Three Weeks in Japan: Disability Studies and Rehab Professionals on the Move

Editor's Note: Prof. Kate Seelman, former director of the U.S. National Institute on Disability and Rehabilitation Research, contributed the following pair of articles: a summary of a recent professional visit to Japan, containing her impressions of the status of disability and rehabilitation initiatives and research in that country, as well as some personal comments about fulfilling a childhood dream to visit Hiroshima and Nagasaki. Also included is a three-part paper she delivered in Japan, highlighting selected trends in disability and rehabilitation research.

Early in 2003, the President of the National Rehabilitation Center for Persons with Disabilities (NRCD) in Japan invited me to do two lectures. I was pleased to receive the invitation because I had worked with and visited NRCD when I was Director of the National Institute for Disability and Rehabilitation Research (NIDDR) from 1994-2001. Dr. Shigeru Yamauchi, Director of the NRCD Research Institute, and I shared a vision of research in support of independent living for people with disabilities. Along with my acceptance, I asked to be introduced more fully to the country, its art and theatre. On a personal note, I remember World War II. Childhood war memories had motivated my visits Pearl Harbor and were the basis for my wish to visit Hiroshima and Nagasaki, the targets of atomic and nuclear bombs dropped by the U.S.

While I was to leave for Tokyo on October 28, 2003, preparation for the trip occurred during the preceding eight months. The technical staff at NRCD was concerned about how to make their auditorium accessible for their severely hard-of hearing guest while also having simultaneous language translation. I use hearing aids and assistive devices manufactured in the West. Confronted by different national technical standards, audiologists and engineers in the U.S. and Japan, we began an extended Atlantic-Pacific dialogue to solve the communications accessibility problems. Researchers, practitioners and advocates here in the U.S., many of whom are NIDRR grantees and faculty at the University of Pittsburgh, were a great resource for accessibility as well as for the contents of my lectures. Of course, development of the lectures themselves was another major challenge.

I was asked to keynote the NRCD's 26 th Rehabilitation Conference and to lecture at the World Health Organization Collaborating Center located at NRCD. Later, I received an invitation to keynote the yearly Osaka City Rehabilitation Seminar for Citizens for which I could use one of the NRCD lectures. For the first NRCD lecture I chose a familiar theme in Disability Studies--the transition from a medical model to an integrative model. The second lecture theme was Access to the Information Age, an area in which NRCD staff person Dr. Hiroshi Kawamura has worked so hard, especially on the international World Summit on the Information Society. Dr. Kawamura wanted me to speak about the Information Age in terms of participation challenges and policy strategies for persons with disabilities. The issues and related policy are familiar to me. I have been involved in communications and information policy research throughout my career. During my years at NIDRR, the Web Accessibility Initiative (WAI) was established at MIT and the 508 regulations were developed. Dr. Kawamura and I both sit on the WAI Advisory Committee. By the time of my departure, the lectures were ready and the auditorium on its way to accessibility.

The trip to Japan was uneventful, if long. Beginning at Narita Airport in Tokyo and throughout my visit, the Japanese were superb hosts. I was met by a kind staff member of the Japanese Society for Rehabilitation of Persons with Disabilities who escorted me to my hotel. Each day a Japanese guide assisted me in reaching my destination which in the first week was mainly the NRCD. Located outside of Tokyo in Tokorozawa City, the Center was established in 1979. Much like NIDRR in the 90s, the NRCD is undergoing a healthy self-exploration about professional- consumer relationships and the Center's role in supporting broad domestic disability policy change in areas such as personal assistant services (PAS) and information and communications access. The Center has traditionally been involved in international issues such as assistive technology standards development and rehabilitation in the Asian Pacific region. Now the NRCD seems to be expanding its issue range to include information and communications technology access. The Center is also the site of a hospital of 200 inpatient beds. However, individuals with disabilities may also go directly into vocational and independent living training courses. While medical research, including traumatic brain injury research, tends to be sequestered within the medical staff, the NRCD Research Institute has formed an interdisciplinary team composed of health-related professionals, rehab engineers and social scientists who are pursuing a broad range of research for daily living. I visited a lab doing virtual reality applications for users of wheelchairs and vans. A sociologist was working with independent living centers on a study of PAS.

