Japanese Journal of Social Welfare, 57(5), 1–10 2017

Original Article

The Prevalence and Characteristics of Married Lives ofJapanese People with Intellectual Disabilities (MJPwID):
According to the Survey for Employment and Livelihood
Support Centers for Persons with Disabilities(ELSCPD “Syogaisya syugyou/seikatsushien center”)
Emiko Tanaka*
Tokyo Kasei University, Tokyo, Japan

Abstract This study describes the prevalence and characteristics of marriage among Japanesepeople with intellectual disabilities. While the number of couples and parents with intellectual disabilities has been relatively small, their circumstances are changing, due to the ratiﬁcation of theConvention on the Rights of Persons with Disabilities.
This article uses a survey that was distributed to 323 Employment and Livelihood Support
Centers for Persons with Disabilities (ELSCPD). One hundred and four (32.2%) questionnaires
were returned.
The survey found regional differences and a trend of couples living in the countryside. Typical couples had light to medium impairments, were middle-aged, lived in a rented house, andraised one child using few childrearing services. They earned relatively high wages compared tothe average salary of disabled people, although the salary of non-disabled people in the same generation was extremely high. Their main support system came from social welfare workers, someof who thought that marriage and raising children were improbable tasks for these disabled.
It is necessary to develop a better childrearing support system and securing a minimum wage
for people with intellectual disabilities. This can be accomplished with more comprehensive andconcrete investigations into good practices.
Keywords: intellectual disabilities, marriage, parents and children, JapanI.

Introduction

1.

Characteristics of the homes of Japanesepeople with intellectual disabilities(JPwID)
This study describes and discusses the prevalence and characteristics of married lives of Japanese people with intellectual disabilities(MJPwID). According to the “Annual Report on* Corresponding address: Tokyo Kasei University,
1–18–1 Kaga, Itabashi-ku, Tokyo 173–8602, Japan.
E-mail: etanaka@tokyo-kasei.ac.jp(Received August 31, 2016; accepted May 12, 2017)

Government Measures of Persons with Disabilities in 2016,” there is an estimated 8,602,000
people with disabilities in Japan. Among these,
741,000 were people with intellectual disabilities(PID), 3,937,000 had physical disabilities, and3,924,000 had psychiatric disabilities. Although
the number of PID is smaller than the number ofpeople with other disabilities, 16.1% of PID have
lived in an institution, compared to 1.9% of people with physical disabilities and 5.9% of people
with psychiatric disabilities. This means that
there has been no deinstitutionalization for PID,
unlike the approach to other disabilities (Cabinet

2

E. TanakaOfﬁce, 2016).
The average PIDʼs lifestyle was described in
the 2011 report “Survey of difﬁculties in everyday life (status survey of persons and children
with disabilities who are at home)” (SDEL 2011).
Although there was a shortage of valid
responses, the study reported that among PID
living with a housemate, 5.1% were living with apartner and 4.3% with their children; 90.7% were
living with their parents. Compared to the living
situations of people with physical disabilities(59.7% of whom live with a partner and 35.5%
with children) and psychological disabilities(25.4% live with a partner and 16.7% with children), the percentage of PID living with theirown families is remarkably low (Ministry of
Health, Labour and Welfare 2011). This implies
that PID face difﬁculties when living in the community, especially with their own families.
2.

