Accepted Manuscript

Balancing the stigmatization risks of disability labels against the

benefits of special education: Japanese parents' perceptions

Misa Kayama, Wendy Haight

PII: S0190-7409(17)31065-4
DOI: doi:10.1016/j.childyouth.2018.04.008
Reference: CYSR 3776
To appear in: Children and Youth Services Review
Received date: 12 December 2017
Revised date: 31 March 2018
Accepted date: 2 April 2018

Please cite this article as: Misa Kayama, Wendy Haight , Balancing the stigmatization risks
of disability labels against the benefits of special education: Japanese parents' perceptions.
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Balancing the stigmatization risks of disability labels against the benefits of special
education: Japanese parents’ perceptions
Misa Kayamaa, Wendy Haightb

Misa Kayamaa
mkayama@olemiss.edu
Wendy Haightb
whaight@umn.edu
Corresponding author: Misa Kayama

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a
University of Mississippi, Oxford

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Department of Social Work
103 Longstreet Hall, P.O. Box 1848, University, MS 38677, USA

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b
University of Minnesota - Twin Cities
School of Social Work
1404 Gortner Ave, St Paul, MN 55108, USA

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Acknowledgement:
This study was funded by the Gamble-Skogmo endowment, University of Minnesota.
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Abstract

Stigmatization can dampen the joys and exacerbate the challenges experienced by parents whose

children have disabilities. This qualitative study examines the experiences of eight Japanese

parents of their children’s mild cognitive and behavioral disabilities and any associated

stigmatization at public elementary schools. These parents’ perceptions reflected Japanese

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people’s general sensitivity to the threat of stigmatization due to individual differences. During

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individual interviews, parents described how their sensitivity to others’ actual or anticipated

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negative responses led to social isolation. After significant, sustained efforts to support their

children by themselves, most of these parents chose to consult with professionals and secure

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special education services for their children. They preferred support to be holistically and
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unobtrusively provided by all school staff members during academic and non-academic activities.

The experiences of these Japanese parents underscore the importance of emotional and social
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support for children with disabilities and their parents. Examination of Japanese parents’
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perspectives on disability and stigmatization highlights our cultural blind spots, allows us to

reflect back on taken for granted beliefs and practices, deepens our understandings (see Morson
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& Emerson, 1990), and may even lead to new and creative solutions to the persistent problem of
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stigmatization.

Key words: Parents; Children with disabilities; Stigmatization; Japan; Elementary school
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1. Introduction

This qualitative study examines Japanese parents’ experiences raising their children who

have disabilities focusing on any associated stigmatization. In cultures around the world, parents

of children with disabilities face some unique challenges and joys. They may experience deep

concern for their children’s future, conundrums related to the impact of disability on their other

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children and family members, and obstacles in securing necessary educational and medical

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services (e.g., Farrugia, 2009; Francis, 2015; Lalvani, 2015; Solomon, 2012; Sato, Araki, Ito, &

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Ishigaki, 2015). Yet seeing their children strive to overcome challenges can also lead to a deep

sense of pride and respect for their children’s strength and perseverance. In addition, it can lead

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to personal growth in their own understandings of human differences and the value of individual
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lives (Berube, 1996; 2016; Ogino, 2004).

Yet the stigmatization associated with disabilities and specialized services can dampen
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the joys and exacerbate the challenges faced by parents. Stigma can be defined as an “undesired
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differentness” that marks, separates, and discredits individuals in the larger society (Goffman,

1963). Individuals with disabilities generally experience stigmatization through labeling,

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stereotyping, status loss, discrimination, social exclusion and negative emotional responses ( Link,
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Yang, Phelan, & Collins, 2004; Yang, Kleinman, Link, Phelan, Lee, & Good, 2007).

Stigmatization also can be directed to those who have close relationships with stigmatized
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individuals (i.e., “courtesy stigma”; Goffman, 1963), including parents of children with

disabilities. Across diverse cultural groups1 , parents of children with disabilities report social

isolation (Gray, 2002; Francis, 2015), blame for “bad parenting” (Blum, 2007; 2015; Farrugia,

2009; Francis, 2015), and feelings of shame (Sato et al., 2015). They also describe others’

negative comments about their children and demeaning, hostile or rude behaviors (Gray, 2002;
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e.g., Australia, the U.S., Japan, South Korea, Taiwan, etc.
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Jegatheesan, 2009). Such behaviors may be displayed by strangers, extended family members,

parents of typically-developing children, and even educators or other professionals (e.g., Francis,

2015; Grinker & Cho, 2013; Jegatheesan, 2009).

Further, in many cultures across the world, parents’ experience of stigmatization can be a

barrier to securing services necessary to their children’s success in school. Some parents, for

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instance, respond to stigmatization through social withdrawal and withholding information about

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their children’s disabilities from others (Farrugia, 2009; Gray, 2002; Koro-Ljungberg & Bussing,

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2009). They may even be reluctant to discuss their children’s challenges with educators (e.g.,

Jegatheesan, 2009), or seek special education and other services (e.g., Grinker & Cho, 2013).

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Parents also may be skeptical about professionals’ competence to assess their children (e.g., Chiu
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et al., 2014), or object to their use of medical diagnoses and disability labels they perceive to be

stigmatizing (Lalvani, 2015). Yet if children do not receive appropriate support, they may
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struggle in isolation or develop low self-esteem, poor self-confidence, and behavioral problems
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(Saito, 2009). These challenges can lead to further stigmatization.

This study underscores how parents of children with disabilities actually navigate
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stigmatization associated with disability and their children’s access to special education services
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using Japanese sociocultural-educational contexts as an exemplar. Japan is an important case, in

part, because Japanese people are generally socialized from childhood to be particularly sensitive
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to their own differences from others, including the negative meanings associated with being

“different” (e.g., Kuroishi & Sano, 2007). Thus, we expect that Japanese parents will be

particularly cautious regarding any risks their children’s differences pose for stigmatization,

including courtesy stigmatization of parents.

Japan also is an important case because of relatively recent changes in Japanese

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educational policies concerning children with mild cognitive and behavioral disorders. In

Japanese public education, mild cognitive and behavioral disabilities are conceptualized as a

group of disorders (Ministry of Education, Japan, 2018) in which children struggle socially and

emotionally, as well as academically (e.g., Saito, 2009). They include specific learning

disabilities, Attention Deficit Hyperactivity Disorder (ADHD), high functioning autism spectrum

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disorders, and certain speech, emotional and behavioral disorders. Japanese children with mild

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cognitive and behavioral disabilities did not become formally eligible to receive special

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education until 2007 (Ministry of Education, Japan, 2007) partly because of concerns among

educators, policy makers, and scholars about stigmatizing children who are otherwise typically

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developing (Kadomoto, 1990). Children formerly seen as “slow learners” or “difficult” became
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children with “disabilities” (Abe, 1998), and new educational strategies needed to be integrated

into traditional Japanese education without stigmatizing them. These changes in how disabilities
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are envisioned in Japan provided us with a unique opportunity to observe the process by which
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disabilities are socially, culturally and historically constructed.

