医療保健学研究９号：43-59頁（2018）ISSN 2185-2227

ReportLiterature review on realities of difficulties Japanese families with a childwith developmental disabilities face and required support
Hiroshi Fujioka1, Rie Wakimizu2, Ayano Ebihara3, Megumi Nakano4
1
2

Department of Nursing, Faculty of Health Science, Tsukuba International University

Division of Health Innovation and Nursing, Faculty of Medicine, University of Tsukuba
3

Department of Nursing, University of Tsukuba Hospital
4

Department of Nursing, Heart Life Hospital────────────────────────────────────────────
Abstract
Purpose: Summarizing the existing research on realities of difficulties faced by Japanese families having achild with developmental disabilities (DDs) and necessary support for them, ascertaining findings of theresearch, and comprehensively examining specific intervention methods for corresponding families in Japan.
Methods: PubMed and CINAHL were utilized to search for English literature on the subject whereas Japan
Medical Abstracts Society (web edition, ver. 5) was used for Japanese literature. The original and review
articles for 2005–2014 were reviewed.
Results: Realities of difficulties were classified into six categories, with “difficulties concerning the child’s
behavior” being extracted the most. Overall, this category was shown to greatly affect the lives of families
with a child with DDs. Such families require four categories of support. Particularly, mental and emotional
support for parents was desired.
Conclusion: The review suggested that specialists needed to assess everyday difficulties of families with achild with DDs from various perspectives, using issues related to behaviors of children with DDs as abeginning. Further, parents’ mental and emotional stabilities need to be supported more actively. Japanese
research focusing on families with children with DDs should be continually accumulated. Based on findings
from such an accumulation, support for both the parents and the child or comprehensive support focusing on
the family collective should be planned.
Keyword：developmental disability, difﾞculties, family, literature review, support─────────────────────────────────────────────────────────────────
Corresponding author: Hiroshi Fujioka
Department of Nursing, Faculty of Health Science,
Tsukuba International University,
6-8-33, Manabe Tsuchiura, Ibaraki 300-0051, Japan.
Phone / Fax: +81–29–826–6622
Email: iryouhoken@tius.ac.jp

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Hiroshi Fujioka et al／医療保健学研究

Introduction

９号：43-59頁（2018）2007). Though a large majority of parents adjust to
raising these children, some fail to adapt; the latter

In Japan, the number of children with developmental

are said to be potential child abusers (Raina, 2004).

disabilities (DDs) is steadily increasing (Japan

Karst and Van Hecke reported that raising a child

League on Developmental Disabilities, 2013). The

with DDs can cause higher stress in the family

results of the National Survey on School Children(Karst & Van Hecke, 2012).

with Special Educational Needs in a Regular ClassIn Japan, nuclear families comprise over 60% ofreported that 6.5% of all children have “mild DDs”

the population, and their burden of child caring isthat cause significant difficulty in learning andsubstantial (Ministry of Health, Labour and Welfare,behavior without mental retardation (Ministry of2012). There are cases where children are abused by

Education, Culture, Sports, Science and Technology,

their parents because they do not have a person or2012).

organization that they can consult with when it is

In addition, as shown by the enforcement ofdifficult for them to handle child care and when

special needs education and the recent establishment

they experience depressive tendencies. (Ministry ofof the Act on Support for Persons with Developmental

Health, Labour and Welfare, 2014a; Ministry of

Disorders (Ministry of Health, Labour and Welfare,

Health, Labour and Welfare, 2013). In particular,2005), the supportive environment for DDs has

parents raising a child with DDs have be en

improved, with a better understanding of disability

reported to undergo difficulties in child caring andemerging in Japanese society. In Japan, DDs arestress more strongly as compared with families

defined as “autism, Asperger’s syndrome, otherraising a healthy child (Ministry of Health, Labour

pervasive developmental disorders, lear ningand Welfare, 2014b). Japan’s Children’s Charter

disorders, attention deficit hyperactivity disorderadvocates that “all children are to be raised(ADHD), and similar higher cerebral dysfunctions

healthily, both in mind and body, and have theirthat usually present symptoms at an early age.”

