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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">jss</journal-id>
      <journal-title-group>
        <journal-title>Open Journal of Social Sciences</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2327-5960</issn>
      <issn pub-type="ppub">2327-5952</issn>
      <publisher>
        <publisher-name>Scientific Research Publishing</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.4236/jss.2026.148020</article-id>
      <article-id pub-id-type="publisher-id">jss-153229</article-id>
      <article-categories>
        <subj-group>
          <subject>Article</subject>
        </subj-group>
        <subj-group>
          <subject>Business</subject>
          <subject>Economics</subject>
          <subject>Social Sciences</subject>
          <subject>Humanities</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Analysis of Safety Education Contents and Teaching Recommendations in Middle-Grade Life Adaptation Textbooks</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name name-style="western">
            <surname>Li</surname>
            <given-names>Yufeng</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name name-style="western">
            <surname>Peng</surname>
            <given-names>Juan</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1"><label>1</label> Guangdong Provincial Key Laboratory of Development and Education for Special Needs Children, Lingnan Normal University, Zhanjiang, China </aff>
      <aff id="aff2"><label>2</label> Sihui City Special Education School, Zhaoqing, China </aff>
      <author-notes>
        <fn fn-type="conflict" id="fn-conflict">
          <p>The authors declare no conflicts of interest regarding the publication of this paper.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub">
        <day>03</day>
        <month>08</month>
        <year>2026</year>
      </pub-date>
      <pub-date pub-type="collection">
        <month>08</month>
        <year>2026</year>
      </pub-date>
      <volume>14</volume>
      <issue>08</issue>
      <fpage>344</fpage>
      <lpage>357</lpage>
      <history>
        <date date-type="received">
          <day>10</day>
          <month>07</month>
          <year>2026</year>
        </date>
        <date date-type="accepted">
          <day>15</day>
          <month>08</month>
          <year>2026</year>
        </date>
        <date date-type="published">
          <day>18</day>
          <month>08</month>
          <year>2026</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>© 2026 by the authors and Scientific Research Publishing Inc.</copyright-statement>
        <copyright-year>2026</copyright-year>
        <license license-type="open-access">
          <license-p> This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link> ). </license-p>
        </license>
      </permissions>
      <self-uri content-type="doi" xlink:href="https://doi.org/10.4236/jss.2026.148020">https://doi.org/10.4236/jss.2026.148020</self-uri>
      <abstract>
        <p>Students with intellectual disabilities have limited cognitive abilities, and safety incidents occur from time to time; therefore, safety education is of utmost importance. Currently, there is little analysis of safety education materials for special education schools, and even less analysis for middle-grade levels. This paper analyzes the safety education content in middle-grade Life Adaptation textbooks and concludes that the safety education content for middle grades in this set of textbooks centers on social safety, public health and accidental injury prevention, with intensive arrangements of relevant learning materials in Grade 5. In contrast, the coverage of natural disaster safety, internet and information safety, and other incident safety is insufficient and scattered. The safety education system has structural imbalance and knowledge gaps in certain grade levels. In addition, the textbooks feature practical and real-life content, hands-on activity design, text-illustration layout, and simple language. In teaching, educators should follow the principle of spiral progression, adhere to individualized instruction, ground lessons in students’ daily needs, employ diverse teaching methods, emphasize hands-on practice, flexibly organize comprehensive activities, prioritize collaboration among home, school, and community, and integrate safety education with other academic subjects.</p>
      </abstract>
      <kwd-group kwd-group-type="author-generated" xml:lang="en">
        <kwd>Life Adaptation</kwd>
        <kwd>Safety Education</kwd>
        <kwd>Textbook Analysis</kwd>
        <kwd>Teaching Recommendations</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec1">
      <title>1. Introduction</title>
      <p>As one of the core compulsory courses in China’s schools for students with intellectual disabilities, the life adaptation curriculum aims to cultivate self-care and social adaptation skills for children with intellectual disabilities. Compiled uniformly by the Ministry of Education and successively published by People’s Education Press since 2017, the Experimental Textbooks for Compulsory Education in Schools for Students with Intellectual Disabilities: Life Adaptation (hereinafter referred to as Life Adaptation textbooks), which as the key teaching materials for this curriculum at present. The Guidelines for Evaluating the School-running Quality of Special Education issued by the Ministry of Education in 2022<sup>1</sup> states that education should promote appropriate development of students and takes social adaptation ability as one of the key indicators. Safety education acts as an important prerequisite for improving students’ social adaptation ability. The Communist Party of China and the state have always attached great importance to safety education to protect the healthy growth of students. The Guidelines for Public Safety Education in Primary and Secondary Schools formulated by the Ministry of Education in 2007<sup>2</sup> (hereinafter referred to as the Guidelines) points out that public safety education should run through all parts of school education. It helps primary and secondary students firmly form the awareness of cherishing life, prioritizing safety, abiding by laws and disciplines, and living in harmony, as well as gain the literacy and ability of self-rescue and self-protection. The Outline for Building a Powerful Country through Education (2024-2035)<sup>3</sup> proposes to strengthen young students’ awareness of cybersecurity and national security education, together with education on drowning prevention, traffic safety and other related fields. The Compulsory Education Curriculum Standards for Life Adaptation in Schools for Students with Intellectual Disabilities (2016 Version)<sup>4</sup> (hereinafter referred to as the New Curriculum Standards) integrates safety education content, such as learning basic knowledge about food safety, mastering common safety rules at home, and gaining a basic understanding of laws and regulations that protect the rights and interests of people with disabilities.</p>