1.1 Conceptual approach

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This report considers parents’ responses to stigmatization associated with disability and
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special education sensitized by sociocultural perspectives, including developmental cultural

psychology (Gaskins, Miller, & Corsaro, 1992; Miller, Hengst & Wang, 2003), specifically, the
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concept of “universalism without uniformity” (Shweder & Sullivan, 1993). Although certain

phenomena, such as disability and associated stigmatization, are common issues in many cultural

contexts (“universalism”), members of different cultural groups vary in how they understand and

experience them (“without uniformity”), reflecting specific sociocultural and historical contexts

(see Varenne & McDermott, 1998). Examination of Japanese parents’ perspectives on disability
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and stigmatization highlights our cultural blind spots, allows us to reflect back on taken for

granted beliefs and practices, deepens our understandings (See Morson & Emerson, 1990), and

may even lead to new and creative solutions to the persistent problem of stigmatization.

1.2 Mild cognitive and behavioral disabilities in cultural context

Our focus on mild cognitive and behavioral disabilities provides an important opportunity

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to explore culturally embedded parental responses to how the relative psychosocial risks of

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stigmatization are weighted against the benefits of specialized services. In many contexts,

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children with mild cognitive and behavioral disabilities appear to be “typically developing.” In

other contexts, however, such as reading, writing, communication, and social interactions, they

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struggle (e.g., Ministry of Education, Japan, 2018; Sato, 2008). These children’s challenges are
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less visible than those with more obvious disabilities involving intellectual, mobility, and sensory

functioning. Thus, parents may choose to disclose their children’s challenges as disabilities to
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receive support, or to conceal them to avoid stigmatization (see Goffman, 1963; Minow, 1990).
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These decisions reflect cultural understandings of disability and associated stigmatization.

Even after the implementation of the new educational policies in 2007, currently, only
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1.6 % of Japanese children in first through ninth grades receive formal special education services
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for mild cognitive and behavioral disabilities (Ministry of Education, Japan, 2016). Yet

classroom teachers indicate that about 6.5% of children in their general education classrooms
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could benefit from such services (Ministry of Education, Japan, 2012). This discrepancy is due,

in part, to parents’ continuing concerns about the risks special education labels and services pose

for stigmatization (Authors, 2017).

In contrast, U.S. children with mild cognitive and behavioral disabilities have been

formally eligible for specialized support since 1975, after the passage of P.L. 94-142, currently
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the Individuals with Disabilities Education Act (U.S. Department of Education, 2017). In U.S.

special education, these disabilities are considered “high incidence” disabilities (Gage,

Lierheimer, & Goran, 2012; National Center for Education Statistics, 2017). Currently, more

than 8% of school-aged children in the U.S. receive special education services for these

relatively milder disabilities (National Center for Education Statistics, 2017).

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1.3 Disability and stigmatization in Japanese sociocultural contexts

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1.3.1 Education

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Japanese parents’ responses to their children’s disability and special education services

are shaped, in part, by Japanese educational contexts. Until the 1990s, only about 1% of Japanese

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children in first to ninth grades received special education for any disability, in part, because such
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services were primarily provided to children with relatively severe disabilities and in segregated

settings, such as special education schools and classrooms (Ueno & Hanakuma, 2006). Such
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segregation reinforced stigmatization associated with special education. The percentage of

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children receiving special education increased to 3.6%2 by 2016 (Ministry of Education, Japan,

2016), largely due to the increase in children receiving services for mild cognitive and behavioral
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disabilities following the special education reform in 2007. Yet many parents and educators
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remain concerned about stigmatization associated with special education services.

Further, in Japanese elementary schools, much of children’s learning occurs within peer
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groups. Children complete academic projects, plan special classroom- and school-wide programs,

and complete routine chores such as cleaning classrooms and serving lunch within peer groups

(e.g., Lewis, 1995; Tsuneyoshi, 1994). Adults watch over children with affection and empathy as

protective figures and provide guidance indirectly. This socialization practice is referred to as

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2.9% of children receive special education services in local public schools, and 0.7% of children attend special
education schools (Ministry of Education, Japan, 2016).
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mimamori [mi(ru): look and watch; mamori; protection and support], a commonly used practice

at home and school. Adults intervene only if children need immediate attention, and allow them

the autonomy to freely explore activities, interact with others, solve problems with peers, and

learn and discover from these experiences (Authors, 2014; Bamba, 2010; Lewis, 1995; Tobin,

Hsueh, & Karasawa, 2009; Tobin, Wu, & Davidson, 1989). Thus, special education services

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provided outside of their general education classrooms can not only stigmatize children by

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singling them out from their peer groups, but also remove them from an important socialization

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and learning context. Japanese educators reported that parents of children who have disabilities

generally prefer accommodations within general educational settings that do not single them out

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from their peer groups, rather than those provided outside of their classrooms (Authors, 2014;
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see also Sato, 2008).

1.3.2 Sensitivity to differences

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Japanese parents’ sensitivity to others’ responses can create challenges for those whose
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children have disabilities. In general, Japanese people are socialized to sense and understand

others’ feelings through their everyday interactions, as well as through direct conversations
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(Lebra, 1976), and to express their own thoughts and feelings in ways that are considerate of
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others’ feelings (see Azuma, 1994; Rice, 2001). People may not refer to others’ differences, but

those who have such differences may sense even slight variations in others’ attitudes and become
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anxious (see Sano & Kuroishi, 2005; see Kuroishi, Ikui, & Sano, 2015), or even speculate on the

negative meanings of others’ offers of help (e.g., Yamada, 2009).

Consistent with Japanese people’s general sensitivity to differences, parents can be highly

conscious of others’ responses to their children’s disabilities. Even if those responses are not

overtly negative, they may sense negative connotations from others’ indirect responses. Parents
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also may respond negatively to others’ empathetic responses, such as “I’m sorry for you,” as

reflecting pity and the assumption that they are unhappy because their children are not “normal”

(Kasahara & Turnbull, 2005). They are sensitive to other people’s “eyes,” and may avoid

situations in which other parents could notice their children’s school struggles, such as talking

with educators in the hallway (Authors, 2014; see also Jegatheesan, 2009).

