Attitudes of Japanese Students Toward People With Intellectual Disability

Journal of Intellectual Disability Research
365
pp
Attitudes of Japanese students toward people with

intellectual disability
W. Horner-Johnson,1 C. Keys,1 D. Henry,1 K. Yamaki,1 F. Oi,2 K. Watanabe,3 H. Shimada3 &
I. Fugjimura4
1 University of Illinois at Chicago, Chicago, Illinois, USA
2 Hirosaki Gakuin University, Aomori Prefecture, Japan
3 Institute for Developmental Research, Aichi Human Service Centre, Aichi Prefecture, Japan
4 Higashiyamata Residence,Yokohama, Kanagawa Prefecture, Japan
Abstract
Background The purpose of the present study was
to gain insight into the structure and organization
of the attitudes of Japanese students toward people
with intellectual disability (ID). The study also
examined how these attitudes are related to individual characteristics, such as experience with people
with ID, major field of study and career interests.
Methods The participants completed a series of
measures developed in the USA: three measures of
attitudes toward people with ID, a demographic
questionnaire and a social desirability scale.
Students completed the measures anonymously.
Results The factor structures of all three attitude
scales replicated the structures found in the USA.
Attitudes toward the community inclusion of
people with ID were negatively correlated with an
endorsement of eugenics. Students in social work
and psychology had more positive attitudes than
other students. Participants who expressed an
interest in a career working with people with ID
Correspondence: Willi Horner-Johnson, Oregon Office on Disability and Health, CDRC PO Box , Portland, OR , USA
(e-mail: willihj@world.oberlin.edu).
Blackwell Science Ltd
had more positive attitudes than students with no

interest in such a career.
Conclusions Attitude measures developed in the
USA can be used in Japan, and can provide useful
information as well as an opportunity for crosscultural comparisons. For a more complete understanding of the attitudes of Japanese people toward
people with ID, these attitudes should also be
studied using measures based in Japanese culture
which have specifically developed to measure attitudes in Japan.
Keywords attitudes, cross-cultural research, Japan,
students
Introduction
The literature on attitudes toward people with
intellectual disability (ID) and on living conditions
for those with ID is primarily focused on developed
Western societies. Less is known about attitudes
toward people with ID world-wide, or about the
lives of people with ID in Asia, Africa and Latin
America. One country in which attitudes toward
people with ID are beginning to receive more
public attention is Japan. There is a sense that the
Japanese public at large has little knowledge of the
existence of facilities for people with ID, or of

366
W. Horner-Johnson et al. Attitudes of Japanese students
people who live and work in them (Ito & Tagawa

; JLMR ). In an effort to change this
situation, parents, professionals and self-advocates
are advocating for community inclusion and disability rights (JLMR ; CIA ). These groups
are working to change the tradition of segregation
and isolation that, as in many other countries,
people with disabilities have traditionally experienced in Japan.
The current interest in attitudes toward people
with ID in Japan makes the present study particularly relevant. The purpose of the study is to gain
an insight into the structure and organization of
Japanese attitudes toward people with ID. A series
of paper-and-pencil scales was used to measure attitudes toward community inclusion of people with
ID among university students in Japan. This study
also examines how these attitudes are related to
individual characteristics, such as experience with
people with ID, major field of study and career
interests.
Importance of attitudes toward people with

A key reason for studying attitudes lies in the
assertion by Ajzen & Fishbein ) that attitudes
are the best predictors of behavioural intentions.
In support of the attitudebehaviour relationship,
Kraus () performed a meta-analysis and found
that attitudes significantly predict behaviour. As a
marginalized group, people with ID are often subjected to discrimination and exclusion. Such negative attitudes and the concomitant behaviours can
greatly limit their choices, both in human-service
settings and in the larger community. Knowledge of
attitudes in specific settings would identify areas in
which people with ID are most likely to encounter
resistance. Knowledge of negative attitudes can also
highlight concerns which need to be addressed in
educating the public, such as public willingness
to use eugenics measures, including involuntary
sterilization.
Measuring attitudes toward people with

