The PEBBLES communication system, designed to link children in the hospital with their regular classrooms, has progressed through three major development and evaluation phases. Many of the design and human factors issues (e.g., daily curriculum planning and co-ordination between two teachers in distant locations, and the need for an appropriate attention device) discovered through this process are unique from other video-mediated communication systems because PEBBLES must support both academic and social tasks with children as users. While technical limitations such as bandwidth and audio tidelitv remain as oroblems to solve with PEBBLES, the system has been successful in providing students with a high level of t&presence in their classrooms INTRODUCTION
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