Insufficient social support for fathers of children with developmental disorders

Infancy and early childhood are periods of rapid developmental change, and parental involvement is central to childrearing. Parents of children with developmental disabilities (DD)—including autism spectrum disorder, attention-deficit/hyperactivity disorder, and learning disabilities per DSM-5—carry higher childcare burdens and anxiety than parents of typically developing children or those with other conditions. In Japan, policy initiatives (e.g., Sukoyaka Oyako 21) promote family health support, and local governments provide substantial medical, instructional, and emotional support chiefly to mothers. Paternal involvement has been linked to improved child outcomes and reduced maternal stress, and targeted programs can reduce fathers’ stress and enhance parenting self-efficacy. Yet, studies focusing on supports for fathers of children with DD are limited, and prior surveys suggest fathers’ needs differ from mothers’ and may be underserved. Purpose: to identify insufficiencies in social support for fathers raising children with DD to inform considerations for increased, tailored paternal support.

Prior work indicates elevated parenting stress and unique challenges among parents of children with DD (e.g., Jellett et al., 2015; Dabrowska and Pisula, 2010; Tsuda et al., 2012; Nomura et al., 2020). Japanese policy emphasizes father involvement, and interventions (e.g., SNS/text-based training) have shown benefits for fathers of children with ASD, including lower stress and higher self-efficacy (May et al., 2021). Paternal involvement is associated with reduced maternal stress and increased family adaptability (Rankin et al., 2019). For typically developing children, active fathering benefits child growth (Maehara et al., 2018). However, evidence on father-specific assistance in DD contexts is scarce. A 2014 survey suggested mothers and fathers differ in childrearing situations, attitudes, and anxieties, and that fathers require distinct forms of support (Ishida et al., 2018). Literature also underscores the importance of reliable information sources for parental mental health and disease management (Ishii and Asano, 2017), family empowerment through collaboration among families, specialists, and communities (Wakimizu et al., 2011), and the potential role of peer and workplace supports. Japanese work culture (long hours, social obligations) may limit fathers’ access to support organizations (MHLW, 2019; Nishida and Terashima, 2019).

Design: Cross-sectional survey using a self-administered, mailed questionnaire. Setting and participants: Fathers and mothers of preschool children (ages 2–5) with developmental disabilities attending rehabilitation centers for disabled preschool children in Nagano Prefecture, Japan. From 39 facilities in the prefecture, 8 participated after director approval. Survey period: July–September 2016. Informed consent was obtained from parents (children did not provide consent due to age). Ethics approval: Shinshu University Ethics Committee (no. 4642); study conducted per the Declaration of Helsinki. Measures: A 19-item questionnaire developed with reference to prior instruments (Ota, 2010; Yamashita, 2013; Fujita, 2014). Items were grouped into four support categories: (1) Information support (6 items), (2) Emotional support (7 items), (3) Evaluation support (3 items), and (4) Daily living support (3 items). For each item, respondents indicated yes/no to receipt of support from specified sources (e.g., spouse, biological mother, mother-in-law, colleagues or bosses at work, welfare organizations). Items covered information on DD and systems/services, advice on medical care and balancing work/childcare; emotional consultations and availability of supportive persons; daily living help (childcare, housework, work duties); and evaluative acceptance/recognition of parenting ideas/methods. Data collection procedures: Questionnaires mailed with an explanatory letter; participation voluntary and anonymous; only basic attributes collected; results used solely for research. Statistical analysis: Group comparisons between fathers and mothers using chi-square tests; Fisher’s exact test applied when expected frequency <5. Significance threshold p < 0.05 (two-sided). Analyses conducted with IBM SPSS Statistics v22.0 for Windows.

Response and sample characteristics:

• Questionnaires sent to 470 parents; 186 returned (response rate 39.6%); all analyzable (no missing item responses).
• Fathers: n = 85, mean age 40.7 ± 8.8 years; Mothers: n = 101, mean age 37.7 ± 5.4 years. Over 80% in both groups reported good health.

