A study for the students under medical treatment in hospital to give a
lot of opportunities in class with ICT
Takeshi HASEGAWA1) Makoto HASEGAWA2) Toru FUKUMOTO3)
E-mail: thasegawa@obu-sh.aichi-c.ed.jp2)m.hasegawa@gifu.shotoku.ac.jp3)fukumoto@nier.go.jp,
1)
Teacher 2) Associate Professor 3)Senior Chief Researcher
1)
Aichi Prefectural Obu Special Support School, Aichi, Japan ,2)
Gifu Shotoku Gakuen University, Gifu, Japan
3)
National Institute for Educational Policy Research, Tokyo, Japan
1)

ABSTRACT
We visit hospitals and give lessons to students in a long-term hospitalization based on
National Curriculum Guideline of MEXT Japan. The purpose of this study is to investigate how
ICT can be used more effectively to help the students to learn. Some of the students stay inhospital all the time, so teachers visit them three times a week to give a 120-minute private
class. It’s usually difficult for students to lie in bed and concentrate on learning for as much as
120 minutes, because of their bad condition, such as a disorder or chronic disease. The teachers
should keep in mind that students learn under restrictive environments. In addition, it isrequired for teachers to make fully worked-out teaching plans considering their academic
ability, motivation to learn, state of student’s condition, medical environment, and treatment
plan for individual student. This study has been practiced in Obu Special Support School in
Aichi Prefecture, Japan
We have set up a hypothesis that ICT provide necessary supplies for students in hospital. Evenin hospital, where learning environment is not preferable, we made much account of practicalexperience for students. In this paper, model lessons were put in practice. Students use theInternet or digital contents using mobile 3G data communication, and they devised ways andmeans to present the materials they prepared. They also used these digital devices ininvestigating learning. Touch panels, such as iPad, or projectors were adopted as necessary, too.
Through these model lessons, ICT seems of use for students in hospital. However, practicalexperience must be emphasized as well. ICT should be one of the supplements when teachingin hospital.
Keyword: Visiting Education for children under Medical Treatment

1.1 The definition of teaching in children’s hospital
According to the government’s report in 1969, there is a suggestion that teachers should visit students
in hospital to provide enough educational activities. Later, in 1994, this suggestion was emphasized again,
requiring educations appropriate for individual students should be carried out. According to National
Curriculum Guideline for Special Support Elementary and Junior High School, teachers’ visiting
children’s hospital should be much effective, and the methods of instructions and teaching systems fully
worked-out. It also says teachers need to take account of disability levels of each student; therefore thenumber of teaching hours can be flexible.
1.2 Visiting students in Obu Special Support School
Since 1976, teachers in Obu Special Support School have been visiting students staying in hospital fora long period of time in Aichi Prefecture. In this visiting style, however, there are some restrictions
providing educational activities. They can be classified into three different categories below.
1.2.1 Temporal restriction
In Obu Special Support School, teachers visit students three times a week to give a 120-minute private
class, which is not enough to teach every school subject. The number of school hours has been increasing
recently in Japan, while it is quite impossible to give more lessons for the students in hospital.
1.2.2 Conditional restriction
Considering physical conditions, it is occasionally impossible to increase the number of class for the
student because the situation or characteristics of the disease is different in each student there. Also it isdifficult for some students to keep studying long hours. In their wide category relating to general daily
life, they usually have a lot of restrictions, which would lead them to spend monotonous life. We thinkthey need more actual experiences, but they have few chances to find something new. Therefore, theirsocial experiences are not sufficient since they tend to be passive and try to do just what they want andavoid what they dislike.
1.2.3 Spatial restriction
Some of the students in hospital stay lying in bed, so they need to take class there, while the others withmild symptoms go to their classroom to take class. (Figure 1) Teachers should devise the ways and meansof teaching and select the content of learning to go with individual student.
2

The importance of learning actual experiences in class
As shown, long-term hospitalization causes the students
Symptoms
lack of actual experiences and knowledge. Under many Restrictions
in daily life
restrictions, however, they can experience a lot of things
by devising teaching materials or selecting the content of