Most efforts to measure attitudes have portrayed
people with ID as relatively passive objects of
others attitudes. It is only in the past decade that

dimensions of empowerment and self-advocacy
of people with ID have been considered (Henry
et al. ). Recent measures such as the Mental
Retardation Attitude Inventory (MRAI; Antonak &
Harth ) have addressed some issues of community living philosophy. However, for the most
part, attitude measures have done little to address
the issues deemed important by people with ID
themselves (Keys et al. ).
In an effort to provide a measure that adequately
captures attitudes relating to the community inclusion and empowerment of people with ID,
Henry et al. () created the Community
Living Attitudes Scale Mental Retardation Form
(CLAS-MR). This scale was developed with the
input of people with ID to tap into beliefs about
their empowerment and self-advocacy, as well as
attitudes regarding their exclusion and sheltering.
The scale also measures the extent to which people
with ID are viewed as similar to oneself and others.
The present study used both the CLAS-MR and
the MRAI to measure attitudes toward people with
ID in Japan. This study also measured attitudes
toward the use of eugenics in relation to ID. The
way in which members of a culture view people
with ID is likely to be related to their willingness to
employ eugenic measures such as involuntary sterilization. An indicated willingness to use eugenics
measures with people with ID implies that people
with ID are not highly valued and are seen as
defective. These views are likely to be influenced
by larger societal values, such as conformity and
productivity.
Because the views of people with ID in Japan
appear to be in a transitional state, it is difficult to
know how people with ID may be received in
Japanese society as they move toward community
inclusion. On the one hand, people with ID have
traditionally been kept in seclusion. On the other,
there are currently enthusiastic advocates working
for increased inclusion of people with ID. Thus,
it seems quite likely that attitudes may vary considerably depending on exposure to and interest
in issues surrounding ID. An understanding of
attitudes toward people with ID is particularly
important during this transitional phase. University
students are a singularly useful group to study to
ascertain whether diverse trends exist because the
Blackwell Science Ltd, Journal of Intellectual Disability Research ,

367
student population is itself in flux. Students are

both reflectors of tradition and carriers of change.
Thus, student attitudes may be a harbinger of
future social attitudes.
Research questions
Given the utility of studying the attitudes of
Japanese students toward people with ID, the
present investigation addressed the following
questions:
How do Japanese students organize their ideas
about people with ID? How well do attitude measures developed in the USA work in Japan? Are the
factor structures of the measures similar?
How do attitudes toward community inclusion of
people with ID relate to attitudes toward eugenics
and ID? Are these constructs related?
Do demographic characteristics such as sex, past
experience with people with disabilities, present
academic major field of study and future career
interest affect responses on measures of attitudes
toward people with ID, and if so, how?
The similarity of attitude factor structures in
Japan to structures found in the USA has not been
studied previously, nor have attitudes toward community inclusion and empowerment been systematically studied in Japan. To the present authors
knowledge, this study is also the first to examine
relationships among attitudes toward inclusion,
empowerment and eugenics in Japan, and to study
relationships between all of these attitudes and the
demographic variables mentioned above.
Subjects and methods

Participants
The research participants were students at
Meisei University in Tokyo, Tokai University in
Isehara City, and Aichi Technical School of Nursing
in Aichi Prefecture, Japan. The survey was an
optional class activity conducted by collaborating
researchers in Japan during classes which they were
teaching. Eleven out of the participants were
dropped from the sample because of multiple
missing responses. The vast majority of the remaining participants were Japanese, were between
the ages of and years, had never married,
were attending a -year college and had no disabilities. Four participants did not indicate their
sex; out of the remainder, .% were female and
.% male. Their major fields of study, and experience with and interest in disabilities are shown in
Table .
Measures
The participants completed three measures of
attitudes toward people with ID and a social
desirability scale. The three attitude measures are
Likert-type scales with positive and negative statements about people with ID, and five response
Table 1 Major field of study, and experience of and interest in disability: (ID) intellectual disability
Variable
Frequency
Percentage
Major field of study

Education
Psychology
Economics
Electrical Engineering
Mechanical Engineering
Literature
Social Work
Civil Engineering
Chemistry
Nursing
Physics
Missing
67
44
27
25
15
14
13
11
11
10
9
29
24.4
16.0
9.8
9.1
5.5
5.1
4.7
4.0
4.0
3.6
3.3
10.5
Do you have a disability?

No
Yes
Missing
264
7
4
96.0
2.5
1.5
Do you have a close friend or relative with a disability?