The need to change the current situation
Although a small number of PID are married,a far greater number desire to marry and havechildren (Ohno, 1989; Honma, 1992; Yamashita
et al., 1992; Inoue & Gouma, 2001). The situation was already changing, and has continued totransform at a greater rate since the 2006 ratiﬁcation of the UN Convention on the Rights of Persons with Disabilities (CRPD). Countries that
ratiﬁed the convention agreed to guarantee therights to marriage and family lives for people
with disabilities. Japan ratiﬁed CRPD in 2014
and is now required to secure the rights of PID tomarry and found a family.
On the grounds of Article 23 of CRPD, a special interest research group (SIRG) for parents
with intellectual disabilities (PwID), part of theInternational Association for the Scientiﬁc Studyof Intellectual and Developmental Disabilities(IASSIDD) produced a summary of previous
studies and published a position paper in 2008
(IASSID SIRG, 2008). This paper pointed to signiﬁcant problems facing PwID, including the difﬁculty in estimating the number of PwID. The
study called PwID a “hidden population” thatwas easy to overlook because many lived with-out special social support until they become parents. The study also pointed to PwIDʼs barriers in
fulﬁlling their parenting roles, as well as greater
rates of poverty, lack of sufﬁcient healthcare, difﬁculty accessing social resources, and a lack ofopportunity to learn parenting skills. The study
also described research that found many PwID
can learn new knowledge. It introduced somepositive interventions and provided groundworkfor subsequently developed collaboration acrossborders (Starke et al., 2013).
3.

Aim of this article and previous studies
Scholars have started estimate the prevalenceof PwID and their living circumstances by using
their countriesʼ national surveys (Hahn, 2014;
Hoglund, 2014; Man et al., 2014ab, 2017) instead of using data from healthcare or social service agencies. According to Man, this data had
two disadvantages: respondents were recruitedusing sampling strategies that specify representativeness within a deﬁned sampling frame at the
population level and it was necessary to obtain aprobability sample of the general population(Man et al., 2017).
In Japan, four previous surveys haveattempted to ascertain the situations of PwID,
using data from healthcare and social service
agencies (Yamashita et al., 1992; Hayashi &Kido, 2000; Kido & Hayashi, 2002; Tegawa etal., 2005). In a survey of institutions for people
with mental retardation (seishinhakujakusya-shisetsu), Yamashita found 718 married people (171
men and 547 women) and 361 children. Hayashi
and Kidoʼs research, which took place between
1999–2000, distributed a questionnaire across 38
social life support centers (seikatsu shien center[SLSC]) throughout Japan, and found 36 couples. The ﬁnal survey, of 500 public healthnurses chosen from about 2,500 by random sampling, found that 173 had experience supporting
mothers with ID. Only Hayashi and Kido investigated the prevalence of couples with ID (CID).
SDEL 2011, the representative national survey
about people with disabilities mentioned above,
was composed through estimated records andThe Prevalence and Characteristics of Married Lives of Japanese People with Intellectual Disabilities

valid responses. Valid responses regarding thehousemates of PID counted only 49 couples and41 parents.
Thus, there have been a limited number ofstudies that researched PwID using healthcare
and social service agencies and nationwide surveys. In addition, laws and service systems
regarding PID have changed over the decades.
For example, we do not refer to PID as having“mental retardation” nowadays. The number of
SLSC when Hayashi and Kido conducted theirresearch was 38, but in 2015 there were 323
Employment and Livelihood Support Centers for
Persons with Disabilities (syougaisya syugyou/
seikatsushien center [ELSCPD]). This paper
aims to disclose the present state of MJPwID andto compile the research about MJPwID.
II.

Methods

1.

Survey methods
The Ministry of Health, Labor and Welfare
explains that ELSCPDʼs provide complete consultation services to disabled individuals, including employment counseling and daily services.
They network with other organizations that provide employment, health, welfare, and education.
There should be an ELSCPD in every Healthcare
and Welfare Zone for People with Disabilities(there were 354 of these zones in 2008).
Each year, a list of the address and telephone
number for each ELSCPD is published online.
Using this information, a questionnaire was distributed in October 2015 to all 323 ELSCPDʼs.
One hundred and four were returned, a response
rate of 32.2%.
2.

Ethical considerations
This questionnaire survey conformed to the
ethical guidelines of the Japanese Society for the
Study of Social Welfare. Respondents were
informed that their answers were used only for
research purposes and that individual responses
were not disclosed. Privacy considerations andthe process of returning the questionnaires were
described, after which ﬁnal consent was

3

received.
3.