livelihood guaranteed” (Ministry of Education,

The qualitative definition is “a disorder that

Culture, Sports, Science and Technology, 1951).

typically causes behaviour, communication, andHowever, to adhere to this policy, support for thesocial adjustment problems during the development

entire family, and not just for the child within its

process” (Hiraiwa, 2009).

perspective, is necessary for families raisingChildren with DDs often cause (or are involved in)children with DDs. Clarifying the everyday

problems (e.g., trouble with friends, isolation fromdifficulties of members of such families and theother children, and falling behind others) in the

support they require is a cr ucial task whencommunity or school one or more times (Takahashi,providing familial support in various fields such as2008). Parents of such children need to deal witheducation, medical concerns, and welfare. Until

problems caused by them due to the DD and undergo

now, several papers referring to family’s difficulties

more stress associated with child rearing than otherand necessary support in each position andparents (Anderson, 2008; Nachshen & Minnes,

perspective were found. However, there were no2005). The pressure of child rearing felt by these

literature-based papers summarizing these contents.

parents is considerable (Karst & Van Hecke, 2012;

Therefore, this study summarizes the existing

Raina, 2004). The presence of a child with DDs canresearch (including case example reports) on realities

also be a source of stress for the child’s kin andof difficulties faced by Japanese families with asiblings (Karst & Van Hecke, 2012; Schuntermann,child with DDs and necessary support for them,

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）ascertains the findings of the research, anddisorders,” “families,” and “Japan” (in Japanese)comprehensively examines specific intervention

were used as keywords to search for original andmethods for corresponding families in Japan.

review articles published between 2005 and 2014.
The Japan Medical Abstracts Society (web edition,ver. 5) was utilized to search for Japanese literatureusing “developmental disorders,” “families,” andMethods“Japan” as keywords to search for original andreview articles published betwe en 2005 andParticipants───

December 2014. Therefore, 38 pieces of English
PubMed and CINAHL were used for searching

literature and 33 pieces of Japanese literature were

English papers on the subject, and “developmental

found. Excluding literature that did not have

Table 1. Literature list

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Hiroshi Fujioka et al／医療保健学研究

families with a child with DDs as the subject ordoes not mention everyday difficulties of families, a
total of 26 pieces of literature were used as analysis
participants (Table 1).

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Analysis methods─────Each selected piece of literature was classified
according to “year published,” “subject” (i.e., children,
family), “the disability of the child,” “the state of

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Hiroshi Fujioka et al／医療保健学研究

difficulties,” “support and needs,” and “familial

９号：43-59頁（2018）

Results

support given.” Thereafter, an analysis form wasdeveloped, and each piece of literature was read

Research contents────

intensively, with its content summarized—the pointsof analysis being realities of difficulties, required

1. Realities of difficulties

support and needs, and familial support being

As a result of the analysis, the difficulties that

performed for families with a child with DDs. Thesefamilies having a child with DDs face wereanalyzes were promoted by researchers continuousclassified into six categories as follows. Each

discussing.

category was further classified by focal themes(Table 2).
Table 2. Realities of difficulties

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Hiroshi Fujioka et al／医療保健学研究

Everyday difficulties

９号：43-59頁（2018）

hours looking after their child every day at home.

Regarding everyday difficulties, it was first

Further more, interview results showed thatindicated that the participants had to quit their

participants felt that their lives stopped during

work to prioritize taking care of their child.

periods when their child or they themselves were ill

Furthermore, even in cases where they did not quit

or during pregnancy. An awareness of difficulties

their job, the results demonstrated a reality inwas discussed regarding raising their child,

which taking care of their child affected their jobs,

including having to communicate visually using

such as being called away while working or having

pictures and charts in light of the child’s development

to take leave from work.

or constantly having to make small adjustments.

