Why did I put forward the concept of "combination of medicine and education" in special education?

Shen Xiaoming, vice mayor of Shanghai and former director of Shanghai Education Commission, is a doctor of medicine, professor of pediatrics and doctoral supervisor. I am a pediatrician. Since I transferred from university to Shanghai Education Commission in 2006, I have been looking at education and observing students from the perspective of a pediatrician out of professional instinct. Analyze the problems existing in education with the logic and thinking of doctors. The conclusion drawn by my method is not necessarily correct, but sometimes it is considered unique. My thinking about special education is based on this method. What is so special about special education? In my opinion, special education is special because its education target is not ordinary students, but all kinds of disabled children or sick children. Of course, the doctor knows these sick children best! Unfortunately, at present, special education exists independently as a category of education, and the system is relatively closed, with little or no participation of doctors, so the effect naturally has room for improvement. I put forward the concept of combining medical education with teaching in special education based on the following considerations: First, different diseases have different effects on learning ability. Diseases that affect learning ability can generally be divided into two categories: congenital and acquired. Congenital diseases are mainly genetic and metabolic diseases, such as Down syndrome (also known as 2 1- trisomy syndrome, congenital idiot), congenital testicular hypoplasia (Creutzfeldt's syndrome), congenital ovarian hypoplasia (Turner syndrome), phenylketonuria, congenital hypothyroidism and so on. The most common are sequelae of pathological processes such as nervous system ischemia and hypoxia, trauma and infection. In recent years, the proportion of nerve injuries caused by psychological, behavioral and mental diseases (such as childhood autism, severe attention deficit hyperactivity disorder, etc.) is increasing. ) and environmental factors (such as lead poisoning and cadmium poisoning in children) have increased. Because of the different causes, locations, degrees and mechanisms of nerve injury, these diseases have different effects on learning ability. Only with the help of doctors can special educators understand these diseases and their influence on learning ability, and teaching can be more targeted and get twice the result with half the effort. Second, different parts of the same disease have different effects on learning ability. For example, cerebral palsy is a non-progressive brain injury syndrome caused by various reasons from before birth to within one month after birth. Because of the different causes and parts of brain injury, it can be manifested as central motor disorder, abnormal muscle tone, abnormal posture and reflex, mental retardation, epilepsy, language disorder and hearing and vision impairment. For each specific patient, it may be a variety of different combinations of the above syndromes. So from the point of view of clinical medicine, no two patients with cerebral palsy are exactly the same. From the perspective of special education, some cerebral palsy patients show motor dysfunction, and their nerve development and learning ability may be completely normal; Some patients with cerebral palsy show mental retardation and backward learning ability, while their motor ability is no different from that of normal people. Obviously, with the help of doctors, special educators should first correctly understand what kind of cerebral palsy their educational objects suffer from, so as to teach students in accordance with their aptitude and improve teaching effect. Simply grouping all children with cerebral palsy into one category violates the basic educational principles. Thirdly, the outcomes and prognosis of various diseases have their objective laws. The pathological basis that affects learning ability is mostly the injury of central nervous system. The second nerve cell is one of the few cells in the human body that can't be repaired and its function is reversed. In other words, once a nerve cell dies, it is impossible to revive, which determines that the damage of learning ability cannot be completely restored to normal. The story of "sincere arrival, stone opening" rarely happens. Special educators should know and understand this law, try to avoid functions that have been "dead" as much as possible, and focus on developing functions that have not been "dead", so that educated children can exert their greatest development potential and their overall life and viability in the future will be as close as possible to normal children. To do this, it is difficult to do a good job in special education without the help of doctors. Fourth, the current hospital-based rehabilitation treatment model does not meet the advanced medical model, nor does it meet the needs of special education. The object of special education often needs long-term rehabilitation treatment. At present, all children's rehabilitation treatment processes are carried out in hospitals. This working mode is entirely for the convenience of medical staff's work arrangement, which is incompatible with the core concept of "patient-centered" in clinical work. This model has two obvious disadvantages. First, it is difficult for rehabilitation treatment targets (that is, special education targets) to give consideration to both learning and rehabilitation, and sometimes the burden of learning makes it impossible to implement and execute rehabilitation treatment plans well; Second, rehabilitation therapy is completely separated from learning, and doctors and teachers have their own experiences, so rehabilitation therapy cannot effectively serve teaching. In the American Individual Education for the Disabled Act (IDEA), it is proposed to vigorously develop the school-based rehabilitation treatment model as part of the education process. This kind of thinking is very necessary at present, and it is also worth learning. These can be roughly regarded as the theoretical basis of the combination of medicine and education. First, reform the training mode and curriculum system of special education teachers. At present, some normal schools in China have special education majors to train special education teachers, which is very important for the development of special education in China. But in my opinion, the following aspects of teaching reform are imperative. First, advocate the cooperation between normal colleges and medical colleges to train special education professionals; Secondly, the proportion of Chinese medicine courses for special education majors will be greatly increased, including classroom education, interviews and internships; Third, through continuing education, the in-service special education teachers are trained in relevant medical courses; Fourth, through dual degrees and joint training of master's and doctoral students, a group of high-level talents in special education will be trained. Second, establish a working system combining medical education with teaching, and formulate corresponding work norms. Through the cooperation of government education, health administrative departments and organizations of the disabled, we will establish a working system of combining medical education and formulate corresponding work norms. Work rules and regulations shall include but not be limited to the following aspects. First, establish an interdisciplinary entrance assessment mechanism composed of special education teachers, doctors and social workers (or volunteers) who serve the disabled; The second is to establish a special education consultation mechanism with the participation of special education teachers, doctors and parents, and to communicate and coordinate opinions on whether to enter special education schools or ordinary schools, the individual teaching objectives and career planning of educational objects, teaching plans and curriculum settings, and the cooperation between special education and family education; The third is to establish a mechanism for doctors to participate in teaching regularly and evaluate the teaching effect regularly, and dynamically adjust the teaching plan and curriculum according to the evaluation results. Third, establish a number of school-based children's rehabilitation centers. With the support of the health administrative department, rehabilitation centers that meet the requirements of health license and the standards of medical rehabilitation institutions should be established in qualified special education schools, so as to achieve the purpose of combining rehabilitation with teaching and promoting each other, and at the same time improve the compliance and actual effect of rehabilitation treatment. These are my thoughts on the combination of Chinese medicine education and teaching in special education. Fortunately, many of my views have been positively responded by many experts in the field of national special education. At present, the combination of medicine and education has been written into the Outline of the National Medium-and Long-term Education Reform and Development Plan, and "Promoting the combination of medicine and education and improving the level of special education" proposed by the Shanghai Municipal Education Commission has been listed as a pilot project of the national education system reform. It is understood that this project is the only special education project among more than 400 educational system reform projects in China. 20 12 Mid-Autumn Festival in Shanghai.