack of pathology but rarely measure strengths. Diagnoses within these settings also focus exclu- sively on the individuals being diagnosed, neglect- ing social, environmental, and contextual factors that influence people's situations.

The medical model views ^ ^ ^ ^ physicians as treatment direc-

tors and nurses, therapists, social workers, and other health care professionals as assistants who help direct pa- tients' lives. Patients are pas- sive recipients of treatments that are dispensed by profes- sionals who are experts. The

^ ^ ^ ^ ^ experts make the decisions and inform patients of those decisions (Trieschmann,

1980). If people with disabilities who use profes- sional ser\'ices attempt to become active consum- ers and control their care, they become vulner- able to the withdrawal of help from providers who do not like having their authority ques- tioned. This dependence forced on people with disabilities by professionals and societ)' as a whole has led to great dissatisfaction. Thus, in the last decade of the 20th century, people with disabili- ties have demanded the right to take control of their lives.

Independent Living and the Minority Model

The birth of disability consciousness in the United States arose out of the turbulence of the 1960s, a decade of re-examination, challenge, analysis, and change. For the first time in U.S. history, perhaps even in Western historv', significant numbers of people with disabilities demanded access to the mainstream of society.

The disability movement matured with the de- velopment of the independent living concept in the early 1970s. Initially led by people such as Lex

Mackelprang and Salsgiver / Peopk with Disabilities and Social Work: Historical and Contemporary Issues

Frieden, Judy Heumann, and Ed Roberts, inde- pendent living applied the minority model as the foundation of the political process of gaining the civil rights of people with disabilities (Berkowitz, 1987). Whereas traditional Judeo-Christian cul- ture and traditional models of professional treat- ment focused on individual pathology (Weick, Rapp, Sullivan, & Kisthardt, 1989), independent living focused on societal responses and discrimi- nation as the primary barriers to civil rights.

The independent living perspective views people with disabilities not as patients or clients but as active and responsible consumers. Indepen- dent living proponents reject traditional treat- ment approaches as offensive and disenfranchis- ing and demand control over their own lives. For example, when people with physical disabilities have needed physical assistance with self-care, that care is primarily provided by licensed profes- sionals assigned through formal agencies. In con- trast, independent living proponents retain their own personal responsibility to hire and fire people who provide attendant care. They eschew the need for licensed providers such as registered nurses to provide care, favoring instead attendants who are trained by the individuals with disabilities them- selves. Social workers become involved with these individuals only by request.

Traditional medical paradigms define the na- ture of disability by individual deficiencies and biology. For example, justifications for keeping children with disabilities out of regular public schools have centered on their impairments. Pro- ponents of independent living contend that chil- dren with disabilities have not been allowed to attend regular schools because of physical, attitu- dinal, and legal barriers and not because of indi- vidual incapabilities. As a group—as a minority— these children have been denied their right to education (Meyerson, 1988).

The minority model asserts that discrimination against people with disabilities is rooted in the beliefs and values of the culture. The most funda- mental belief is that people with disabilities can- not and should not work or otherwise be produc- tive. For example, Stone (1984) stressed that residual benefits of the Elizabethan Poor Laws are the ensured support and services to people with disabilities in the current welfare state. What Stone and others failed to recognize is that catego- rizing people with disabilities as deserving of char- ity creates a dubious benefit wherein they qualify

for an ever-eroding baseline of services and are relegated to subsistence-level living. At the same time, the social welfare system creates pervasive disincentives to work and reinforces the idea that people with disabilities do not need to work. For example, if people receiving Social Security Dis- ability and Medicare return to work, they will lose not only their payments but also their medical coverage, which would be financially devastating and potentially life threatening. The minority model views the lack of work options as repressive and decries this discrimination.

Contributing to the belief that people with dis- abilities should not work is the role of sick people in Western culture. People with disabilities, whom society assumes are "sick," are expected to fill this role even when they are perfectly healthy. As with those who are sick, people with disabilities are to be taken care of and to be provided for. Their only obligation is to be grateful for the help given them (Devore & Schlesinger, 1987), thus subjecting them to a form of benevolent oppression.

When the expectations that people with dis- abilities should not work and should fulfill the sick role are foisted on people for their lifetimes, they invariably believe those messages and act ac- cordingly. Also, people with disabilities have been given few opportunities to develop skills associ- ated with independence and self-sufficiency. At- tributions of personal unworthiness based on spiritual beliefs further promulgate oppression and isolation.

