Young Adults and Transitioning Youth With Autism Spectrum ...

2017 REPORT TO CONGRESS

Young Adults and Transitioning Youth with Autism Spectrum Disorder

Prepared by the: Department of Health and Human Services Submitted by the: National Autism Coordinator U.S. Department of Health and Human Services

Cover Design Medical Arts Branch, Office of Research Services, National Institutes of Health

Copyright Information All material appearing in this report is in the public domain and may be reproduced or copied. A suggested citation follows.

Suggested Citation U.S. Department of Health and Human Services. Report to Congress: Young Adults and Transitioning Youth with Autism Spectrum Disorder. October 2017. Retrieved from the U.S. Department of Health and Human Services website:

Young Adults and Transitioning Youth with Autism Spectrum Disorder

The Autism Collaboration, Accountability, Research, Education and Support Act (Autism CARES Act) of 2014 REPORT TO CONGRESS

Submitted by the National Autism Coordinator of the U.S. Department of Health and Human Services

August 3, 2017

Table of Contents

Interagency Workgroup on Young Adults and Youth with Autism Spectrum Disorder Transitioning to Adulthood. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

Steering Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Members iv . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OASH Stakeholder Listening Panel Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Part 1: Background on Autism Spectrum Disorder and the Transition to Adulthood. . . . . . . . . . . . . . . . . . . . . . . 1 Introduction to Autism Spectrum Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Scope of Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Population Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Trends in Health and Well-being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Transition Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Figure 1. ASD Research Funding by IACC Strategic Plan Question. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Challenges and Barriers to Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Background for this Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Coordination of Autism Activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Summary of Background Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Table 1. Participating Federal Agencies in the Interagency Work Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Part 2: Federal Agency Activities on Young Adults and Youth with Autism Spectrum Disorder Transitioning to Adulthood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

U.S. Department of Health and Human Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Administration for Children and Families (ACF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Administration for Community Living (ACL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Agency for Healthcare Research & Quality (AHRQ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Centers for Disease Control and Prevention (CDC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Centers for Medicare & Medicaid Services (CMS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Health Resources and Services Administration (HRSA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Indian Health Service (IHS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 National Institutes of Health (NIH) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Substance Abuse and Mental Health Services Administration (SAMHSA). . . . . . . . . . . . . . . . . . . . . . . . . . . 24

U.S. Department of Defense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Congressionally Directed Medical Research Programs (CDMRP). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

U.S. Department of Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Office of Special Education and Rehabilitative Services (OSERS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Office for Civil Rights (OCR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Promoting the Readiness of Minors in Supplemental Security Income (PROMISE) . . . . . . . . . . . . . . . . . 31 Institute of Education Sciences (IES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Office of Postsecondary Education (OPE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

U.S. Department of Housing and Urban Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Section 504 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Section 811 Supportive Housing for Persons with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

U.S. Department of Justice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Educational Opportunities Section (EOS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Disability Rights Section (DRS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

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2017 REPORT TO CONGRESS

Special Litigation Section (SPL). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Office of Justice Programs (OJP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Bureau of Justice Assistance (BJA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 U.S. Department of Labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Office of Disability Employment Policy (ODEP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Disability Employment Initiative (DEI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 U.S. Department of Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Accessible Transportation Technologies Research Initiative (ATTRI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 U.S. Social Security Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Supplemental Security Income (SSI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Demonstrations of Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Work Supports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 The 2020 Federal Youth Transition Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Summary of Current Federal Investments for Transitioning Youth with ASD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Table 2. Federal Activities by Agency Relevant to Young Adults and Youth with Autism Spectrum Disorder Transitioning to Adulthood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Part 3: Stakeholder Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 OASH Stakeholder Listening Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Gaps in Research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Gaps in Services and Programming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Public Comments to IACC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 GAO Roundtable Views of Services Needed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Table 3. Key Services Identified by GAO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Summary of Input from External Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Part 4: Conclusions and Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 A Coordinated, Comprehensive Approach to Services and Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Support Coordinating Across Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Family Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Data and Research on Transition-age Youth and Young Adults with ASD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Improving Outcomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Epidemiological Data Collection and Monitoring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Supports and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Summary 64 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Appendix 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Autism CARES Act of 2014, amending Sec. 399DD(b) of the Public Health Service Act . . . . . . . . . . . . . . 68

Appendix 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Authorizing Legislation by Agency and Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Other Federal Policies that May Apply To Young Adults with ASD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

III

YOUNG ADULTS AND TRANSITIONING YOUTH WITH AUTISM SPECTRUM DISORDER

Interagency Workgroup on Young Adults and Youth with Autism Spectrum Disorder Transitioning to Adulthood

STEERING COMMITTEE

Thomas E. Novotny, MD, MPH (National Autism Coordinator) Deputy Assistant Secretary for Health (Science & Medicine) Office of the Assistant Secretary for Health Office of the Secretary U.S. Department of Health and Human Services

Susan Daniels, PhD Director, Office of Autism Research Coordination National Institutes of Health U.S. Department of Health and Human Services

