The Birth and Spread of an Unofficial Diagnostic Term: A Case of Developmental Disabilities in Japan

Annemarie Jutel (2011) argues that an official medical diagnosis plays a significant role in contemporary society. She further mentions that a diagnosis operates beyond official medical jurisdiction, which implies that paying attention to unofficial or alternative disease classifications is essential for future sociological studies on diagnoses.

This presentation explores a case whereby an unofficial diagnostic term originating from an official psychiatric diagnosis arises in both medical professional discourses and discourses among laypeople.

The term ‘hattatsu shougai’ (meaning ‘developmental disabilities’ [DD]) has been used as a generic term for attention deficit hyperactivity disorder (ADHD), learning disability (LD), and autism spectrum disorder (ASD) in Japan since it was defined in Japanese law in 2004. Similarly, a new term, ‘hattatsu dekoboko’ (meaning ‘developmental unbalance’ [DU]), has gradually gained popularity.

The latter term was coined by a leading ASD medical expert in his 2011 book for the general public. He describes DU as a predisposition and DD as a full-blown disease. Therefore, DU can be related to the concept of risk.

DU might also be intended to mitigate stigma, as he notes that this term is necessary to avoid the negative connotations of the term ‘shougai’ (i.e., ‘disability’). DU is a widely accepted term and can be found in the titles of some books and academic articles, as well as in many homepages.

Furthermore, a new phenomenon is being observed. The term ‘dekoboko’ and a similar term ‘outotsu’ (i.e., ‘unbalance’) are being used in lay discourses to describe many types of minorities, including those with DD/DU and mental illness and members of the LGBT community.

The phenomena described here might help enhance our understanding of the social function of an official diagnosis, problems related to that diagnosis (e.g., stigma), and the tension between official and unofficial diagnostic terms.