Abstract
BackgroundThe new Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) redefined the boundaries of autism as a spectrum. It has been reported that the number of schoolchildren with undiagnosed developmental disorders (DDs) has risen in Japan. Such children referred to as kininaru-kodomo (KK, “children of concern”) by healthcare professionals fall into a gray area. Therefore, KK are often overlooked at infant medical checkups. This leaves KK without necessary medical care and special needs education. It is urgent to explore the KK concept to enable professionals to properly assess and provide for the healthcare needs of these children at a high risk of DD, ideally with early intervention.MethodsA hybrid model of concept analysis was conducted. Working definitions were obtained from a systematic literature review in the theoretical phase. Subsequent in-depth personal interviews initiated in the fieldwork phase corroborated and refined the concept. These qualitative data were integrated in the final analytical phase to yield the practice-based real definition of KK in clinical settings.ResultsThree themes emerged regarding KK children: children who require special care, children whose special healthcare needs are owing to both individual and environmental factors, and children waiting for the development of a new support system for them or their parents.ConclusionsThis study implies that KK are children who require special support because of individual and environmental factors. The concept of KK is considered useful for keeping children with undiagnosed DDs and/or other healthcare needs connected with support networks. It is strongly recommended that a screening tool be developed that reflects the concept of children at a high risk of DD so that children in this gray area may receive necessary support even before diagnosis.
Highlights
IntroductionThe new Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) redefined the boundaries of autism as a spectrum
The new Diagnostic and Statistical Manual of Mental Disorders redefined the boundaries of autism as a spectrum
We included articles on the perceptions of public health nurses (PHNs), DCC teachers, and kindergarten teachers who we considered in this study to be child healthcare professionals
Summary
The new Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) redefined the boundaries of autism as a spectrum. It has been reported that the number of schoolchildren with undiagnosed developmental disorders (DDs) has risen in Japan Such children referred to as kininaru-kodomo (KK, “children of concern”) by healthcare professionals fall into a gray area. The boundaries are symptomatic thresholds dividing the continuum of children with autism spectrum disorders (ASD), children with autistic behaviors, and normal children [2] In keeping with this continuum theory, it has been proposed that even in the general population, individuals with autistic traits exist, the severity of their traits is clinically subthreshold [2, 3]. In many areas around the globe, it is recommended to provide early intervention for a wide range of children who are considered at risk of developing behavioral and emotional disorders, to prevent future social exclusion as well as their parents’ difficulties (for example in Australia and Sweden [8, 9])
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