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If their children are to receive services, however, Japanese parents eventually must face

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others’ responses to their children’s disabilities. After their children’s diagnoses of disabilities,

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maintaining their social relationships in the community, especially with parents of typically-

developing children, is a primary concern for many Japanese parents (Sato et al., 2015). They

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may exert enormous efforts to “lay the foundation” so that their children are accepted by
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typically-developing children and their parents, but also express feelings of social isolation and

challenges in building and maintaining relationships with other parents (Sato et al., 2015). Even
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if other parents express empathy, they may become reluctant to engage socially when they notice
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that other parents do not fully understand the challenges of raising children with disabilities

(Authors, 2014). Further, parents may feel that they are placing extra burdens on other parents by
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disclosing their children’s disabilities and choose not to openly discuss their feelings and
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challenges (Sato et al., 2015).

Japanese parents of children with disabilities also may face negative responses from
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family members. Primary caregivers tend to recognize their children’s disabilities and view

specialized services as beneficial before other family members. Other family members, including

extended family, may reject their concerns about their children’s struggles, in part, due to their

anticipation of the family’s loss of face in the community (e.g., Iwasaki & Kaizoji, 2008;

Yamane, 2009; see also Authors, 2017). Primary caregivers may choose not to express their
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thoughts and feelings to maintain relationships within their own families (Iwasaki & Kaizoji,

2008).

Parents’ responses to disability and stigmatization can have a significant impact on their

children. Even if children are not informed of their disabilities, they are aware that they struggle

in school more than other children (Maret, 2008; see also Sato, 2008). They also are sensitive to

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parents’ responses to their struggles, especially arguments, and even conclude that they are

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failures (Authors, 2014). Further, many Japanese children with disabilities are left in general

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education classrooms without specialized support (Ministry of Education, Japan, 2012), in part,

because of parents’ choices not to allow their children to receive special education. These

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children not only struggle in school academically, but also are at risk for further stigmatization
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including labeling by peers as a problem child (Saito, 2009; see also Authors, 2016b).

1.4 Current study

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This study examines the experiences of Japanese parents of children with mild cognitive
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and behavioral disabilities at elementary schools. We addressed the following research questions

through semi-structured, qualitative interviews: 1) How do Japanese parents experience raising

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their children with disabilities, including the impact of stigmatization on their children and
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themselves? 2) What support do they recommend be provided to other parents with similar

challenges?
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2. Methods

Interviews with Japanese parents were conducted as part of a larger study examining the

school experiences of children with disabilities, their educators and parents (Authors, 2014; 2016

a, b; 2017). Participants were purposely selected to obtain diverse perspectives, including parents

whose children with mild cognitive and behavioral disabilities were and were not receiving
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special education services.

2.1 Research sites and participants

Data were collected in one large city in Japan. The primary research site was an

elementary school serving approximately 200 children from 1 st to 6th grades. This site was

nominated by an administrator of the Center of Special Education within the city’s board of

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education. It has children mostly from Japanese families with a few from immigrant and

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bicultural families. The school is located in a lower middle- to middle-income agricultural area.

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It had a reputation among educators and scholars as providing high quality special education

services, and served as a model school for the implementation of special education services for

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children with mild cognitive and behavioral disabilities (See Authors, 2014 for details). A team
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of specialists from the Center of Special Education recommended that about 10% of children at

this school receive specialized support, but only 2% did so primarily due to parents’ reluctance to
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enroll their children in special education, as well as limited special education resources3 . [Author
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1] collected ethnographic data at this site in 2009-2010. The principal nominated parents of three

children with mild cognitive and behavioral disabilities, whom she felt would be comfortable
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with discussing their children’s “school struggles,” but not necessarily “disabilities.” All of them,
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two mothers plus a married couple, agreed to participate in individual interviews from this site.

Additional data collection occurred in 2013 to examine the transferability of findings

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from the primary site, and to broaden the focus of analyses to include perspectives of parents

whose children attended other schools within the city. The same administrator from the Center of

Special Education nominated 5 mothers of children with disabilities. Four mothers responded to

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This still remains an issue in many Japanese schools, even at model schools. For instance, our research site had
more resources, relative to other local public schools, but they had to rely on volunteer teaching assistants to provide
support for children with disabilities in general education classrooms.
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[Author 1’s] invitation, and agreed to participate in individual interviews. Their children were

graduates of three other public elementary schools within the city. At the time of the interviews,

their children were in middle and high-school, but had attended elementary school during

approximately the same time period as those from the primary site.

A total of eight parents of seven children with disabilities (five boys and 2 girls)

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participated in individual interviews. At the time of the interview, the grade levels of their

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children ranged from second to tenth (See Table 1). Five children received specialized support

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under the category of “autism spectrum disorders and/or emotional disturbances 4 ”. One child had

a learning disability and a speech problem. Another child, whose parents were reluctant to have

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her formally assessed due to concerns about stigmatization, was informally assessed by
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educators as having a learning disability. This distribution of mild cognitive and behavioral

disabilities in our sample is broadly consistent with Japanese national data. At the time of the
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data collection, 22% of Japanese children receiving special education did so for autism spectrum
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disorders and/or emotional disturbances, while only 1.7% received services for learning

disabilities (Ministry of Education, Japan, 2010).

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4
This is one disability category in Japanese special education.
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Table 1 Characteristics of Japanese participants’ Children

Child’s name Gender Grade Disability Placement

(Pseudonym) level
Primary site
Dai Male 3 High-functioning autism Special and general education
spectrum disorder classrooms

Yusuke Male 5 Learning disability & Special and general education

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speech problem classrooms; and Resource room

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Kakeru Male 2 High-functioning autism General education classroom
spectrum disorder

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Secondary sites
Megumi Female 8 (Learning disability) General education classroom

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Aki Female 10 High-functioning autism General education classroom and
spectrum disorder Resource room
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Taku Male 10 High-functioning autism General education classroom and
spectrum disorder Resource room
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Satoru Male 7 High-functioning autism General education classroom

spectrum disorder
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2.2 Procedures

Semi-structured individual interviews were conducted in Japanese by [Author 1].

Interviews were held in private spaces, such as conference rooms at school. Interviews lasted 20-

605 minutes and were audio-recorded. Due to parents’ sensitivity to disability, [Author 1]

refrained from using the term “disability” during the interviews. Instead, she asked parents to

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describe their children’s school struggles. Participants were asked to discuss: 1) their perceptions

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of any stigmatization associated with their children’s school struggles and special education

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services, 2) any impact of stigmatization on themselves, their family and children, 3) their

understandings of special education services, and 4) support they recommend for other parents

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with similar challenges. In addition, participant observations were conducted by [Author 1] who
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volunteered as a teaching assistant for children with mild cognitive and behavioral disabilities.

