She never graduated from Temple and needed one more credit, in organic chemistry, to meet the pre-med requirements at Hahnemann. The only university nearby that was offering organic chemistry over the summer was Villanova, which at the time accepted only men. She enrolled anyway, but after she had attended class for a week, officials insisted she leave. Her professor offered to give her private lessons and said that if she could pass the exam, he would give her the credit she needed. She passed and began medical school in the fall of 1941.

She graduated in 1945 — one of three women in the class, Hahnemann’s second to accept women — and did her internship at New York Medical College in Valhalla. A friend there set her up on a blind date with Dr. Louis J. Salerno, who had just returned from service as a major in the Army at the end of the war. They married in 1948 at St. Patrick’s Cathedral in New York.

She kept her own name, which was highly unusual in that era. She and her husband were both professors at New York Medical College (she taught pediatrics; he taught obstetrics and gynecology), and she wanted to minimize any confusion.

In addition to her son Louis, she is survived by three other sons, Robert, Justin and Mark Salerno; five grandchildren; and two great-grandchildren. Her husband died in 1988.

Dr. Giannini’s work at the Mental Retardation Institute, of which she was director from 1950 to 1978, drew the attention of President Jimmy Carter, who appointed her the first director of the National Institute on Disability and Rehabilitation Research (now the National Institute on Disability, Independent Living and Rehabilitation Research).

After Mr. Carter lost the 1980 election, she joined the Department of Veterans Affairs, where she expanded her work to encompass physical disabilities related to military service, including post-traumatic stress disorder, traumatic brain injury, blindness, deafness and other problems.

In her second presidential appointment, President George W. Bush named her the principal deputy assistant secretary for aging at the Department of Health and Human Services. There she got to know Tommy Thompson, the secretary of the department, who appointed her director of the department’s office on disability in 2002.