Next, it was shown that there was deterioration

There have also been reports on the participants’in participants’ mental and physical health because

life rhythms being disrupted because of reasonsof issues such as concerns related to problematic

such as having to remain awake through the night

behaviors of their child. There have been statements

for children whose night and day is reversed.

by participants complaining about their physicalproblems (e.g., “I feel that my body is aching” andDifficulties associated with the child’s behavior“my weight is decreasing”) as well as an increase in

Impacts on one’s lives included families falling

psychological stress and the development of

into a confused state when their child threw a

psychological illnesses.

tantrum, having a panic attack, or child caring

The results also indicated the reality in whichbecoming difficult because of their child’s behavior.

spending their daily lives with a child with DDs

In addition, there have been reports of things in theincreased the participants’ exhaustion from childhouse getting broken or family members being

rearing and household chores. This included

physically attacked because of the child’s rough or

instances such as the parents having to carry theiraggressive and impulsive behaviors. The anxiety

child home after grocery shopping because the childand fixations of such children are strong. To be

did not want to go home and the child making thespecific, there have been cases where families haveyounger brother cry by teasing him without

had to stock specific food products in their refrigerator,

considering his feelings. Moreover, the analysis

and remove all mirrors in their house because of

revealed causes of participants’ exhaustion, such as

their child’s strong drive to lose weight, and because

having to spend considerable time helping withthey could not go out with their daughter who

their child’s homework or having to spend many

would pursue a perfect appearance. As such, the50
Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

characteristics of the child’s disorder also affected

faced many concerns and anxieties when selecting

the families’ lives.

schools and facilities because of the inability to

The participants worried about dealing withidentify schools and classes suitable for the child.

their child (e.g., “I do not know how to deal with the

Furthermore, participants felt that “our requests

delay in development,” and “I don’t know how to

are not being heard” and “we cannot voice ourdeal with my child’s problematic behavior”) anddissatisfaction” regarding educational institutions.

also about the child’s growth and changes (i.e.,

There were also concerns such as the teaching staff“changes that occur during puberty” and “sexual

at school did not understand the disability and theinterest and concer n”). The state in which

participants could not receive continuous support.

participants worried about their relationship with

Complaints were also made stating that the school

their child (i.e., “difficulties in interacting with their

could not ascertain the support needed by children

child,” “difficulties in raising the child,” andwith DDs or their families.

“difficulties in feeling an attachment [to the child]”)
was also indicated.
Issues that made the participants concerned
included the conspicuous behavior of their child

There were complaints of difficulties faced inproviding learning support for the children at homeand spending too much time helping them with
their homework.

that caused annoyance to the people around them.

In association with the child’s school attendance,

Furthermore, difficulties within the child’s social

the participants’ source of concerns graduallylife were also raised, including the difficulties inchanged to “being unable to fit with the group” andsustaining concentration, prematurity in verbal“bullying and secondary disabilities.” Parents wereexpression, and the child’s attendance or non-concerned because they were unaware of effective

attendance at school. The issues that the child faced

methods of supporting the child’s school life. The

in interpersonal and social aspects, such as

participants wished that classmates would know

difficulties in communication, were perceived as

how to interact with their child. Though there weredifficulties on the part of both the child and theparticipants who knew the specific state of theirfamilies.

child’s school life, there were also those who did notknow the state of their child because of the lack ofDifficulties related to family relationships

status reports provided by the school.

There were many complaints from mothers

Participants also mentioned difficulties inregarding their husband’s lack of understanding,establishing a positive relationship with othersuch as “my husband does not understand ourguardians.

child’s disability and cannot accept it” and “myhusband does not understand the difficulties ofDifficulties related to rehabilitation

child caring.” Furthermore, the review showed theParticipants had a sense of difficulties in carrying

state in which the entire family left the responsibility

on with the rehabilitation of the child because ofof dealing with the child with DDs to the motherthe lack of information related to rehabilitation.

without attempting to understand the child’s

Furthermore, they were experiencing financial,disabilities.

physical, and time-related burdens and emotional
conflicts for the continuation of such rehabilitation.