Her detailed field notes described everyday interactions among these children, their parents, and
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educators at the primary site for a total of 16 weeks across two school years. They included
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informal discussions with parents regarding any stigmatization associated with their children’s

disabilities
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2.3 Data analyses

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All individual interviews were transcribed verbatim and analyzed in Japanese. Using

analytic induction techniques, the initial analyses focused on understanding parents’ perceptions
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and meanings of their experiences through repeated readings of the transcribed interviews (emic

coding; Schwandt, 2007), contextualized by participant observations of parents at the primary

site. The initial analyses were conducted by [Author 1] who is a native Japanese speaker.

Negative cases were used to expand initial interpretations and refine cultural meanings (Lincoln

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Interviews with a few parents were shorter because the interviewer had had informal conversations with them on a
daily basis, described in fieldnotes, prior to the individual interviews. These interviews were conducted to formalize
the information that had been already obtained or fill in missing information.
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& Guba, 1985). The next step was cultural analyses, guided by developmental cultural

psychology (Miller et al, 2003; Shweder & Sullivan, 1993). More specifically, [Authors 1 and 2]

identified culturally central beliefs and practices through discussion and review of the literature

on disability, stigmatization, and socialization practices at home and school in Japan (see

Authors, 2016a,b; 2017). The credibility of our interpretation of participants’ experiences was

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critiqued by Japanese colleagues for the purpose of peer debriefing (Lincoln & Guba, 1985).

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2.4 Researchers

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A significant strength of this study is researchers’ insider and outsider perspectives of

disability as well as Japanese sociocultural contexts. [Author 1] who collected the Japanese data

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is a Japanese citizen. She obtained her MSW and PhD in the U.S. [Author 1] also has used a
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wheelchair for nearly 20 years. [Author 2] is a U.S. citizen. She is the parent of an adult son who

has dyslexia and recently completed his graduate education in the U.S. Our insider perspectives
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on disability (Authors 1), parents’ experiences of children’s disabilities (Author 2) and Japanese
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sociocultural context (Author 1) allowed us to explore, interpret and contextualize parents’

understandings of disability (see Authors, 2017). [Author 2’s] cultural outsider perspective was
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critical to identifying Japanese sociocultural “blind spots” taken-for-granted by insiders

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[including Author 1] and probing deeper understandings of cultural beliefs about disability and

stigmatization (Morson & Emerson, 1990). Although the focus of this study is on Japanese
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parents, these insider/outsider perspectives facilitate reflection on some broad implications for

Western professionals.

3. Results

Japanese parents described their experiences raising their children as including that of

stigmatization associated with disabilities and special education services. Many parents’
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anticipation or actual experience of stigmatization led to their initial reluctance to use disability

labels and services for their children. Resources including emotionally sensitive professionals

and other parents of children with disabilities were important sources of support (Section 3.1).

Over time, their concerns about the impact of disability and stigmatization on their children’s

education and development (Section 3.2) motivated them to actively seek out specialized

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services (Section 3.3). Parents also discussed their preferences that educators provide to children

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support in a holistic and unobtrusive manner beneficial to all children. They also lauded the work

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of home-school liaisons (Section 3.4).

3.1 Parents’ experiences of their children’s disabilities and stigmatization

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Given stigmatization and the relatively mild nature of their children’s disabilities, some
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parents described an initial reluctance to use disability labels and associated services. Some

reasoned that their children look “normal,” and in most respect are no different from typically-
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developing children. Taku’s mother observed:

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One [reason parents do not allow their children to receive special education services] is

[the label of] “disability”. If there is no problem intellectually, I’ve seen some mothers
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who really struggle with accepting [their children’s] disabilities. For these parents, I think
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their [children’s] IQs make a lot of difference. [Their children] can study and

communicate well, and there are lots of things they can do. …They wonder if that
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[difficulty] is severe enough to be considered a disability. They may think, and want to

believe, “Other children are also like [my child]”, instinctively. They may have a strong

feeling that, “There is no problem with my child, [he/she] doesn’t have a disability.”

Similarly, Aki’s mother articulated, “There is a sort of barrier to resource rooms. [Many parents]

don’t agree to send [their children] there probably because they don’t like the [label] of ‘children
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with disabilities.’”

Further, many parents expressed vulnerability to educators’ and other parents’ negative

responses to their children. For example, Aki’s mother described others’ responses to her child’s

repeated misbehaviors. As is customary in Japanese elementary schools when children

misbehave and are involved in incidents with their peers, she described apologizing to parents of

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those peers and educators:

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My child always tried to solve problems by hitting, kicking, or laying down [on the floor].

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So, it was really hard for a long time. I kept apologizing [face-to-face] all the time, my

head down, to everyone [including parents of children involved in such incidents] who

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said and laughed, “[Why doesn’t she behave] like a girl?”
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Dai’s mother also expressed frustration toward a societal expectation for individuals with

disabilities to remain hidden, “I wonder why people with disabilities have to remain belittled
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[unnoticed, low in status]… We should be able to go out more openly [without worrying about
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others’ responses].”

Some parents felt discomfort with other parents’ responses to their children’s difficulties.
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These parents acknowledged their empathy, but perceived that other parents did not necessarily
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understand the challenges they faced on a daily basis. For example, Yusuke’s mother described,

“I explained [about my child] to parents of [children] in his general education classroom. They
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said, ‘Sure, I can understand that,’ but I felt that they didn’t fully understand what I meant.”

Some parents also expressed frustration with other parents’ comments. Satoru’s mother

described, “I was told, ‘You are overprotecting [your child].’” Similarly, Aki’s mother observed:

My child’s [disability] is not easy to notice, [and other parents may say], “Really? [Is

she] different? Is she ok?” [Such responses] make me feel upset. Does that mean she is a
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failure? That sounds like she is not good, at all. They also said, “Let her take the test

[evaluation] again!” Then I thought, “That’s not what I am talking about,” but at the same

time, [I know] I don’t have to be close to these people. Instead there are people who tell

me, “Aki was doing such and such [behaving incorrectly],” without any [biases or

stigma], and I appreciate that.

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In some families, mothers described pressure from other family members who believe

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their children to be typically-developing, and are reluctant to engage them in special education.

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Megumi’s mother described her husband’s response when she asked if they should consult with

professionals regarding their child:

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My husband said, “What are you talking about? Are you serious?” My family reacted like
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this. In that kind of atmosphere at home, I thought, “I can’t talk to [anyone.]”… Recently

[in eighth grade], there are things I can’t handle by myself, so I frequently feel I should
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consult with professionals, but my husband is still like that [not acknowledging any
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problem].

Most parents did eventually decide to discuss their children’s struggles with educators
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and other professionals, including child psychiatrists, in part, due to difficulties in raising their
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children. They experienced varying degrees of success with such consultations. Satoru’s mother

described, “I now understand that it doesn’t work if I scold him blindly [yamikumo: without
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thinking carefully], but I used to tell my child [to correct his behaviors] many times, repeatedly.