The behavior, self-concept, educational achievement, and economic success of people with disabilities can be understood only by view- ing people with disabilities as a minority group who are subjected to discrimination found in their social environments (Fine & Asch, 1988). Independent living encourages people with dis- abilities to begin to assert their capabilities per- sonally and in the political arena.

Social Work, Independent Living, and Disability

Social work philosophy shares many similarities with the minority model of viewing people and their environments. Social workers use a systems perspective, acknowledging the influences of the environment on personal functioning. However, the person-in-environment perspective differs from independent living in that it maintains a heavy emphasis on Freudian and neo-Freudian

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philosophy (Hepworth & Larsen, 1993). With the emergence and expansion of other trends of thought in recent decades, the importance of sys- tems, culture, and social supports has become in- creasingly emphasized. Ecological systems theory has been a natural outgrowth and synthesis of these trends (Hepworth 8c Larsen, 1993).

As social work matured from a person-in-envi- ronment to an ecological systems approach, a ma- jor method of practice evolved from casework to case management. Moore (1990) contended that "case management" is a new name for traditional social work practice; however, case management has a stronger emphasis on professionals interact- ing with multiple systems that affect clients. In addition, case management emphasizes the use of a number of roles from counselor to advocate to educator to mediator. Social workers also "em- power clients to become active participants and decision makers in all phases of their lives" (Sheafor, Horejsi, & Horejsi, 1991, p. 64) and help people fmd the power within themselves (Saleebey, 1992). This practice perspective is fur- ther reinforced by the strengths-based practice model (Rapp, 1992). Weick et al. (1989) empha- sized that assessment and intervention based on the strengths of individuals is the cornerstone of empowerment: "Focusing on human strengths is one significant strategy for helping people reclaim a measure of personal power in their lives" (p. 354). The ecological systems perspective com- bined with a strengths-based case management approach that uses the principle of empowerment is a departure from the medical model and is a step toward the minority model.

However, the profession has not shown a con- sistent commitment to people with disabilities. The numbers of social work students and educa- tors who have a disability are low, there are few disability-related articles in the social work litera- ture, and social work conferences are nearly bereft of presentations on disability (Mackelprang, 1993). Likewise, people with disabilities have not regularly sought social work services (Servoss, 1983). One reason may be that social workers of- ten practice in organizations such as hospitals and mental health centers in which professionals make the decisions, thus relegating clients to passive, receiving roles. Many social work jobs are also located in public-sector settings that are bureau- cratic and cumbersome. Longmore (1987a) re- counted the experiences of people with severe

physical disabilities attempting to live indepen- dently: "severely disabled adults . . . must spend their lives confined to families' homes or impris- oned in institutions. . . . The very agencies sup- posedly designed to enable severely physically handicapped adults . . . to achieve independence and productivity in the community become yet another massive hurdle they must repeatedly battle but can never finally defeat" (p. 153). Longmore also offered illustrations of the cata- strophic effects of public social policies in the lives of people with disabilities. When social workers are identified as the professionals who implement and enforce such policies and regulations, they are viewed with skepticism and distrust.

Empowerment has been a guiding tenet of both social work and independent living. How- ever, independent living views empowerment from a different perspective than social work. Whereas social work envisions professionals in- volving clients or patients in prescribed care or treatment plans, independent living views social workers and other professionals as consultants only. Even when individuals have severe disabili- ties that limit learning and decision-making capa- bilities, social w^orkers and other professionals teach skills and facilitate self-management but do not assume responsibility or control over people. In this manner people's capacities are maximized and abuses of power (for example, inappropriate institutionalization, involuntary sterilization, co- erced treatments) are prevented.

Independent living proponents believe that the greatest constraints on people with disabilities are environmental and social. Social work, while ac- knowledging the multiple systems that affect people, often focuses on individual factors that contribute to client problems. Social work's ten- dency to intervene in personal problems without being asked is rejected by independent living pro- ponents as intrusive.

Although social work has pioneered efforts to encourage the use of natural helpers in people's environments, departing from traditional reliance on professionals used in the medical model, inde- pendent living proponents assert that the informal support model still breeds dependence, shifting control from formal providers to informal provid- ers (Dejong, Batavia, & McKnew, 1992). Indepen- dent living espouses a philosophy that advocates natural support systems under the direction of the consumer.