Items studied
The questionnaire used the results of Hayashi
and Kidoʼs survey (2000) as a reference. However, while Hayashi and Kido not only asked forbasic information about CID and support staff,
but also about CIDʼs experience with everythingfrom pregnancy to raising a child, the questionnaire in this study focused on the former information.
1) Basic information
The survey asked about the numbers of CID
each ELSCPD served, as well as their ages anddegrees of impairment. The degree of intellectual
impairment in Japan differs according to prefecture and city ordinances. However, for the purposed of this study, the survey deﬁned fourstages of intellectual impairment, based on intelligence quotient (IQ) and physical condition.
“Most severe” referred to an IQ under 35,“severe” to an IQ between 36 and 50 accompanied by physical impairments, “middle” to an IQ
between 36 and 50, and “light” to an IQ between
51 and 75.
The survey included questions on support systems, services for aiding parents raising children,
residence status, employment type, work style,and income grades and pension plans for people
with disabilities.
“Employment type” was separated into four
categories, related to the status and length of
employment: “full time,” “part time,” “jobless,”and “other.” “Full time” referred to members who
had labor and social insurance and worked over
30 hours a week. A “Part time” employee could
have labor and social insurance and worked
between 20 and 30 hours a week. “Work style”
was broken into six categories: “regular employment,” “transition support for employment,”“continued employment support (type A/B),”“care for daily life” and “other.” “Regular
employment” included workers who worked in
the regular job market using the welfare program
for the disabled. Members of the other categories
belonged to the Beneﬁts for Welfare Services

4

E. Tanaka

and Supports for People with Disability program.
“Income” was divided into nine categories: under$50, $51–$100, $101–$200, $201–$300, $301–$500, $501–$1,000, $1,001–$1,500, $1,501–$2,000, and more than $2,001 per month. The
exchange rate was 1 dollar to 100 yen. “Pension”
was separated into three categories: “ﬁrstdegree,” “second degree,” and “no pension.”
Approximately $9,800 per year is paid for ﬁrstdegree pensions and $7,800 for second-degree
pensions (from April 2016).
2) Contents of support
Ten support categories were represented:
money management, regular life style habits,
diet, domestic affairs, sexuality (including sex
education), employment, childrearing, healthmanagement, relationships (including couples
and neighborhoods), and other. Staffs were also
required to indicate the areas they have had difﬁculty handling. Multiple answers were permitted.
3) Information about ELSCPD
The survey asked for information about thename of each ELSCPD, their prefecture and representatives, year established, kinds of corporation, number of full- and part-time workers, andthe age, sex, and licensure of workers. Questions
were asked regarding whether the ELSCPD had
support systems for MJPwID or any sex education systems. Staffs could write opinions in thedescriptive data forms.
4.

Analysis methods
The questionnaire data was compiled in March
2016, using ASSUM for WINDOWS ver4.5 created by the Nihon Denshi Keisan cooperation(NTT DATA). The opinions written in thedescriptive data forms were separated by keyword
and categorized into three groups: present state,desirable systems, and problems to be solved.
III.
1.

Results

Prevalence and basic information about
CID
Table 1 shows that MJPwID were conducted
throughout Japan. However, there is a large dif-ference in the number in different prefectures,
even accounting for the differing number of
ELSCPDʼs in general and ELSCPDʼs supporting
CID between prefectures. The prefecture withthe highest number of CID was Hokkaido, with33 couples; the second highest was Tokyo, with
19 and third was Tokushima, with 13 couples.
All ELSCPDʼs in Okayama supported more than
one couple. 54.4% of ELSCPD in Hokkaido and
50% in Oita also supported more than one couple. The ELSCPD that supported the greatest
number of couples was in Tokyo. In Tokushima,
one ELSCPD supported 13 couples, and in
Ishikawa, another supported 10 couples.
There were 101 parents with more than one
child, or 48% of couples. Among PwID, 61.3%
had one child and 30% had two children. Forty
percent of children were under 5 years old, 27%
were teenagers, and 22% were between 6 and 9
years old. The highest number of parents (11)
lived in Hokkaido, while 6 parents lived in both
Miyagi and Shimane. No parents lived in Tokyo
or Ishikawa, although the number of couples inboth prefectures was relatively high.
Among the husbands surveyed, 29% were in
their 40s, 26% in their 30s, and 21% in their 50s.
Among the wives, 31% were in their 30s and
24% in their 40s and 50s. Seventy-four percent
of husbands had a light impairment, and 20%
had an intermediate impairment. Sixty-four percent of wives had a light impairment and 31% anintermediate.
Seventy-eight percent of couples lived independently, 36% relied on social workers from the
ELSCPD for their main support system, and 17%
on workers from other welfare ofﬁces. On theother hand, 22% relied mainly on family members, including the coupleʼs parents and siblings.
Thirty-six people, or 35.6% of parents, used childrearing services. This included not only special
services for disabled children, including homehelpers, day care (including after school care),and guide helpers, but also services for non-disabled infants and young children, including regular visits by a public health nurse or municipal
advisor to discuss raising children, nutritional

