Japan has a high autism rate compared to other developed countries; 1 of every 55 children is diagnosed. Scientists discussed its possible reasons and for many years they blamed MMR jab which was a triple vaccine against measles, mumps, and rubella. Then, the vaccine was banned in 1993. Quite the contrary it had nothing to do with the jab because autism cases in Japan were on the rise despite the ban.
The most shocking piece of information is that there is an obvious negative attitude towards people with an autism spectrum disorder. Society either is not aware of the syndrome, or they do not know the characteristics of autism. They consider such people as dangerous, and regardless of their syndrome, they dislike people that do not follow the rules. It is a highly standardized country, and you have got to stick with the designed order.
It is true that the state offers assistance and surprisingly a vast majority of children in need of special education (which is 98%) are taught in regular schools. The Japanese government also provides another option called Development Disability Support Center where you can receive necessary information or support. This center works together with local hospitals as well as health and welfare offices to identify and to advise on treatment for special needs children.
So, although the government is somehow trying to make their lives easier, it was not expected to see that the society is not welcoming people with autism very well and you might want to think twice before moving to Japan if you have someone with autism in your family.
Japanese Trend in Treatment for Autism Spectrum Disorder
Autism Spectrum Disorder has been introduced in Japan over 60 years ago. It is only the last 10 years; ASD is recognized as intellectual disabilities in society. Few Japanese medical doctors believing the treatment for autism is difficult to introduce treatment.
The term autism was translated as “jiheisho” in Japanese. The term “jiheisho” sounds terrible connotation in the Japanese language, as the word may bring connotation of never curable, never speaking, never communicable and so on. In recent years, the change finally began autism in Japanese society. It became recognized as one of the disabilities.
Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis. Behavior analysts began working with young children with autism and related disorders in the 1960s. It knows as autism therapy, which was begun in the United States.
The introduction of TEACCH (Treatment and Education of Autistic and related Communication handicapped Children) by Professor Masami Sasaki has been accepted in the Japanese Society. Professor Sasaki, who was also a great author, and a great teacher, contribute great achievement for autism spectrum disorder in Japan.
ABA has been gradually spread its names to Japanese society last 10 years, and the clinicians also start to recognize as evidence-based treatment with objective data. Currently, the understanding of ABA is still scarce and the public health services may not yet greatly accompanied in Japan.
In spite of increasing the number of ABA therapy, structured therapist training is not possible and acquiring training ABA therapist will put the families with financial strains. The quality of ABA is often not been able to guarantee even the one claims to use ABA. The international credentials of BCBA (Board Certified Behavior Analyst) need to be recognized. There are few BCBAs in Japan who received education in the United States. Introducing BCBA and RBT (Registered Behavior Technician) to the education system may occur in the future in Japan.
During the adolescence period, the Japanese student appears to have various medical and behavioral problems, such as non-attendance at school, depression, and bullying occurred at school. Although in Japan, the medical service for adolescents has been a social problem because the gatekeeper in medical service for adolescents is unclear. It is similar in adolescents with an autism spectrum disorder.
In addition to medical and behavioral problems, a transition into adulthood in social/ medical support is regarded as a difficult problem. The discussion for the transition is currently starting within the medical professionals in Japan. Currently, it is not the status to prevail in the children that individual therapy like ABA for ASD. It is important for you to make an effort for children with autism in order to improve their skills and fair treatment in the future.
The Japanese method was developed by Kiyo Kitahara, who said it has reduced the symptoms of autism in more than 3,000 children. The Boston Higashi School, modeled after the school Mrs. Kitahara runs in Tokyo, is to open next fall. Mrs. Kitahara has provided much of the money needed to start school here.
The Americans hope to study the behavior and biology of children at the new school to confirm a hypothesis they share with Mrs. Kitahara. They believe symptoms displayed by children with autism spectrum disorder including lack of language development, reclusive and obsessive behavior and self-mutilation, result from feelings of fear and anxiety associated with physiological problems.
According to Dr. Hardy, this theory contradicts the prevailing notion of autism. He said that many people now believe that the language disorder is the primary deficit and that behavior related to autism arises from an inability to communicate. He thinks that the primary problem is just one of physiologic, hormonally controlled anxiety.
Mrs. Kitahara’s conviction that emotionally paralyzing fears cause children with autism to isolate themselves and behave obsessively led her to the approach she has practiced since 1964 at her school, which has both normally developed students and students with autism. Children with autism at the school study and play with their healthy counterparts and engage in vigorous daily exercise routines.
