In the present study, an Inclusive Engagement Scale was developed to measure the engaging behaviors of mainstream classroom teachers in elementary schools as they communicate with children in a manner that reflects the children's intellectual disabilities to promote inclusive education and to explore factors influencing inclusive engagement. First, 2 preliminary research studies were conducted in order to develop a draft of the Inclusive Engagement Scale. Using those data, items in the proposed scale were evaluated and a hypothetical model for factors influencing inclusive engagement was created. Then, a web-based survey was conducted, using the newly developed scale, which obtained 196 valid responses from mainstream classroom teachers (131 men, 65 women) in elementary schools. Factor analysis of the Inclusive Engagement Scale identified 3 factors: “conveying instructions to children with intellectual disabilities,” “understanding children with intellectual disabilities,” and “independent/normalizing engagement.” All 3 factors showed high internal consistency, thereby supporting reliability. Moreover, criterion-related validity was supported by a moderate positive correlation with an existing scale with which association was expected. In the examination of factors that influence inclusive engagement, previous experience with special education was set as the first level; self-help resources and support resources, the second level; current relationship formation, the third level; and inclusive engagement, the fourth level. The results of a path analysis under these conditions indicated specific effects from each level.

Smith-Magenis syndrome (SMS) is a genetic disease caused by partial deletions or mutation of the RAI1 gene in chromosome 17p11.2. The main clinical symptoms include craniofacial differences, intellectual disability, sleep disturbance, and behavior problems. However, in Japan, behavior problems in individuals with SMS have seldom been studied. The present study aimed to identify characteristics of these problems. A Japanese version of the Child Behavior Checklist (CBCL) was completed by 61 (73.5％) of the 81 families who were members of an association for families of children with SMS. T-scores could be calculated for 30 of their children with SMS; the children were from 4 to 15 years old. The total scores and mean T-scores for 4 out of 10 sub-scales were within the clinical range. More than half of the 61 participants were rated as displaying behavior that corresponded to 29 of the 108 subscales on the Child Behavior Checklist, such as “attention problem” or “temper tantrum”. In addition, the average T-scores on some sub-scales and the percentage of participants displaying the behavior corresponding to some of the sub-scales were significantly higher for participants who were 12 years old or older than for those younger than 12. These results indicate that, in Japan, individuals with SMS are likely to develop a variety of behavior problems. The results also suggest that from now on, strategies should be considered for preventing the occurrence of behavior problems in children with SMS, and for providing more appropriate accommodations in relation to children's behavior problems that are associated with SMS.

The purpose of the present study was to examine the usefulness for students with cerebral palsy of individualized instruction based on the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, and specifically whether that type of instruction fostered their ability to solve problems independently. The participants, 2 teenage students with cerebral palsy who were attending a high school for students with special needs, received individual instruction for 3 months. The results suggested that, after the individualized instruction, the students were able to set their own goals, discover their goal strategies, and achieve their goals. Their scores on the Canadian Occupational Performance Measure (COPM), Goal Achievement Scaling (GAS), and the Performance Quality Rating Scale (PQRS) were higher for both students in the post-intervention evaluation compared to the pre-intervention evaluation, and the effects were maintained in a follow-up evaluation 3 months after the end of the individualized instruction program. On a fourth test, the Vineland-II, 1 of the students improved from a score of 22 in the coarse motor component in the pre-intervention assessment to a score of 34 in the post-intervention assessment. These results suggest that individualized instruction based on the Cognitive Orientation to daily Occupational Performance approach was effective in a special needs education setting for improving independent learning for these students with cerebral palsy.

In Japan, even though parent training is gaining attention and is recommended by the central government as support for families of children with disabilities, only 20％ of local governments are implementing it. The present study examined effects of a short version of a parent training program that was provided by elementary school teachers. Teachers (N＝11) from 7 schools participated in 10.5 hours of training. They then provided a 4.5-hour (1.5 hours a day for 3 days) parent training program to parents who agreed to participate. The participating parents (N＝43) included parents of children in special needs classes and in regular classes. Data were collected from 19 of those parents. No change was found in the teachers' support for the parents, but an increase was observed in the scores on the self-efficacy of class management, including an item about the extent to which the teachers could approach students' families so that they could support their children's increased participation in school. The parents' depression scores and the children's behavior scores decreased significantly; this suggests that the teachers were capable of providing effective parent training when they were given adequate training. On the Child Behavioral Checklist (CBCL), 10 of the 19 children were in the clinical range before the parent training, and, after the training, the scores of the 4 children who had been in the clinical range were no longer in that range. These results suggest that parent training in elementary schools can function as a sustainable community-based parent-training model. Limitations of the study include that insufficient data were collected, a control group should have been included, and follow-up data should have been collected to examine the duration of the effects.

The usefulness of various treatment programs for people who stutter has been highlighted recently. In implementing evidence-based clinical practice, the quality of the studies extracted during systematic reviews that serve as guidelines for treatment programs should be assessed, and, as clinical studies may involve some risk of biases, the reliability, validity, and reproducibility of protocols and designated outcomes should be examined. The present paper reviews reports of clinical studies of school-aged children in Japan who stutter. Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), a tool for assessing the risk of bias in observational studies, was used. RoBANS evaluates the risk of bias in the following domains: selection of participants, confounding variables, measurement of exposure, blinding of outcome assessments, incomplete outcome data, and selective outcome reporting. Because more relevant case reports have been published in the Japanese literature than in the non-Japanese literature, and because of limitations such as study design, assessing the risk of bias as “low” or “high” canoften be difficult. Despite these limitations, the quality of clinical studies could be improved in several ways. Therefore, in order to have a more reproducible manner for disseminating the results of clinical studies of people in Japan who stutter, thestudies reported should consider the risk of bias. Furthermore, the issues necessary for describing high-quality clinicalstudies were discussed.