일본 발달장애의 변화가 주는 시사점 -발달장애의 증가와 발견의 어려움을 중심으로- = Implications of the Changes of Developmental Disabilities in Japan : with Priority Given to an Increase in Developmental Disabilities and Detection Difficulty

다국어 초록 (Multilingual Abstract)

The purpose of this study was to make a theoretical research into Japanese literatures to shed light on an increase in developmental disabilities and detection difficulty. As for the research method, 20 books, DSM-5, ICD-10, Japanese White Paper on Developmental Disabilities, Japanese Journal on Developmental Disabilities and Japanese Developmental Disabilities Net were analyzed, which had been published since 2000 in relation to developmental disabilities. The findings of the study on the increase in developmental disabilities were as follows: First, in terms of society and welfare, there were a rise of prevalence in school age and a great increase in the use of welfare and facilities by life cycle. Second, owing to the recent advancement of science and medicine, doctors were involved in the identification of chromosomes and early detection/identification, and the concept of disabilities was extended a lot. Third, the number of students with developmental disabilities who were in the support stage for compulsory education by special needs education increased greatly. The findings on difficulty with detection of developmental disabilities were as follows: First, there were problems including over-diagnosis and under-diagnosis in the medical setting, the ambiguity of the boundary, many unknown causes, the possibility of change during developmental stages and the quality of early diagnosis. Second, when the necessity of the actualization of inclusive education is taken into account, changes in the concept of developmental disabilities and curriculums geared toward pre-service teachers are required, and interaction between heredity and environments is another issue that arises. The implications of the findings of the study are as follows: First, categorial approach and dimensional approach should properly be taken toward diagnosis classification. Second, efforts to use common instruments to quantify the degree of symptoms should be made. Third, grounds for early diagnosis should fully be guaranteed. All the efforts will facilitate intervention by educational support.

국문 초록 (Abstract)

본 연구는 일본 문헌을 조사하는 이론 연구로 발달장애의 증가와 발견의 어려움을 밝혀보고자 하는 목적으로 실시하였다. 연구방법으로는 2000년 이후 발간된 발달장애관련 단행본 20권, DSM-5와 ICD-10, 발달장애백서, 발달장애연구, 발달장애연감을 중심으로 알아보고자했다. 연구결과로는 발달장애의 증가로는 첫째, 사회·복지측면에 학령기의 유병률 증가와 생애 주기별 복지 및 시설 이용의 증가가 크다. 둘째, 최근 과학과 의료의 발달로 염색체 규명, 조기 발견/판정에 의사의 참여, 장애개념의 확대도 크다. 셋째, 특별지원교육을 통한 의무교육지원단계의 발달장애학생 수의 증가가 크다. 발달장애의 발견의 어려움으로는 첫째, 의료에서 진단의 과잉/과소의 문제, 경계의 모호함, 다수의 원인불명, 발달과정상의 변화 가능성, 조기진단의 질의 확보에 애로가 있다. 둘째, 통합교육을 구현한다는 측면에서 본다면 모두가 포함된다면 발달장애의 개념, 교사 양성과정에 변화가 요구되고, 유전과 환경의 상호작용의 문제도 제기된다. 연구의 결과로부터 도출되는 시사점은 첫째, 진단분류의 범주적 접근과 차원적 접근의 적정한 사용 둘째, 공통된 도구로 증상 정도를 정량화하려는 노력 셋째, 조기진단의 충분한 근거 확보 등은 교육적 지원의 개입을 더욱 촉진 시킬 것이다.

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