Difficulties related to education
The analysis result showed that participants

In addition, they possessed the understanding thatthe disabilities of their child could not be cured with

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

Psychological burden

their care.
Concerning the treatment of their child, there

The participants had a long-lasting anxiety

were families who could not receive treatment,

concerning their children. Specifically, they had

despite desiring treatment, because of limited

worries such as “Will my child be able to become

resources, such as doctors and hospitals (e.g., “there

self-sufficient in the future and hold a job?” andare few doctors who specialize in developmental“Will my child commit a crime?”

disabilities,” “the special hospital is far away,” andMoreover, there were participants who became
pessimistic by comparing their child with other“it is difficult to secure a reservation”).
There were also cases where the participants felt

children, wondering “whether my child can keep up

suspicious toward the specialized organization they

with studies” or “whether my child is having

attended for rehabilitation and cases where thedifficulties interacting with friends or being part ofparticipants could not find an appropriate specialista group.”
Furthermore, there were participants who felt

to deal with their child’s disability.
In addition, there was a situation where public

guilty for being unable to accept their own children’s

assistance was unsuitable for the participant’s child.

disabilities despite being mothers and being unable
to tell the people around them about the disabilities.

Table 3. Support and needs

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Hiroshi Fujioka et al／医療保健学研究

2. Support and needs

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them by becoming involved with families facing

Support required by mothers and families having

difficulties in a sympathetic manner was also

children with DDs includes physical support,sought. Furthermore, the analysis result suggested

psychological support, and support focused on thethe importance of providing mental health support

child. There were also needs for appropriate measures

for the participants in a long-term and continuous

at facilities and specialized organizations (Table 3).

manner. An assistance method that provides a place
for interaction among guardians and enables them

Physical support

to consult regarding their concerns and support one

Physical support includes financial support foranother, thus helping them gain emotional support,

the families, including rehabilitation fees. Further-is required. Another method mentioned was tomore, participants sought services in which options

provide time during which mothers can leave

would be given to guardians and families raisinghousework and child caring behind, leading to

the child, such as providing information related toemotional support. Literature 16 reported situationssocial resources and notifying them about how towhere participants were supported by those arounduse such resources. In addition, the participants

them (e.g., “I am supported by the understanding

also required support from specialists, such as

and cooperation from my husband and my parents,”“explanations in which parents can appropriately“I am supported by the help of those who understandunderstand the developmental state and behavioral

in the community,” and “I am supported by thecharacteristics of the child” and “support that caninteraction and advice from mothers who also have

depict the future state as much as possible.” Moreover,a child with DDs.”)

participants wished for physical support from theirspouses and other family members.

Support focused on the children
Concerning support focused on the children, thePsychological support

participants wished for further enhancement of

Psychological support required by the participants

welfare support toward children. In particular, they

includes more active support for mental anddesired support that focused on the strength andemotional stability of parents and families. The

positive characteristics of those with DDs andneed for diagnosis and treatment of mental illnesses

further strengthened these characteristics.

concerning psychological complaints that weremanifested has been indicated. A support that
understands participants’ emotions and consoles

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

Support sought from facil ities and special ized

participants stated that being informed of theinstitutions

positive aspects and development of their child

From facilities and specialized institutions,verbally by the members of the institution and theparticipants desired support such as the enforcement

specialists became a source of encouragement andof connections with external specialized institutions,

support for child caring.

the enforcement of DD-related training of staff
members, and the allocation of designated specialists.

3. Support focused on families

In addition, when the child could do more things

Among the examined literature, there were somewith training, the participants felt that their childthat conducted research with the aim of providing

was slowly growing and moving forward. The

familial support (Table 4).

Table 4. Familial support being provided

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

Literature 1 discusses an intervention that promoteswith a child with DDs has been increasing in recent

acceptance by school advisors and doctors in a caseyears. This can be attributed to the impact of theinvolving difficulty in the acceptance of disabilities.