No
199
72.4
Yes
72
26.2
Missing
4
1.5
Have you ever been employed to work with people with ID?
No
211
76.7
Yes
54
19.6
Missing
10
3.6
Are you interested a career working with people with ID?
No
113
41.1
Not sure
106
38.5
Yes
47
17.1
Missing
9
3.3

368
options: () disagree strongly, () disagree moderately, () neutral, () agree moderately and ()

agree strongly.
Community Living Attitudes Scale Mental
Retardation Form
The CLAS-MR (Henry et al. ) is a -item
measure consisting of four subscales: Empowerment, Exclusion, Sheltering and Similarity. The
Empowerment subscale ( items) taps into attitudes toward the self-advocacy and empowerment
of people with ID. The Exclusion subscale (eight
items) measures the tendency to exclude people
with ID from community life. The Sheltering subscale (seven items) measures the extent to which
people with ID are seen as needing sheltering and
protection. The Similarity subscale ( items) captures the perceived similarity of people with ID
to people without ID. The CLAS-MR subscales
have demonstrated acceptable internal consistency
(a = ..), retest reliability (.. at one
month), construct validity in correlations with other
attitude scales and no significant relationship with
social desirability (Henry et al. ).
Mental Retardation Attitude Inventory
The MRAI (Antonak & Harth ) is a -item
scale measuring attitudes toward people with ID
on four subscales: IntegrationSegregation, Social
Distance, Private Rights and Subtle Derogatory
Beliefs. IntegrationSegregation (seven items) refers
to beliefs about including or excluding people with
ID in various aspects of community life. Social
Distance (eight items) involves willingness or reluctance to be associated with someone with ID. The
Private Rights subscale (seven items) concerns the
rights of individuals who wish to exclude people
with ID. The Subtle Derogatory Beliefs subscale
(seven items) refers to degrading views of the abilities and character of people with ID. Antonak &
Harth () reported internal consistencies of the
subscales ranging from . to . (Cronbachs
alpha) and a split half reliability of ... Subscale scores were significantly related to familiarity
with individuals who have ID and were shown to be
independent of social desirability response bias
(Antonak & Harth ).
Scale of Attitudes Toward Mental Retardation

and Eugenics
The Scale of Attitudes toward Mental Retardation
and Eugenics (AMRE; Antonak et al. ) is a
-item measure tapping beliefs about the reproductive rights of people with ID. For example,
People with ID should be permanently sterilized
before they are allowed to marry. This measure
yields a single scale score. Antonak et al. ()
found that the scale had a coefficient alpha internal
consistencyhomogeneity index of . and that
scale scores did not differ significantly by social
desirability score.
MarloweCrowne Social Desirability Scale
Short Form
The -item version of the MarloweCrowne Social
Desirability Scale (MCSDS-SF; Strahan & Gerbasi
) has a correlation of . with the original item scale and an internal consistency alpha of .
(Fischer & Fick ). This scale measures the participants tendency to select a socially acceptable
response, even though it may not be true. This
information is important because participants may
be inclined to indicate positive attitudes toward
people with ID because they think they should,
rather than because these responses represent their
own attitudes.
The participants also completed a demographic
questionnaire. In addition to information such as
sex, age and major field of study, students were
asked to indicate whether they had friends or relatives with disabilities, whether they had ever worked
with people with ID, and whether they were interested in a career working with people with ID.
Procedures
Translation of the measures was conducted according to the method used by Liang & Bogat () to
establish cultural equivalence. Content equivalence
was established by having four bilingual Japanese
nationals read all of the items in English, and indicate whether each item was relevant to Japanese
culture, questionably relevant or irrelevant. Items
marked irrelevant by one or more people were eliminated. Items marked questionably relevant by at
least two people were reworded or eliminated. This

369
process resulted in one item being eliminated from

each of the three attitude measures.
Semantic equivalence was established through
translation and back-translation of the measures.
Collaborating researchers in Japan were responsible
for the translation of the measures into Japanese.
The translated measures were then translated back
into English by a professional translation service in
Chicago, IL, USA. The two English versions (i.e.
the original and the back translation) were then
compared. Items were rated by four knowledgeable
researchers of attitudes toward people with ID as
having the same meaning in both versions, almost
the same meaning in both versions or different
meanings in the two versions. Items which did
not have the same meaning were examined by a
bilingual Japanese national to determine whether
the change in meaning occurred in the translation
into Japanese and/or in the back translation into
English. Items in which the translation into
Japanese was judged to be true to the original were
left unchanged. Items in which the translation into
Japanese differed in meaning from the original were
re-translated. Five items were reworded because of
difficulties with translating the original items.
Researchers in Japan administered the translated
measures to students in classes which they were
teaching. Students were informed that completing
the measures was optional and was not related
to class grades. They completed the measures
anonymously.
Results
Scale scoring
Mean scores on the AMRE and each subscale of
the CLAS-MR and MRAI were calculated by
summing the scores on individual questions and
dividing the total score by the number of questions.
Thus, the mean scores are on a scale of . The
Empowerment and Similarity subscales of the
CLAS-MR were scored so that higher scores indicate more positive attitudes (i.e. more likely to
endorse empowerment of people with ID and more
likely to see individuals with ID as similar to
oneself). For the Exclusion and Sheltering subscales of the CLAS-MR, higher scores indicate less
positive attitudes (i.e. more likely to favour exclu-
sion of people with ID and more likely to endorse

unnecessary protectiveness of people with ID). All
subscales of the MRAI were scored so that higher
scores indicated more positive attitudes toward
people with ID. The AMRE is also scored this way,
meaning that higher scores indicate less endorsement of eugenics in relation to ID.
Confirmatory factor analysis

