Support systems for homebound/hospital education program for children with sever motor and intellectual disabilities.

严重运动和智力残疾儿童由于严重发育迟缓和一种或多种残疾而无法上学。他们接受家庭/医院教育计划。本研究的目的在于发展SMID儿童居家/医院教育计划的支援系统。结果如下：1。SMID患儿对教师干预没有表现出明显的行为反应。通过后续的研究，我们有了更详细的早期沟通过程。为了促进有意表达，促进早期互动是一个关键因素。具体而言，教师在与SMID儿童的互动中，需要持续不断地提供各种表达方式。在这些互动过程中，SMID儿童获得了有意性表达。患有SMID的儿童在与他人交流方面有严重的限制。最近，在日常生活中出现了网络会议的新方法，这种环境的改变可能会改善SMID儿童的交流限制。本研究旨在探讨SMID儿童互动品质的改变，并厘清网际网路会面的建议条件。研究对象是一名患有SMID的儿童，他在半年的时间里接受了AAC技能的培训。在网络会议开始的时候，大部分的互动都是由老师开始的。经过11次网络会议，儿童表现出积极的保持沟通的倾向。这种趋势在孩子的家庭环境中直接、面对面的交流中也可以观察到。儿童自身的言语行为改变了交流的主题。以上结果表明，教师网络会议在促进交流方面是有效的。

The children with sever motor and intellectual disabilities (SMID) are unable to attend school due to profound retardation and one or multiple handicaps. They receive homebound/hospital education program.The purpose of this study was to develop the support systems for homebound/hospital education program for children with SMID. Results were as follows :1.The children with SMID don't express overt behavior response to teacher's intervention. Through follow-up studies, we had more detailed processes of early communication. To facilitate to intentional expression, it was a critical factor to promote early interaction. Specifically, teacher needed to provide various expressions consistently and continuously, in his interaction with the children with SMID. In the course of these interactions, the children with SMID acquired the intentional expression.2.The children with SMID have sever restriction in communication with other people. Recently, newly developed method of Internet-meeting is available in daily life and such change of environment might improve restriction of communication in the children with SMID. This study aimed to investigate change of quality of interaction in the children with SMID and to clarify recommended conditions of internet-meeting. A subject was one child with SMID who has been taught AAC skills during half a year. At the beginning of the sessions of internet-meeting, most interaction was started by the teacher. After eleven sessions of Internet-meeting, a child showed active tendency of maintaining communication. This tendency was also observed in direct, face to face communication in a child's home environment. Theme of communication was changed by child's own behavior with utterance. Above results indicate that internet-meeting by the teacher is effective in facilitation of communication.