Mackelprang and Salsglver / People with Disabilities and Social Work: Historical and Contemporary Issues

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Social Work and Independent Living: Forging a Partnership

The lack of social work involvement in the inde- pendent living movement is disturbing because both have much to offer each other.

Benefits to Social Work

Social work can benefit greatly from a shift in fo- cus from case management in which clients are labeled ''cases" to a consumer-driven model of practice that acknowledges self-developed empowerment and not empowerment bestowed from others. The independent living movement has more than 20 years of experience developing and refining this approach. The following example illustrates the differences.

Sharon, age 32, received so- ^ ^ ^ ^ cial work case management ser- vices after an automobile acci- dent caused a spinal cord injury that resulted in quadriplegia. During Sharon's hospitaliza- tion her social worker facili- tated the procurement of Med- icaid, ordered medical equip- ment such as a wheelchair, pro- cured the services of a home ^ ^ ^ ^ health agency for home nurs- ing visits, arranged for voca- tional rehabilitation services, and worked with Sharon's family to prepare for her discharge from the hospital. Similar case management services were provided for six months after discharge; the social worker generally informed Sharon of the services she would be providing, and Sharon also made requests for services.

Six months after discharge from the hospital, Sharon became involved with a local independent living center for peer counseling and independent living training. When Sharon began to have trouble with Medicaid, she asked the independent living counselor to intervene on her behalf. Simi- larly, she asked the counselor to procure a com- mode chair. Rather than meet her requests as the social worker had done, the independent living counselor taught Sharon to self-advocate with Medicaid and guided her through the process of ordering medical equipment so Sharon could do so in the future. In addition, the counselor in- formed Sharon how she could gain access to a program in which she could hire and direct her

The lack of social work involvement in the independent living

movement is disturbing because both have much to

offer each other.

attendants rather than having nurses and aides assigned to her. Sharon developed the knowledge and skills to direct her own personal care, includ- ing hiring, firing, and money management, essen- tially reclaiming control over her life.

The social worker viewed her interventions on Sharon's behalf as client centered and empower- ing. She took control in the immediate weeks and months after Sharon's accident because "to ask Sharon to do so would be overwhelming because Sharon needed time to adjust" to her injury. As time progressed, the social worker maintained her involvement level because working with so many agencies was "complicated." Her actions empow- ered Sharon because she was able to access nu- merous services. The social worker always informed

Sharon of her plans to assist ^ ^ ^ ^ Sharon, and Sharon often re-

quested the services the social worker provided. The social worker cited her close relation- ship with Sharon and Sharon's appreciation of her efforts as evidence of the effectiveness of their relationship.

Although the social worker's activities helped

^ ^ ^ ^ ^ Sharon, the social worker un- intentionally encouraged de- pendence and impeded

Sharon's self-determination. The independent living counselor, on the other hand, saw her role as facilitating Sharon's self-determination, and she did not consider directly intervening in activi- ties Sharon was capable of Through mutual ex- ploration with the counselor, Sharon was able to greatly enhance her independence in several areas.

Benefits to the Independent Living Approach

If the person-in-environment approach can be criticized for being too intrapsychic, the indepen- dent living approach can be criticized as viewing problems too much from an external perspective. Independent living may be too quick to assume that consumers already have knowledge and abili- ties rather than recognizing that they may need assistance to develop their strengths. The follow- ing example illustrates the differences.

Jim, age 28, had a traumatic brain injury. He sought assistance with budgeting and financial difficulties at an independent living center. The independent living counselor, who was also an

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MSW student in practicum, helped Jim develop a budget and strategies to deal with creditors. Dur- ing the sessions with Jim, it became apparent that his head injury was also a contributing factor to significant marital and family difficulties. How- ever, because these problems were not problems identified by Jim, the counselor felt constrained from intervening in this area.

Jim seemed relatively unconcerned by his marital situation (almost certainly because of lack of insight as a result of his head injury). However, his wife and adolescent daughter were in signifi- cant distress. Competent counseling was available at the independent living center but was inacces- sible unless Jim identified problems and requested help. Although his family could seek counseling at a mental health center, this center did not employ people who understood the implications of brain injury. Therefore, no marriage reconciliation ser- vices were provided. Jim and his wife later sepa- rated and divorced, and Jim's wife maintained primary responsibility for their child. By the time Jim became responsive to the need for help, it was too late to save his marriage.