Serious
Living space

mild

ICU

Private Hospital
room
room

many
Studying space

BedsidePrivatestudy roomHome,
School

Few

Class
-room

teaching. Having actual experiences not only makes up for Figure 1 Relationships between symptoms
and restrictions in daily life
their lack of experience, but also enriches the students in mind.
Then, in 2010, Hasegawa and Fukumoto focused on experiments in science class. They made a study
about how active and effective learning can be done for students in hospital, and trying to use ICT devices.
They make much account of the students having actual experiences. However, to prevent infectious
diseases, they use positively those devices instead.
Of course, ICT devices are not used only for science class. They can be applicable to many subjects,
like social studies or life environmental studies, which actual experiences are valued.
3. The purpose of this study
By the reasons mentioned above, we can provide interesting, explicit lessons that students canparticipate in voluntarily when we utilize ICT devices. In this study, we discuss our opinions on the
hypothesis that ICT devices remove restrictions to give class and supplement actual experiences for the
students in hospital. Specific ways of learning are verified and reported. Targeted subjects are following:
Social Studies, Science, Life Environmental Studies, Independent Activities, and Life-Unit Learning.
4.1 Utilizing ICT devices
4.1.1 Removing spatial restrictions
In Science class, for example, it is difficult for the students in hospital to observe things in nature. It
seems that ICT devices can be utilized effectively in this case. However, there are various problems tohave class with them in children’s hospital. One of the reasons is that it is not desirable to take huge andheavy experimental facilities to hospital. Also, in Social Studies class, visiting libraries or museums,
doing fieldworks would be difficult. In this case, ICT devices, such as digital devices should be utilized,
based on the situation.
4.1.2 Removing temporal restrictions
Since the total school hour is limited for the students in hospital, ICT devices enable us to save time inthe lessons, helping the students to learn the targeted content effectively. In 2010, Hasegawa andFukumoto gave experimental lessons with Meaningful Reception Learning in a Special Support School.
In these lessons, ICT devices made it possible to save time to present or explain the task in the lessons.
Also, students could have spent enough time thinking about the experimental results.
4.1.3 Removing restrictions from disability or condition of disease
When utilizing ICT devices, the extent of disability or disease should be taken into consideration.
Students with a slight disorder or
Mild
Symptoms
Serioussymptom are able to take lessons like Restrictions in
studying
Actual experienc
Virtual experience
Quality of experiences
non-handicapped. For the ones with (1)SocialeModelStudiesVideo, Picture
severe situation, on the other hand, it is (2)Science
Website, Digital contents
Many
Few
Real thingE-mail, Telephone, Video letter, Video chatconsidered to be quite effective. ICT (3)Life
Environmental
Studies
Field work, Experimentdevices can make the things once (4)Activities toWith ICT
impossible possible, when utilized Promote
Independence
according to the condition of the (5)Life-Unit
Learning
Figure 2 Relationships between symptoms
students. Also it can be concluded thatand restrictions in learning or quality of actual experiencesthey can compensate for the shortage of having social experiences for the students in hospital. (Figure 2)
4.1.4 Purpose of utilizing ICT devices for students in hospital
National Information Center for Educational Resources classifies the purpose of utilizing ICT devices
into 11 groups; in these situations, ICT devices are generally helpful to eliminate temporal, conditional,
and spatial restrictions. Then, we have classified those restrictions under following three topics: i) spatial
restrictions, ii) temporal restrictions, and iii) disabilities and symptoms. The following (Table 1) is about
the purpose of utilizing ICT devices in teaching in hospital. Criterion for valuation is as follows; A: Good
enough to eliminate restrictions B: Almost enough C: Not enough.
Table 1 Purpose of utilizing ICT and its actual use for students in hospital
Purpose of utilizing
ICT

restrictions
eliminate

Examples of practical ICT utilizationi)
spatialIntroducing
task
2 Motivating
1

theExplainingfor
3 materials
teachers
Explaining
4 materials
forlearners
Establishing
5 imagesbyrepeatingPresenting learning
6 models
Presenting failure
examplesRecalling
8 experiences
7