To address the question of whether Japanese attitudes toward people with ID follow the same factor
structure as that found in the USA, confirmatory
factor analyses of the CLAS-MR and the MRAI
were conducted. A model was tested, using the
AMOS . computer program, in which each
item was allowed to load only on its own factor
(Arbuckle ); the factors were allowed to
correlate.
The overall chi-square value for the CLAS-MR
was significant [c2(639) = ., P < .]. This is
not surprising since complex models often result
in large chi-square values. The root mean square
(RMS) residual and the probability of a close fit
(Pclose) are more appropriate indices of model fit.
The RMS residual is an indicator of the average
amount of error around each estimated parameter.
Any RMS values below . are considered acceptable and those below . are excellent (Steiger
, cited in Henry et al. ). The RMS residual
for this model was .. The Pclose is the probability
that the RMS is really below .. A value of . or
higher is an indication that the model is in fact a
good fit. For the present model, Pclose was .. The
RMS residual and the probability of a close fit indicate that the four-factor structure of the CLAS-MR
was a very good fit to the Japanese student data.
The four factors are Empowerment, Exclusion,
Similarity and Sheltering. Factor loadings are listed
in Table . Out of the items, (%) had
factor loadings of . or higher in the appropriate
direction on their subscales.
The same type of confirmatory factor analysis
was conducted with the MRAI items. The overall
chi-square value was significant [c2(339) = .,
P < .]. Again, this value is inflated because of
the complexity of the model and merely indicates
that the fit is not ideal. The RMS residual was
. and the Pclose was .. These values indicate
370
Table 2 Community Living Attitudes Scale: confirmatory factor loadings: (ID) intellectual disability
Factor
loading
Subscale/item
Empowerment
2. People with ID should not be allowed to marry and have children*
3. A person would be foolish to marry a person with ID*
7. People with ID should not hold public office*
12. People with ID should not be allowed to drive*
15. I would trust a person with ID to be a baby-sitter for one of my children
21. People with ID should be encouraged to lobby legislators on their own
22. People with ID are the best people to give advice and counsel to others who wish to move into community living
23. The opinion of a person with ID should carry more weight than those of family members and professionals in
decisions affecting that person
24. People with ID can plan meetings and conferences without assistance from others
25. People with ID can be trusted to handle money responsibly
32. The rights of people with ID are more important than professional concerns about their problems
33. Agencies which serve people with ID should have them on their boards
38. Professionals should not make decisions for people with ID unless absolutely necessary
0.32
0.47
0.53
0.41
0.60
0.32
0.30
0.50
0.55
0.50
0.50
0.38
0.19
Exclusion
18. I would not want to live next door to people with ID
26. Residents have nothing to fear from people with ID living and working in their neighbourhoods*
29. The best care for people with ID is to be part of normal life in the community*
34. The best way to handle people with ID is to keep them in institutions
35. Homes and services for people with ID should be kept out of residential neighbourhoods
36. Increased spending on programmes for people with ID is a waste of tax dollars
37. Homes and services for people with ID downgrade the neighbourhoods they are in
39. People with ID are a burden on society
0.65
0.39
0.49
0.67
0.64
0.51
0.66
0.60
Similarity
4. People
5. People
8. People
9. People
10. People
11. People
13. People
14. People
16. People
17. People
19. People
should be guaranteed the same rights in society as other people

do not want to work*
should not be given any responsibility*
can organize and speak for themselves
do not care about advancement in their jobs*
do not need to make choices about the things they will do each day*
can be productive members of society
have goals for their lives like other people
cannot exercise control over their lives like other people*
can have close personal relationships just like everyone else
are usually too limited to be sensitive to the needs and feelings of others*
0.27
0.27
0.31
0.54
0.39
0.49
0.48
0.48
0.45
0.45
0.46
0.55
Sheltering
1. People with ID are happier when they live and work with others like them
6. People with ID need someone to plan their activities for them
20. People with ID should live in sheltered facilities because of the dangers of living in the community
27. People with ID usually should live in residential facilities where they can have the help and support of staff
28. Sheltered workshops for people with ID are essential
30. Most people with ID prefer to work in a sheltered setting that is more sensitive to their needs
31. Without some form of control and supervision, people with ID could get in real trouble out in the community
0.01
0.33
0.59
0.46
0.23
0.20
0.37
with
with
with
with
with
with
with
with
with
with
with
ID
ID
ID
ID
ID
ID
ID
ID
ID
ID
ID
* Reverse scored item.

