[MHLW] The Modality of Support for Children with Disabilities at Daycare Facilities (A study group report already made available)

On 20 October 2021, the Ministry of Health, Labour and Welfare (MHLW) published the report of the Study Group on the Ideal Support for Children with Disabilities at Daycare Facilities.

This study group was established on 14 June 2021, in light of the fact that the number of children with disabilities using daycare support has increased over the past decade, partly due to the increased awareness of developmental disabilities.  From the viewpoint of inclusion, the study group has worked on the future of daycare support for children with disabilities, including matters such as roles, functions, and beneficiaries; and after eight meetings, they were prepared to present a report.

The report pointed out the following:

1. The modality of child development support centers ("centers")

  • In response to the current lack of clarity in the roles and functions that centers should perform, the following functions in the system should be clarified if they are to be considered as core support institutions in the community:

(1) Developmental support and family support functions based on a wide range of high-level expertise
(2) Supervision and consultation functions for local service providers
(3) Core functions for promoting inclusion in the community
(4) Consultation functions as the entry point for developmental support

The remuneration system should also be designed to encourage the fulfillment of these functions.

  • A suitable system should be created to unify the "welfare approach" and the "medical approach" so that people can receive the appropriate developmental support in their communities regardless of the type of disability.

2. The role and function of child development support and after-school day services

  • To prepare for the next revision of remuneration, the standard number of personnel and remuneration according to the types of developmental support should be reviewed so that the length of support time is appropriately determined.
  • After-school day services will also be considered for children with disabilities who attend special training schools and other schools, if the head of municipality recognizes their need for developmental support.

3. Promotion of inclusion

  • To accelerate support for transition to nurseries, etc., the MHLW must present effective standard support methods to the centers and after-school daycare services and consider conducting an appropriate remuneration evaluation.
  • Careful consideration should be given to the appropriate assessment of support provided by visits to nurseries and such, taking into account the importance of such visits as a core function of the centers, along with various support methods needed by different children.
  • Consider necessary revisions that point to improving facilities and nurseries needed for integrated child development support, regardless of whether they have disabilities or not.

4. Other aspects (e.g. eligibility screening, designation of service providers, improvement of the quality of support)

  • The survey indicators relating to the conditions of children with disabilities in the eligibility screening process (including the so-called "5 domains and 11 items") should be reviewed.
  • In designating service centers, in order to eliminate uneven distribution and shortage of services, etc., it is necessary to consider the projected amount of services indicated in the welfare plan for children with disabilities and focus on hard-to-reach needs such as severe physical and mental disabilities and medical care.
  • To raise the quality of daycare support for children with disabilities in the community as a whole, the following measures should be considered so that the centers can act as a core:

(1) Train local service providers on how to handle difficult support cases;
(2) Cooperate with municipalities and support councils for independent living ;
(3) Analyze the strengths and weaknesses of each service provider and improve their services based  on the results of both self-evaluation and the parents’ evaluation with the participation of concerned citizens in the community; and
(4) Learn from each other’s effective approaches.

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