      <p>Over the past decade, domestic research on safety education in special education schools has been on the rise. Most existing studies focus on safety education interventions, prevention and control of common risks, and current situation investigations. Several scholars have also explored safety education content included in textbooks for students with intellectual disabilities ([<xref ref-type="bibr" rid="B4">4</xref>]; [<xref ref-type="bibr" rid="B1">1</xref>]; [<xref ref-type="bibr" rid="B7">7</xref>]). Nevertheless, academic research on safety education curricula and relevant textbooks remains limited in both depth and breadth ([<xref ref-type="bibr" rid="B6">6</xref>]). Compared with textbooks for life Chinese and life mathematics courses, far fewer studies have examined Life Adaptation textbooks. In addition, existing research on textbooks for students with intellectual disabilities mostly targets lower grades, while insufficient attention has been paid to middle and upper grades ([<xref ref-type="bibr" rid="B2">2</xref>]). Grades 4 to 6 (middle grades) in schools for students with intellectual disabilities serve as a critical period for students to develop safety awareness and good behavioral habits. Students at this stage have limited cognitive ability, weak awareness of following rules, and poor capacity to predict potential dangers, which makes them vulnerable to safety hazards such as electric shock, scalds, getting lost, and abduction by strangers. Therefore, systematically analyzing safety education content in middle-grade Life Adaptation textbooks and exploring effective teaching strategies carries great practical significance for improving students’ self-protection skills and protecting their physical and mental health.</p>
      <p>To this end, this study, based on the requirements of the New Curriculum Standards, adopts literature research and content analysis methods to systematically review the safety education content in the middle-grade Life Adaptation textbooks for students with intellectual disabilities, analyze its characteristics, and propose actionable teaching suggestions grounded in frontline teaching practice, with the aim of providing reference for safety education teaching in special education schools for students with intellectual disabilities and promoting the effective development of students’ safety awareness and self-protection abilities.</p>
    </sec>
    <sec id="sec2">
      <title>2. Methods</title>
      <sec id="sec2dot1">
        <title>2.1. Research Objects</title>
        <p>This paper takes six volumes of middle-grade Life Adaptation textbooks as research objects, covering all lesson contents of Grade Four Volume One, Grade Four Volume Two, Grade Five Volume One, Grade Five Volume Two, Grade Six Volume One and Grade Six Volume Two.</p>
      </sec>
      <sec id="sec2dot2">
        <title>2.2. Research Tools</title>
        <p>2.2.1. Detailed Classification Table for Safety Education Content Analysis</p>
        <p>At present, there is no unified classification standard specially for safety education content. This study compiles a detailed classification table for safety education content analysis by referring to the dimension classification of safety education content in the Guidelines and combining safety education requirements listed in the New Curriculum Standards. The natural disaster section of the Guidelines requires students to know common ecological problems affecting their hometown and build awareness of environmental protection. The units of “resource conservation” and “garbage classification” are designed to cultivate students’ environmental awareness. Accordingly, these two themes are included in the statistical scope of safety education content in the textbooks (<bold>Table 1</bold>).</p>
        <p>2.2.2. Classification Table of Research Scope for Safety Education Content</p>
        <p>In accordance with the structural layout of the Life Adaptation textbooks, this paper divides each lesson of the textbook into six modules: lesson title, lead-in, main text, extended learning, comprehensive practice, evaluation and feedback. The comprehensive activity in the final lesson contains two modules, namely task sheet content and evaluation and feedback (see <bold>Table 2</bold>). This study thoroughly analyzes the safety education contents contained in lesson titles, lead-ins, main texts, extended learning, comprehensive practice, evaluation and feedback as well as comprehensive activities in the Life Adjustment textbook.</p>
        <p>Table 1. Detailed classification table for safety education content analysis.</p>
        <table-wrap id="tbl1">
          <label>Table 1</label>
          <table>
            <tbody>
              <tr>
                <td>Key Contents of the Guidelines</td>
                <td>Corresponding Requirements in the New Curriculum Standards</td>
                <td>Examples of Safety Education Content in Life Adaptation textbooks</td>
              </tr>
              <tr>
                <td>
                  <bold>1. Social Safety:</bold>
                  (1) Recognize the harm and scope of social safety emergencies or incidents, and do not participate in activities that affect or endanger social safety.(2) Consciously abide by the basic rules of interpersonal interaction in social life and safety norms in public places.(3) Learn how to deal with suspicious strangers and improve self-protection awareness.(4) Understand general methods for dealing with blackmail, intimidation, and sexual assault, and improve self-protection ability.
                </td>
                <td>1. Take good care of family property and do not give it away arbitrarily2. follow the school daily timetable3. Understand and follow student rules4. Learn to use leisure facilities in the community5. Take care of public facilities in the community and follow public order6. Know safety knowledge when interacting with strangers7. Do not violate laws and discipline, and know the consequences of doing so8. Learn to express one’s emotions9. Learn to share and cooperate10. Learn to be grateful, tolerant and respectful to others11. Learn to communicate with relatives and friends12. Respect and trust teachers, and build positive relationships with them13. Be friendly to classmates, treat them equally, and help each other14. Learn to appreciate others’ strengths15. Respect the labor of staff16. Respect others and know how to yield politely17. Learn to share with others18. Be willing to help those in need</td>
                <td>Protect Household PropertyTake Good Care of Public FacilitiesLaw-Abiding YoungstersThe Joy of SharingThe Power of CooperationPolite Reception of GuestsHeart-to-Heart Communication with TeachersHand in Hand with Classmates</td>
              </tr>
              <tr>
                <td>
                  <bold>2. Public Health:</bold>
                  (1) Strengthen knowledge of hygiene and diet, and develop good personal hygiene and healthy eating habits.(2) Understand the harm, transmission routes, and prevention measures of common diseases and infectious diseases.(3) Gain a preliminary understanding of the harm of bad habits such as smoking and excessive drinking, know that drug use is illegal, and gradually develop a healthy life awareness of staying away from tobacco, alcohol, and drugs.(4) Gain a preliminary understanding of basic knowledge of puberty development, and form clear gender awareness and self-protection awareness.