That made me so frustrated, [and I consulted with a professional].”

Due to the relatively mild nature of their children’s disabilities, however, many parents

reported that professionals did not consider their children’s struggles as disabilities, especially

prior to first grade. In some cases, parents described being not only left without support, but
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blamed by professionals for their children’s struggles. Megumi’s mother elaborated such an

experience: “[In third grade], when I talked to [a school psychologist], she just told me, ‘It’s

Mother’s fault.’ I came back [home] crying. Since then, I haven’t talked to any professionals

[about my child].” She went on to discuss how children’s struggles can make parents feel

anxious, and how it is difficult to discuss their concerns with educators:

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When parents notice that this child is not typical, even if it’s a little thing, that makes

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parents anxious. So, if we discuss that with [educators and other professionals], it’s

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because we have become very desperate. We want them [educators] to take it [parents’

concerns] seriously… I was anxious [about my child] in many ways, and I used all my

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effort to talk to [educators], even though, honestly, I didn’t want to talk. I don't want to
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talk [about such a thing]. [I’m] hoping that [my child] can do well, normally, without any

[specialized support].
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In many families, it took several years for children to begin receiving special education
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and/or other services. Consequently, these parents experienced feelings of isolation and a lack of

support. Megumi’s mother reflected, “I didn’t have anyone [to talk with] when my child was in
PT

elementary school.” Taku’s mother elaborated:

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I was told that I had a problem [by a professional when my child was in preschool]. To

me, he was a very difficult child to raise. He couldn’t communicate well, so he didn’t
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understand how I felt. When I talked to him, he didn’t respond. So, I really wanted to

know more professional strategies, or some ways to [handle such situations], but the

professional said [it was my fault]. It’s like [we were left], only parents and child, and felt

very lonely. I didn’t know at all why my child was like that, and didn’t know what I

should do.
 ACCEPTED MANUSCRIPT

Some parents also described helpful support from parents of other children with

disabilities. Satoru’s mother, for example, described, “After [my child] received a medical

diagnosis, I got to meet and talk with teachers, and also other parents who have the same

problems. I learned, and am still learning a lot of tips and other things [from these parents],

which gave me a feeling of security/comfort.”

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3.2 Effects of disability and stigmatization on children

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Parents also described how stigmatization associated with disability has affected their

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children. They identified elementary school as a particularly challenging time. All parents

expressed their concerns about their children’s relatively negative relationships with peers, and

US
how such relationships affected their overall experiences at school. Some children were involved
AN
in physical fights. Others experienced teasing and bullying, had only a few or no friends at

school, or even excluded themselves from their typically-developing peers. Aki’s mother stated,
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“It seems that [Aki] suffered at [elementary] school a lot. It was really hard. I think there wasn’t
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anything that made her happy.” Similarly, Megumi’s mother reported, “[My child] described

[her elementary school years], ‘It was like a hell.’” Taku’s mother described her child’s peer
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relationships:
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It was never good. There were troubles everywhere. It was hard… My child usually

become friends with children who are just like him, who [are not sensitive to others]. All
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of them want to be the first, and can’t give in, so then battles begin all the time. My child

is sort of slow, and there are lots of things others can pick on. Therefore, every year, in

the beginning of the school year, after a month, he becomes the target of bullying in his

group.

Likewise, Satoru’s mother described her child’s experiences with his classmates in fifth grade:
 ACCEPTED MANUSCRIPT

[Because there were several children who often had trouble with peers], my child’s

classroom teacher became overwhelmed, and [didn’t pay attention to my child’s peer

struggles]. In that classroom, he was trapped and stressed out. Until then, there was no

major problem, and he was smiling, but from the first day in that class, his face was

different. It looked bad. That situation continued for half of the year, then the [major]

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incident [involving bullying by several peers] happened. That made him think, “I can’t go

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to school anymore.” He was stressed out, crying [at home], and even said, “I want to die.”

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Similarly, Dai’s and Yusuke’s mothers discussed their children’s refusals to go to their general

education classrooms after problems with their peers.

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Given the emphasis on peer group collaboration in Japanese elementary schools,
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(Ministry of Education, Japan, 2008), challenges can arise for children with mild cognitive and

behavioral disabilities even in the absence of peers’ teasing or overt rejection. If they are not able
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to meet expectations academically and socially, parents reported that their children perceived
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themselves as failures, or felt, “[Others] don't care whether or not I’m present”. Megumi’s

mother described her child, “At school, her mind was full of feelings like, ‘I’m a failure,’ or ‘I’m
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always slow.’” Aki’s mother similarly described:

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It was hard at school, because children have to do things together in groups. My child

cried a lot. Yes, in terms of [her life at elementary school], she cried a lot. She also had
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painful experiences. She was even traumatized, I think.

Some parents also described how their children understood their own disabilities. Many

of their children did not know their medical diagnoses, but they were aware that they struggled

more than other classmates. Satoru’s mother described her son’s response:

In 6th grade, he said, “My goal is to break through what I am, what I got when I was born. ”
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We haven’t told his diagnosis [to him] yet, but [when I heard this], I thought he himself

has begun to understand that there are many things he is struggling with, and then he is

trying to change them.

Similarly, at home, children with disabilities may notice their own differences though their

interactions with siblings. Kakeru’s father discussed:

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He has a younger sister. For her, it’s her fate that she has a big brother like him. Also for

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Kakeru, it’s his fate that he has a little sister who can generally do many things well,

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much better than him. Instead of [trying to fix the disability], I’d like him to become able

to accept [it].

3.3 Benefits of disability services

US
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While many parents discussed a variety of negative consequences of their children’s

disability and stigmatization, most also acknowledged the benefit of the services their children
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received. After exerting enormous effort to support their children over many years by themselves
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due, in part, to stigmatization, some parents expressed relief when their children received formal

diagnoses. Aki’s mother described, “I didn’t know what I could do any more so I went to [a
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special education center of the city, where specialists evaluate children for their eligibility for
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special education]. Then they said, ‘It must have been very hard for you.’” This mother

continued to describe how she felt:

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I’d been thinking, “Why?” for a long time. So, [instead of feeling bad], I was pleased and

thought, “Now, I can ask for the help I need.” It may sound somehow strange, but I was

pleased. Also, I thought I don’t have to worry any more alone about how I should raise

my child [and handle my child’s disability].

Parents’ acknowledgement of their children’s medical diagnoses, however, did not

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necessarily mean that they immediately agreed that their children should receive special

education services. Dai’s mother stated, “Dai struggled in preschool a lot. So, to some extent, I

have accepted [his] disability, but he has developed in first and second grade [without obvious

problems]. It was a big challenge [when I was told that he needs special education] in third

grade.” Megumi’s mother described her hesitation to engage with educators around disability

T
issues due to shame and uncertainty regarding how she and her child might benefit, “First of all,

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I felt ashamed. Then I also wondered if they would understand [my child’s struggles]. Even if I

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talked to them, I wasn’t quite sure how that would make the situation better.”