Children with autism are likely to be isolated from a group. Mrs. Kitahara has tried to put them in a group and get them to imitate normally developed children’s behavior. Those who could not play learned to play. Those who could not speak learned to speak. And those who were hyperactive learned to sit through the day. She said the one-on-one encounters between a teacher and a student with autism that are common in America are not helpful to the child in learning to relate to others or in understanding normal behavior in Japan.
Mrs. Kitahara’s method relies heavily on exercise to stimulate and engage children with autism. She expects them to roller skate, do calisthenics, swim, use playground equipment and perform gymnastics.
Some American neurologists feel that Mrs. Kitahara, in her emphasis on exercise as therapy, has isolated a crucial yet unexplored biological point about autism. Dr. Hardy said he believed physical exertion reduced the internal anxiety that autistic people feel because it caused the body to release endorphins, hormones that regulate the body’s sensitivity to pain. Dr. Hardy said he believed these hormones, the same ones responsible for the ”runner’s high” that many joggers experiences, might govern the behavior of autistic people.
Dr. Jerome Kagan, a professor of developmental psychology at Harvard who is president of the Boston Higashi School’s Board of Directors, said Mrs. Kitahara’s policy of issuing only praise, without the ”aversives” or punishments used by some educators of the autistic, seemed to work very well.
Some doctors and educators have expressed doubts about the approach and about the likelihood of her methods working successfully in the United States. Skeptics say that children with autism, who crave order in their lives, may benefit from Japanese schools’ more disciplined atmosphere, with such methods as rote learning and memorization, and that it may not be possible to easily duplicate those conditions in this country.
Mrs. Kitahara said she planned to open the school with about 50 residential students and 40 students who are coming daily basis, all of them would have autism spectrum disorder. She hopes to bring groups of normally developed children from her school in Japan in three-month rotations to the Boston Higashi school so that they can polish their English and absorb American culture.
Current Status of Education for Children with Autism Spectrum Disorder in Japan
Children with an autism spectrum disorder in Japan are taught at schools for special needs education, at classes for special needs education and resource rooms set up in regular elementary and lower secondary schools, or in regular classes, depending on the degree of disability. There are an estimated 20,000 children and students with an autism spectrum disorder in schools.
Schools for special needs education have been set up to provide education pursuant to that given at regular schools to children with autism, and to alleviate the difficulties they encounter in daily living and learning caused by their disabilities.
The educational contents for those children provided at schools differ in accordance with their life stage; however, they are all oriented toward self-reliance through the acquisition of skills that serve them well in daily living and in future vocations.
The classes promote joint activities and learning with the cooperation of regular classes. However, the main focus is on alleviating the difficulties the children with autism face in their daily living and learning due to their disabilities. Most children with autism are in classes for autism/emotional disturbance or for intellectual disabilities. Both classes provide education to children with autism.
The services are provided to children with autism enrolled in regular classes of elementary and lower secondary schools on a part-time basis in order to alleviate the difficulties they face in their daily living and learning due to their disabilities. The special needs services provided are aimed at children with high functioning autism without intellectual disabilities, who learn in regular classes for most of the time.
For several hours a week, instructions that take into account their specific cognitive characteristics are provided to help them build up proper human relations, to learn rules in collective activities and to adjust their own behavior through games and exercises.
Issues of Autism Education in Japan
Recently, it was clearly stated autism spectrum disorder as a discrete category of disability in-laws in Japan. Children with autism, particularly those with intellectual disabilities, have up to been educated within the framework of education for children with intellectual disabilities. Furthermore, because the education of children with autism was started mainly in the classes for children with emotional disturbance, those children have so far been taught in the framework of emotional disturbance.
There is a field survey which is conducted by the National Institute of Special Needs Education in 2006 for emotional disturbance, it showed that those children accounted for approximately 75% in elementary schools, and 60% in lower secondary schools. This survey led to the renaming of special needs education classes for emotional disturbance to classes for special needs education for children with autism/emotional disturbance in 2009, and the recognition of autism education has been on the gradual rise.
Since the condition of children with autism is also affected by the degree of intellectual development, schools and classes are conducting a wide variety of education, from instruction with major emphasis on intellectual disabilities to instruction aimed at children with high functioning autism without intellectual disability. In education, one of the major issues is whether the contents and methods of education match the characteristics of each child and whether the instruction is appropriate.
On the other hand, there is an issue in terms of the expertise of teachers in charge of teaching classes. In Japan, teachers who have the license to teach in regular elementary or a lower secondary school may also teach classes for special needs education which means there is no need for a special license in order to teach children with autism.
As a result, it is not a good thing for those children. Because of the fact that some teachers may be teaching children with autism without any experience, and may teach them without understanding the special needs arising from autism.