Comparingmaterials
9
Reconfirming thelessonSubstitutingfor
11 actual experiences

10

Present the latest news picture or an imminent phenomenon with the digitalteaching materials and let students discover problems and keep aware of them.
Utilize ICT as an incentive, showing documents or images that students areinterested in.
Spread and show documents and explain the contents which are selected
carefully. Perform the supplement of the textbook. When visiting hospital,
devise contents and methods of the presentation in consideration for the actual
situation, including the physical condition of the students.
Let the students utilize ICT and show the document for presentation which
they made, then let them present in class. However, it is difficult to secure
enough time in class in hospital.
Play animations or music repeatedly and establish their images. In class in
hospital, it is difficult to secure enough time, but let them utilize them byvoluntary learning out of the school hour.
Show the things that are difficult to show the real ones, such as molecularmodels, the movement of heavenly bodies or the structure of the inner earth.
In class in hospital, it is preferable to show models and figures with the digitalteaching materials, considering prevention of infections.
Show with the digital teaching materials when it is dangerous or takes a lot oftime and cost to show failure examples of the experiment.
Show pictures and let the students remind the experiences that are common to
all of them, such as the movement of moon, the change of the season, or
earthquakes.
Compare with digital images when an actual comparison is difficult, such as
the color or the form of shield and dome-shaped volcanoes, which can’t betaken to class. Compare places or examples that cannot experience directly byhospitalization.
Let the students recur using the animation which was photographed in theprevious lesson.
Let the students utilize ICT and experience what they cannot experience; notonly the things that they can’t experience by the hospitalization, but also thethings that people usually can’t experience, such as outer space or deep in the
sea.

ii)

to
iii)

disabilities
andtemporal
symptoms

B

B

B

B

B

A

A

A

A

B

C

A

B

C

B

A

B

A

B

B

B

B

B

B

A

A

B

B

B

B

A

B

A

5 Practical lessons
Practical lessons with ICT devices were held in Social Studies, Science, Life Environmental Studies,
Activities to Promote Independence, Life-Unit Learning class. Targeted members were 11 students who
had been in or once belonged to Obu Special Support School. ICT devices were utilized according to theactual condition or learning content of the targeted students. Teachers recorded how they participated inclass. Questionnaire method was not used, considering their literacy or descriptive ability for the students
in lower classes of elementary schools. For the students with intellectual disability, active participations tothe class were recorded, using time sampling method. Evaluations were done by teachers with rating scale
method, depending on students’ participation to class.
Evaluation criteria are as following: the degree of achievement 1) about the aim for utilizing ICT
devices, 2) as actual experiences, and 3) in students’ participation. Each criterion was estimated in one offour categories: “A” represents very good, and “B”, “C”, “D” means good, not enough, poor, respectively.

Additional information were recorded, such as repose, difficulty in moving, danger of infection, lying in
bed, difficulty in taking class for long hours due to their medical or physical condition. Choose theapplicable classification according to "Purpose of utilizing ICT and its actual use for students in hospital(table 1)" about the purpose of ICT utilization.
The practice result is shown in table 2
Table 2 Practice result(1)Social Studies

1 A

2 B

3 C

(2)Science

4 D

5 A

6 A

Observe Shonai plains in Google map and understandlarge-scale rice growing directly, looking at theGooglephotograph from the sky. / Student B said “It’s
Rice
5
A AA
Map
✓
surprising!” when found that the green lump was a
growing
Projector
large rice field, with a close-up from earth, then Japan,
Yamagata prefecture, and finally Shonai plains.
Research on the Internet the life of people in the
Jomon, ancient period. Make real Jomon ware by
paper clay and give designs with a rope. Let theKids
student get interested in the life of people at that time.
MuseumFrom/ The student researched how to make the ware with avillage
6
Tablet-type tablet-type device with touch panel. After having A A A✓
todevice with understood a procedure, he started to make one withnationtouch panel paper clay. He thought about how to put designs using
the rope, watching the photograph of the earthenware.
(iPad)
He turned it carefully to make rope design. He seemed
glad and said, “I want to show this to my family.”Research on the Internet the life of people in the
Jomon, ancient period. Make real Jomon ware by
paper clay and give designs with a rope. Let theKids
student get interested in the life of people at that time.
MuseumFrom/ The student researched how to make Jomon warevillage
6
Tablet-type with a computer. Using keyboard seemed easier than A A A✓
todevice with using touch panel. He thought about how to put
nationtouch panel designs using the rope, watching the document of the(Windows) earthenware. He started the manufacture of theearthenware after researching more on the Internet. He
looked satisfied with his performance.
Observe growth of okra, a plant, together with water
culture. The soil had been sterilized.
Growth of okras stopped for lacking in the sunshine
How doand malnutrition. / The student gave original names to
Science
3 plants
them. He measured their height, the size of the leaves A A A ✓ ✓✓network
grow?
every day. He realized their growth, and told about it
happily to his chief physician or nurses. After their
growth had stopped, he kept observing their growth on
the video.
Observe germination and the growth of kidney beans.
Observation was cancelled because mold grew on
Growththem. / The student really enjoyed observing them andScience
5 oflooking forward to their germination. However, his A A A ✓ ✓✓networkplantsfamily brought them home and took care instead
because of mold. He kept observing their growth on
the video.
Confirm distinction between male and female of thekillifish. Watch the birth from an egg. Because
Observa
keeping killifish is not allowed, video is utilized
Science
5 tion of
instead. / The student watched the video with A B A ✓ ✓✓network
fascination about the birth from an egg or how to takekillifishcare. Photographs were used to make a distinction
between male and female.