371
that the four-factor structure of the MRAI was

also a very good fit to the data gathered from
Japanese students. The four factors of the MRAI
are IntegrationSegregation, Social Distance,
Private Rights and Subtle Derogatory Beliefs. Out
of the items, (%) loaded at . or higher
in the appropriate direction on their subscales.
Factor loadings are listed in Table .
Antonak et al. () found a single-factor structure for the AMRE. An exploratory factor analysis
was conducted to determine whether the Japanese
data also indicated a unidimensional structure.
Although seven factors with eigenvalues over .
emerged, the first factor is considerably larger than
the others. The first factor had an eigenvalue of
. and accounted for .% of the variance. The
Table 3 Mental Retardation Attitude Inventory: confirmatory factor loadings: (ID) intellectual disability
Subscale/item
Factor
loading
IntegrationSegregation
1. School officials should not place children with ID and children without ID in the same classes*
2. We should integrate people with ID and people without ID in the same neighbourhoods
7. It is a good idea to have separate after-school programmes for children with ID and children without ID*
12. Integrating children with ID and children without ID into the same pre-school classes should not be attempted
because of the turmoil it would cause*
16. Having people with ID and people without ID work at the same job sites will be beneficial to both
22. High school students with ID should be assigned to the same classes as high school students without ID
28. The child with ID should be integrated into regular classes at school
0.70
0.60
0.57
0.61
Social Distance
3. I would allow my child to accept an invitation to a birthday party given for a child with ID
5. I am willing for my child to have children with ID as close personal friends
11. I have no objection to attending the movies or a play in the company of people with ID
14. I would rather not rather not have people with ID as dinner guests with my friends without ID*
17. I would rather not have a person with ID swim in the same pool that I swim in*
18. I would be willing to introduce a person with ID to friends and neighbours in my home town
23. I would be willing to go to a competent barber or hairdresser with ID
26. I would rather not have people with ID live in the same apartment building I live in*
0.56
0.71
0.67
0.77
0.67
0.65
0.57
0.71
Private Rights
6. If I were a landlord, I would want to pick my tenants, even if this meant only renting to people without ID*
8. Regardless of her or his own views, a private nursery school director should be required to admit children with ID
13. Real estate agents should be required to show homes to families with children with ID regardless of the desires
of the homeowners
19. Campground and amusement park owners have the right to refuse to serve anyone they please, even if it means
refusing people with ID*
21. If I were a barber or a beauty shop owner, I would not resent it if I were told that I had to serve people with ID
27. A person should not be permitted to run a day-care centre if she or he will not serve children with ID
Subtle Derogatory Beliefs
4. People with ID are not yet ready to practice the self-control that goes with social equality for people without ID*
9. Even though children with ID are in public school, it is doubtful whether they will gain much from it*
10. Although social mixing of people with ID and people without ID may be all right, it is impractical until people with
ID learn to accept limits in their relationships with the opposite sex*
15. Children with ID waste time playing in class instead of trying to do better*
20. The problem of prejudice toward people with ID has been exaggerated*
24. In the same social situations, people with ID do not do as well as people without ID*
25. Even though people with ID may be treated unfairly, they could get what they want if they were more patient*
*Reverse scored item.
0.61
0.63
0.39
0.09
0.60
0.29
0.27
0.75
0.20
0.64
0.62
0.48
0.46
0.04
0.49
0.15

372
second factor had an eigenvalue of . and

accounted for only .% of the variance. Subsequent factors with eigenvalues greater than .
accounted for amounts of variance close to that
accounted for by the second factor. These secondary factors did not add conceptual clarity to the
solution; thus, a single-factor solution was accepted.
Construct validity
The correlations between the subscales of the
CLAS-MR and the MRAI were examined for convergent validity. All four CLAS-MR subscales were
significantly correlated with all four subscales of the
MRAI in the appropriate direction, with the exception of the correlation between the Sheltering subscale of the CLAS-MR and the Private Rights
subscale of the MRAI. When a Bonferroni correction was applied, only this last correlation was no
longer significant. Each of these two subscales also
had significant correlations with the remaining subscales (see Table ).
Correlations between community inclusion and

eugenics attitudes
Correlations between each of the CLAS-MR and
MRAI subscales, and the AMRE were significant
and relatively strong with the Bonferroni correction
applied (see Table ). Students with high scores on
the Empowerment and Similarity subscales on the

