2019 Volume 104 Pages 193-214
This research examines how a biological factor, “central nervous system dysfunction”, was adopted as the official definition for LD by the Ministry of Education in Japan in 1999. For analysis, administrative documents and stakeholders’ documents were used.
In Japan, LD was said to be not a medical concept but an educational one since it had a different origin from medical terms e.g. MBD (Minimal Brain Dysfunction) or dyslexia. Although the educational LD concept was criticized by some doctors in the early 1990s, the significance of the concept was gradually recognized among medical and educational professionals because it was expected to play a leading role in the discovery and treatment of children with problems at school.
Sociological interest in this research looks at how the biomedical model and other models coexist when the cause of a disease is discussed and determined. The biomedical model is a way of understanding diseases that has been presupposed by modern Western medicine. Although LD has been studied as a case for medicalization (= the dissemination of the biomedical model) in previous studies, they do not consider the complex forms of medicalization that have been developed in recent decades where there are various interpretations of disease. Recently, alternative models to the biomedical model (e.g. CAM [Complemental and Alternative Medicine] or the social model of disability) have been proposed, and they have influenced society’s understanding of disease in a variety of ways. Previous studies fail to catch some facts related to this change: doctors can detect central nervous system dysfunction in only 30% of patients and a medical treatment for LD has not been found. In other words, medicine has been unable to monopolize the management of LD. Instead, various fields such as medicine, education and welfare have been needed to share the jurisdiction and treatment of LD.
The result of this research shows that there were two options regarding the cause of LD in the official discussion: the American model, which assumed biological factors and the British one, which was based on a social model of disability. Eventually, the American model was adopted because ( 1 ) it emphasize that it is not appropriate to handle LD in normal classes, and ( 2 ) Japan’s special education system did not have enough resources to treat the large number of children who would belong to the new special classes needed if the British option was to be adopted (the American one required relatively fewer resources). Since both the social and institutional circumstances of Japan were considered, the British option was not chosen to be the official definition of LD.