In general, parents preferred that their children remain in their general education

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classrooms as much as possible. For example, instead of attending a nearby school, Dai and
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Kakeru walked 40 minutes to attend a smaller school where they could study in general

education classrooms. Kakeru’s mother described:

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In this school, the principal said, “Let’s start at the small sized [general education]
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classroom with 20 other children6 , and then we can adjust later [as he develops],”

including support in a self-contained special education classroom. Instead of [assuming

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that he needs to be placed in the special education classroom], we wanted to [first] see
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how he might do when we let him stand in the same field as others. [Kakeru] also wanted

to do with others, but we didn’t know [if he could] until we tried. [Teachers] also allowed
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us to try. It actually worked well.

Other parents described how they balanced the benefit of specialized support with

stigmatization associated with special education services. Satoru’s mother articulated how she

made the decision to disclose her child’s disability to others:

6
The maximu m classroom size in Japanese elementary schools is 35 in 1 st grade and 40 in other grade levels.
 ACCEPTED MANUSCRIPT

I didn’t have any hesitation about specialized support when we had a major problem.

[Due to troubles my child had with classmates], we seriously considered and requested a

classroom change for him. Then we were told that [if we changed classrooms], there was

a possibility that other people would learn about [my child’s diagnosis]. They asked us if

that would be ok. [My husband and] I thought, if that makes my child’s life [at school]

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easier, it’s better than an even worse scenario, such as him not being able to go to school.

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That was really an extreme situation. If it were 10 or 20 years ago, we may have

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responded differently, … but when weighing [the benefits and risks of this change], we

thought that there may be something negative in his future to save his “face 7 ”, but he

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actually was suffering now, and we wanted to save him first.
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3.4 Suggestions for educators supporting their children

Parents preferred that their children’s support be provided by all educators within the
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school, not just by their classroom or special education teachers. Aki’s mother described, “They
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all know [my child] is someone who needs assistance, so, I think that worked well to help her.”

If all educators understand what the particular child needs, the child can receive consistent
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support throughout the day, including in the hallway and playground during recesses. Similarly,
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Satoru’s mother discussed how consistent support from adults throughout the school helped

Satoru to recover from the problem with peers that made him to feel like he wanted to die:
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[Prior to the bullying incident with peers], it seemed that educators stepped back and just

watched [problems happening], but after that, the whole school, including nutritionists

and other staff members, are all meeting regularly. They also placed teachers who

watched and supported him [e.g., during recesses]. After educators’ mimamori of the

7
In other words, maintain social status within the groups he belongs to currently and in the future, such as peers at
school and colleagues at work.
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whole school for a half year, he was able to recover, as he used to be, and also develop.

Note here that the assumption of the practice of mimamori is that children are usually capable of

resolving their difficulties and in so doing learn from one another (see Lewis, 1994; Walsh,

2004). The problem arises when some children do not behave as expected socially or tease and

bully others, including a child with a disability. In these cases, children may need adults to step

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in. Such support is most effective when all adults are aware that they may need to intervene more

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directly in conflicts between peers. Similar to Satoru, teachers' mimamori of Dai and Yusuke

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allowed them to regain confidence in their peer groups.

In addition, participant parents described some educators who served as liaisons with

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other educators. Aki’s mother, for instance, described how a resource room teacher in another
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school whom her child saw once a week8 helped her to communicate with her child’s classroom

teacher:
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When negotiating with teachers at school, [classroom teachers] may perceive that parents
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are spoiling [their children] if parents request [support in their classrooms], but resource

room teachers are outside persons. Also, they both are teachers, so if resource room
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teachers say, “This child needs this support,” [classroom] teachers will hear that [and take
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it seriously]… We actually had a note exchange with [Aki’s] classroom teacher, a

resource room teacher, and me. When her classroom teacher wrote about her, then the
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resource room teacher wrote, “In such a case, please do this.” I also wrote what I noticed

at home. It worked well to collaborate and work together.

Parents at the primary site recognized a special education coordinator, Sano Sensei9 , as a helpful

8
This is typical in Japan. Currently, resource rooms are created only in selected local public schools. If children
attend a school that does not have a resource room, they go to another school on assigned days to receive instruction
at a resource room.
9
In Japan, educators are addressed as “sensei” to acknowledge their knowledge and expertise.
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liaison in connecting with other educators. Yusuke’s mother described how the coordinator

helped her to talk with a school psychologist:

I talked with Yamashita sensei [school psychologist]. At first I thought I didn’t have

anything to talk with a psychologist about. They knew what to do. Sano sensei [special

education coordinator] told Yamashita sensei to help me. It started like that, and then she

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called me and arranged that I was able to make an appointment, naturally. Yamashita

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sensei told me recently, “You were under so much tension and there was no room to get in,

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but if we didn’t do something, [not only] Yusuke, but you would have crashed/collapsed

(tsubureru).” So, Sano sensei and Yusuke’s classroom teacher, all of them made a route

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for me to go to see Yamashita sensei. [Authors, 2014, p. 118]
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She also encouraged Dai’s mother to talk to the special education coordinator, “She is fighting

against too much anxiety and doesn’t know what to do, just like I used to be, so I told her to talk
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to Sano sensei.”
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4. Discussion

Japanese parents of children with disabilities weighted heavily the risk of stigmatization
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against the benefits of special education services for their children with mild cognitive and
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behavioral disabilities. Although most eventually did decide to allow their children to receive

special education services to support their school functioning, their experiences were fraught
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with social and emotional challenges. This Japanese case is illustrative for U.S. professionals, in

part, because it draws our attention to the importance of attending to the social contexts and

emotional responses of parents of children with mild cognitive and behavioral disabilities. U.S.

professionals have provided leadership around the world in terms of educational policy and

cognitive and behavioral interventions for children with disabilities (e.g., U.S. Department of
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Education, 2017; Evans, Owens, Reinicke, Brown & Grove, 2013). In general, they have focused

less on the social and emotional aspects of living with, or raising a child with, disabilities

(Summers et al., 2007). Yet U.S. parents have reported that professionals often are too focused

on paperwork or technical aspects of diagnosis and service plans, and that this emphasis can

make them appear uncaring (Blue-Banning et al., 2004; Summers et al., 2007). Such perceptions

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by parents can impede subsequent parent-educator collaborations (e.g., Bunting, Drew,

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Lasseigne, & Anderson-Butcher, 2013; Lalvani, 2015) that are necessary for children with mild

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cognitive and behavioral disabilities to receive the support they need to succeed in school. Our

experience suggests that researchers, educators, and social workers can design more adequate

US
theories and more effective policies, programs and practices by learning from one another
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through exploration of culturally diverse responses to common challenges.