CLAS-MR and on the MRAI subscales also scored
high (indicating positive attitudes toward people
with ID) on the AMRE. The students who scored
high on the Exclusion and Sheltering scales of
the CLAS-MR scored lower on the AMRE, indicating that they were more likely to approve of using
eugenics in relation to ID. These correlations are
in the appropriate direction to indicate that the
CLAS-MR, the MRAI, and the AMRE are
measuring related constructs.
Discriminant validity
Correlations between the MCSDS-SF on the one
hand, and the CLAS-MR subscales, the MRAI subscales and the AMRE on the other were computed
in hopes of establishing discriminant validity. Nonsignificant correlations with social desirability would
indicate that responses to the attitude measures
were not unduly influenced by a tendency to
provide socially desirable responses. None of the
correlations were significant when a Bonferroni correction for the number of correlations in the matrix
was applied (see Table ).
Demographic variables and attitudes

Overall, the respondents in the present study
expressed moderately positive attitudes. Five of the
Table 4 Correlations between scales
Empowerment (Emp)
Exclusion (Excl)
Similarity (Sim)
Sheltering (Shelt)
Integration-Segregation (INSE)
Social Distance (SDIS)
Private Rights (PRRT)
Subtle Derogatory Beliefs (SUDB)
Reproductive Rights (AMRE )
Social Desirability (SDes)
Emp
Excl
Sim
Shelt
INSE
SDIS
PRRT
SUDB
AMRE
SDes
-0.58*
0.57*
-0.31*
0.52*
0.58*
0.33*
0.47*
0.64*
0.13
-0.68*
0.36*
-0.63*
-0.66*
-0.50*
-0.50*
-0.69*
-0.15
-0.27*
0.56*
0.55*
0.39*
0.46*
0.63*
0.16
-0.36*
-0.35*
-0.14
-0.33*
-0.44*
-0.12
0.62*
0.40*
0.56*
0.62*
0.20
0.54*
0.57*
0.68*
0.17
0.31*
0.49*
0.08
0.61*
0.12
0.16
* P < . (Bonferroni corrected probabilities).

Higher scores indicate more negative attitudes on the Exclusion and Sheltering subscales of the Community Living Attitudes Scale, but more
positive attitudes on all other scales: (AMRE) Scale of Attitudes Toward Mental Retardation and Eugenics.

373
tion, literature and nursing made up the Mixed

category. Psychology and social work majors
comprised the Mental Health category.
A multivariate analysis of variance (MANOVA) was
used to determine the relationship of major field of
study to the CLAS-MR subscales and the MRAI
subscales. Major field of study had a significant
effect on the combined CLAS-MR subscales
[F(12, 800) = ., P < .]. With a Bonferroni correction applied to the probabilities, Mental Health
(i.e. social work and psychology students) was contrasted with the other three groups on each of the
subscales. There were no significant differences
between groups on the Empowerment subscale.
The Mental Health group scored significantly lower
on the Exclusion subscale (indicating more positive
attitudes) than Physical Science & Economics and
Engineering, as well as students who did not indicate a major. On the Sheltering and Similarity subscales, Mental Health scores were significantly more
positive than those students who had declared no
major. Means and standard deviations are listed in
Table .
Major field of study also had a significant effect
on the combined MRAI subscales [F(12, 800) = .,
P < .]. There were no significant differences on
demographic variables had sufficient variability for