                </td>
                <td>1. Understand dietary safety knowledge2. Develop healthy eating habits3. Learn basic skills such as combing hair, washing hair, bathing, and trimming nails4. Develop good personal hygiene habits5. Keep the home environment clean and tidy6. Keep clothes clean7. Understand basic knowledge of common diseases8. Learn simple measures to prevent common diseases9. Understand physical changes during puberty</td>
                <td>Food Safety AwarenessHow to Wash HairHow to Take a BathNail TrimmingKeep Clothes NeatHealthy Eating HabitsCold PreventionEye CareMe in Puberty</td>
              </tr>
              <tr>
                <td>
                  <bold>3. Accidental Injuries:</bold>
                  (1) Develop good habits of following traffic rules and form the awareness of actively avoiding vehicles.(2) Improve self-protection awareness, understand the risks of unapproved outdoor swimming and ice skating; learn basic knowledge and solutions to prevent and handle drowning, scalds, animal bites and foreign objects in the trachea.(3) Develop awareness of prevention regarding facilities and areas with potential safety hazards, and understand safety knowledge of special equipment closely related to learning and life.(4) Learn effective methods for avoiding accident disasters and basic skills for self-protection, seeking help, and evacuation in the event of accident disasters.(5) Enable students to gain a preliminary understanding of basic insurance knowledge related to student accidental injuries and improve their insurance awareness.
                </td>
                <td>1. Know safety knowledge of daily home life2. Learn to safely use school equipment and facilities3. Recognize common safety signs in the community4. Understand traffic safety knowledge and follow traffic rules5. Be able to follow the teacher’s instructions in emergencies</td>
                <td>Community Safety SignsSafe Use of ElectricitySafe Travel: WalkingSafe Travel: Taking BusesCampus Emergency EvacuationSafety in Activity Classes</td>
              </tr>
              <tr>
                <td>
                  <bold>4. Network and Information Safety:</bold>
                  (1) Gain a preliminary understanding of the positive significance of online resources and the harm of harmful online information.(2) Learn to use online resources appropriately and enhance the ability to distinguish various types of information.(3) Learn to control one’s own behavior and prevent addiction to online games and other electronic games.
                </td>
                <td>1. Understand safety knowledge of online interaction</td>
                <td>Online Communication</td>
              </tr>
              <tr>
                <td>
                  <bold>5. Natural Disasters:</bold>
                  (1) Understand common problems affecting the local ecological environment, and develop awareness of protecting the natural environment and avoiding natural disasters.(2) Learn basic methods to avoid dangers caused by natural disasters.(3) Master the meaning of early warning signal levels for sudden natural disasters and the corresponding preventive measures.
                </td>
                <td>1. Learn methods of garbage sorting2. Understand the finite nature of resources, understand the importance of environmental protection, and have basic environmental awareness</td>
                <td>Waste SortingResource Conservation</td>
              </tr>
              <tr>
                <td>
                  <bold>6. Other Incidents:</bold>
                  (1) Develop awareness of resolving conflicts among classmates.(2) Develop awareness of seeking timely help from teachers, parents, or the police when personal safety is at risk.
                </td>
                <td>1. Comply with school safety rules and know how to ask for help when in danger</td>
                <td>Safety in Activity Classes</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>Table 2. Column structure of safety education contents for each topic and comprehensive activities in life adaptation textbooks.</p>
        <table-wrap id="tbl2">
          <label>Table 2</label>
          <table>
            <tbody>
              <tr>
                <td>Type</td>
                <td>Individual Topic</td>
                <td>Comprehensive Activity</td>
              </tr>
              <tr>
                <td rowspan="6">Constituent Elements</td>
                <td>1. lesson titles</td>
                <td>1. Contents corresponding to task sheets</td>
              </tr>
              <tr>
                <td>2. Lead-in</td>
                <td>2. Evaluation and Feedback</td>
              </tr>
              <tr>
                <td>3. Main text</td>
                <td>
                </td>
              </tr>
              <tr>
                <td>4. Extended Learning</td>
                <td>
                </td>
              </tr>
              <tr>
                <td>5. Comprehensive Practice</td>
                <td>
                </td>
              </tr>
              <tr>
                <td>6. Evaluation and Feedback</td>
                <td>
                </td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>2.2.3. Coding Procedure</p>
        <p>The first author acted as the primary coder in this study. With reference to the self-compiled analysis schedule for safety education content, the researcher coded safety-related contents across the six volumes of Life Adaptation textbooks. To reduce subjective bias and improve coding reliability, the second author was invited to conduct independent coding for three textbooks: Grade 4 Volume 1, Grade 5 Volume 2 and Grade 6 Volume 1. Both researchers separately coded textbook content relying on the unified safety education analysis framework. Two indicators were adopted to test intercoder reliability: the Index of Category Agreement (CA) and the Intercoder Reliability Coefficient (R). The calculated CA value was 0.92 and R value was 0.96, demonstrating satisfactory high coding reliability. All inconsistent coding results were discussed by the two researchers to reach a unified final coding standard.</p>
      </sec>
    </sec>
    <sec id="sec3">
      <title>3. Results</title>
      <sec id="sec3dot1">
        <title>3.1. Safety Education Content and Concepts in Middle-Grade Life Adaptation Textbooks</title>