To return to the concept of “universalism without uniformity” (Shweder & Sullivan,

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1993), parents’ concerns about stigmatization associated with their children’s disabilities are
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common in many cultural groups (e.g., Farrugia, 2009; Gray, 2002; Grinker & Cho, 2013; Koro-

Ljungberg & Bussing, 2009; Lalvani, 2015). Furthermore, there appear to be a number of
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similarities in the particular challenges described by Japanese participants in this study and the
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available literature on U.S. parents including that: children’s disabilities and associated

stigmatization can be socially and emotionally sensitive issues for parents (e.g., Blum, 2015;
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Farrugia, 2009); parents can experience social exclusion, and others’ demeaning, hostile or rude

behaviors (Gray, 2002); and parents’ responses to such courtesy stigmatization can include

emotional sensitivity or distress (e.g., Lalvani, 2015), limiting information about their children’s

challenges and social withdrawal (Farrugia, 2009; Gray, 2002).

Of course, the experiences of all parents also must be understood and interpreted within
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their cultural contexts. So although parents in both the U.S. and Japan may experience the

universal challenge of responding to stigmatization associated with their children’s disabilities,

they do so “without uniformity.” In other words, there are cultural nuances in parental responses

that must be considered in providing culturally-sensitive services. In this study, the challenges

described by Japanese parents, and supportive practices they preferred, were shaded both by the

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similar experiences of parents across cultures and by the Japanese cultural context.

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4.1 Japanese sensitivity to others’ responses: Mutual support from other parents of

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children with mild cognitive and behavioral disabilities

Although parents of children with mild cognitive and behavioral disabilities in both the

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U.S. and Japan may be sensitive to others’ responses (“universalism”), these sensitivities may be
AN
particularly pronounced within the Japanese cultural context (“without uniformity”). Japanese

parents responded strongly not only to the stigmatization they actually experienced at school and
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in the community (i.e., “enacted” stigma), but also the stigmatization they anticipated based on
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their own understandings of disability (i.e., “felt” stigma; Scambler & Hopkins, 1986). Japanese

parents’ anticipation of stigmatization is consistent with Japanese cultural values in which a

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sensitivity to others has to be balanced with one’s own personal thoughts and feelings (Lebra,
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1976). Before expressing their own thoughts and feelings about their children’s disabilities,

parents considered how others, including family members, parents of typically-developing

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children, and educators might respond, and adjusted their presentations accordingly. As a result

of these considerations, some parents chose to support their children by themselves, experienced

social isolation, and their children went without timely professional support.

In contrast to support from professionals, some parents described other parents of

children with disabilities as helpful resources. Their shared understandings of the joys and
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challenges of raising children with disabilities provided them with feelings of comfort. Parents

described an acceptance and lack of stigmatization from these other parents that allowed them to

disclose their internal thoughts and have honest conversations.

4.2 Accepting professional support in Japan: Family-school liaisons and emotionally

sensitive professionals

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Although parents in both the U.S. (e.g., Francis, 2015; Lalvani, 2015) and Japan may find

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interactions with professionals around their children’s disability issues initially uncomfortable

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(“universalism”), many Japanese parents described merely approaching educators and

professionals as daunting (“without uniformity”). Some parents had to overcome their feelings of

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intense shame just to mention their children’s struggles. For Japanese people, awareness of their
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own and their children’s differences can result in negative feelings, such as anxiety (Sano &

Kuroishi, 2005; see Kuroishi, et al., 2015), especially when interacting with educators and other
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professionals who have higher social status. Although such authority is weakening in
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contemporary Japanese society, it remains difficult for many parents to openly disagree with

professionals’ opinions or to raise concerns regarding how educators support their children.
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Parents may worry that such disagreement can negatively affect how educators work with their
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children (Kasahara & Turnbull, 2005).

Some parents also described that professionals who served as liaisons between family and
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school helped them to communicate with classroom teachers and avoid unnecessary conflicts. In

the elementary schools attended by participants’ children, either a special education coordinator

or a resource room teacher served as a liaison, both of whom are available in public schools
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across Japan10 .

Some parents also described helpful emotional support they received at school from

professionals sensitive to the emotional challenges faced by parents of children with disabilities.

The way Japanese educators support parents often is indirect. For example, a special education

coordinator worked with a school psychologist to create an environment in which a mother, who

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was hesitant to talk about her child’s disability-related challenges, could comfortably and

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naturally make an appointment with the psychologist (see also Authors, 2014, 2017). This

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practice is consistent with how educators’ mimamori created an environment in which children

could recover from problems with peers.

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4.3 Japanese elementary education: Peer conflicts as contexts for social development
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Parents of elementary school children with mild cognitive and behavioral disabilities in

both the U.S. (see Authors, 2016a) and Japan may express concerns about their children’s social
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and emotional development (“Universalism”). Indeed, peer relationships are considered to be a

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primary developmental context during middle childhood in many cultural groups (e.g., Chen,

French, & Schneider, 2006; Harter, 2006). All participant parents expressed concerns about their
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children’s social development. They described that their children have no or only a few friends,
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and are teased or bullied by their peers. The negative impact of peer difficulties on children at

school, however, may be particularly intense in Japan (“without uniformity”). In Japanese

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elementary schools where children study, work and play in various peer groups during non-

academic as well as academic periods (Ministry of Education, Japan, 2008), conflicts with peers

can affect their experiences throughout the day (Authors, 2014). Indeed, after incidents with

peers, several parents in this study reported that their children said, “I want to die,” and some

10
After the special education reform in 2007, all public elementary schools are required to assign one educator to
serve as a special education coordinator (See Authors, 2014). Resource rooms are available for children with
disabilities who are determined by specialists at local boards of education as needing such support (See footnote 7).
 ACCEPTED MANUSCRIPT

children began to refuse to go to their general education classrooms.

When children with disabilities initiate disputes or even fights with their peers, however,

the consequences for them at Japanese school may be much less severe than would be expected

in the U.S. (Lewis, 1995). In Japanese schools, conflicts with peers are considered contexts for

children to learn interpersonal skills. Unless there is a risk for harming others or themselves,

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educators consider that children are responsible for solving problems with peers on their own

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(Authors, 2014; Lewis, 1995; Tobin et al., 1989, 2009). As indicated by some parents in the

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current study, however, parents may be considered responsible for their children’s behaviors and

be expected to apologize to the parents of other children, in part, to moderate the parents’

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emotional response. This process can be especially daunting when it must be repeated many
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times over.