In Jim's case, the independent living approach resulted in a lack of intervention, which ultimately had negative effects on Jim and his family, in part because independent living's narrow view ofthe consumer does not include the family. This case also illustrates the conflict between absolute self- determination and the need to sometimes impose professional inter\'ention. Although some would argue against any change in Jim's intervention, a social work approach would have allowed for broader intervention and ultimately may have been more empowering to Jim and his family.

Conclusion

Social work and the disability movement have much to offer each other. However, before both can forge a partnership, the social work profession must work to increase the low numbers of social work students, practitioners, and educators with disabilities (Mackelprang, 1993); re-examine its attitudes and beliefs about people with disabilities (Salsgiver, 1993); provide disabilit)'-competent education; and become more involved in disabil- ity advocacy work in agencies with activist phi- losophies. Social work can contribute decades of experience with the ecology of society and mul- tiple systems. The disability movement can help social work enhance approaches to clients, better

empower oppressed and devalued groups, and understand the needs of people with disabilities. It is a partnership that is long overdue. •

References

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Livneh, H. (1980). Disability and monstrosity: Further comments. Rehabilitation Literature, 41, 280-283.

Livneh, H. (1982). On the origins of negative attitudes toward people with disabilities. Rehabilitation Lit- erature, 43, 338-347.

Longmore, P. K. (1987a). Elizabeth Bouvia, assisted suicide and social prejudice. Issues in Law & Medi- cine, 3, 141-168.

Longmore, P. K. (1987b). Uncovering the hidden his- tory of people with disabilities. Reviews in American History, 15, 355-364.

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Mackelprang, R. W., & Santos, D. (1992, March). Educational strategies for working with persons of

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disability. Faculty Development Institute presented at the Annual Program Meeting of the Council of Social Work Education, Kansas City, MO.

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Moore, S. T. (1990). A social work practice model of case management: The case management grid. So- cial Work, 35, 444-448.

Morris, R. (1986). Rethinking social welfare: Why care for the stranger? New York: Eongman.

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Rapp, C. A. (1992). The strengths perspective of case management with persons suffering from severe mental illness. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 45-58). White Plains, NY: Eongman.

Rhodes, R. (1993). Mental retardation and sexual ex- pression: An historical perspective. In R. W. Mackelprang & D. Valentine (Eds.), Sexuality and disabilities: A guide for human service practitioners (pp. 1-27). Binghamton, NY: Havvorth Press.

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Saleebey, D. (1992). Introduction: Power in the people. In D. Saleebey (Ed.), The strengths perspective in social work practice (pp. 3-17). White Plains, NY: Eongman.

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Techniques and guidelines for social work practice (2nd ed.). Needham Heights, MA: Allyn & Bacon.

Stone, D. (1984). The disabled state. Philadelphia: Temple University Press.

Trieschmann, R. B. (1980). Spinal cord injuries: Psycho- logical, social and vocational adjustment. New York: Pergamon Press.

Weick, A., Rapp, C , Sullivan, P., & Kisthardt, W. (1989). A strengths perspective for social work prac- tice. Social Work, 34, 350-354.

Wright, B. (1960). Physical disability—A psychological approach. New York: Harper & Row.

Romel W. Mackelprang, DSW, CSW, is associate professor. Inland Empire School of Social Work and Human Services, Eastern Washington University, 526 Eifth Avenue, MS-19, Cheney, WA 99004. Richard O. Salsgiver, MSW, DA, is associate pro- fessor. Department of Social Work Education, Cali- fornia State University, Eresno. An eariier version of this article was presented at the Annual Program Meeting of the Council on Social Work Education, March 1993, New York.

Accepted January 25, 1994

THE FIELD OF ADULT SERVICES

SOCIAL W O R K

PRACTICE A N D

A D M I N I S T R A T I O N

Gary M. Nelson, Ann C. Eller

Dennis W. Streets, and Margaret L Marse,

Editors

lelps define fhe complex world of adult services delivery by examining the specialized body of values, knowledge, and skills that constitute the field. This book presents a clear model for the field by combining an overview of key skills with a framework for excellence in adult services practice. ISBN: 0-87101-250-2 • Item #2502 • 1995 $34.95

To order, send $38.45 (includes $ 3 5 0 postage and hondling) to N A S W Press, P.O. Box 4 3 1 , Annapolis JCT, MD 2 0 7 0 ) , USA. Credit card orders coll 1 - 8 0 0 - 2 2 7 - 3 5 9 0 (in metro Wosh., DC, call 301-317-8688), or fax 301-206-7989

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