The Application of Proportional Universalism to Early Childhood Intervention in Japan: A Cross-Sectional Survey

The application of proportionate universalism has been proposed as an approach that may promote timely access to necessary early childhood intervention (ECI) for children with disabilities. Child and family (CF) centers have recently been established in Japan through the merging of maternal and children's comprehensive support (MCCS) centers using a population approach and comprehensive child and family support centers using a targeted approach. However, reports on how proportionate universalism can be implemented in practice are lacking. Therefore, the present study aims to examine Japan's challenges and actionable recommendations in new CF centers. An anonymous, online survey was conducted on mothers of children aged ≤3 years who had been randomly selected from a special panel throughout Japan. The survey included items on the characteristics of the participants, whether they used MCCS centers and were concerned about their child's development, and whether they were receiving any follow-up. Responses were obtained from 866 mothers. Among mothers who knew about MCCS centers, those with children with developmental delays who received follow-up care were significantly more likely to use them (p = 0.003). Overall, 75.4% of the children with developmental concerns were connected to not only hospital visits but also ECI by government agencies; these families were also significantly more likely to use MCCS centers (p = 0.004). These findings suggest that when children's developmental delays are noticed, ongoing involvement at an MCCS center is associated with timely and appropriate referrals. The services to be provided at CF centers should be based on proportionate universalism.