吃音の児童生徒に対する「合理的配慮」ニーズの実態を解明 ー学校環境への適応を促し、二次的な困り感(不登校・社交不安)を防ぐ手がかりにー

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2026-10-30 九州大学

九州大学病院、福岡教育大学、長崎県立大学の研究グループは、吃音のある児童生徒が学校生活で必要とする合理的配慮について、発達段階に応じた変化を明らかにした。九州大学病院を受診した小中高校生116人の意見書・診断書を分析した結果、小学校では、からかいやいじめへの対応、教師による周囲の児童への吃音の説明など、安心して学校生活を送るための保護的支援が多く求められていた。一方、中学・高校では、担任以外の教科担当教員との情報共有や、学校外での面接への配慮など、自立や社会参加を支える支援へとニーズが移行することが分かった。また、音読や発表時の配慮は、学齢を問わず共通して高いニーズが確認された。本研究は、吃音のある子どもが抱える困難を学校や家庭が把握し、進学・進級に伴う環境変化に適切に対応するための基礎資料となる。二次的な社交不安や不登校の予防にも貢献が期待される。

吃音の児童生徒に対する「合理的配慮」ニーズの実態を解明 ー学校環境への適応を促し、二次的な困り感(不登校・社交不安)を防ぐ手がかりにー

<関連情報>

吃音のある生徒に対する合理的配慮における学齢期による違い:医療文書の内容分析 School-Age Differences in Reasonable Accommodations for Students Who Stutter: A Content Analysis of Medical Letters

Yoshikazu Kikuchi, Yumi Yamaguchi, Masamutsu Kenjo, Eriko Yoshida, Aoi Sato, Takashi Nakagawa
Pediatrics International  Published: 29 October 2026
DOI:https://doi.org/10.1111/ped.70566

Abstract

Background
Japanese schools must provide reasonable accommodations for students who stutter, but developmental variations in these needs are poorly understood. This study characterized accommodation requests in clinician-drafted medical letters to clarify these needs.

Methods
Medical letters for 116 students who stutter (65 elementary, 51 secondary) were retrospectively analyzed. Accommodation content was classified using inductive content analysis. Group proportions were compared, and stuttering frequency (%SS) and social anxiety (LSAS-CA) were analyzed descriptively.

Results
Five accommodation categories were identified. Elementary students significantly more frequently requested teacher-mediated protective support, such as reporting teasing and classroom stuttering explanations. Secondary students more frequently requested social functioning accommodations, including subject-teacher information sharing and entrance examination support. Presentation-related accommodations were highly prevalent across both groups (61.2% overall). Participants who completed the anxiety assessment exhibited elevated social anxiety (mean LSAS-CA: 42.1).

Conclusion
Accommodation needs reflect structural school transitions, shifting from classroom protection under the elementary homeroom system to social participation support under the secondary subject-teacher system. Importantly, presentation-related needs represent a consistent concern, likely driven by subjective anxiety rather than objective stuttering severity. Medical letters may serve as valuable tools for initiating constructive clinician–family–school dialogue to facilitate tailored support.

医療・健康
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