Act on Support for Persons with Developmental

However, it was ineffective and instead reported

Disabilities (Ministry of Education, Culture, Sports,that the family was rather in conflict with the school

Science and Technology, 2004), the 2005 revision ofand medical team concerning the aspect of support.

the Child Welfare Act (Ministry of Health, Labour

Literature 2 involved conducting a study seminarand Welfare, 1947), and the 2011 revision of theon high-functioning autism and Asperger’s syndrome

Child Welfare Act (Ministry of Health, Labour andfor families. Consequently, the understanding of the

Welfare, 2011). However, such literature is sparse,families toward their children was promoted.

and further accumulation of results is required.

Furthermore, the effect of the study seminar was
sustained even after some lapse of time.

The majority of participants in the research
considered were the main rearers. Given that

Literature 7, 8, and 20 reported that, as a result of

Schuntermann reported the burden on the siblings

examining the efficacy of parent training, the senseof children with DDs, findings on each familyof difficulties parents felt toward dealing with theirmember’s reality of life and on the support required

children with DDs was alleviated, and their mental

by them need to be accumulated in Japan as wellhealth improved. It was also suggested that the(Schuntermann, 2007).

secondary disability of the child was reduced due tothe training. Moreover, it was reported that the

Research contents────

training was also important from the perspective ofproviding an early rehabilitation support before
consulting a medical institution.

1. Realities of difficulties
As a result of the analysis, the difficulties of

Literature 16 stated that a camp was held tofamilies with a child with DDs were classified into

stimulate the sensory perception of children withsix categories: everyday difficulties, difficulties

DDs and promote exercises, providing comprehensive

related to the child’s behavior, difficulties concerning

familial support. The literature reported that throughthe familial relationship, education-related difficulties,

the camp activities, the autonomic nervous system

rehabilitation-related difficulties, and psychologicalactivities of the children were stabilized and theirburden.

stress was reduced along with the promotion of theAmong these categories, difficulties related to theactivation of the frontal lobe’s restraining function.

child’s behavior were mentioned most frequently.

However, no intervention was implemented for

Most of the child’s behaviors mentioned as problematicparents or other family members, and the literature

were symptoms of DDs. The participant family felt

did not mention any changes in the outcome withgreat difficulties with the child’s problematicfamilies before and after the camp.

behavior pertaining to DDs and also indicated it as
the fundamental cause for everyday difficulties,
education-related difficulties, and psychological

Discussion

burden. In general, it was observed that thedifficulties related to the behavior of the child

Research trends and participants────────

greatly impacted the lives of families with a childwith DDs.

The amount of literature focusing on families

The content of difficulties related to familial

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

relationships, education-related, and rehabilitation-practice after having lost her confidence because of

related difficulties reported in Table 2 infers ahaving a strong sense of rehabilitation-related

situation in which participants do not have a person

difficulties. Literature 9 reported on parents’ depres-or lack opportunities to consult their household or

sion, neurosis, personality disorder, schizophrenia,

school, thus becoming isolated in terms of childcare.

and alcohol dependency based on survey results. It

In particular, there were many statements thatwas believed that the behavior and conduct ofindicated the isolation of mothers, such as “mychildren with DDs affected the state of parents’husband does not understand how difficult

health, including mental health. Thus, the literaturechildcare is” and “my husband does not accept thesuggested that providing psychological support andchild’s disability.” There was also a case of conflictintervention for families that have a child with DDs

between a participant and the school officials

is indispensable.

concerning the guidance and support provided toWhat is considered most important is support

the child. To prevent the isolation of participantsthat understands parents’ emotions and provides

with regard to childcare, it is crucial to hold seminars

accompaniment. In reality, the evaluation andon disabilities for parents and family members as

understanding of parents who have a child withwell as set up a regular place for discussion thatDDs were different than those of specialists. Literatureprovides a connection between each specialist and

11 showed that specialists evaluated children based

other parents.