4.4 Japanese children’s understandings of self and disability: Holistic support

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Parents of children with mild cognitive and behavioral disabilities in the U.S. (e.g., Blum,
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2015; Koro-Ljungberg & Bussing, 2009) as well as Japan may express concern about the impact

of disability and stigmatization on children’s understanding of self (“universalism”). Although

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many Japanese children were not aware of their own disability diagnoses, they were aware that
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they struggled more than other children. Parents described children’s sensitivity to their own

differences as well as the negative meanings associated with those differences as contributing to
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their negative understandings of themselves as “failures”. In response to their children’s

struggles and damaged sense of self, parents expressed their preferences that educators provide

support for their children in a holistic manner, consistent with elementary educational practices

in Japan (Ministry of Education, Japan, 2008). Educators’ holistic approaches allow all children

to benefit from adult support throughout the day without obviously labeling and singling them
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out. Parents described support provided not only from particular educators, but from all staff

members at the school, who guided children to learn from working collaboratively, and to solve

problems with their classmates (Tobin et al., 1989, 2009). This practice of mimamori is

frequently used at home and school to create social environments in which children are internally

motivated to take responsibility for their own learning and development (Doi et al, 2005; Levine

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& White, 2003). Japanese adults tend to prefer such indirect socialization practices, rather than

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explicitly teaching children how to behave in a socially expected manner. Such practice requires

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adults’ patience and trust in children as inherently good and capable of learning through their

social interactions and experience of overcoming challenges (e.g., Doi et al., 2005; Lewis, 1995;

Walsh, 2004).
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4.5 Limitations

This study has a number of limitations that have to be addressed before discussing
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implications. First, this report is based on interview data. Although we conducted participant
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observations in school, they were used primarily to contextualize interviews. More

comprehensive observations of parents and their children are necessary. Further, children’s age
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range at the time of the interviews was relatively wide. Some parents described their children’s
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elementary school experiences, retrospectively. Thus, we chose to focus on themes commonly

articulated by parents of children across the age range, and consequently did not explore any
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within group variations. In addition, we relied on the principal’s and district administrator’s

judgments as to which parents would be comfortable in participating in our interviews. In the

Japanese cultural context, a child’s disability typically is an extremely sensitive and emotionally

painful topic, and one which would not be openly discussed, especially with outsiders. Many

parents referred by educators had already accepted their children’s disabilities and engaged with
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professionals. Thus, their responses to disability and stigmatization may be more positive than

those of parents who have declined specialized support for their children. What is striking in our

findings, however, is the extent to which even these parents, who were relatively open to

discussing their children’s disabilities, were nonetheless affected by stigmatization. Further, the

sample size is relatively small. This report described only issues and themes addressed by

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multiple participants. There may be other themes that have been left unidentified. Finally, we are

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broadly interested in mild cognitive and behavioral disabilities, but our participants

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disproportionately included parents of children with high-functioning autism spectrum disorders.

Parents of children with other mild cognitive and behavioral disabilities may have different

US
experiences and perspectives concerning, for example, academic as well as social and
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interpersonal challenges.

4.6 Implications
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This study does not have specific implications for policy and practice outside of the
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Japanese context. Rather, it is important because it provides opportunities for policy makers,

professionals, and scholars to reflect back on services and policies pertaining to children with
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disabilities; identify and re-examine taken-for-granted practices; and perhaps think in new and
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creative ways about addressing the persistent problem of stigmatization. Overall, the Japanese

case sensitized us to the significance of attending to parents’ social and emotional contexts when
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engaging them around disability services for their children. It also sensitized us to a number of

more specific issues relevant to parents of children with mild cognitive and behavioral disorders.

First, parents are experts on their children and their voices have to be heard and respected.

Although many parents in this study observed their children’s developmental differences in early

childhood, and several brought their concerns to professionals, their concerns were not acted
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upon. Such responses of professionals may be more common in Japan, where there are relatively

few professionals who might be expected to detect children’s minor developmental differences

early in development (Arai, 2012). Parents in other countries may face similar challenges.

Although the importance of timely intervention for children with more severe or apparent

disabilities and their families is widely recognized across cultures, some U.S. children with mild

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cognitive and behavioral disabilities are not typically diagnosed until they have already

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experienced school failure (U.S. Department of Education, 2016, 2017).

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Second, parents of children with mild cognitive and behavioral disabilities can benefit

from communicating with other parents experiencing similar challenges. Due to the relatively

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mild and hidden nature of their children’s disabilities, parents of children with mild cognitive
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and behavioral disabilities may have limited access to other parents who have children with

similar challenges. Indeed, Japanese parents described the importance of the support they
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received from other parents of children with similar disabilities. Mutual support and information
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exchange is a strategy frequently used in many cultures for those who face disability, mental

illness, and some chronic illnesses (e.g., Cucciare, 2008). Yet support groups typically are
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formed for individuals with more obvious and severer disabilities and illnesses. Parents of
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children with mild cognitive and behavioral disabilities can be isolated from other parents with

similar challenges.
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Third, a family-school liaison can facilitate communication between parents and

educators leading to timely intervention for children with mild cognitive and behavioral

disabilities. Japanese parents described the benefit of having a professional who helped them to

communicate with educators. Likewise, parents in other cultural contexts may benefit from such

services. For example, some U.S. parents participate in workshops regarding special education
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and invite professionals, including from parent advocacy organizations, to facilitate

communication with educators (e.g., Pacer Center, 2017). In many U.S. schools, school social

workers and other professionals, such as school counselors and psychologists, may serve as

liaisons. The number of such professionals who can serve in the role of liaison, however, is

limited. In 2015-2016, for example, 38,780 school social workers served 98,176 public

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elementary and secondary schools (National Center for Education Statistics, 2016; U.S.

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Department of Labor Statistics, 2017), which likely is not sufficient to fully meet the needs of

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children with mild cognitive and behavioral disabilities, their families and educators.

Finally, Japanese parents’ emphasis on a holistic approach also may benefit Western

US
special education systems where interventions are individually tailored (e.g., U.S. Department of
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Education, 2017). Japanese parents described that children with disabilities can function better if

support is provided by educators in the whole school. Such support does not single children with
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disabilities out from their peer groups and may reduce stigmatization, even at schools in Western
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countries where individualized services are valued (e.g., Shweder et al., 2006). For instance,

some U.S. educators emphasize the importance of developing school and classroom cultures that
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accept all children including those with disabilities (Rogoff, Goodman-Turkanis, & Bartlett,
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2001; see also Authors, 2016b).

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Conflicts of interest: none

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Highlights
 Parents face stigmatization associated with their children’s disabilities.
 Parents’ sensitivity to stigmatization can result in social isolation.
 Parents weigh the risk of stigmatization against the benefit of special education.
 Japanese parents preferred support to be holistically and unobtrusively provided.
 Japanese parents’ experiences sensitize Western professionals to stigmatization.

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