        <p>The safety education content integrated into the Life Adaptation subject is based on the actual needs of students’ current and future lives, with the core objective of cultivating students’ awareness of risk prevention and practical self-protection skills. For the middle grades, the New Curriculum Standards indicate that in the domain of personal life, students should recognize abnormal physical conditions, understand basic knowledge of disease prevention and coping measures, gain a preliminary understanding of fundamental knowledge about puberty, and maintain good emotions; in the domain of family life, students should understand major home safety knowledge; in the domain of school life, students should abide by student rules, be able to use school facilities safely, and master simple methods of seeking help; and in the domain of community life, students should make reasonable use of community resources and possess basic community safety knowledge. The Guidelines divide the safety education content for the middle grades of primary school (grades 4 to 6) into six categories: social safety, public health, accidental injuries, network or information security, natural disasters, and other events. This study analyzes the safety education contents in Life Adaptation textbooks based on the safety education modules stipulated in the New Curriculum Standards and the Guidelines. Each lesson of Life Adaptation textbooks consists of six columns. If safety education contents appear in a certain column of any lesson, this column is counted once only, regardless of the volume of safety-related information contained within it. For example, the lesson Food Safety Awareness, classified into the public health category, includes safety education materials in all six columns. Each column is counted as one entry, generating a total statistical count of six times. The comprehensive activity section of Life Adaptation is divided into two columns: contents matching task sheets, and evaluation and feedback. Likewise, each column of every comprehensive activity is recorded as one occurrence if safety education content is involved, no matter how much relevant content is presented.</p>
        <p>3.1.1. Distribution of Safety Education Contents in Middle-Grade Life Adaptation Textbooks (See Table 3)</p>
        <p>In terms of the distribution of safety education contents in the middle-grade Life Adaptation textbooks, social safety category has the highest frequency, followed by public health and accidental injury. Natural disaster and network and information security have relatively fewer occurrences, while other incidents rank the lowest. Grade 5, Volume 1 contains the largest number of safety education contents across all textbooks. Overall, the safety education system exhibits an unbalanced structural layout, accompanied by knowledge discontinuity in certain grades.</p>
        <p>Table 3. Statistical distribution of safety education content in each category (Unit: Times).</p>
        <table-wrap id="tbl3">
          <label>Table 3</label>
          <table>
            <tbody>
              <tr>
                <td>Category</td>
                <td>Grade 4 Vol.1</td>
                <td>Grade 4 Vol.2</td>
                <td>Grade 5 Vol.1</td>
                <td>Grade 5 Vol.2</td>
                <td>Grade 6 Vol.1</td>
                <td>Grade 6 Vol.2</td>
                <td>Total</td>
              </tr>
              <tr>
                <td>Social Safety</td>
                <td>9</td>
                <td>13</td>
                <td>20</td>
                <td>18</td>
                <td>10</td>
                <td>26</td>
                <td>96</td>
              </tr>
              <tr>
                <td>Public Health</td>
                <td>9</td>
                <td>14</td>
                <td>20</td>
                <td>14</td>
                <td>0</td>
                <td>8</td>
                <td>65</td>
              </tr>
              <tr>
                <td>Accidental Injury</td>
                <td>3</td>
                <td>12</td>
                <td>4</td>
                <td>20</td>
                <td>6</td>
                <td>2</td>
                <td>47</td>
              </tr>
              <tr>
                <td>Network and Information Security</td>
                <td>0</td>
                <td>0</td>
                <td>0</td>
                <td>0</td>
                <td>5</td>
                <td>2</td>
                <td>7</td>
              </tr>
              <tr>
                <td>Natural Disasters</td>
                <td>0</td>
                <td>0</td>
                <td>0</td>
                <td>6</td>
                <td>7</td>
                <td>0</td>
                <td>13</td>
              </tr>
              <tr>
                <td>Other Incidents</td>
                <td>0</td>
                <td>2</td>
                <td>0</td>
                <td>0</td>
                <td>0</td>
                <td>0</td>
                <td>2</td>
              </tr>
              <tr>
                <td>Total</td>
                <td>21</td>
                <td>41</td>
                <td>44</td>
                <td>58</td>
                <td>28</td>
                <td>38</td>
                <td>
                </td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>3.1.2. Distribution of Safety Education Contents in Various Columns (See Table 4)</p>
        <p>Table 4. Statistical table of safety education content distribution in various columns (Unit: Times).</p>
        <table-wrap id="tbl4">
          <label>Table 4</label>
          <table>
            <tbody>
              <tr>
                <td>Category</td>
                <td colspan="6">Regular Lesson Columns</td>
                <td colspan="2">Comprehensive Activity Columns</td>
              </tr>
              <tr>
                <td>
                </td>
                <td>lesson titles</td>
                <td>Lead-in</td>
                <td>Main text</td>
                <td>Extended Learning</td>
                <td>Comprehensive Practice</td>
                <td>Evaluation and Feedback</td>
                <td>Contents corresponding to task sheets</td>
                <td>Evaluation and Feedback</td>
              </tr>
              <tr>
                <td>Social Safety</td>
                <td>9</td>
                <td>14</td>
                <td>17</td>
                <td>12</td>
                <td>16</td>
                <td>18</td>
                <td>5</td>
                <td>5</td>
              </tr>
              <tr>
                <td>Public Health</td>
                <td>9</td>
                <td>9</td>
                <td>10</td>
                <td>9</td>
                <td>9</td>
                <td>9</td>
                <td>5</td>
                <td>5</td>
              </tr>
              <tr>
                <td>Accidental Injury</td>
                <td>6</td>
                <td>6</td>
                <td>8</td>
                <td>6</td>
                <td>6</td>
                <td>7</td>
                <td>4</td>
                <td>4</td>
              </tr>
              <tr>
                <td>Network and Information Security</td>
                <td>0</td>
                <td>1</td>
                <td>1</td>
                <td>1</td>
                <td>1</td>
                <td>1</td>
                <td>1</td>
                <td>1</td>
              </tr>
              <tr>
                <td>Natural Disasters</td>
                <td>2</td>
                <td>2</td>
                <td>2</td>
                <td>1</td>
                <td>2</td>