Gunma(101)
Tochigi

Number of parent which raised more than one child

85

Number of parent which raised more than one child5
3 (16.7%)

Number of couples which were supported by ELSCPD

Number of ELSCPD where supporting couples

Number of the centers which answered (with prefecture name)

18

4

4

3
2 (20%)

10

Hyogo

Osaka

Number of ELSCPD

2

2

2

2

1
1 (25%)

4

Number of parent which raised more than one child1
1 (50%)

Number of couples which were supported by ELSCPD

Number of ELSCPD where supporting couples

Number of the centers which answered (with prefecture name)2

Yamanashi

Fukui

Number of ELSCPD

3

0

5

0

4
3 (37.5%)

Number of parent which raised more than one child00 (0%)

Number of couples which were supported by ELSCPD

Number of ELSCPD where supporting couples

Number of the centers which answered (with prefecture name)

8

11

(212)

Number of couples which were supported by ELSCPD

6

33

(68)

Number of ELSCPD where supporting couples

Number of ELSCPD

66 (54.4%)

(91)

11

Number of the centers which answered (with prefecture name)Hokkaido

Total
(323)

1

2

1
1 (20%)

5

Nara

2

4

1
1 (10%)

10

Nagano011
1 (10%)

10

Saitama2

6

2
1 (16.7%)

6

AomoriThe Number of ELSCPDʼs Supporting Couples, Parents, and Children in Each Prefecture

Number of ELSCPD

Table 100

30 (0%)

7

Wakayama221
1 (20%)

5

Gifu

4

4

4
3 (18.8%)

16

Chiba

3

9

3
3 (33.3%)

9

Iwate

0

1

1
1 (33.3%)

3

Tottori22

1
1 (12.5%)

8

Shizuoka

019

2
1 (16.7%)

6

Tokyo

6

6

3
3 (42.9%)

7

Miyagi66

1
1 (14.3%)

7

Shimane32

2
1 (8.3%)

12

Aichi

1

3

2
2 (25%)

8

Kanagawa

11

1
1 (16.7%)

6

Akita

2

5

3
3 (100%)3

Okayama55

1
1 (14.3%)

7

Mie

3

3

2
2 (28.6%)

7

Niigata01

1
1 (25%)

4

Yamagata

48

2
1 (14.3%)

7

Hiroshima000
0 (0%)

7

Shiga

0

0

1
0 (0%)

4

Toyama58

3
2 (33.3%)

6

Fukushima

12

2 (33.3%)

2

6

Yamaguchi

13

1 (14.3%)

2

7

Kyoto

0

10

1 (33.3%)

1

3

Ishikawa

45

2 (22.2%)

3

9Ibaraki

The Prevalence and Characteristics of Married Lives of Japanese People with Intellectual Disabilities
5

1

9
2

2
0

0
1

1
0

4

Okinawa5

1

1 (20%)

1

1

Kagoshima60
0 (0%)

