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Clinical Pedagogy versus Pedagogical Pediatrics

Until recently, I had not heard of the term "clinical pedagogy" used very often. However, I have actually been teaching a course at a women's university in Kobe for the past two years on this subject.

The word clinical is a medical terminology meaning, "to examine the sickness" or furthermore, "related directly to the patient." In Western medicine, clinic originally meant, "the sick person in the bed," but has evolved to mean, "the skill of the doctor or surgeon who treats illnesses."

The word, "clinical" has come to be used in a widespread manner with the onset of various problem behaviors emerging in schools, such as bullying or school refusal. School teachers are now faced with these problems and have no choice but to attack these problems one by one.

In 1987, Department of Education at the University of Kyoto was the first to incorporate clinical pedagogy into their curriculum. When I had the opportunity to speak with the founding professor, Hayao Kawai, he informed me that the teachings were based on the German model.

The relationship between pediatrics and education is very deep, and goes a long way back with even a subspecialty in pediatrics called pedagogical pediatrics or pediatric pedagogy. This is because pediatricians have always thought about healthy children with the same concern as for ill children. Pediatricians care for the emotional and physical well-being of all children, sick and well, because the academic foundation of pediatrics lies in studies on the growth and development of children, and helping mothers raise their children. Currently, childcare has also joined this league and is becoming an area of concern in thinking about children.

Furthermore, today's pediatricians are often visited by patients who have not only physical complaints but also psychosomatic symptoms, which school teachers deal with daily. Thus, in most cases, those children who go to school only to go to the nurse's room instead of the class room, have already made a trip to the pediatrician.

Children who visit doctors in the children's hospitals or university hospitals where specialized doctors are readily available, often end up being examined by the pediatric neurologist or pediatric gastroenterologist when they complain of headaches or stomach aches. They are treated the same as seriously ill children and many of them are examined by many doctors until a diagnosis can be made. However, their symptoms often turn out to be psychosomatic and are related to not wanting to attend school for one reason or another.

As a pediatrician, I am surprised and disconcerted at the increasing amount of emotional challenges and psychosomatic disorders that are observed in schoolchildren today. It seems only natural, since the programs of the mind and programs of the body, that I have spoken of in earlier articles, are interacting with each other. However, because physical symptoms are often caused by some illness, it is critical to be able to rule out the possibility that the child is suffering from actual physical illness or from a psychosomatic disorder.

In the early 1960's, when I was still associate professor, I had a conversation with a famous pediatrician, Professor Enjoji at the University of Kyushu on the topic of pediatrics seen from an educational viewpoint. He spoke on this topic based on his experience of having studied abroad in German in the late 1930's combined with his clinical work. At that time, I had been thinking of pediatrics in terms of cancer or incurable diseases, and was very surprised at Dr. Enjoji's words about how pediatrics and education interact with each other, which eventually allowed me to think deeper about pediatrics as a profession. I wish Dr. Enjoji would have been with us today so we could hear his insights on the problems facing children and the educational system today.

There are many pediatricians who have retired from pediatrics and choose to teach at private universities (especially women's universities) on the subjects of infant health care, child care, child rearing, education and nutrition.

Every spring the Japan Pediatric Society has a convention and at the convention, former pediatricians now involved in academics take the opportunity to exchange information about their teaching. We discuss how we can reach the larger society and families through educating these students on these topics. Pediatricians are very concerned at the low birth rates of Japanese children today and cannot simply sit around and watch the struggles of young people today. As an anecdote, I must say, that we also discuss how we can deal with the talking that goes on in the classroom!

The challenges facing children today are certainly very serious. Bullying and school refusals have been around for a while now, and continue to be serious dilemmas for children and educators alike. However, the problems are not stopping there, and seem to be escalating to prostitution of minors and homicide. It seems that the problems of the adult society are becoming the problems of minors.

When I was a young professor at the University of Tokyo, I experienced the student riots and I recall the chaos we experienced in trying to teach. However, in today's classroom, it is not the university students in moratorium who are acting out, but the elementary school students. Perhaps there is some developmental crisis to be seen in this population of children that still need to be examined deeply.

Educators alone, and of course, pediatricians alone cannot solve the problem of these children. However, if we combine the expertise of these various professionals, aggressive discussions can take place on these children's problems. We will be able to examine children and their environments from a psychological, medical, educational, political, economical and sociological perspective which is what I believe is the true meaning of "child studies (Kodomogaku in Japanese)". This will help fuse the professions of "clinical pedagogy" and "pedagogical pediatrics" to form one strong limb in thinking about children's issues.
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