difficulty for long hours
Objective classification of
ICT utilization

lying in bed

The aim for utilizing ICT devices/ Actual experiences

Level of achievement
experiential
positive
spatialreposedifficulty in moving
danger of infection

Utilized teachingmaterials, software,
himepage

Name of unit /Details of activity

No.
Student
Grade

Subject
Study area

Restrictions

1-A
2
3-A
11-A

1-A
3-A

1-A
3-A

3-A
11-A
✓

3-A
11-A

3-A
11-A

7 C

8 D

9 D

10 E

(3)Life Environmental Studies

11 B

12 F

13 G

Learn changing the color of the limewater or how to
3-A
use a gas-detecting tube. For using fire is prohibited,
11-A
the student watches video about the combustion of thecandle. / The student confirmed that foaming bathing
powder produces carbon dioxide when dissolved in
Changewater, and that gaseous product, collected by a method
Science
6 s whencalled water substitute, changes limewater white. In an A B A ✓ ✓network
burnt
experiment with the gas gas-detecting tube, thestudent read the textbook and instruction manual
carefully, and worked on the experiment positively.
Also he could find a document more detailed than thecontent of textbook on the Internet when learning
about the ingredient and density of air.
Observe with LCD monitor, not looking into the2
microscope microscope column, lying in the bedside. Also learn
3-A
Small with LCD how to operate a microscope. For the prevention of
6
creature monitor
infections, ready-made prepared slides are used. / The
7 s instudent was not able to work because it was right after A A B✓✓
freshwa ready-made an operation. He set a prepared slide by himself andter
prepared observed microbes. He looked surprised when hefound that small objects on the prepared slide wereslidesreal creatures after magnified.
3-A
Observe with 3D images about transportation of thenourishment, for it is prohibited to carry on plants.
11-A
Learn how water, oxygen, carbon dioxide, andchloroplast moves in conducting tube or sieve tube of
Structura plant. / The student observed a 3D image of a plant
Science
A A A ✓
7 e of✓whose stem was divided vertically and section was
networkplantsshown. He operated that object with a mouse, thenturned or rotated it. He also observed movement ofwater, oxygen or carbon dioxide. He moved theirimage on the screen by himself, saying “I see it.”
3-A
Observe with 3D images about transportation of
nourishment, lying in bed. Learn how nourishment go
11-A
along conducting vessel or sieve tube. Use wirelesslaser mouse, which is easier to handle. / Computer
Science
Structur network
screen was rotated by 90 degrees, so it was easier for
7 e ofthe student to watch the screen and operate the mouse. A A A✓ ✓ ✓ ✓ ✓plants Wireless
He used it by his left hand, since he couldn’t use hislaser mouse right hand by intravenous feeding. At first he didn’t
handle well, but gradually he became accustomed tooperating it. Finally, he was able to open the file of all
the images, and observed them eagerly.
3-A
Prepare for the experiment about how to gather gases,
lying in bed. Use real equipment for the experiment to11-A
Equipment
understand its procedure. Watch video and learn how
for thegases from chemical reaction are gathered. / The
Chemicexperimentstudent prepared equipment for the experimental
A A A ✓
8✓✓
eagerly, looking at a figure in textbook. He breathedreaction
Science
directly into water for downward displacement. Hesnetwork
was little embarrassed, and breathed into a test tube.
He looked glad to see that water in a test tube replaced
his breath.
Teaching Look for the autumn trees and plants. / The student
11-A
materials showed much interest even before computer is ready.
on the Web He intended to look for as many autumn trees and"Autumn plants as possible. It took time until images were
Let'sPlants and displayed under the influence of transmission rate, but
B A A
1 look for✓✓he didn’t care about it and enjoyed looking for them.
Trees"
autumn.
Computer Also he found other information about plays orwith touch cooking with autumn plants. He kept looking for trees
panelsand plants for more than 30 minutes, and found(Windows) everything in this teaching material.
Teaching Look for the autumn trees and plants. / The student
11-A
materials showed interest on computer. However, he showedon the Web little interest looking for autumn trees and plants. He
Let's"Autumn touched panels several times, but not all. Even when
1 look for
C C C
✓
✓
Plants and the scene had changed, it didn’t attract him very much.
autumn.
This activity finished about 10 minutes. In the next
Trees"
class, he tried to make spins with acorn. At first, heComputer didn’t show much interest as well. However, after he(4)Activities to Promote Independence

