A tour through theYokohama RehabilitationCenter

Yokohama　National　University

Every time I went to a care center, here in Japan I see only very nice things. The place is full of light, the rooms are clean, and the place smells good, not like a hospital. The doctors and educators are polite, and the place is very well equipped. There are rooms that look like kitchens, bathrooms, toilets, spacious play rooms; they all are having special accessories (like shelves with big knobs, in order to be easier to handle), until now this is something normal to expect from a rehabilitation center, but also, I would like to pay a special attention to the research department (the 4th floor of the building). New machines are designed there, to enhance the development and exercise of different skills of people with special needs. Also, especially interesting for me was to see the ski devices that were used at the winter the Paralympics in Nagano four years ago. It is a grate thing to offer everybody the possibility of practicing sports at a high performance level. I was very glad to find out that. It is very important that Japanese educational system is paying so much attention to the research part. Unfortunately others countries with very few exceptions are not doing that. Also, another important thing was special equipment for stairs climbing (when there was no elevator, 5th floor).
When I came toJapan, I couldn’t understand in the beginning, what is the meaning of those yellow paths on the pedestrian’s road. Only after a while I realized that they were designed for special needs people. A things like this is a result of some research, some scholar thought that this kind of roads could help blind people a lot, and it was implemented. It is astonishing.

My visit to the Yokohama Integral Rehabilitation Center and some consideration on Japanese present situation of special education


Special educator from foreign country

It had been some time since I wanted to visit this center, but I hadn't had the chance. This is precisely the reason why I was so glad to visit.
First, our guide suggested we should define the term "disability" as if we were explaining it to a child in elementary school. This task proved to be harder than it seemed, and in trying to come up with a definition, I noticed that although I have been working in the field of education for children with disabilities for many years, there are many things I thought I knew but I really don't fully understand, and individuals in the healthcare field (medical staff, e.g., child neurologist, child psychiatrist, physical therapist, occupational therapist, speech pathologist and education staff, etc.) have a hard time trying to explain the concept to other people in simple terms. This visit reminded me that we can't forget about the basics while making effort to specialize in a field of knowledge.
This center's functions are as complete as I had imagined, it is an example of the level of social assistance the city of Yokohama provides. The investigation and design development departments in the center grabbed my attention particularly. They develop devices not only to facilitate activities, but also to improve well-being and quality of life of individuals with disabilities. This is not a profitable business for companies, so other organizations such as this center have to take on this function. This is an issue that reminded me of the Japanese society's immaturity. The center recognizes it can still improve in the fields of education and early treatment; they are making great efforts to improve, although they don't have the required capacity yet because Yokohama City has the population of 3.4 million. I consider these fields are the mainstay for healthcare and will follow the development of this center closely.
An outstanding subject to be discussed in the center is "continuous connection between such early medical and educational intervention and special education" which greatly attracts me. Human development has to been understood as a continuum. However, administrative intervention has divided human development into different stages such as infant age which is under the control of the department of health and social welfare, a school child age which is under the educational board and adult that is again under the control of the department of health and social welfare. And in the field of Japanese special education the medical staff is excluded from the school and only special educators “educate” children with disabilities. Is there any meaning if an educator feed cerebral palsy child using all the school time without using nasal tube. This unnatural division and irrational exclusion of medical staff can cause problems. I think that there is greater and urgent need to link special education with mecical care in Japanese special education in every stage of human being.

Impressions of my visit to the Yokohama Integral Rehabilitation Center

Motoko Kimura

1. Introduction
I had the opportunity to visit the Integral Rehabilitation Center in the city of Yokohama. I had visited the Yokohama Pole and the community pool, but didn't know this center was located in the neighboring buildings. Neither did I know the center's functions. I will therefore describe my impressions during this visit.

2. About the "Integral Rehabilitation Center" name.
When I heard the name "Integral Rehabilitation Center", I imagined a center for the rehabilitation of mobility-impaired individuals, not for intellectually impaired individuals.
While entering the center I noticed an elder man who seemed to have no impairment, talking to the receptionist (maybe a patient's relative). On the other hand, as I imagined, I noticed people in wheel chairs and smoking cigarettes in the cafeteria. The informative plate (map) at the center's entrance states the center was established as a hospital. Thus the real center was a little different from what I imagined.

3. What the center rehabilitates.
Just as we started the tour,our guide (a chief clerk Mr. Takahashi), suggested we should define the terms "handicapped people and children" and "people and children with intellectual disabilities" as if we were explaining it to a 10-year-old child.
I answered the following: Regarding handicapped people and children, they are people and children who cannot do certain things, but depending on the type of care they receive, they may do them, or not being able to do them, their problems can be eased. As for people and children with intellectual disabilities, they are people and children who think slowly, understand things thinking slowly or don't understand things even when thinking slowly; some can't even think slowly, but depending on the type of care they receive, they can do things they weren't able to do, or if this change cannot be accomplished, their problems can be eased. Defining "disability" proved to be harder than it seemed. New questions emerged: what kinds of people come to this center for rehabilitation? What can this center rehabilitate?

4. Tasks determine disability
Mr. T, our guide during this tour, used to work in City Hall developing welfare programs. Therefore, what he commented during our visit came from a welfare and administrative point of view. This was very interesting since it is very different from what we hear everyday at the university. The single phrase that impressed me the most was "When dealing with people and children with disabilities, medicine, psychology, sociology, and administration are mutually related, but they are not related to education". For those of us in the field of education it is normal to think of things revolving around education. But listening to Mr. T's speech, medicine, psychology, sociology, and administration are given much more importance in the real world. We in the field of education, ignoring the outside world, tend to think that we are closer to people and children with disabilities, but this is and illusion. This speech made me notice that care for people and children with disabilities has to be though of in terms of an integral social system.
We are aware of the relation between welfare, medicine, and psychology in the field of education, but sociology and administration are left aside. According to Mr. T's speech this is a common point of view in the fields of welfare and administration. I felt a little embarrassed noticing this point of view is lacking in the field of education. I am currently working on an investigation that involves sociology and confirmed the importance it will have in the future.
Back to the issue of defining "disability", according to Mr. T's speech, a dividing line must be drawn when measuring the degree of disability and providing welfare services. For example, regarding intellectual disability, a point must be defined from which an impediment is considered as intellectual disability. While treating individuals with disabilities we cannot state it is too hard to define "disability", we have to link the results of investigations from different fields. I can't yet imagine a tangible way to link these different fields, but it will be important to have this in mind when conducting future studies.

5. Rehabilitation Practices
After the speech, we visited different areas within the facilities where actual rehabilitation is carried out. There are specific areas for children and adults, and people with mobility disabilities or intellectual disabilities.
I didn't have time to find answers to some questions: What type of relation exists between individuals requiring and providing the service? Is rehabilitation the service they require? What is the meaning of rehabilitation? This question is closely related to the initial matter: "What is a disability?"

6. Conclusions
We spent more time listening to a speech than visiting the facilities. As a result I couldn't fully understand the center's functions. However, this visit helped me notice the importance of appropriately defining disabilities and visiting places different from education centers. If possible, I would like to visit the Yokohama Early Education and Medical Treatment(Early Intervention)Centers. We would be able to learn from their early intervention in educational and medical system for children with disabilities, which deals with cases similar to those we treat every day in special schools.

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