00Miyazaki

7

guidance in a public health center, meetings forparents, nursery care, temporary day care, daycare after school, infant and child home care, andspeciﬁc type of volunteer in Japan who received
payment for supporting a babyʼs care.
Seventy-eight percent of CID lived in rental
houses, while 22% owned their homes. Ninetyﬁve percent lived in an apartment and only 5%
lived in a single-residence house. Fifty-eight ofhusbands worked full time, 23% worked parttime, and 9% were unemployed. Thirty-six percent of wives worked full time, 26% worked parttime, and 24% were unemployed. Sixty-eightpercent of husbands and 57% of wives worked inregular employment, 24% of husbands and 30%
of wives used continued employment support.
The majority of husbands (40%) had an income
ranging from $1,001–$1,500 and wives anincome from $501–$1,000 (42%). The next mostcommon income for husbands was $500–$1,000(28.8%) and $1,000–$1,500 for wives (17.2%).
The majority of both husbands (78%) and wives(85%) had second-degree pensions. Sixteen percent of husbands and 11% of wives received nopension.

3

1
Number of parent which raised more than one child2.

Number of couples which were supported by ELSCPD

Number of ELSCPD where supporting couples

Number of the centers which answered (with prefecture name)22 (28.6%)

2

Number of ELSCPD

2

3
Number of parent which raised more than one child

Number of couples which were supported by ELSCPD

Number of ELSCPD where supporting couples

13

0

5

3

3 (50%)

05

6

2
2 (33.3%)
00 (0%)

4
4

1
1 (25%)
5
1 (7.7%)13

4
2 (33.3%)
00 (0%)

2
1 (20%)

6
4

1
1 (33.3%)
Number of the centers which answered (with prefecture name)

Number of ELSCPD

35Kumamoto
NagasakiSaga
Fukuoka
Ehime
KagawaTokushima

Kochi

Continued.
Table 1

6

E. Tanaka

Oita

6Contents of support
Respondents reported that the following ﬁve
areas of support were given the most attention:
employment (78%), health (55%), basic life habits (50%), managing money (45%), and relationships (40%). Among the ELSCPD staff, 58%
reported difﬁculty to adjust with CIDʼs money
management, 47% with CIDʼs employment environment, 40% with childrearing support, 33%
with CIDʼs health, and 30% with dietary habits.
3.

Information about the ELSCPDʼs
Ninety percent of ELSCPDʼs were incorporated as social welfare organizations. The mostcommon numbers of full-time employees wasfour and ﬁve (16%), followed by 6 (10%). The
most common number of part-time employees
was one (28%), followed by a range of 21–30
people (11%), and two employees (9%). Fiftyseven percent of workers were women and 43%

The Prevalence and Characteristics of Married Lives of Japanese People with Intellectual Disabilities

were men. Twenty-six percent were in their 40s,
25% in their 30s, and 22% in their 50s. Twentyﬁve percent of workers were nationally certiﬁed
to be care workers, 22% had social work certiﬁcations, and 20% were certiﬁed as home-helpers.
Ninety-seven percent of ELSCPDʼs did nothave any support systems for CID, 96% did nothave any support systems for PwID, and 97%
did not have any kind of sex education program.
The survey questions regarding “the present
state” of the ELSCPD were answered by 92
respondents, “the desirable system” by 89, and“problems to be solved” by 88. The answers tothis question will be discussed further in anotherarticle, however, it is important to point out thatthese answers fell into one of three groups: someanswered that they did not need systems for
MJPwID, while others answered that they supported or were supporting MJPwID. The formergroup felt no need to support MJPwID because
of insufﬁcient need. They said that individual
PID should manage their own personal matters,
including marriage: their main job was related toproviding social services. Some ELSCPD
referred marriage issues to other organizations,such as consultation support operators or organizations with experience dealing with couples.
Although staff pointed out the relatively
expensive and time-consuming system needed tosupport PwID in any comprehensive way, including 24-hour-service, they also said they hoped toestablish more feasibly systems, including peergroups for MJPwID and matchmaking meetings.
Some included services like group homes forcouples, which are now allowed since the 2013
revision to disability law.
IV. Discussion
1.

