Health Literacy for Disabled Students: A Case Study of Curriculum Development in Japanese Special Schools

1. Location And Purpose Of The Problem

The purpose of this chapter is to examine the learning issues in children's health literacy education for the intellectually disabled. Health literacy, as a further development from the concept of health promotion, is positioned as a key concept in health education (Nutbeam, 2000). It is considered to be a concept that goes further from a process that allows people to control and improve their own health and to recognize patients and their families as entities that can actively acquire health. Health literacy and related practical issues have been the subject of discussion recent research. In with-COVID 19 times, the discussion and practice on the health literacy are also critical in the schooling, for the safe schooling and classroom activities. The purpose of this chapter is to discuss the chief issues on health literacy for the children with the special educational needs, especially focused on the intellectually and developmentally disabled students.

This chapter will also focus on the recent characteristics of health literacy. The importance of maintaining children's mental and physical health and supporting their recovery from mental and physical illnesses has become increasingly strong. One example is the acquisition of hygiene concepts and the habituation of hygiene behaviors due to the spread of the novel coronavirus infection (COVID-19). The spread of the COVID-19 infection has not only affected the maintenance of one's own health and health care, but also the maintenance of health in relation to close others, such as family members, and the wearing of masks in public spaces. In May 2023, the World Health Organization (WHO) declared the end of the “public health emergency of international concern (PHEIC)” for COVID-19, but the challenges of maintaining and managing health, including the so-called sequelae, continue. Challenges to health maintenance, including the so-called after-effects, continue. This is one of the possibilities of health literacy education, not only for health care of the self but also for concern regarding health in the public sphere at large. This chapter tries the theoretical and case studies in Japanese classes how students with special educational needs learn and acquire the health literacy through the daily lessons, and how health literacy program relate the other learning fields such as natural sciences, physical education, media literacy education, and so on.

In Japan's special education schools and other special-needs education, learning about independent activities is positioned as an essential part of the curriculum. In the self-reliance activities stipulated in the curriculum guidelines for special-needs schools in Japan, six categories and 27 learning contents are presented (Ministry of Education, Culture, Sports, Science and Technology, 2019). For example, in the category of “health maintenance,” the content includes matters related to the formation of lifestyle habits, understanding of disease states, and life management (Ibid.). Independent activities are required to be implemented not only in special-needs schools but also in special-needs classes and day classes. The 27 learning contents are expected to be selected, organized, and embodied as appropriate learning tasks in accordance with the actual conditions of individual students. For example, when considering learning issues related to health in the context of education for the intellectually disabled, the emphasis is not only on disease and the maintenance of health, but also on “developing the ability to manage one's own health.” This emphasis is not only on the prevention of disease through daily life, but also on the long-term issue of social participation after graduation.

The same can be said not only for independent activities but also for combined instruction in each subject area, for example, in the teaching of daily life and life-unit learning. Furthermore, students need to be able not only to manage their own health but also to choose their own activities and communicate with others on that basis. The ability to be aware of one's physical condition and disease status and to accurately judge what one can do and to what extent one can do it under exiting circumstances is also emphasized.