                <td>2</td>
                <td>1</td>
                <td>1</td>
              </tr>
              <tr>
                <td>Other Incidents</td>
                <td>0</td>
                <td>0</td>
                <td>1</td>
                <td>0</td>
                <td>0</td>
                <td>1</td>
                <td>0</td>
                <td>0</td>
              </tr>
              <tr>
                <td>Total</td>
                <td>26</td>
                <td>32</td>
                <td>39</td>
                <td>29</td>
                <td>34</td>
                <td>38</td>
                <td>16</td>
                <td>16</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
        <p>For dedicated safety education topics, the textbooks construct a complete structural framework covering main-text teaching, extended learning supplements, comprehensive practical activities, and evaluation and feedback. Safety education contents embedded in conventional teaching topics are primarily presented through the main text. The safety knowledge explained in the main text is mostly accompanied by corresponding consolidation assessments in the evaluation and feedback column of the same lesson, which forms a coherent closed-loop teaching system with strong internal consistency. In the column framework of comprehensive activities, the frequencies of safety education contents in task sheets and evaluation and feedback are consistent.</p>
      </sec>
      <sec id="sec3dot2">
        <title>3.2. Presentation Forms and Characteristics of Safety Education Content in Middle-Grade Life Adaptation Textbooks</title>
        <p>3.2.1. Arrangement: Closed-Loop Teaching System Aligned with Students’ Growth Trajectory</p>
        <p>Horizontally, the content covers personal life, family life, school life, community life, as well as the national and the world. Specific themes include personal dietary hygiene safety, household safety, campus safety, traffic safety, community safety, getting along well with others, and basic legal knowledge. Vertically, knowledge is expanded layer by layer with clear levels, and each unit consists of several fixed sections namely scenario picture introduction, knowledge learning, extended learning, comprehensive practice, and evaluation and feedback. It forms a complete closed-loop teaching structure with sound integrity.</p>
        <p>First of all, the textbooks use illustrations of daily life scenarios to activate students’ existing life experience and introduce relevant teaching knowledge points of each lesson step by step. Second, the learning of basic knowledge and practical operational skills forms the core of the whole teaching process and sets basic learning standards that all students need to achieve. Third, layered extended learning materials are provided to fully accommodate students with different cognitive levels. The safety education materials are arranged in a stepwise manner to help teachers carry out targeted differentiated instruction. Fourth, practical exercises are arranged under a unified column named comprehensive practice. This part mainly helps students internalize knowledge learned in class and deepens their understanding and memory of safety knowledge through hands-on practice. Finally, a supporting teaching evaluation module is provided for both teachers and students, and its evaluation items correspond exactly to key learning points of each lesson ([<xref ref-type="bibr" rid="B2">2</xref>]). For instance, the Grade Four Volume One lesson Pay Attention to Food Safety opens with a scene where Beibei and her mother buy bread at a bakery and the mother checks the shelf life label to lead into the theme of food safety. The lesson then presents core food safety knowledge, followed by extended learning about shelf life, a comprehensive practice activity that asks students to distinguish edible and inedible foods, and ends with evaluation and feedback completed by both students and teachers. Overall, the arrangement of safety education content in the revised Life Adaptation textbooks is scientific and reasonable. The textbooks follow a logic from simple to difficult and take varying student abilities into consideration, leaving room for flexible teaching adjustments.</p>
        <p>3.2.2. Content: Highly Life-Oriented and Closely Tied to Real Daily Scenarios</p>
        <p>All safety education content in the textbook is drawn from the four high-frequency life circles of students’ personal life, family life, school life, and community life, with no abstract theories. The cases, illustrations, and practical tasks mainly involve behaviors that students encounter in daily life, such as tying shoelaces to prevent falls, being careful of slippery floors when bathing, avoiding getting hands caught when taking the bus, and preventing electric shocks when using electricity at home. In addition, there are no complex safety concepts; only visible and actionable behavioral norms are retained, and no in-depth principles are involved.</p>
        <p>3.2.3. Presentation: Primarily Illustrations with Simple Text, Adapted to Cognitive Levels</p>
        <p>First, the entire volume combines illustrations with text. All safety sections are accompanied by real-life photographs, cartoon images, and step-by-step diagrams, with a high proportion of pictures that are clear and easy to understand. The text is brief, with simple sentence structures, mostly using short sentences and imperative language, which reduces the difficulty and lowers the threshold of reading comprehension, which matches the cognitive feature that middle-grade students with intellectual disabilities in special education schools are dominated by concrete thinking. Second, skill components are broken down step by step. Skills such as dressing, tying shoelaces, washing hair, bathing, and taking transportation are all broken down into step-by-step diagrams, with complex actions divided into sequential steps and one diagram per step, making it convenient for students to imitate and learn. Third, the sections are fixed and consistent. Each lesson is structured with four major modules: “main text,” “extended learning,” “comprehensive practice,” and “evaluation and feedback,” with a fixed structure that helps students easily adapt to the classroom routine. Comprehensive practice mainly involves selection, judgment, hands-on practice, and picture-based discrimination, with simple question types that emphasize behavioral application. Fourth, the presentation form highlights activity-based learning, integrating the processes, methods, and skills of activities.</p>
        <p>3.2.4. Goal: Emphasize Behavioral Practice over Theoretical Memorization</p>
