Group care size and difficulties of children with developmental disorders in Japanese residential homes

Unlike other developed countries, residential care in Japan is the most common form of out-of-home care for children. Half of Japanese residential homes are large with many children being raised in one facility. Reducing group... [ view full abstract ]

Unlike other developed countries, residential care in Japan is the most common form of out-of-home care for children. Half of Japanese residential homes are large with many children being raised in one facility. Reducing group sizes is an urgent tasks for Japanese society. Moreover, in recent years, the number of children showing signs of developmental disorders has increased. The purpose of this study is to clarify the relation between group care size and difficulties of both care workers and children with developmental disorders in Japanese residential care settings.

Questionnaires were administered to psychotherapists working at 170 residential care institutions for children in Japan. These questionnaires included items about institutional group care size and the numbers and difficulties of children with developmental disorders. Data were analyzed from 7970 children.

The prevalence of developmental disorders was as follows: 486 children (6.1%) had autism spectrum disorder (ASD), 573 (7.2%) had attention deficit/hyperactivity disorder (ADHD), and 64 (0.8%) had learning disorders (LD). A chi-square test revealed that the number of children with a definite diagnosis of ASD and LD was significantly greater in the large-scale institutions with more than 20 children. The ratio of children with ADHD was not significant by care scales, but the ratio of those with a definite or suspected diagnosis of ADHD was significantly greater in the large-scale institutions.

These results indicate high prevalence of developmental disorders, especially in the large-scale care institutions. Therefore, it is important to subdivide large institutions into smaller units and to develop a therapeutic model for these children that is tailored for Japanese residential care settings.