Practical Study of Homebound/Hospital Education Services for Children with Severe Motor and Intellectual Diabilities.

在日本，由于严重的运动和智力残疾(SMID)而不能往返于学校的学生已经被提供了居家/医院教育。为了了解居家/医院教育计划的现状和涉及的问题，我们对提供居家/医院教育的学校进行了全国范围的调查。调查结果指出：(1)有需要与家长讨论课程内容；(2)有需要鼓励在家中更多使用医疗和福利服务；(3)有需要增加就学机会。他们不能适当地将自己的唤醒或激活水平转移到正常的人类环境中，也不会对照顾者的干预表现出公开的行为反应。通过这项实践和心理生理学研究，我们更详细地考虑了早期经验的过程。为了促进SMID儿童的发展，促进早期干预至关重要。具体地说，照顾者必须在他们与患有SMID的儿童的互动中提供一致和持续的各种表达线索。在这些互动的过程中，患有SMID的儿童获得定向-搜索活动，并能够预测到一个重要的刺激(例如，最近提到的一个名字)。随着对定向搜索活动所依据的科学原理有了更好的理解，我们。将更好地帮助患有SMID的儿童。

In Japan, homebound/hospital education has been offered to students who are unable to commute to school due to severe motor and intellectual disabilities (SMID).In order to understand the current situation and issues involved in homebound/hospital education program, we conducted a nationwide survey of school offering homebound/hospital education. The following findings were pointed out in this survey : (1) the need to discuss the curriculum with parents, (2) the need to encourage greater use of medical and welfare services at home, (3) the need to increase schooling opportunities.Children with SMID respond weakly to external stimuli because of central nervous system dysfunction. They cannot shift their level of arousal or activation appropriately to a normal human environment and do not express overt behavioral responses to caregiver interventions. Through this practical and psychophysiological study, we considered in more detail about the processes of early experience. To facilitate the development of children with SMID, it is critical to promote early intervention. Specifically, caregivers must provide various expressive cues consistently and continuously in their interactions with children with SMID. In the course of these interactions, children with SMID acquire orienting-search activities and can anticipate a significant stimulus (e.g., a name recently mentioned). With a better understanding of the scientific principles on which orienting-search activity is based, we. will be in a better position to help children with SMID.