        <p>First, the core objective of the textbooks is not to require students to memorize safety rules, but to help students master actionable safety behaviors. Comprehensive practical tasks primarily take the forms of picture-based judgment, scenario simulation, hands-on operation, and real-life identification, with no written memorization questions included. Second, the extended content mostly consists of life-related extended skills for real-world practical application. Third, the evaluation and feedback dimensions focus on whether students can complete operations in a standard way, such as proper mask wearing and abiding by pedestrian traffic regulations, while downplaying the memorization of knowledge points.</p>
      </sec>
    </sec>
    <sec id="sec4">
      <title>4. Conclusion and Recommendations</title>
      <sec id="sec4dot1">
        <title>4.1. Conclusion</title>
        <p>The safety education contents in the Grade 4 - 6 Life Adaptation textbooks for students with intellectual disabilities mainly cover social safety, public health, and accidental injury, with the highest content density distributed in Grade 5. However, the contents concerning natural disasters, network information safety, and other safety categories are insufficient and fragmentarily arranged. The overall safety education system exhibits an unbalanced structure and presents knowledge discontinuity in certain grades. In addition, the safety education contents in the middle-grade Life Adaptation textbooks are rooted in the daily life of students with intellectual disabilities, conform to their cognitive laws, focus on behavioral cultivation, and possess high practicality.</p>
      </sec>
      <sec id="sec4dot2">
        <title>4.2. Teaching Recommendations</title>
        <p>Students with intellectual disabilities generally have limited comprehension abilities and have difficulty generalizing learned knowledge. Therefore, how to effectively teach the safety content in Life Adaptation classes is a major challenge. Based on the psychological development patterns of children with intellectual disabilities, the basic principles of the Guidelines for Public Safety Education in Primary and Secondary Schools, the teaching recommendations proposed in the New Curriculum Standards (2016 Edition), and the guiding principles for textbook compilation, in combination with the characteristics of the safety education content in the middle-grade Life Adaptation textbooks, this paper puts forward several recommendations for teachers in special education schools for students with intellectual disabilities.</p>
        <p>4.2.1. Follow the Principle of Spiral Progression and Differentiate Curriculum Goals for Different Grade Levels</p>
        <p>To carry out safety education in middle-grade Life Adaptation, it is necessary to follow a spiral progressive design approach, set tiered learning objectives for grades 4, 5, and 6 respectively, and arrange teaching content from shallow to deep in a gradual and progressive manner, so as to achieve cyclic reinforcement of safety knowledge and progressive increase in learning difficulty. In teaching, it is necessary to connect with the safety knowledge already learned in the lower grades, continuously reinforce it, repeat core safety points, and increase the depth of practice, while avoiding simple repetition of content. In class, teachers should design tiered tasks based on students’ real-life scenarios and gradually cultivate students’ life adaptation abilities and comprehensive literacy in self-protection.</p>
        <p>4.2.2. Respect Students’ Individual Differences and Adhere to Individualized Education</p>
        <p>Implement tiered teaching appropriately and pay attention to individual differences ([<xref ref-type="bibr" rid="B8">8</xref>]). Currently, special education is still primarily delivered through collective teaching, and in this process, the relationship between individuality and commonality should be properly managed, with differentiated teaching implemented ([<xref ref-type="bibr" rid="B5">5</xref>]). Assess students’ abilities and current status, and carry out targeted instruction. Adopt a tiered grouping classroom model to implement teaching tasks and accommodate the developmental needs of students with different learning profiles; at the same time, combine students’ classroom performance and the degree of completion of learning objectives to conduct teaching review and continuously optimize classroom teaching methods.</p>
        <p>4.2.3. Base Instruction on Students’ Life Needs and Select Appropriate Teaching Content</p>
        <p>Ding Yong pointed out that textbooks are compiled based on the common characteristics of learners; however, due to cultural diversity across regions in China, imbalanced regional development, and individual differences among children with intellectual disabilities, teachers should, while fully implementing the national curriculum plan, flexibly optimize the overall curriculum planning by adding special education-related teaching modules such as potential development and functional compensation for impairments, thereby enhancing the diversity, flexibility, and appropriateness of curriculum content ([<xref ref-type="bibr" rid="B3">3</xref>]). Moreover, common safety issues may vary across different regions. Therefore, the selection of teaching materials should be grounded in students’ real daily lives and focus on the various practical problems they actually face in their learning, growth, and everyday life. Based on real scenarios in middle-grade students’ daily campus, home, and travel experiences, teachers should select high-frequency and likely safety incidents as teaching materials, while avoiding abstract cases detached from reality. Teaching materials should be designed around common experiences such as students being home alone, going out with peers, activities between classes, and using household appliances, while promptly capturing safety blind spots that students tend to overlook. Teachers should use real-life events and typical campus examples in instruction to help students intuitively perceive the practical value of safety knowledge, guide students to transform what they have learned into daily self-protective behavioral habits, and effectively enhance their safety awareness in life adaptation.</p>
        <p>4.2.4. Adopt Diverse Teaching Formats and Emphasize Practical Experience and Hands-On Practice</p>
        <p>Teaching formats should be flexibly selected based on the actual conditions of the school, including situational drills, role-playing, fun competitions, game interactions, group discussions, and experience-sharing activities, so as to build learning scenarios that match students’ cognitive levels and guide students to form personal experiences and reflections, gradually enhancing their comprehensive ability to handle real-life problems. It is important to emphasize the integration of classroom instruction with practical activities. Priority should be given to using real-life settings such as school corridors, staircases, cafeterias, playgrounds, and school entrances for teaching; simulation areas (simulated electrical outlets, simulated intersections, simulated bus stops) should be set up in the classroom to reduce the difficulty of scene transitions. At the same time, attention should also be paid to environmental infiltration on campus. On the one hand, activity areas should be designated: walking routes should be marked on playgrounds, corridors, and staircases to regulate students’ movement patterns and reduce the risk of collisions. On the other hand, signs should be posted throughout the campus: “Mind the Steps” on staircases, “Danger: Electric Shock” near power sources, “No Running or Chasing” in corridors, and sorting labels on trash bins, so that the environment becomes a “silent classroom”.</p>