on observation and research conducted in one

Based on the fact that Table 2 shows “the lack ofsetting whereas parents evaluated their children

specialists on developmental disorders” regarding

over a long period of time. Therefore, the parents’rehabilitation-related difficulties and “the lack of theevaluation was higher than that of the specialists. In

understanding of developmental disorders incontrast, parents also felt that specialists did noteducational institutions” regarding education-

understand the difficulties of raising their child.

related difficulties, the participants experienced

Specialists should consider the possibility of there

difficulties in raising the child without being able tobeing discrepancies between their judgment andrely on specialists or public institutions. However,parents’ perception of their children and their sense

these rehabilitation-related and education-relatedof difficulties in child caring. Thereafter, suchdifficulties that parents face are believed to also

specialists should actively provide support todecrease the qualities of the child and not just thefurther stabilize parents’ mental and emotional

parents. The analysis showed that there areaspects. Providing an opportunity for guardians todiscrepancies in the content of rehabilitation andinteract is one way in which specialists can support

the quality that the participants received depending

them in a feasible manner within a community.

on their residential area because of the lack ofRegarding the support focusing on the children,

specialists and specialist institutions on DDs in

the analysis demonstrated that participants’ need ofJapan. It is necessary to develop a system in which

support also extended to the future of the child (i.e.,

participants can attain services of a certain level,school attendance and employment) and not just theirrespective of where they live.

child’s current phase of life. In particular, they sought
support that focused and built on the strength and2. Support and needs

positive aspects characteristic to DDs. Many concerns

Literature 8 had a case of a mother who attended

were raised on how school teaching staff lacked thesessions at a psychosomatic medicine and psychiatricunderstanding of DDs and did not comprehend how

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Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）

to deal with them. Furthermore, based on statements

children who are the target of the assistance and thethat stipulated that the child’s quality of life differed

type of assistance they need.

depending on the teacher’s qualities, the improvement

In addition, it is crucial to plan the support to be

and support sustained at school, where children

provided in conjunction with society’s events.

spend their time outside the household, wasLiterature 11 reports the support for children andconsidered indispensable. It is essential for all

adults with DDs during the Great Tohoku Disasterteachers to support children with DDs during theirthat occurred on March 11, 2011 and proposed

school life and deal with their families. Moreover,“registered evacuation sites,” in which evacuation

promoting the teachers’ understanding of DDs forsites are to be determined in advance. Planningsuch support to continue in future was deemed tosupport for unusual events in such a manner may

be an issue.

lead to reducing the family’s anxiety as well as

Participants viewed hospitals and rehabilitation

providing psychological assistance to them.

institutions as essential support resources. They

It is inferred that alleviating the symptoms ofperceived the growth and progress of their child

children with DDs (Literature 16) will also alleviate

when their child could do more things throughthe difficulties of dealing with a child with DDs inrehabilitation. Furthermore, they obtained encour-

everyday life (Table 2). Parents themselves attending

agement and support by having the strength andseminars (Literature 2) to develop the acceptancedevelopment of the child pointed out objectively by

and understanding of disabilities and acquiring

staff members. On the other hand, there were

specific childcare skills in parent training (Literature

participants who could not receive specialized

7, 8, 20) are believed to be able to alleviate thesupport despite wanting to proceed with rehabilitationdifficulties in dealing with their child in daily life.

(Literature 13). First and foremost, an institutional

On the basis of these findings, it can be concluded

environment is required for rehabilitation support.

that familial support should be provided to both

Thereafter, the improvement of specialized support

children and family members and not just either one(i.e., rehabilitation) needs to be planned, along withof them. Some of the literature consulted in thisincreasing its quantity and quality, such that morestudy also discussed support given to only one

children and parents can receive such services.

party. However, the findings from the analysis
suggested the necessity of providing comprehensive

3. Support focusing on families
It is crucial to ascertain the needs of the families

support to both parents and children or focusing on
the family collective.

when providing support. Literature 15 mentions
such situations where information does not reachfamilies. These scenarios include the participants

Conclusion

not receiving any infor mation at all at theirkindergarten (such as lectures related to DDs) andIn this review, difficulties in families’ daily lifeon the education of children with DDs in schools

were classified into six categories, and support thatthat the participants have to select for their children.

families required was classified into 4 categories.

