services should be provided for people with disabilities, and, at least in urban areas, this is already being established. However, is it the same situation for people living in sparsely populated areas and on remote islands?
The treatment of those people with developmental disabilities who have adaptive or behavioral disorders is still difficult. In order for them to be treated immediately, people with disabilities sometimes must be placed in a residential institution or hospitalized in a neuropsychiatric hospital. Thus, many people are concerned about how to treat children with mental retardation who also have autism or autistic tendencies. For such children, the program called TEACCH, developed by Prof. Eric Schopler at the University of North Carolina seems to produce consistent progress when used in many countries. It is drawing attention as an effective countermeasure for serious behavioral disorders.
C. Early Intervention
On April 25,1957, the 15th amendment to the Children's Welfare Act went into effect, and seven day care centers for children with mental retardation began as child welfare facilities. Day care centers for children with physical disabilities started in 1963; day care programs for children with physical and mental disabilities in 1972, day nursery programs for younger children with disabilities in 1974, and day care programs for young children with hearing impairments in 1975. Support services in the community for children who have various kinds of disabilities have been expanded and steadily improved.
Enforcement in 1979 of compulsory education for children with disabilities was the turning point in terms of who was cared for at day care centers. Instead of the school-age children who had been cared for there, children of preschool age became the users.
Moreover, recently, the Engel Plan in 1994, and the Plan for People with Disabilities in 1995, were prepared; day care programs provided for by the Children's Welfare Act for children with disabilities are thought to be a progressive major center for supporting the development and training of people who were born, raised, and continue to live in each region, regardless of their age, the presence or absence of disability, or the type and grade of their disability if they have one. The movement to re-evaluate what a professional agency promoting the development of children with disabilities should do has begun.
The background for this trend includes a remarkable change in the social conditions surrounding infants and children. The following conditions are among those that characterize contemporary society:
a) a marked decrease in birth rate;
b) progressive shift to a nuclear family;
c) full realization of health examinations for mothers and children, and medical examinations in infancy and childhood;
d) development of facilities for the care of infants and children, and the diversification of these facilities;
e) progress in perinatal and postnatal medicine;
f) development and progress in various kinds of treatment technology;
g) spread of the normalization principle and extension of this approach to integration.
As a result, increasingly diverse types of intervention are being demanded, not only in various related agencies in the community, but also at the local administrative level, and, in response to increasing needs on the part of the users and the region, various specific programs must be developed (but those are often one-time only programs, or programs not connected with other existing programs).
At the national level, joint meetings of sub-committees of the Central Children's Welfare Council on Children with Physical and Mental Disabilities started on December 6,1993. This group reconsidered the system of day care programs for children with mental and physical disabilities and then changed the name of the joint sub-committees' meeting to Disability Welfare Council. On March 29,1996, a report titled, "How Day Care Programs for Children with Disabilities Should Be Provided" was submitted to the Ministry of Welfare. The fundamental recommendation of this report is that by social demands, such as the decreasing number of children being born, user-centered services, and quality services, the present system of separate programs for each type of disability should be changed so that all the programs are