The day of the Rehabilitation Conference, I arrived at NRCD with a CD containing 85 slides. After a warm greeting, I was whisked off to the auditorium to test accessibility. Later, I presented before an audience of professionals and citizens, both disabled and not disabled. I was pleased to learn that a Society for Disability Studies had been recently established in Japan by and for disabled people and their colleagues interested in the field. Professor Jun Ishikawa (ishikawa@u-shizuoka-ken.ac.jp) who, apparently, was the first blind person to complete a Ph.D. at the University of Tokyo, is directing the Society and presented at the Conference. Other presenters included an education ministry representative. He did not give the impression of being involved in the various services and supports for inclusion, such as assistive technology. Generally, the audience was attentive and expressed interest in a number of areas such as the influence of the ADA, especially on employment.

During the period between the first and the second lecture, I traveled by train to Hiroshima and Nagasaki with a member of the NRCD staff. Hiroshima is home to a peace park and museum known throughout the world. Somewhat reminiscent of Vad Yashem in Jerusalem, the peace park features a number of monuments, including one in remembrance of children adorned with necklaces of cranes. At the peace park museum, I used a listening device that was hearing-aid compatible without taking off my hearing aids--a rare accessibility feature in the U.S.! Nagasaki, located in the southwestern part of Japan, received relatively early visits from Europeans and seemed the most Western of the Japanese cities I visited. Nonetheless it retained many extraordinary memories of the bomb and the War through its own museums and monuments. While I traveled on excellent trains, I noticed the accessibility features including elevators and ramps. Later in the trip, in the underground subways, I also saw accessibility features, including elevators, wheelchair accessible escalators and accessible bathrooms. When I returned to Tokyo, I had completed a personal journey which was rooted in childhood memories of World War II.

My second lecture on participation in the Information Society was delivered at the World Health Organization Collaborating Centre seminar entitled, "Creation of an Inclusive Society in an Advanced Information and Communication Society". My 65 lecture slides focused on international and domestic policy especially the U.S. communications law triad of regulatory policy (section 255 and the FCC), Civil Rights policy (ADA) and market incentives policy (Section 508 of the Rehab Act). The panel discussion that followed was lively, especially since it included panelists involved with the World Summit on the Information Society and a representative of the Japanese ministry responsible for telecommunications.

Having been invited to provide opening comments for the panel, I covered a range of issues. For example, I reported that deaf and hard of hearing people in the U.S. use Japanese televisions with inbuilt captioning capacity and expressed surprise that an advanced country like Japan did not provide captioning. Further, I was very curious about why the Japanese telephone system does not provide relay services. Apparently, there is discussion within Japan about provision of these services. Discussion also turned to the proposed legislation in the U.S., an educational format act to make educational materials accessible. Discussion also highlighted the tension between a welfare framework for people with disabilities versus a civil rights and equal opportunity framework. The panel and audience discussion were quite challenging and the reception that followed allowed everyone to relax.

My remaining days in Japan were spent in travel to the home and university of my colleague, Dr. Osamu Sueda and then on to Osaka for a presentation. I visited many shrines and parks in Kyoto and Nara and attended an AWA dance concert in Dr. Sueda's home town of Tokushima from which this participatory dance was developed. Everyone, including a young man in a wheelchair, danced with the dance troupe! Dr. Sueda and his wife had invited me to spend the night at his home, a "smart house" equipped with some intelligence to monitor and control energy usage, electricity and other amenities. At the entrance, there was a lift and inside an elevator and many other accessibility features within a traditional interior design of sliding doors with rice paper panels. Dr. Sueda also introduced me to his labs at Tokushima University where he is conducting safety studies for blind people and gait research. Toward the end of the trip I was introduced to the staff and consumers at the Osaka City Rehabilitation Center--an impressive group who proved to be super hosts at the Center, for restaurants and cultural attractions. The Director of the vocational rehabilitation center, Dr. Hiroyuki Seki, was a legend in the struggle to move from a medical model to a more vocational model.

The Center is really composed of two centers, one providing medical rehab services and the other vocational. The latter works closely with the employer community to provide work opportunities. The Center houses a clinic for assistive technology and provides computer training, counseling and other services. The educational background of the professional staff was in fields such as social work and special education. Apparently, Japan does not have a formal vocational rehabilitation educational training program.

During the long trip home, my mind played back this short, intense and satisfying three weeks. My impression is that Japanese professionals are changing, becoming more consumer-oriented. Disability Studies is making in-roads. I hope that the Disability Studies organizations around the globe are networking.

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