「伝えたい」を支援する自立活動の指導 : 知的障害と肢体不自由を併せ持つ重度・重複障害児への実践

In this study，we aimed to examine Jiritsu-Katsudou of communication for 2 children with severe and multiple disabilities which include both intellectual disabilities and physical disabilities. First，the actual conditions of children were assessed by using “Enjouji Bunsekiteki Hattatsu Kensahou” and the association chart of ICF (International Classification of Functioning， Disability and Health). Secondly，individualized programs of Jiritsu-Katsudou were prepared. The child “A” became to seek help to others independently and experienced that she communicated her will to people by her action through the instruction of the Taker and utterance effectively. The child “B” realized that she could make a request by giving cards to people and start to communicate from her. In both cases，since we associated with their family， they got same instructions and supports at home too. As a result，they became to be able to use their communicative abilities which they obtained in this instructions within their daily lives. We considered it is important in the instruction for children with severe and multiple disabilities to repeat evaluation in a short term while reexamining the goal in a long-term based on PDCA cycle (plan-docheck-action).