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		<h1 class="catchCopy">小児・発達期のセラピーについて，評価から治療手技選択に向かうクリニカル・リーズニングを軸に記述．小児・発達期の実践現場に置いて活用して欲しい1冊！</h1>
		

		<h1 class="title">小児・発達期の包括的アプローチ<span class="version"></span></h1>
		<h2 class="subTitle">PT・OTのための実践的リハビリテーション</h2>

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					編集：新田　收（首都大学東京大学院教授）
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					<span class="transparent">編集</span>　竹井　仁（首都大学東京大学院教授）
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					<span class="transparent">編集</span>　三浦香織（東京医療学院大学講師）
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				<ul class="property"><li class="disc">B5判・512頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-4501-3</li><li class="disc">2013年12月3日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">小児・発達期のセラピーについて，評価から治療手技選択に向かうクリニカル・リーズニングを軸に記述．総論では，小児・発達期の障害を理解するための基礎的な知識と，小児，発達障害に対する理学療法・作業療法の実践に必要な知識を概説する．各論では，日頃，PTやOTが直面しやすい小児発達障害の症状，徴候を取り上げ，評価項目選択の意義を確認し，実際の臨床で遭遇したケースを1～数例提示し，評価を元に選択した治療を提示する．「人はどのように発達するのか」，「人はどのように歩行を獲得するのか」，「器用さとは何か」，「食べることは生きるための基本です」，「コミュニケーションは社会で生きる基本です」，「NICU」，「脳性麻痺の理学療法―運動発達を引き上げるこころみ」，「脳性麻痺の理学療法―学童期の理学療法」，「脳性麻痺の作業療法」，など．小児・発達期の実践現場に置いて活用して欲しい1冊！</section><section class="preface">序文<br><br>　本書を手に取っていただきありがとうございます．小児領域に関わるセラピストの方々とセラピストを目指す学生の皆様に是非お役に立てていただきたく執筆者一同総力上げて完成させました．<br>　本書は「小児・発達期の包括的アプローチ」をテーマにしております．ところで小児領域の意味する範囲は広く簡単に定義することはできません．年齢から小児期，成人に達する以前の年齢層を対象とする領域と定義することも可能です．つまり人として未完成な状態にあり，発達の過程にある者を対象とする領域とすることもできます．この定義にしたがえば内部疾患であれ，運動器疾患であれこの年齢層を対象とする場合小児理学療法となる．ただ年齢層だけの定義では十分とは言えません．<br>　小児リハビリテーションの代表的対象疾患である「脳性麻痺」「筋ジストロフィー」等について考えると，成人した脳性麻痺であっても通常小児の専門家が対応します．養成課程においても，これら疾患は年齢に関係なく一貫して小児領域として扱われます．<br>　つまり小児領域のセラピストは人の全般的な発達と，当領域に特徴的な疾患について深く理解することが求められます．このことを念頭に目次構成を検討いたしました．前半「総論」として，人の発達に関して，運動，認知，コミュニケーション，セルフケア等に分け解説しています．