CURRENT STATE AND ISSUES SURROUNDING THE HEALTH CHECK-UP FOR 5-YEAR-OLDS IN JAPAN

Abstract

Recently, increase in the prevalence of Autistic Spectrum Disorder (ASD) has become a focus of wide-spread attention, prompting many studies on the etiology, early diagnosis and early intervention for ASD throughout the world. Discussed here will be the current state and issues surrounding the Health Check-up for 5-year-old children in Japan. Browsing through literature on early detection and diagnosis worldwide, it is seen that while studies abroad report intensively on epidemiological research and biomarkers to detect ASD on one hand, problems such as the presence of an endophenotype that fails to meet diagnostic criteria for ASD in the later stages of development have been revealed. In our country, health checks for pregnant women and infants based on the 1965 Maternal and Child Health Act are being conducted as standard practice. However, it is as yet difficult to pick up developmental disabilities, such as Attention Deficit-Hyperactivity Disorder (ADHD) and Specific Learning Disorder (SLD), and ASD without Intellectual Disabilities. To this end, efforts aimed at the early detection and early intervention for developmental disorders have been incorporated into national policy, recommending implementation of Health Check-ups for 5-year-old children by local government. However, many problems exist regarding this check-up for 5-year-olds. For example, implementation has not been unifrom across all regions as it is not a legal requirement like the medical checkups for 18-month-olds and 3-year-olds. Additionally, even where implemented, assessments have not been standardized, calling for further scientific validation. Scientific clarification should bring about needed change in the recognition and concrete aid for developmental disorders including ASD. Just as infant health checkups were instrumental in reducing infant mortality rates historically, it is hoped they will similarly contribute to the early diagnosis and support of developmental disorders in future.