Social withdrawal is thought to be a common cause of non-attendance at school. Much attention has been paid to shaping going-to-school behavior. In treating non-attendance at school, little research, however, has focused on the withdrawn behavior. In the present study, social skills training was applied to a 7-year-old girl with social withdrawal and non-attendance at school. The training consisted of two stages; in each stage, the training procedure followed three steps: 1) behavior assessment carried out through analysis of interactions, 2) selection of target behaviors, and 3) social skills training, comprised of modeling, feedback, and shaping. In Stage 1, assertiveness was chosen as the target behavior. After training, the subject had acquired target behavior, and the frequency of her interactions had increased. But her social initiations were not sufficient to establish social chains. Then, in Stage 2, behavior of praising other children was chosen as her target. The results were that she acquired praising behavior and established social chains. In addition, her withdrawn behavior disappeared, and the problem of non-attendance at school improved as well.

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The purpose of the present study was to investigate the learning process of early speech behavior in 124 3-to 6-year-old children with developmental retardation. In this study, speech behavior is defined as discriminative behavior that uses the visual and auditory senses. To analyze the process of learning speech behavior, Sugai's Speech Behavior Test was used. A popular Japanese nursery rhyme ("Genkotuyama no Tanuki-san") was used in the test. The nursery rhyme is usually sung with 7 typical patterns of gestural movements. Here, the verbal sign system was categorized into three systems: manual sign system, speech system, and letter system. The nursery rhyme could affect both the manual sign system and the speech system. The test communicated with a child as follows: First, the nursery rhyme was presented to the child by the tester singing the song with gestural movements. Second, it was presented by tape recorder as just the song, without any gestural movements. The tape recording was played twice, at different speeds, so that the first presentation took 13 seconds, the second, 10 seconds. Third, the nursery rhyme was presented as a recorded song with a band. In this case, the song was presented three times, at three different speeds; the first took 12 seconds, the second, 10, and the third, 8. The results were grouped into the following five stages: First stage: The children began to learn how to move and control their body and hand gestures. For them, the tactile and visual signs were more effective than auditory signs (songs). Second stage: The children began to learn how to form the hand gestures that went with the nursery rhyme. For them, a visual sign (hand gesture) was necessary in order for them to be able to form the hand gesture themselves. Third stage: The children began to form the hand gestures of the nursery rhyme and made them match the song when it was presented in 13 seconds. In this stage, the children began to sing. Fourth stage: The children could make the hand gestures and match them to the song when it was presented in 10 seconds. Fifth stage: The children could discriminate the nursery rhyme recorded with the band, could make the hand gestures match the song, and could sing the whole song. For children in the first and second stages, tactile and visual signs played a more important role than auditory signs (i.e., the song) in their forming the hand gestures. From the third stage, the auditory signs were effective for the children. Appropriate interventions depending on the child's stage were discussed.

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The present article reports an experimental early language intervention with a 3-year-old girl with Down syndrome who was in a prelinguistic stage. She was taught communication skills in the context of an action routine: Physical play on a circuit, and snack. From an analysis of these two situations, 50 basic activities could be distinguished. The subject needed to request 10 basic activities. The level of her understanding of the routine was assessed by 7 stages, and the level of requests, by 6. In communicating with her, the teacher gradually raised the level. In request situations, the teacher was required to wait at least 5 seconds. In the early part of the experiment, the subject could not understand the context. In the middle part, even though she could not understand the instruction from the spoken words, she came to be able to participate in the routine with prompting. In the later part of the experiment, she could understand the spoken instructions. In the request situations in the early part of the experiment, she simply waited. But in the middle part of the experiment, she began to make requests, using looking behavior. In the later part of the experiment, she became able to make requests, using gestures and vocalizations accompanied by looking behavior.

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The present research was designed to investigate the relation between different parts of the body and manipulation in a preschool child with severe multiple disabilities. The child, 2 years 7 months old, with severe multiple disabilities, including cerebral palsy, hypocalcemia, infatile spasm and severe mental retardation, was the subject. Since postural control of the head-trunk-hands-legs system is a prerequisite to development of part of the body and to manipulation of various objects, we observed the relation between parts of the body and the child's manipulation of things in terms of postures that the child was in. First, while in a supine position, he learned to ring a chime by kicking with his legs. In addition to that, he learned to manipulate toys with his legs. Second, while turned sideways on the floor, he learned to ring a chime or light a bulb with his hands while looking at his hand. Eye-hand coordiation appeared only after this manipulation. Third, while in a seated posture, he learned to ring a chime or to light a bulb by kicking with his legs while looking at them. Moreover, he learned to light a bulb by switching it on with his mouth, supporting his body on the floor with his legs. Our conclusion is that in the early stage of human behaviors, children with severe multiple disabilities interact with the surrounding world by manipulating various objects with parts of their body.

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Only a few attempts have been made so far at researching heart rate changes in persons with profound disabilities. The purpose of this paper is to discuss the relationship between heart rate changes and aging. The first study investigated 216 persons (CA 3-49 years) with profound disabilities, using a cross-sectional method. The patients were divided into two groups according to their locomotive abilities. One group included 133 bedridden patients (mean CA, 20 years 8 months); the other, 83 non-bedridden patients (mean CA, 31 years 10 months). Average heart rate was compared between the two groups. The scond study utilized a longitudinal method with 40 patients with profound disabilities (CA 1-40 years). They were divided into two groups as in the first study. An annual heart rate measure was compared in two groups. In both studies, heart rates measured at midnight by ward nurses were analyzed by statistical methods. The results were as follows: Even in persons with profound disabilities, heart rate showed decreasing patterns depending on age, similar to the pattern reported for persons without disabilities (Fig. 1). Within the two groups, the bedridden patients showed a significantly lower heart rate than the non-bedridden patients (Fig. 2). The differences between these decreasing heart-rate patterns depended on the patients' locomotive abilities. These findings were shown not only through the cross-sectional method, but also with the longitudial method. This study found that the decreasing patterns of heart rate in persons with profound disabilities were influenced by two factors. First, the changes depended on the degree of locomotive ability, and second, they depended on the age of the patients (Table 1).

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