        <p>4.2.5. Combine School Education with Family and Community Education</p>
        <p>Home-school collaborative education should be advocated to boost teaching effects ([<xref ref-type="bibr" rid="B8">8</xref>]). Special education is a complex systematic project for the whole society, which requires multi-level and multi-dimensional participation of different groups, departments and organizations such as schools, communities and families ([<xref ref-type="bibr" rid="B10">10</xref>]). Students with intellectual disabilities have weak ability to transfer safety knowledge. Inconsistent behavioral standards between home and school will greatly weaken teaching effects, so a unified training system should be constructed as follows. First, align teaching content. Schools can distribute Family Safety Tips to parents every month to match the classroom themes of the current month. For instance, if household electricity safety is covered in class that month, parents will be reminded to eliminate hidden dangers at home and teach children not to touch power sockets. Second, assign parent-child practical homework. Typical tasks include checking expired food at home with parents, practicing crossing roads, simulating receiving strangers and practicing garbage classification. Third, unify verbal instructions. Identical safety phrases and expressions such as sentences for turning down strangers shall be used both at school and home to prevent students from getting confused. Fourth, carry out one-on-one communication for high-risk students. Teachers will make separate management plans with parents for students with problematic behaviors including running around without restraint, eating unknown objects, opening doors randomly and trusting strangers easily. Fifth, maintain consistent safety guidance for outdoor activities. Parents are reminded to follow the behavioral norms taught at school when taking children to ride public transport, go shopping or walk on roads.</p>
        <p>4.2.6. Organize Comprehensive Activities Flexibly and Adopt Integrated Objective Evaluation</p>
        <p>The Ministry of Education-edited Life Adaptation textbooks for the middle grades has added a comprehensive activity section, which designs various practical activity themes. These themes integrate the knowledge and skills related to life adaptation acquired throughout the semester, embed them into real-life scenarios, and accomplish knowledge consolidation and practical application. Teachers conduct observational assessments based on the activity process to determine whether students have achieved the preset teaching requirements. The model of conducting academic evaluation through comprehensive practice can both promote flexible transfer of knowledge and skills and allow for intuitive judgment of students’ mastery levels in authentic contexts. In actual teaching, teachers should flexibly view the evaluation form of “activity as a vehicle,” clearly recognize that goal integration is the key focus in comprehensive activities, incorporate goal requirements into all aspects of the activities, and assess students’ goal attainment during the activities. At the same time, teachers should be able to flexibly adapt the themes of activities and select the most suitable themes for students with different conditions in different regions ([<xref ref-type="bibr" rid="B9">9</xref>]).</p>
        <p>4.2.7. Emphasize Integration with Instruction in Other Subjects</p>
        <p>The three subjects of Life Chinese, Life Adaptation, and Life Mathematics share unified character settings and life scenarios, facilitating subject integration. Emphasis should be placed on cross-curricular complementarity with the new Life Chinese textbooks by incorporating safety education content into them. On the one hand, this helps improve the quality of school instruction; on the other hand, it can fully stimulate students’ enthusiasm for learning safety knowledge and enhance their ability to solve problems in emergency situations ([<xref ref-type="bibr" rid="B7">7</xref>]). In daily teaching, subject boundaries should be broken down, and safety-related materials embedded in Life Chinese texts, picture-based speaking activities, oral communication exercises, and the “Chinese Little World” sections should be explored, so that content such as recognizing safety signs, using help-seeking language, and following travel rules can be taught in an integrated manner. At the same time, integrated practice should be carried out in coordination with subjects such as Life Mathematics and Labor Skills, using recognition reading, hands-on practice, and situational drills to consolidate safety skills. Multiple subjects working in the same direction and reinforcing each other can reduce knowledge fragmentation, allowing students with special needs to repeatedly consolidate safety knowledge across multiple scenarios and steadily enhance their life safety literacy.</p>
      </sec>
    </sec>
    <sec id="sec5">
      <title>Author Contributions</title>
      <p>Conceptualization, Yufeng Li; methodology, Yufeng Li; validation, Yufeng Li and Juan Peng; formal analysis, Yufeng Li; resources, Yufeng Li; data curation, Yufeng Li and Juan Peng; writing—original draft preparation, Yufeng Li; writing—review and editing, Yufeng Li; visualization, Yufeng Li; supervision, Yufeng Li; project administration, Yufeng Li. All authors have read and agreed to the published version of the manuscript.</p>
    </sec>
    <sec id="sec6">
      <title>NOTES</title>
      <p><sup>1</sup><ext-link ext-link-type="uri" xlink:href="http://www.moe.gov.cn/srcsite/A06/s3331/202211/t20221107_975922.html">http://www.moe.gov.cn/srcsite/A06/s3331/202211/t20221107_975922.html</ext-link></p>
      <p><sup>2</sup><ext-link ext-link-type="uri" xlink:href="http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/tnull_27696.html">http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/tnull_27696.html</ext-link></p>
      <p><sup>3</sup><ext-link ext-link-type="uri" xlink:href="http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/202501/t20250119_1176193.html">http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/202501/t20250119_1176193.html</ext-link></p>
      <p><sup>4</sup><ext-link ext-link-type="uri" xlink:href="http://www.moe.gov.cn/srcsite/A06/s3331/201612/t20161213_291722.html">http://www.moe.gov.cn/srcsite/A06/s3331/201612/t20161213_291722.html</ext-link></p>
    </sec>
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  <back>
    <ref-list>
      <title>References</title>
      <ref id="B1">