The issues in education for children with an autism spectrum disorder in Japan may be narrowed down to some points. Because it is assumed that educating children with autism differs from the way children with intellectual disabilities or with emotional disturbance who have psychogenic difficulties are educated, it is necessary to examine.
It is not only the contents and ways of teaching children with autism accompanying intellectual disabilities but it is also the contents and ways of teaching children with high functioning autism. In terms of the expertise of teachers in charge of autism education, it is also necessary to investigate the programs for teacher training and special needs education license acquisition to enhance the expertise of teachers in charge of autism education.
Stories of Individuals with Autism Spectrum Disorder in Japan
There was a 13-year-old boy named Naoki Higashida who got diagnosed with an autism spectrum disorder in Japan. He felt deep envy of people who can know what their own minds are saying, and who have the power to act accordingly. His brain was always sending him off on little missions, whether or not he wants to do them. It is like he is being pushed over the brink into a kind of hell. Because of the fact that for people with an autism spectrum disorder, living itself is a battle.
He published a book in 2007. The book, a memoir and personal insight into what life is like with autism, came to international attention when it was published in English in 2013. The book has been successful, deservedly so, because it offers “neurotypicals” — that is, people not on the autism spectrum — a flavor of what it is like to be on the spectrum. However, it has also changed perceptions of what it means to be on the autism spectrum. If you have ever read the book or have personal experience with autism, you may assume that the condition is entirely connected with how the brain is wired. Certainly, that was his assumption.
Naoki says that “What we are anxious about is that we are causing trouble for the rest of you, or even getting on your nerves.” He is now 23 years old and the author of more than 20 books of poetry, fiction, and nonfiction. It seems fitting to close this month’s column with another extract from his memoir:
“Criticizing people, winding them up, making idiots of them or fooling them doesn’t make people with autism laugh. What makes us smile from the inside is seeing something beautiful or a memory that makes us laugh.”
Kana Umagami has a passion, obsession and strong interest in Asperger’s, which comes from her recent diagnosis of Asperger Syndrome. She had no idea about Asperger’s until her parents told her about it when she happened to be in a lecture by a person with Asperger’s last year. Then, she started to search and read everything she could find about it. The first book she read was “Aspergirl” by Rudy Simone, which described her life and other women’s lives she interviewed.
In Japan, the schools allowed them a lot of freedom within discipline. They did not use textbooks, and instead, they worked on one college-level math problem in class from different perspectives or they did research on their own interests and presented them in class for social studies. It allowed her to be herself in some ways but she did not feel comfortable being in class due to sensory issues. Ballet, which she has been doing since she was three, also hid her autism.
She started college education in Japan in 2013. Then, she decided to leave college after 1.5 years of being there. She had huge anxiety walking around the campus to get to class or being in class. She was also depressed at that time and eventually could not go to class anymore.
Even though she did not see it as a disorder at the time, she lost 15kg when she started college. She is strict to herself and a perfectionist, so she decided to lose some weight at first and it went beyond anyone’s control. After a couple of recovering attempts, at that time, she was thinking of studying abroad to make a fresh start because Japanese college did not seem to suit her.
In 2015, she moved to Boston in the US to go to college. While she was studying in the US for almost 3 years and using counseling centers, she noticed that students were using the service much more than in Japan. When she saw a therapist in college in Japan, he was one of the only two therapists they had and she never saw other people coming in because they adjust the time so students coming to therapy do not have to see each other.
In Japan sometimes rules take over what really matters, such as mental health. In mental health, promptness is important because clients are suffering now not 6 months later. It might be the same as some autism support in the US, as she was put in a 9 months-long waiting list when she first contacted an autism center for assessment, but she ended up getting a diagnosis in a local clinic so it ended up alright.
It was good that the US had many therapists and clinics she could go to, but in Japan, especially for an autism spectrum disorder diagnosis, there are few clinics that specialize in it. It is a kind of problem in Japan, as well as the stigma around autism and mental illness. Furthermore, they do not have active autism communities in Japan. Community is a very important part of support and its absence is not good.
Autism Related Organizations in Japan
- Autism Society of Japan
Address: 6F, Tsukiji 622 Bldg. 6-22 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Asperger Society Japan
Address: 187-#201, 2-chome, Kamiotai, Nishi-ku, Nagoya, Aichi, 452-0821, Japan
Phone/ Fax: +81-52-505-5000
- Autism Society of Kyoto
- Research Institute for the Education of Exceptional Children
Address: TokyoGakugei University Koganei Tokyo 184, Japan