理学療法士，作業療法士などセラピストはそれぞれ養成課程において，重点を置かれる内容が異なります．このためにそれぞれ知識に偏りがあることも否めません．臨床の場ではこうした養成課程の事情にかかわらずセラピストは発達に関する総合的な知識が求められます．一度ページをめくってください，発達について知識を整理し，理解を深めることにきっとお役に立てると思います．<br>　そして目次後半では「各論」として，疾患と治療手技について具体的に解説しています．それぞれの解説は実践的であることを心がけました．疾患の理解から，評価方法，プログラムの立案と実行に至るまで，事例を挙げ詳細に述べています．もしいま気になる疾患があるようでしたらそのページだけでもお目をお通しください．きっと参考になると思います．<br>　また取り上げる疾患についても慎重に検討いたしました．これは最近小児領域にみられる変化に敏感に反応し，より臨床現場のニーズに答えた形にすることに焦点を当てたからです．周産期医療の変化により，セラピストが対象とする児像も変化しつつあります．<br>　以前多かった歩行獲得を目標とする障害児は減少し，重症心身障害児が増加する傾向が報告されています．一方走り回る障害児である発達障害が増加しているとの報告も見られます．超未熟児，NICU といった一連の経過がこうした障害像の変化に何らかの関連があるとの指摘もあります．こうした状況下でセラピストは従来の専門性にこだわらず広く疾<br>患を理解することが求められています．<br>　本書は各セラピストの専門性の枠をこえて対象児の理解に役立つことを確信しております．どうか実践的な臨床現場でお手元にお置きください．<br><br>編者一同</section><section class="indexes">総 論<br>1 人はどのように発達するのか<br>　受精から出産まで<br>　人はどのように発達するのか<br>　心理的な発達<br>2 人はどのようにして歩行を獲得するのか<br>　運動器の発生<br>　運動発達<br>　姿勢反射<br>　Milaniの運動発達評価表<br>3 器用さとは何か─視覚機能と手の機能の発達から考える─<br>　はじめに─器用さとは─<br>　手の役割<br>　視覚機能と手の機能の発達<br>　視覚機能と手の機能の連続機構<br>　脳性麻痺児の手とセラピィ<br>　脳性麻痺児の視覚機能とセラピィ<br>4 食べることは生きるための基本です<br>　摂食・嚥下機能はどのように発達するのか<br>　嚥下障害とは<br>　誤嚥対策<br>　摂食・嚥下指導<br>5 コミュニケーションは社会で生きる基本です<br>　子どものコミュニケーションの発達にかかわる概念<br>　コミュニケーションの力が育つ樹<br>　子どものコミュニケーションを育てるために<br>　子どもとのコミュニケーションを促すために<br>6 感覚統合について知ろう<br>　感覚統合理論<br>　それぞれの感覚はどのような情報を私たちに提供しているのだろうか？<br>　感覚の統合とはどのようなことなのだろうか<br>　感覚統合はどのように発達するのだろうか<br>　感覚と運動はどのように連携するのだろうか<br>　人の生活と感覚統合はどのように関係しているのだろうか？<br>　感覚統合障害に対する支援とは？<br>7 認知の発達を知ろう<br>　認知とは何か<br>　運動・行為を創り出す「身体」<br>　身体─運動・行為─認知（知覚）<br>　自分の身体を知る<br>　自分を取り巻く環境を知る<br>　発達の神経基盤<br>　脳性麻痺児の世界<br>　認知運動療法とは？<br>　認知運動療法（認知神経リハビリテーション）における運動のとらえ方<br>　認知運動療法（認知神経リハビリテーション）における評価<br>　認知運動療法の実践<br>　認知運動療法の実際<br>8 セルフケアの発達，遊びの発達<br>　食事行動の発達<br>　更衣動作の発達<br>　排泄の発達<br>　遊びの発達<br>9 障害の病理を知ろう<br>　中枢神経疾患はどのようにして発生するのか<br>　遺伝性疾患のいろいろ─遺伝が関係する疾患のとらえ方<br>　小児の代謝障害<br>10 痙性の整形外科的な治療<br>　痙性の治療─整形外科的選択的痙性コントロール手術―<br>　OSSCSの概念<br>　OSSCSの目的<br>　OSSCSの適応と時期<br>　手術部位<br>　術後リハビリテーション<br>11 障害のある子どもを育てるのに必要なサービス・支援とは？