The prevalence of MJPwID
Table 2 described ranking of number of
ELSCPD, percent of ELSCPD supporting number of couples, parents in each prefecture andTable 3 showed ranking of prefecture population
density, percent holding certiﬁcation for intellectual disabilities, percent holding certiﬁcation for7

light-intermediate intellectual disabilities, andpercent of total fertility rate in 2015.
Like Hayashi and Kidoʼs study, this survey
marked some regional differences. Hokkaido had
the highest number of both CID and PwID andsecond-highest percent of ELSCPDʼs supporting
CID. This might be due to the number of people
who hold a certiﬁcation of intellectual disabilities; because Hokkaido has a higher population
density, there are more people who have a certiﬁcation for intellectual disabilities. Tokyo, which
has a large number of CID but nobody was a parent, can be explained when you consider boththat most of the PID had light to intermediate
intellectual disabilities and Tokyoʼs total fertility
rate in 2015. Tokyo has the lowest fertility rate inJapan, implying that it is hard to raise a childthere in general. However, Hokkaido, Miyagi
and Chiba had larger number of parents despiteof the low fertility rate. Number of parents andtotal fertility rate is not connected each other.
Generally speaking, the rankings of rural prefectures in this study corresponded with those inManʼs research (Man et al., 2014ab, 2017).
2.

Characteristics of MJPwID
The survey found that most CID aged from 30
to 50 years old, had light or intermediate impairments, and were raising one young child. They
tended to live independently in a rented houseand were supported by social welfare staff. They
held down regular employment; husbands, but
not wives, worked full time, and husbands
earned more money than wives (excluding pensions).
The ﬁndings regarding age, impairment category, and lifestyle were similar to those of previous studies (Yamashita et al., 1992; Hayashi &Kido, 2000; Kido & Hayashi, 2002). This study
found that most CIDʼs had a much higher income
compared with outcome of SDEL: the most common income was $600–$900, including pension.
However, the earnings of CIDʼs in their 40s was
low compared to similar non-disabled individuals. According to a “survey on the salary actual
conditions of private companies in 2015,” theIwate, Ibaraki

Osaka
Chiba
Fukuoka
Aichi
Hokkaido
Saitama, Nagano, Hyogo

Prefecture

9

18
16
13
12
11
10

NumberNumber of ELSCPD

100
54.4
50
42.9
37.5
33.0

Miagi
Gunma
Iwate, Fukushima, Ishikawa,
Tottori, Yamaguchi, Tokushima,
Ehime, Kumamoto,

Percent

Okayama
Hokkaido
Fukui, Oita

Prefecture

Aomori, Miyagi, Shimane

Fukushima, Osaka, Hiroshima

Hokkaido
Tokyo
Tokushima
Ishikawa
Iwate, Oita

Prefecture

6

8

33
19
13
10
9

NumberNumber of couples
which were supported by ELSCPD

Percent of ELSCPD
where supporting couples

Number of parent

4

5

Fukushima, Mie, Osaka, Kochi

Ibaraki, Chiba, Hyogo, Hiroshima

11
6

NumberHokkaido
Miyagi, Shimane

Prefecture

which raised more than one childTokyo
Kanagawa
Osaka
Aichi
Saitama
Chiba
Hyogo
Hokkaido
Fukuoka
ShizuokaPrefecture

10.3
7.1
6.9
5.8
5.6
4.9
4.4
4.3
4.0
2.9

Percent

Density of population*

8.2
7.4
6.4
5.7
5.0
4.6
4.4
3.8
3.0

Chiba
Shizuoka

Percent

Tokyo
Osaka
Kanagawa
Hokkaido
Aichi
Hyogo
Saitama, Fukuoka

Prefecture
Tokyo
Okinawa
Yamagata
NaganoOkayama
Tottori
Oita
Shiga
Fukushima
Shizuoka

72.1
68.2
66.9
66.7
66.1
65.4
65.1
65.0
64.4
64.2

Prefecture Percent of total number of each prefecture

Holder of certiﬁcation for intellectual disabilities** Holder of certiﬁcation for light-middle intellectual disabilities***
Census 2010** Report of Welfare Administration 2015*** Vital statistics 2015

