THE PAST, PRESENT AND FUTURE OF A COMMUNITY SUPPORT SYSTEM FOR CHILDREN WITH DEVELOPMENTAL DISORDERS IN MIYAKE TOWN : FOCUS ON LESSONS LEARNED AND NEEDS FOR THE FUTURE

Introduction Support for early detection and intervention for developmental disorders in children as well as support that provides assistance for their families is vital for the establishment of community support systems for children with developmental disorders. We investigated the structure of a community support system in Miyake Town, Nara Prefecture, based on these two perspectives and examined the needs that may arise in future. Methoas Using a participatory action research framework, we interviewed community health nurses involved in establishing community support systems for children with developmental disorders, collected records of past community support activities and observed participants. Results The conrmunity support system for children with developmental disorders in Miyake Town included the following 4 phases: 1) health examinations for infants; 2) first-stage intervention classes; 3) second-stage intervention classes, and 4) a network of people as a part of the community support system. Infants specifically suspected of a developmental disorder were screened during medical examinations when aged 1.5 years. Children subsequently participating in first-stage intervention classes were observed in second-stage intervention classes during kindergarten, if needed, and received continual support after entering elementary school. Of the children who participated in second- stage intervention classes, 75% were found or suspected to have developmental disorders when aged 1.5 years, and 62% had participated in first-stage intervention classes. Families of such children communicated problems in daily life associated with these disorders to a community support staff member, which promoted the establishment of a conrmunlty support system. Conclusions 1) Medical examinations of 1.5-year-old infants and children participating in first-stage intervention classes are important for the early detection of developmental disorders and for establishing community support systems for such children. 2) Families of such children are strengthened through the community support system. The bond formed between parents during first- and second-stage intervention classes has been a factor