performing further analyses: () sex; () having a
relative or close friend with a disability; () having
been employed in the field of ID; () major field
of study; and () interest in a career working with
people with ID. The three dichotomous demographic variables (i.e. sex, whether or not students
had a friend or relative with a disability, and
whether or not they had ever been employed in
the field of ID) were correlated with all of the
attitude measures. When a Bonferroni correction
was applied, the only significant correlation was
between the Private Rights subscale of the MRAI,
and having a relative or friend with a disability
(r = .). Those with a relative or close friend with
a disability were more likely to endorse the rights of
people with ID.
There were different majors, which were
collapsed into four categories which roughly
approximate a continuum from quantitative physical sciences to helping professions and follow the
general pattern of their attitude scores. The Physical
Science & Economics category included physics,
chemistry and economics. The Engineering category consisted of electrical, mechanical and civil
engineering majors. Students majoring in educa-
Table 5 Scale means and standard deviations (SDs) by major field of study: (AMRE) Scale of Attitudes Toward Mental Retardation and
Eugenics
Major field of study
Mental Health
Mixed
Engineering
Physical
Science
& Economics
No declared
major
Scale
Mean
SD
Mean
SD
Mean
SD
Mean
SD
Mean
SD
Empowerment
Exclusion
Similarity
Sheltering
Social Distance
Private Rights
Eugenics (AMRE)
3.48
1.62
4.18
3.03
3.63
3.99
3.13
3.50
3.71
0.36
0.38*
0.41
0.47
0.46*
0.65*
0.44
0.40*
0.38*
3.45
1.92
4.01
3.13
3.47
3.68
3.11
3.35
3.51
0.46
0.61
0.51
0.52
0.52
0.76
0.43
0.47
0.40
3.37
2.00
3.96
3.18
3.29
3.46
2.99
3.09
3.41
0.54
0.61
0.48
0.52
0.48
0.74
0.41
0.58
0.42
3.38
2.23
3.92
3.26
3.21
3.33
2.88
3.22
3.38
0.54
0.85
0.68
0.48
0.68
0.86
0.55
0.57
0.50
3.27
2.28
3.78
3.38
3.18
3.28
2.92
3.07
3.23
0.47
0.74
0.63
0.44
0.63
0.82
0.62
0.59
0.49
* Significantly different from Engineering, Physical Science & Economics and no declared major.
Significantly different from no declared major.

374
Table 6 Scale means and standard deviations (SDs) by career interest: (ID) intellectual disability: (AMRE) Scale of Attitudes Toward Mental
Retardation and Eugenics
Interested in a career in ID
Yes
Not sure
No
Scale
Mean
SD
Mean
SD
Mean
SD
Empowerment
Exclusion
Similarity
Sheltering
Social Distance
Private Rights
Eugenics (AMRE)
3.59
1.75
4.13
3.05
3.62
4.06
3.21
3.40
3.70
0.34*
0.52*
0.48*
0.54*
0.53*
0.60*
0.39*
0.47*
0.38*
3.52
1.80
4.11
3.04
3.49
3.80
3.09
3.47
3.60
0.45*
0.55*
0.49*
0.47*
0.47*
0.68*
0.44*
0.49*
0.38*
3.25
2.17
3.84
3.30
3.24
3.26
2.92
3.08
3.31
0.50
0.74
0.56
0.48
0.59
0.78
0.53
0.48
0.42
* Significantly different from the not interested group at the P < . level. No other significant differences were found.
the Private Rights subscale. For the three other

subscales, the Mental Health group had significantly more positive attitudes than Physical Science
& Economics, Engineering and the no declared
major group (for means and standard deviations,
see Table ). A univariate ANOVA was conducted to
measure the effects of major on AMRE scores.
There was a significant effect [F(3, 274) = .,
P < .]. Post hoc comparisons indicated that the
significant group differences were that both Mental
Health and Mixed differed significantly from no
declared major. The Mental Health category also
responded significantly more positively than the
Engineering group and the Physical Science &
Economics category (for means and standard
deviations, see Table ).
MANOVAs were also performed with career interest as the independent variable. The effect of career
interest on the combined subscales of the CLASMR was significant [F(8, 518) = ., P < .]. For
each of the subscales, three groups were contrasted:
students who answered yes to the question of
whether they were interested in a career in ID,
those who responded no and those who were not
sure. A Bonferroni correction was used to control
for the inflation of type I error with multiple tests.
On all four subscales, the interested and not sure
groups expressed significantly more positive attitudes than the not interested group, but did not
differ significantly from each other. The means and

standard deviations are shown in Table .
There was a significant effect of career interest
on the combined subscales of the MRAI [F(8,518)
= ., P < .]. As with the CLAS-MR, the
interested and not sure groups were not significantly different from each other, but both indicated
significantly more positive attitudes than the not
interested group. Table lists the means and standard deviations. A univariate ANOVA was conducted
to measure the effects of career interest on AMRE
scores. There was a significant effect [F(2, 265) =
., P < .]. Post hoc comparisons (Bonferroni
corrected) indicated that both the interested group
and the not sure group were significantly more
positive than the not interested group, but did not
significantly differ from each other (for means and
standard deviations, see Table ).
Correlations between demographic variables and
the MCSDS-SF yielded no significant results when
the Bonferroni correction was applied.
Discussion
The first research question that the present study
sought to answer was: How are Japanese attitudes
toward people with ID conceptually organized? It
was not known whether Japanese attitudes would be
interpretable along the same dimensions which