Information support (6 items):

• Fathers most frequently cited the spouse as the primary information source for all items; mothers most frequently cited welfare organizations (e.g., kindergartens, DD support centers).
• Examples (Item 1: information on DD): Fathers “spouse” 85.9% vs mothers 41.8% (p < 0.001); Fathers “welfare organizations” 57.6% vs mothers 88.1% (p < 0.001).
• Similar patterns across items: fathers relied on spouse (and to lesser extent biological mother), while mothers used welfare organizations significantly more often (multiple p < 0.001).
• Fathers rarely reported workplace or specialized institutional sources for balancing work and DD-related childcare (Item 5), indicating limited employer-provided information.

Emotional support (7 items):

• Fathers’ main source was the spouse across all items; mothers cited spouse for most items but also welfare organizations for DD-related consultations (Items 1–2).
• Workplace colleagues/bosses were a notable emotional support source for fathers for personal problems/relationships (Item 3), with 47.1% citing colleagues (significantly higher vs mothers, p < 0.001, per narrative and table p-values).
• Overall, fathers received limited emotional support from welfare organizations (generally low percentages), while mothers accessed a broader range (spouse, biological mother, welfare organizations).

Daily living support (3 items):

• Both groups primarily relied on spouse and biological mother for childcare and housework help.
• Fathers more frequently reported workplace support for daily living/work duties (flexible schedules, time off) than mothers (e.g., Items 2–3; colleagues/bosses significantly higher among fathers, p ≤ 0.001–0.037 across items), though still less than half of fathers received such support.

Evaluation support (3 items):

• Fathers’ evaluative support primarily from spouse, then biological mother; mothers from spouse and welfare organizations.
• For fathers, reliance on family for acceptance/recognition of parenting ideas/methods was significantly higher, whereas mothers more often received such recognition from welfare organizations (e.g., biological mother lower among fathers vs mothers, p < 0.01; welfare organizations higher among mothers).

Overall pattern:

• Fathers reported fewer and narrower external support sources, heavily dependent on spouse; mothers accessed broader external networks, especially welfare and medical organizations. Findings consistently showed significant differences between fathers and mothers across many items (frequent p < 0.001).

Findings indicate that fathers of children with developmental disabilities depend primarily on close family—especially spouses—for information, emotional, evaluative, and daily living support, whereas mothers engage more with external resources such as welfare and medical organizations. This narrower paternal support network may limit fathers’ access to reliable information and professional guidance, potentially impeding appropriate responses to their child’s needs, increasing stress, and reducing engagement in childcare. Constraints related to Japanese work culture (long hours, limited flexibility) likely reduce fathers’ opportunities to access specialized services and build relationships with support organizations. Notably, colleagues and supervisors can serve as an important source of emotional and practical (work-related) support for fathers, suggesting workplaces are a viable venue for interventions. Strengthening external, non-spouse resources—specialist advice through rehabilitation centers and nurseries, engagement with grandparents, and peer connections (father-to-father)—could enhance family empowerment and paternal involvement. Administrative and community systems should be improved to provide father-inclusive, continuous support programs, addressing gaps between awareness and practice in municipal paternity initiatives.

Japanese fathers raising children with developmental disabilities reported fewer social support sources than mothers and relied primarily on their spouse. This dependence likely hinders fathers’ acquisition of DD-related knowledge and coping methods, and may affect their mental health and involvement in childcare. Developing father-specific parenting support systems, expanding peer (father-to-father) networks, and integrating workplace and specialist supports are recommended. Further, more detailed investigations into fathers’ work-life balance and inter-family relationships are needed to design concrete, empowering support measures that enhance paternal roles in raising children with DD.

• Small sample size from eight facilities in a single prefecture with a 39.6% response rate; potential selection bias limits generalizability.
• Cross-sectional design; causality cannot be inferred.
• Context is Japan, based largely on pre-COVID-19 conditions; applicability to other countries and to post-pandemic work/childcare environments may be limited.
• Limited detail on children’s diagnostic subtypes and severity; potential heterogeneity not explored.
• Reliance on self-report yes/no responses may constrain nuance in support utilization and perceived adequacy. Future research should include larger, more diverse samples; examine barriers to fathers seeking support; clarify optimal paternal roles; and evaluate tailored expert and government programs, considering evolving work patterns (e.g., remote work) and service availability post-COVID-19.