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

在日本，对因严重运动和智力障碍（SMID）而无法上学的学生实施在家/住院教育。为了了解在家/住院教育的现状和问题，我们在全国范围内对提供在家/住院教育的学校进行了调查。调查结果指出：（1）与家长讨论课程的必要性;（2）鼓励更多地利用家庭医疗和福利服务的必要性;（3）增加入学机会的必要性。SMID儿童由于中枢神经系统功能障碍，对外界刺激反应较弱。他们不能将自己的唤醒或激活水平适当地转移到正常的人类环境中，并且不会对看护者的干预做出明显的行为反应。通过这种实际的心理生理学研究，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。具体来说，照顾者必须提供各种表达线索一致，不断与SMID儿童的互动。在这些互动的过程中，患有SMID的儿童获得定向搜索活动，并且可以预期重要的刺激（例如，最近提到的名字）。通过对定向搜索活动所依据的科学原理的进一步理解，我们可以对定向搜索活动的基本原理进行分析。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.