1. Further enhancing the expertise of support personnel:
 a. It is crucial to develop personnel who can correctly understand the characteristics of challenging behaviors, provide support within a team approach based on evidence-based standardized methods, and preventing challenging behaviors from occurring in the first place.
 b. It is necessary to develop core personnel (tentative term) who will play a central role in on-site support, provide the appropriate support based on standard support practices, and be able to provide the appropriate guidance and advice within the organization.
 c. There is a need to develop wide-area support personnel (tentative term) who can guide and advise core personnel dealing with complex cases and can support the community with their high expertise.
 d. A human network needs to be established to promote efforts by local supporters to help each other, provide cooperative support, exchange frank opinions, and share information.

2. Identifying support needs and coordination functions in relation to counseling and services:
 a. It is important for municipalities to correctly identify the support needs of individuals and their families to link them to support services. It is also important to further develop local support systems by utilizing the opportunities provided by the Council for Self-Reliance Support. In doing so, it is necessary to explore and keep an eye on individuals and families who have not yet used support services.
 b. It is important that consultation support organizations—such as consultation support offices, core consultation support centers, and support centers for persons with developmental disabilities—coordinate consultation support and services while utilizing the roles and strengths of each organization.

3. Improving daily support systems, expanding support services, and increasing the rate of admission at service facilities:
 a. It is important to improve the service system so that daycare services (mainly daily living care for persons with profound disabilities who require constant care, such as when bathing, toileting, and eating during daytime at facilities), short-term stays at residential facilities, and home-visit services can be stably provided in the community.
 b. It is necessary to improve the system for admitting people with challenging behaviors to group homes as places where they reside.
 c. Support facilities for persons with disabilities need to promote the transition of users to the community and improve their support capabilities, including standard support practices in buildings and facilities as living environments.
 d. In order for individuals with disabilities and their families to be able to live peaceably in the community, municipalities need to improve the functions of community life support centers, emergency response, and community transition.
 e. It is important to deepen the understanding of certification surveyors on challenging behaviors so that they can conduct the appropriate assessments of behavior-related items in the certification survey for disability support categories.
 f. There is a situation where persons with very high total scores on behavior-related items in the assessment, i.e., those with a problematic state profile, are not being admitted for support services. In light of this situation, it is necessary to set a higher compensation for service providers from the perspective of increasing admittance and improving support.

4. Intensive support for persons whose conditions have deteriorated:
 a. When the condition of a person with challenging behaviors worsens, making it difficult to live at home or in a group home, intensive support should be provided to stabilize the condition through the appropriate behavioral assessment, analysis of factors contributing to the behavior, organization of effective support methods, and subsequent intensive environmental adjustment.
 b. Specific details of intensive support may include the following:
 1) Measures to promote the development of a conducive environment in which wide-area support staff members take the lead in intensively visiting service providers to offer consultation, conduct appropriate assessments, and work together to develop effective support methods.
 2) Measures to temporarily change their residence by using group homes, institutional placement, short-term placement, etc., and to make the transition to the original or new residence after appropriate assessments and effective support methods have been organized.
 c. For intensive support, a wide-area implementation system, such as prefectures, designated cities, and regional units, may be developed, taking into consideration the actual support needs and the availability of specialized human resources. Even in such a case, it is necessary to link the system with the regional support system of each municipality to ensure that all regions are supported without omission.

5. Preventive support from childhood and cooperation with educational institutions:
 a. Appropriate early childhood intervention based on the characteristics of each child and family situation may prevent future challenging behaviors. It is necessary to understand the risks of children who may develop challenging behaviors from early childhood and to create a system of community life support for children and their families according to their life stages.
 b. In supporting children in infancy, school age, and adolescence, welfare and education must work together to provide consistent support according to the characteristics of intellectual and developmental disabilities and to work on assessing disability characteristics and environmental adjustment to provide the support that does not trigger challenging behaviors.
 c. In order to support children with challenging behaviors living at home, it is important to promote efforts to seamlessly link various support-related organizations according to their life stages. For example, staff with expertise should visit and coordinate with families, offices, schools, medical institutions, etc., and regularly participate in collaborative meetings attended by multiple providers to share information.

6. Establishment of a system of cooperation with healthcare:
 a. It is difficult to completely cure the illness or impairment behind a challenging behavior through medical treatment, so it is necessary to promote support in cooperation with welfare and education, with the enhancement of medical care.
 b. With regard to hospitalization in psychiatric hospitals, proactive intervention is necessary from the time of admission, with a view to coordinate with places of residence and welfare after their discharge. Promoting standard support practices in psychiatric care to prevent prolonged hospitalization is also important.
 c. It is necessary to establish a system whereby people with challenging behaviors can receive treatment for their physical illnesses and, likewise, consider reimbursements for medical institutions that also takes into account the hardships associated with the treatment of people with challenging behaviors. Strengthening the daily coordination between welfare and medical services is also important.