14 H

15 I

(5)Life-Unit Learning

16 J

17 K

with touch started making them, he gradually became interested.
panelsAfter all, he was able to enjoy this activity.
(Windows)
Talk with foreign people on Skype as a part ofeducation for international understanding and foreign
language activity. / The student talked with foreign
Internati
people working at JICA, Japan International
onal
Video
Cooperation Agency, on Skype. As a prior learning, he
A A A
8 commu -chatting✓
thought about how he introduces himself in English,
nication (Skype)or tried to understand how they live in their homescountries. At first he didn't feel like talking with them,but he said it was a good opportunity to communicate
with people living in foreign countries.
Encourage communication and emotional stability. /The student in a clean room talked with the teachers
Commu Videoon Skype, and talked about how they spend there or
7 nication -chatting his physical condition. One of the teachers appeared A A A✓ ✓ ✓s(Skype)with wig and sunglasses, and the student seemedenjoying. Also he talked with foreign people visiting a
tourist spot close there.
Experience relationships and communication with
Software people.. When the student touches the screen of theLet'stablet computer, his mother or teacher appear withforplay
presentation their voice. / When the student touched its screen, histogether (Keynote) mother or teacher appears with his face hidden by his
5 !
Tablet-type hands. Then it became close-up, saying "Who am I?" A A A ✓ ✓ ✓ ✓device with He strongly reacted to the voice of one teacher of the
Who am touch panel three. When he heard someone say something, he tried
I?
(iPad),
to find out what was happening on the computer. Afterhe got accustomed, he started to relax and tried toreact to everything he saw.
Understand the rules and enjoy learning with teachers.
Find the same figure in playing. / The student played
card matching game in iPad. She concentrated on thegame. When she did the same activity with theiPadoriginal cards made by himself, he talked to theapplication teacher everytime he did something; such as when he(Mr.
couldn't decide, his guessing was not correct, or he got
Shape's
the right guessing. He often expressed his pleasant
Card
Touch
feeling. Time sampling method was used.
1 matchin
B A A
✓
✓
Card)
iPad
Card matching game withg game(Mr. Shape's Touch Card) original hand-made cards
Original
hand-madecards

Operation
time (sec.)
Actions
and expressions

ActiveVery active
Verbalcommunication

11-A

11-A
✓

5-A
11-A

５-A
11-A
11-B

1st trial:18 pairs in 84 sec. 1st trial:18 pairs in 470 sec.
2nd trial:21 pairs in 68 sec. (11 pairs of student and 7
3rd trial:13 pairs in 48 sec. pairs of teacher)
Total: 52 pairs in 200 sec.
13 times (3.9 time / 60 sec.) 23 times (2.9 time / 60 sec.)
1 time (0.3 time / 60 sec.)
10 times (1.3 time / 60 sec.)

3 times

23 times

6 Obtained results and remarks
6.1 In each subject(1) In Social Studies class, using geographical maps was considered to be efficient. Even in their
hospital rooms, it was easier for students to comprehend geographical characteristics of the areas because
ICT devices can enlarge the images when necessary. Also they could recognize that the pictures on their
textbook is one of them taken somewhere in Japan, or feel passage of time comparing to the past andpresent of a certain area. ICT devices make the class more adaptable because of their capabilities.
(2) In Science class, using ICT devices provided the students with virtual experiences. They
participated to the lesson eagerly by clicking or dragging the objects on the screen. They looked very
interested in the objects moving or happening chemical reactions. However, they became passive when
they keep watching the screen of the computer. Not just watching, using both strengths in laboratory
instruments and ICT devices would furnish the students with more realistic experiences.
(3) In Life Environmental Studies, the two students showed contrasting reactions on ICT devices. One
was very curious for the fact that the chirping of insects differs from their species, while the other showed
little interests. That’s probably because he wanted to go out to look for the real ones.