1
2
3
4
5
6
7
8
9
10

Ranking

Okinawa
ShimaneMiyazaki
Tottori
Kumamoto
Saga
NagasakiKagoshima
KagawaFukui

Prefecture

1.94
1.80
1.72
1.69
1.68
1.67
1.67
1.65
1.64
1.63

Percent

Total fertility rate in 2015***

Table 3 Ranking of Prefecture Population Density, Percent Holding Certiﬁcation for Intellectual Disabilities, Percent Holding Certiﬁcation for Light-intermediate Intellecutal
Disabilities, and Percent of Total Fertility Rate in 2015

1
2
3
4
5
6
7
8
9
10

Ranking

Table 2 Ranking of Number of ELSCPD, Percent of ELSCPD Where Supporting Couples, Number of Couples, Parents and Children Supported by ELSCPD in Each Prefecture
8
E. Tanaka

The Prevalence and Characteristics of Married Lives of Japanese People with Intellectual Disabilities

average salary for people in their 40s was$46,100 for one year, $56,700 for men. The salaries of CID could only compete with that averagewhen both members of the couple worked andhad a second-degree pension. This may relate to
why more CID lived in rural areas (as describedabove): given their lower income, it may be difﬁcult for them to have enough funds to live in thecities, especially with a child.
The study found that the majority of
ELSCPDʼs have no support programs for
MJPwID. Only 35.6% of parents used childrearing services, whether intended for special needs
or non-disabled children. According to opinions
written in the descriptive data ﬁeld, most staff
were concerned with employment services anddealt with MJPwID on a case-by-case basis. In
addition, the fact that the main supporters of CID
were the staffs suggests that negative attitude ofstaffs toward CID inﬂuenced the differences ofnumbers among prefectures, as Hayashi & Kido
explained the possibility in their paper (Hayashi& Kido, 2000: 35).
Most ELSCPDʼs were social welfare corporations, a special type of Japanese company that islevied no tax. The corporations are required to bepioneer in the ﬁeld where few support existed
regardless large needs, especially after thechanging of Social Welfare Act in 2016. There
are now some programs or system that are possible under the present law and could be implemented that could not before. Cooperation withother organizations and a knowledge of bestpractices are necessary in new trials. Positive
interventions can be learned from other countriesʼ research, especially in the ﬁeld of supporting the parents of young children, an area where
staff felt difﬁculties.
V.

Conclusion

It is hard to draw any overarching conclusions
from this research because of the small numberof questionnaires that were returned. However,the followings may be indicated. It corroboratesManʼs studies in Australia, ﬁnding that CID and

9

PwID are more apt to live in the countryside andhave one child. Based on these ﬁndings, Manrecommends several policy responses: (a) moresocial and communal services for PwID with one
child and (b) ensuring services in outer urban,
regional, and rural areas (Man et al., 2017). Thisis afﬁrmed by this studyʼs ﬁndings that despite
the fact that there are a relatively high number ofCIDʼs in Tokyo, none have any children and rural
areas having more children despite of low fertility rate; it is difﬁcult for PIDʼs to found their own
family in cities. This might be due to PIDʼsextremely low income. Thus, it is necessary tobetter the childrearing support system and tosecure minimum wage throughout Japan, especially in the cities.
There were regional differences in the numberof CIDʼs and PwIDʼs, as described in Hayashi
and Kidoʼs research. Although ELSCPDʼs staffsʼ
negative attitude toward MJPwID might affectregional differences, it is difﬁcult to conclude it
as the reason. Further study about prevalence of
MJPwID, more comprehensive and concrete
investigations into good practices are necessary
to ﬁnd out how to change this situation.
Acknowledgements
The author would like to express her gratitude
to all who responded to the questionnaire.
This study summarizes research conductedunder a Grant-in-Aid for Scientiﬁc Researchfrom the Japan Society for the Promotion of Science of the Ministry of Education, Culture,
Sports, Science and Technology (Basic Research
C, Project No. 15K03960).
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