早期治療教育がダウン症状改善に寄与するための媒介要因 : 事例研究を中心に

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In Recent years, professionals have been recognizing the improving effects of early therapeutic education for children with Down's syndrome . However, the age criteria for the effective use of therapeutic education have not been clearly defined. There are variety of questions concerning so-called "critical period" in developmental psychology, such as, in what age a child should begin receiving these educational programs, whether the earlier the better is true or not, and if there is a definite and absolute developmental period for improving the child's deficiency. In previous report (Fujinaga etal, 1996), eleven typical cases of children with Down's syndrome caused by 21 trisomy were chosen as subjects from about 100 candidates by collaboration of Kumon Institute of Education , because all of them have learned in the Kumon class-rooms . By interviewing the children and their mothers, sometimes their Kumon teachers, we examined their developmental case histories, especially the types of early therapeutic education received and their effects. As a result of this research, we reached a tentative conclusion that unless children with Down's syndrome receive therapeutic education by age two, its effect will be confined to minimum. In the course of the study, we have recognized some important mediating factors that have enhanced the effectiveness of therapeutic education in successful cases leading these children to the acquisition of self-autonomy and social competence, though limitted. In present study, these mediating variables that might enhance, or in contrary, reduce the effectiveness of early therapeutic education were examined. Six of the eleven cases clearly showing these mediating variables were rechosen for this purpose and their case histories were analyzed in detail further. As a result, the mediating variables were divided into five different categories. The first one is the additive effect by the enthusiasm and appropriate choices of learning strategies for social and cognitive skills made by the child's mother and family members, with collaboration of child's teacher. The most typical example was the case Y.S.. His combined symptomes at his birth, such as anal fusion, were the severest in our cases, neverthless he reached the highest developmental level among them. Now he is studying in a usual class of a junior high school. On the contrary, the second category is the negative effect caused by mother's fatalistic or desperate attitude . The mother of case M.A. received so severe shock when her child's doctor told her M.A. had the Down's syndrome that she could not help only crying and did not even go out for about two years. So it is inferred that MA. was raised in a condition of almost complete social isolation from birth to about two years and this condition now brought M.A. to a very difficult state for recovery. Thirdly, again on the contrary, the additive effect lead by mother's optimistic and hopeful attitude must be pointed out. It is recently called Pygmalion effect by Rosenthal (1968) and the cases of R. 0. and K. H. were the typical examples. The fourth category is the additive effect lead by social tolerance and nondiscriminating attitude of institutions, such as Kindergarten or elementary school. The case of N.Y. clearly showed the importance of this condition. Finally we want to point out the additive effect lead by the recognition of special talents that children with Down's syndrome might possess. The case S.S. is a typical example. Until now they are called savant syndrome and believed to be latent only in the case of autistic children. There are varieties of this talent, for example drawing or musical ones. S.S. had so excellent talent producing artistic textile goods that her products can be exhibited in a famous department store in Tokyo district. From this study, we also recognized the some possibilities that the fifth category might bring for the future of children with Down's syndrome. Therefore, we described in detail the inferential factors for developing latent abilities of savant syndrome for future studies.
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早期治療教育がダウン症状改善に寄与するための媒介要因 : 事例研究を中心に

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