Realities and Challenges of Support for Children with Special Needs in Nursery Schools.

Various neurodevelopmental disorders (NDDs), which are discussed in the Japanese edition (2014) of “the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,”1 include intellectual disability, communication disorder, autism spectrum disorder, attention-deficit/hyperactivity disorder, specific learning disorder, and motor disorder including tics. Moreover, the fact that there are cases with NDD wherein individual children suffer from a combination of multiple symptoms of the disorders makes it difficult to diagnose and support such children. Gillberg2 has coined the term “Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examination” (ESSENCE) to refer to children whose developments subtly deviate from what may be considered normal despite having received no clear diagnosis. This term could describe the ones who could be categorized into a group of “children with special needs” (ki ni naru ko, literally “concerned children”) in Japan. It is critical to provide appropriate support according to the symptoms being presented. In general, in this study, “children with special needs” refers not only to the children whose conditions include mildly delayed intellectual or physical development and maltreatment but also to the children who NSTs considered to be “children with special needs who appear outwardly ordinary” and “children who are left out of a group of children.” In particular, the NSTs should be able to perceive that developmental disorder(s) might underlie problem behavior in a child they are dealing with once they have “noticed” something different about that child at an earlier stage. In recent years, it has been noted that there are children who require early detection and intervention even at the nursery school and kindergarten level.3 Shimono et al.,4 Nakashima et al.,5 and Kurokawa6 have reported that children with special needs are enrolled in around 70% of nursery schools. Fukuyama et al.7 pointed out that while 40% of the NSTs were aware of and provided support to children with special needs, a considerable number of behaviors and characteristics associated with the developmental disorders remained. In this study, in light of the present situation of local support systems, we clarify the societal and learning resources that NSTs need in the future. While discussing how administrative bodies and professionals in fields such as medicine, welfare, psychology, and education should play their roles and render cooperation support for those involved, including the parents, we examined possible future challenges to enhance support for children and childcare.