<br>　障害のある子どもを支援するサービス<br>各 論<br>1 NICU<br>　増加する低出生体重児〜発達の場としてのNICU<br>　NICUにはセラピストが必要<br>　児の現在と未来を評価する<br>　NICUでセラピストが考えるべきこと，やるべきこと<br>　どのように介入手段を決定しアプローチを進めていくか<br>2 脳性麻痺の理学療法〜運動発達を引き上げるこころみ〜<br>　脳性麻痺の運動発達の特徴<br>　セラピストは試されている？<br>　病態像を整理する<br>　脳性麻痺児の運動の着眼点を学びとろう！<br>　見通しをもった治療を展開する<br>　治療成果をわかりやすく提示する<br>　理学療法介入後の動作の変化を確かめる取り組み<br>3 脳性麻痺の理学療法〜学童期の理学療法〜<br>　脳性麻痺（Cerebral Palsy：CP）とは？<br>　脳性麻痺の定義<br>　脳性麻痺の分類<br>　学童期の理学療法<br>　理学療法の介入手段<br>4 脳性麻痺の作業療法<br>　脳性麻痺と遊び<br>　運動発達と知覚・認知の発達の特性<br>　「意味のある作業」としての遊び<br>　セルフケア<br>　就学に向けた準備<br>　アテトーゼ型脳性麻痺の作業療法<br>　作業を獲得するために必要な事柄<br>　教科学習<br>　心理面<br>　社会参加<br>5 Duchenne型筋ジストロフィーの理学療法<br>　Duchenne型筋ジストロフィーの特徴<br>　DMDはどのようなことで困るのか？<br>　DMDの理学療法で必要なことは？<br>　DMDの理学療法評価で大切なことは？<br>　DMDの理学療法<br>　脊柱の変形に対して何をするのか？<br>　コンディショニングについて<br>6 デュシェンヌ型筋ジストロフィーの作業療法<br>　疾患の概要<br>　DMDの経過と支援<br>　まとめ<br>7 二分脊椎の理学療法<br>　二分脊椎とは何か<br>　乳児期の特徴（0〜1歳）<br>　幼児前期（1〜3歳）<br>　幼児後期（4〜6歳）<br>　学齢期の特徴<br>　二分脊椎児の歩行<br>　補装具を活用しよう<br>　長期的予後<br>8 二分脊椎の作業療法<br>　SB児に対するOTの流れ<br>　幼児期の特徴を知ろう<br>　学齢期の特徴を知ろう<br>　SB児の評価と援助の実際<br>　重度のSB児についても知ろう<br>9 重症心身障害児者<br>　重症心身障害児者とはどのような方々で，何を必要としているのか<br>　正常運動発達の連続性を胎内にまでさかのぼって類推するようにする<br>　長期の時間経過のなかで変形や拘縮が進行することを知る<br>　体幹のアライメントの崩れを見逃さない<br>　ポジショニングの重要性を認識し，関係者に伝達する<br>　年少・年長を問わず，既製品の車椅子・座位保持装置を安易に提示しない<br>　職員数が少ないことや学齢期ということを理由に理学療法の機会を制限しない<br>　安楽な車椅子をつくる<br>　養育者の努力に敬意を払い，その経験から学ぶ姿勢をもつ<br>　セラピスト自身の哲学を構築する<br>　重症心身障害児者の治療効果とは何であろうか<br>10 ダウン症候群の理学療法<br>　ダウン症候群とはどのような疾患だろうか？<br>　なぜ，染色体数の異常が生じるのか？<br>　ダウン症候群は合併症が皆異なる<br>　ダウン症候群児では年齢別の母子指導で発達を促そう<br>　ダウン症候群の特徴に沿った発達援助によって抗重力姿勢を促そう<br>　ダウン症候群児のリスク管理ってあるの？