Alicia Richmond Scott, MSW Senior Policy Analyst, Office of the Assistant Secretary for Health Office of the Secretary U.S. Department of Health and Human Services

Robin Harwood, PhD Health Scientist, Office of the Assistant Secretary for Health Office of the Secretary and Health Resources and Services Administration U.S. Department of Health and Human Services

MEMBERS

Melinda Baldwin, PhD, LCSW Child Welfare Development Specialist, Children's Bureau Administration for Children and Families U.S. Department of Health and Human Services

Gary Blau, PhD Chief, Child, Adolescent and Family Branch Center for Mental Health Services Substance Abuse and Mental Health Administration U.S. Department of Health and Human Services

Susan Crawford Director, Compliance Disability Rights Division Office of Enforcement Fair Housing and Equal Opportunity U.S. Department of Housing and Urban Development

Daniel Dodgen, PhD Director, Office for at Risk Individuals Office of the Assistant Secretary for Preparedness and Response Office of the Secretary U.S. Department of Health and Human Services

Julianna Rava, MPH Science Policy Analyst, Office of Autism Research Coordination National Institutes of Health U.S. Department of Health and Human Services

Nicole Dowling, PhD Chief, Developmental Disabilities Branch Division of Congenital and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention U.S. Department of Health and Human Services

Joel Dubenitz, PhD Social Science Analyst, Office on Disability, Aging, and Long-Term Care Policy Office of the Assistant Secretary for Planning and Evaluation Office of the Secretary U.S. Department of Health and Human Services

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2017 REPORT TO CONGRESS

Tiffany Farchione, MD Acting Deputy Director, Division of Psychiatry Products Food and Drug Administration U.S. Department of Health and Human Services

Richard Gonzales Director, Interagency and Tribal Affairs Office of the Deputy Assistant Secretary for Early Childhood Development Administration for Children and Families U.S. Department of Health and Human Services

Melissa Harris Senior Policy Advisor, Disabled and Elderly Health Programs Group Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services

Stephen Holve, MD Chief Clinical Consultant for Pediatrics National Council of Chief Clinical Consultants Indian Health Service U.S. Department of Health and Human Services

Jennifer Johnson, EdD Acting Deputy Commissioner, Administration on Disabilities Administration for Community Living U.S. Department of Health and Human Services

Denise Juliano-Bult, MSW Social Work Program Specialist, National Institute of Mental Health National Institutes of Health U.S. Department of Health and Human Services

Alex Khalife Sands Legislative Analyst Office of the Assistant Secretary for Legislation Office of the Secretary U.S. Department of Health and Human Services

Ashley Knotts International Health Analyst Office of Global Affairs Office of the Secretary U.S. Department of Health and Human Services

Cheryl Levine, PhD Senior Program Analyst Office of the Assistant Secretary for Preparedness and Response Office of the Secretary U.S. Department of Health and Human Services

Jennifer Masoodi, JD, PhD Program Analyst, Special Litigation/Disability Rights Section Civil Rights Division U.S. Department of Justice

Hae Young Park, MPH Deputy Director, Division of Maternal and Child Health Workforce Development Maternal and Child Health Bureau Health Resources and Services Administration U.S. Department of Health and Human Services

Lauren Raskin Ramos, MPH Director, Division of Maternal and Child Health Workforce Development Maternal and Child Health Bureau Health Resources and Services Administration U.S. Department of Health and Human Services

Scott Michael Robertson, PhD Policy Advisor Office of Disability Employment Policy U.S. Department of Labor

Marguerite Schervish, JD Technical Director, Division of Benefits and Coverage Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services

V

YOUNG ADULTS AND TRANSITIONING YOUTH WITH AUTISM SPECTRUM DISORDER

Mathew Schutzer, JD Trial Attorney, Special Litigation Section Civil Rights Division U.S. Department of Justice

Harvey Schwartz, PhD Senior Advisor, Priority Populations Office of Extramural Research, Education, and Priority Populations Agency for Healthcare Research and Quality U.S. Department of Health and Human Services

Christine Smith Senior Equal Employment Opportunity Specialist Office of the Assistant Secretary for Administration Office of the Secretary U.S. Department of Health and Human Services

Melissa Spencer Deputy Associate Commissioner, Office of Disability Policy U.S. Social Security Administration

Lawrence Wexler, EdD Director, Research to Practice Division Office of Special Education and Rehabilitative Services U.S. Department of Education

Lisa Wiggins, PhD Epidemiologist National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention U.S. Department of Health and Human Services

Nicole Williams, PhD Program Manager, Autism Research Program Congressionally Directed Medical Research Programs U.S. Department of Defense

Marshalyn Yeargin-Allsopp, MD Associate Director for Children with Special Healthcare Needs National Center on Birth Defects and Developmental Disabilities Center for Disease Control and Prevention U.S. Department of Health and Human Services

Mohammed Yousuf Program Manager, Accessible Transportation Technologies Research Initiative Federal Highway Administration U.S. Department of Transportation

VI

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