The literature also discusses a situation where the

The results suggested that specialists need to

public assistance provided varies from the needs ofassess everyday difficulties of families with a childthe participants. It is necessary to conduct preliminary

with DDs from various perspectives, using issues

research on the types of disabilities suffered by the

related to the behaviors of children with DDs as a

57
Hiroshi Fujioka et al／医療保健学研究９号：43-59頁（2018）beginning. Furthermore, they also suggested that/shingi/chukyo/chukyo3/004/siryo/attach/1298

parents’ mental and emotional stabilities need to be

450.htm [cited 2016 Aug 16]

promoted more actively. Though the review clarified

Ministry of Education, Culture, Sports, Science andthe overall picture of the realities of life of JapaneseTechnology (2004) Act on Support for Persons

families having children with DDs, the support they

with Developmental Disabilities. Available from:want, and the actual assistance they receive, the

http://www.mext.go.jp/a_menu/shotou/tokubet

research is still inadequate. Further research needs

u/material/001.htm [cited 2016 Aug 16]

to be conducted in Japan in future. Based on the

Ministry of Education, Culture, Sports, Science andfindings of such research, support for both theTechnology (2012) Report on national survey

parents and the child and comprehensive support

on school children with special educational

focusing on the family collective should be plannedneeds in a regular class. Available from: http://

and executed.

www.mext.go.jp/a_menu/shotou/tokubetu/mat
erial/__icsFiles/afieldfile/2012/12/10/1328729_0
1.pdf [cited 2016 Aug 16]

Acknowledments

Ministry of Health, Labour and Welfare (1947) The
Child Welfare Act. Available from: http://www.

This study was funded by the Ministry of Education,
Culture, Sports, Science and Technology, Japan

mhlw.go.jp/bunya/kodomo/dv22/04.html [cited
2016 Aug 16](Grant-in-Aid for Young Scientists (A), 2014–2017,

Ministry of Health, Labour and Welfare (2005)

No. 26713057). The authors declare that they have

Establishment of the support law for people

no competing interests.

with developmental disorders. Available from:http://www.mhlw.go.jp/english/wp/wp-hw2/
part2/p2c8s2.pdf [cited 2016 Aug 16]

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告発達障害児をもつ日本人家族が直面する困難実態と必要とされる支援に関する文献検討藤岡寛1，涌水理恵2，海老原彩乃3，中野愛41

つくば国際大学医療保健学部看護学科2

筑波大学医学医療系
3

筑波大学附属病院4

ハートライフ病院【要 旨】本研究では、発達障害児をもつ日本人家族が直面する困難実態と必要とされる支援に関して現存する研究を要約し、その所見を明らかにし、同様の家族に特異的な介入方法を包括的に探索することを目的とした。英語の文献に対しては Pubmed 及び CINAHL を用いて、日本語の文献に対しては医学中央雑誌を用いて、検索した。2005年から2014年まで刊行された原著及びレビュー論文を対象とした。その結果、困難実態は６つのカテゴリーに分類された。中でも、「児の行動に関する困難」では多くの内容が抽出された。このカテゴリーの内容は総じて発達障害児をもつ家族の生活に大きな影響を与えていた。家族が必要としている支援については4つのカテゴリーが明らかになった。特に、親に対する心理的情緒的支援が切望されていた。本レビューは、専門職者が発達障害児をもつ家族の日常的な困難について、発達障害児の行動に関することをはじめとして様々な視点から評価する必要があることを示唆した。更に、親の心理的情緒的安定を図るためにより積極的に支援する必要がある。日本では、発達障害児の家族に焦点をあてた研究を絶えず蓄積していく必要がある。そのような蓄積からの所見をもとに、親子双方への支援や家族全体に焦点をあてた包括的な支援を計画していく必要がある。

キーワード：発達障害，困難，家族，文献検討，サポート