<br>11 知的障害の作業療法<br>　知的障害とは<br>　知的障害児へのアプローチ<br>12 発達障害の作業療法<br>　感覚統合療法<br>　TEACCHプログラム<br>　認知行動療法<br>　SST（Social Skill Training：社会生活技能訓練）<br>13 発達障害と姿勢の安定（発達障害の理学療法）<br>　理学療法士はどのように発達障害をとらえるか<br>　DCDの基本的運動機能評価方法<br>　協調運動障害とはどのような障害なのか<br>　症例紹介<br>　評価の解釈<br>　介入の考え方<br>　基本的な介入方法<br>　比較的速い動きを伴った介入方法<br>14-1 視覚障害児の作業療法<br>　視覚障害の概念をおさえよう<br>　視覚機能（「視力」と「視野」）とその評価方法についておさえよう<br>　視覚障害児が生活，学習している場を知ろう<br>　視覚障害児に対する具体的な支援の例を知ろう<br>14-2 聴覚障害<br>　耳のしくみを簡単解説！！<br>　難聴（聴覚障がい）とは<br>　私たちの聴力は，オージオグラムで表される<br>　聴覚障がいのある子どものオージオグラムの例とその様子<br>　聞こえにくさを補うために<br>　心がけたいこと<br>15 子どもの虐待の作業療法<br>　子どもの虐待とはなにか<br>　虐待の分類をあげよう<br>　虐待の相談件数を知ろう<br>　虐待はひとごとではない<br>　虐待の世代間連鎖とは<br>　評価項目から虐待が子どもに及ぼす影響の大きさを知ろう<br>　虐待を受けた子どもと家族への支援の流れ<br>　虐待を受けた子どもとかかわるための基礎知識<br>　評価と治療・援助の実際<br>16 小児整形外科疾患の理学療法<br>　小児整形外科疾患を評価・治療するうえで必要なこと<br>　子どもにかかわるうえで必要なこと<br>　保護者への配慮<br>　代表的な小児整形外科疾患<br>　【小児の側弯症におけるクリニカルリーズニングの流れ】<br>17 小児スポーツ外傷・障害<br>　二極化する小児・成長期スポーツ<br>　小児・成長期という特性をふまえる<br>　スポーツ外傷とスポーツ障害の違い<br>　骨端線とは<br>　復帰の際に考慮すべき小児・成長期スポーツ外傷・障害の要因<br>　内的要因：成長<br>　成長と個人差<br>　内的要因：性別<br>　内的要因：身体機能<br>　外的要因 403<br>　小児・成長期スポーツ外傷・障害の予防，再発予防<br>　ストレッチングと体幹エクササイズ<br>　ストレッチング<br>　体幹エクササイズ<br>　片脚立ちと片脚スクワットでの姿勢チェックの方法<br>　トレーニング開始に先立って<br>　腹筋（腹斜筋）<br>　殿部のトレーニング<br>　小児・成長期に特有なスポーツ障害<br>18 徒手療法<br>　徒手療法とは<br>　構造的アプローチ＋機能的アプローチ＝包括的アプローチ<br>　脳性麻痺の運動障害のとらえ方<br>　成長に伴う筋の変化<br>　成長に伴う筋膜の変化<br>　痙縮と拘縮との関係<br>　筋･筋膜が拘縮を生じる悪循環<br>　筋長や筋節長の短縮に対する治療効果<br>　徒手療法による治療介入<br>　筋膜リリース<br>　小児の筋膜リリース<br>19-1 中枢性疾患へのアプローチいろいろ ボバースコンセプトに基づくセラピー<br>　ボバースコンセプトとは何か？<br>　ボバースコンセプトに基づく治療とは<br>　ボバースコンセプトを構成する治療原則<br>　ボバースコンセプトに基づく治療（実践場面）<br>　ボバースコンセプトとは何か？<br>19-2 中枢性疾患へのアプローチいろいろ─ボイタ法について─<br>　ボイタ法って，なに？<br>　ボイタの理想的な正常運動発達<br>　反射性移動運動について<br>　ボイタ法の特徴<br>　ボイタ法に興味がある方へ<br>20 小児の訪問リハビリテーション<br>　はじめに<br>　小児の訪問に対する社会的ニードや制度<br>　対象となる疾患，年齢など<br>　訪問支援に対する親の期待<br>　特に実施している理学療法技術<br>21 特別支援教育<br>　はじめに<br>　特別支援教育は今<br>　外部からの専門職による支援が求められている<br>　学校にいるOT は何をやっているか<br>　校内OT の視点で「学校」をとらえる<br>　校内研修会の企画<br>索引</section></article>
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