        <label>1.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Cao, L. H., Yang, Y. H., &amp; Ma, J. J. (2023). Interpretation and Teaching Suggestions of Safety Education Contents in New Lower-Grade Life Adaptation Textbooks for Schools for Intellectual Disabilities. <italic>Modern Special Education,</italic><italic>No.</italic><italic>7,</italic> 22-25. (In Chinese)</mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Cao, L.</string-name>
              <string-name>Yang, Y.</string-name>
              <string-name>Ma, J.</string-name>
              <string-name>Education, N</string-name>
            </person-group>
            <year>2023</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B2">
        <label>2.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Cui, K. X., &amp; Zeng, M. L. (2026). Research Status and Implications of “Three Life-Based” Textbooks in Schools for Intellectually Disabled Students. <italic>Modern Special Education, 4,</italic> 28-35.</mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Cui, K.</string-name>
              <string-name>Zeng, M.</string-name>
            </person-group>
            <year>2026</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B3">
        <label>3.</label>
        <citation-alternatives>
          <mixed-citation publication-type="report">Ding, Y. (2022). Strengthening the Public-Benefit Orientation of Special Education Development and Let Every Child with Special Needs Glow with Life Brilliance—Reflection on Studying the Report of the 20th CPC National Congress. <italic>Chinese Journal of Special Education, 11,</italic> 8-13. (In Chinese) https://kns.cnki.net/kcms2/article/abstract?v=CK5qQJ1_U0yy3vacuIXOD_0ULYgHlK87lmtTRGeqtsyRKxMuzdIaQS1_-RP7lEWowvBF8L4CI67c0flKgXYkZ0zLyEVlsxOt84K1cqT2f9rOAWFZT6XVIY5aKh047aIZrt1KykaTMC7XcakFr-b7xzyy5Z_jWivw0CEJwxMfsxf8AQGl7QH3gg==&amp;uniplatform=NZKPT&amp;language=CHS</mixed-citation>
          <element-citation publication-type="report">
            <person-group person-group-type="author">
              <string-name>Ding, Y.</string-name>
            </person-group>
            <year>2022</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B4">
        <label>4.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Gao, P. L., &amp; Zhao, Z. (2025). Text Analysis and Teaching Suggestions on Safety Chapters in Senior-Grade Life Adaptation Textbooks. <italic>Modern Special Education,</italic><italic>No.</italic><italic>19,</italic> 43-46. (In Chinese)</mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Gao, P.</string-name>
              <string-name>Zhao, Z.</string-name>
              <string-name>Education, N</string-name>
            </person-group>
            <year>2025</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B5">
        <label>5.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Hua, G. D., &amp; Yan, X. M. (2022). The Comparison of Differential Instruction between China and Foreign Countries and Its Enlightenment to Special Education. <italic>Chinese Journal of Special Education,</italic><italic>No.</italic><italic>2,</italic> 10-14. (In Chinese) https://kns.cnki.net/kcms2/article/abstract?v=CK5qQJ1_U0ytlB9xMMmiCxmGe9F6l5AgmwMQrHsbhVk-91lgoCWwAOmCur9N7gKB9LGnt3gUWvYWahFSeJaWq-xB4jplDdwlbh0-3OnUw2HAtcBcyywP-IMP6rX5iR1ubFduSS3UF6JVQ7ljY9UJGnjcUEXCrEiSbGTZrmcZCbM5Lfe3pYyj9Q==&amp;uniplatform=NZKPT&amp;language=CHS</mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Hua, G.</string-name>
              <string-name>Yan, X.</string-name>
              <string-name>Education, N</string-name>
            </person-group>
            <year>2022</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B6">
        <label>6.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Li, Y. (2025). Domestic Research Review on Safety Education in Special Education Schools over the Past Decade. <italic>Education</italic><italic>Study,</italic><italic>7,</italic> 1190-1196. https://doi.org/10.35534/es.0711222 <pub-id pub-id-type="doi">10.35534/es.0711222</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.35534/es.0711222">https://doi.org/10.35534/es.0711222</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Li, Y.</string-name>
            </person-group>
            <year>2025</year>
            <pub-id pub-id-type="doi">10.35534/es.0711222</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B7">
        <label>7.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Wang, Y. X. (2021). Analysis and Reflections on Safety Education Contents in New Life Chinese Textbooks: Taking Grade 4 and Grade 5 Textbooks as Examples. <italic>Modern Special Education,</italic><italic>No.</italic><italic>23,</italic> 38-41. (In Chinese)</mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Wang, Y.</string-name>
              <string-name>Education, N</string-name>
            </person-group>
            <year>2021</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B8">
        <label>8.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Yuan, J. X., &amp; Hu, Y. M. (2023). Analysis and Teaching Suggestion of “Life Adaptation” Textbook in the Lower Grades of Peizhi School. <italic>Journal of Suihua University, 43,</italic> 50-53. (In Chinese)</mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Yuan, J.</string-name>
              <string-name>Hu, Y.</string-name>
            </person-group>
            <year>2023</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B9">
        <label>9.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Zhao, F., &amp; He, P. (2021). Ministry Compiled Version of Middle Life Teaching Adapt to the Characteristics and Teaching Advice—Taking Ministry Compiled Version Four Teaching Material Analysis as an Example. <italic>Journal of Suihua University, 41,</italic>71-73. (In Chinese)</mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Zhao, F.</string-name>
              <string-name>He, P.</string-name>
            </person-group>
            <year>2021</year>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B10">
        <label>10.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Zhou, X. L., &amp; Wang, P. F. (2022). Strengthening the Public-Benefit Orientation of Special Education Development: Ideological Connotation, Policy Thinking and Path. <italic>Chinese Journal of Special Education,</italic><italic>No.</italic><italic>12,</italic> 23-28. https://kns.cnki.net/kcms2/article/abstract?v=CK5qQJ1_U0waIln9j_uIl0MF1CDYtYn6HR9Q1c7XIybX1JrNY4bYRzOsGwez5qtEF_x1QumhKMxVRvSET4tOOw4TRoWv7YBZqQd5JEYPGlYkR6bp8kSJ2Q1E9zIofJG9vYPb5NgWJvjlsNd00I9_VYUfb-8qI9HOQkGizD1jhm3YE7r-4kLhVg==&amp;uniplatform=NZKPT&amp;language=CHS</mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Zhou, X.</string-name>
              <string-name>Wang, P.</string-name>
              <string-name>Connotation, P</string-name>
              <string-name>Education, N</string-name>
            </person-group>
            <year>2022</year>
          </element-citation>
        </citation-alternatives>
      </ref>
    </ref-list>
  </back>
</article>