(4) In Activities to Promote Independence, students enjoyed real-time video chatting with mobile data
communication network. Using Skype, they can communicate with people in a distant place. They
communicated with their friends, teachers, or foreigners they had never seen before. In a clean room,
where even their family is not allowed to enter, they could use Skype to communicate with each other.
This should be quite close to actual experiences, or an actual experience to some extent. ICT devices were
helpful also for the students with severe multiple disabilities. They showed great interest on the screen
when they found their teachers or family members. When they touched the screen, some changes
occurred, like hearing something or changing the images on the screen, which led them to expect
someone to appear or something to happen. Consequently, they could participate to this activity on theirown initiative.
(5) In Life-Unit Learning, In card matching game, the amount of learning content increases with ICT
devices, compared with using actual cards. However, the student becomes more active and tries tocommunicate more when actual cards are used. This means the student becomes positive and enjoys
learning with actual object. So we should make much account of real experiences with actual object.
When utilizing ICT devices, we should consider that communication between students and teachers is still
important.
6.2 Characteristics on the purpose in utilizing ICT devices
ICT devices are utilized frequently as explanatory materials of teachers and substitute for actual
experiences (Figure 1, the classification table of utilizing ICT devices). They seem to be used for
reduction of time, and that shortened time is considered to be devoted to experiments or investigative
learning. However, students tend to listen passively to what the teachers explain, so the content oflearning can’t become established easily. If time allows, repeating should be done after the lesson.
Traditional

Explaining for teachers
With textbook, dictionary

Actual experiences
Field work, Experiment↓ ↓ ↓a 120-minute class, three times a week

With ICT

Explaining for teachers
With ICT

Figure 3

Actual experiences or Substituting for actual experiences
Field work, Experiment or virtual experience with ICT

Substituting ICT for actual experiences

6.3 Relation diagram of classification of restriction and utilizing ICT devices
According to practical experiences, we can classify restrictions in teaching children’s hospital intoroughly three elements; A. temporal restriction, B. physical restriction, C. restriction of students’ own. In
addition, we found that utilizing ICT devices is effective for overcoming or relieving theserestrictions.(Figure4)
Utilizing ICT- Overcoming or relieving restrictions

B. Physical restriction

A. Temporal restriction･Being unable to secure enough school hours
on the curriculum･Cancellation of the lessons due to inspections
or bad shape･Restriction of the equipment taken from outside･Lacking opportunities to discuss with classmates･Difficulty joining school events

C. Restriction of students’ own･Being in bad mood because of side

effects, serious symptoms, injuries･Difficulty of studying for a long time

because of their bad condition･Keeping their study lying in bed･Having a risk of infections.

Figure 4

Restrictions in teaching in hospital

7 Conclusion and future issues
In this study, we set up a hypothesis that ICT devices can provide experiences quite close to reality forstudents in hospital. They have many restrictions to learn there, but we presumed that students would play
an active role in learning with ICT devices. Then we carried out a number of learning activities andmethods to supplement their real experiences. As a result, ICT devices alleviated restrictions in learningin the subject of Science, Social Studies, Life Environmental Studies, Activities to Promote Independence,and Life-Unit Studies. With ICT devices, they experienced many learning activities enthusiastically
However, ICT is not omnipotent; we can’t do everything with ICT devices. The more efficient learning
environment becomes with ICT, the less communicative the class becomes. Also, students usually get
tired of learning with ICT devices after a while because of their monotonousness.
The thing we should remember is that real experiences are important for students in hospital.
Experiences with ICT can be one of supplements of real experiences. But it is from these real experiencesthat students learn characters or special features that words can’t convey, like seeing or touching realthings. These experiences would be a guide to think about the things deeply, and also they can change theway of thinking.
If ICT devices should be one and only means under many restrictions, we must depend on them.
However, if possible, it is much effective for students to learn things with real experiences. It is true that
ICT seems of use for students in hospital. However, practical experience must be emphasized as well toform the basic concept of the things. ICT should be one of the supplements when teaching in hospital
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Acknowledgments
My deepest appreciation goes to ex-principal Mr. Michinori Matsui whose enormous support andinsightful comments were invaluable during the course of my study. I would also like to thank principal
Mr. Shoji Ogoda, Mr. Shuji Mizuno of Aichi Prefectural Education Center, Dr. Kengo Nishimaki and Dr.
Kuniyoshi Takigawa of The National Institute of Special Needs education, and the teachers of Obu
Special Support School whose comments made enormous contribution to my work. Finally, I gratefully
appreciate the financial support of MEXT Japan. KAKENHI that made it possible to complete my thesis.
This work was supported by MEXT KAKENHI 24501237 , JSPS KAKENHI 24910010.