375
had been found for attitude scales designed in the

USA. The confirmatory factor analyses of the data
from this sample of Japanese students indicate that
the same dimensions and factor structures are
applicable to this population. The CLAS-MR and
the MRAI, both intended by US researchers to
measure similar constructs, were significantly correlated, indicating that the Japanese respondents also
perceived these constructs as related to each other.
The AMRE was correlated with the other two
attitude measures to address the second research
question of whether people who responded negatively on the CLAS-MR and the MRAI would also
endorse the more dehumanizing views contained in
the AMRE. The AMRE includes items which are
more strongly worded than the statements on the
CLAS-MR and the MRAI. For example, it is one
thing to say that one would not wish to live next
door to a person with ID. It may require a more
deeply seated negative attitude to be willing to say
that one believes people with ID should be involuntarily sterilized. On the other hand, a tendency to
exclude people with ID and view them as dissimilar
to oneself is likely to reflect a lack of valuation of
people with ID. As Wolfensberger () argued, it
is this failure to value the lives of people with ID
that leads to a willingness to end or prevent those
lives through the use of eugenics. The data from the
present sample indicate that attitudes toward community inclusion and toward eugenics are strongly
related. Those who support the empowerment and
inclusion of people with ID are less likely to
approve of eugenic measures to control ID. Those
with less inclusive and affirming views are more
likely to endorse eugenics.
It should be noted that correlations of the
Sheltering subscale of the CLAS-MR with the
other attitude scales, while significant, were moderate relative to the other correlations among scales.
Unlike the other scales, Sheltering includes items
which do not necessarily indicate either a negative
or a positive attitude toward people with ID.
Rather, this subscale assesses protective attitudes.
These attitudes could be considered negative in the
sense that people with ID are not perceived as able
to take care of themselves, make their own decisions and live independently in the community.
However, protective attitudes may sometimes be
realistic, and they may indicate that people with ID
are at least valued enough to be worthy of care and

concern.
Thirdly, the present study examined the relationship between various demographic variables and
attitudes toward people with ID. Students with a
relative or friend with a disability showed more
support for the rights of people with ID than the
others. There was a tendency toward more positive
attitudes on the part of students who had been
employed working with people with ID, but these
correlations were not significant when the number
of correlations (and the probability of type I error)
was taken into account. Nevertheless, these results
provide some support for findings from other
research in the USA that experience with people
with disabilities is associated with more positive
attitudes toward members of that group (Levy et al.
; Kregel & Tomiyasu ; Hernandez et al.
). Indications that experience with people with
ID may lead to more positive attitudes should be
encouraging to advocates of increased inclusion
in Japanese schools. Recent efforts to develop a
feeling of comradeship (MESC , p. )
between children with and without ID through
inclusive activities may be helping more people
without ID to grow up with positive attitudes
toward inclusion of people with ID. However,
as Allport () discussed in research on race
relations, increased contact does not automatically
lead to more positive attitudes. He listed a number
of variables affecting the degree and direction of
attitude change, including frequency and duration
of contact, whether equal status contact occurs,
whether the interaction is positive or negative,
and whether it is seen as representative or as an
exception to the rule. Eberhardt & Mayberry ()
have studied equal status contact and attitudes
toward people with disabilities among occupational
therapists. They found that attitudes were related
not only to contact, but also to the therapists
education programmes and the holistic philosophy
of the profession. Additional research is needed to
elucidate the conditions under which contact with
people with ID leads to more positive attitudes and
the amount of contact needed to have positive
effects.
Students in mental health majors and students
interested in a career in the field of ID responded
more positively on all of the attitude measures. The

376
students now in such fields as social work and psychology, and those expressing a desire to work with
people with ID are the people most likely to interact with people with ID in the future and to have a
direct impact on their lives. It is encouraging that
these are the students displaying the most positive
attitudes.
Also encouraging is that, overall, attitudes toward
people with ID expressed by the students in the
present sample were clearly on the positive side of
neutral. Whether these results indicate increasing
inclusivity in Japanese culture as a whole is a question for further research. The students who participated in this study were drawn from convenience
samples, rather than being randomly selected, and
may not be representative of Japanese university
students as a whole. Furthermore, young university
students may be more indicative of future societal
trends than they are of current attitudes of the
greater Japanese public. More representative community samples are needed to develop a fuller
understanding of Japanese attitudes toward people
with ID. In addition to research on general community views of people with ID, attitudes of staff
currently working with people with ID should be
investigated because their attitudes directly affect
people with ID.
Implications for theory, research and practice

The factor structures and inter-scale correlations
previously found for the measures used were upheld
in the present sample from Japan. These similarities
indicate that there are some cross-cultural components of attitudes toward people with ID which
can be compared. A next step will be to compare
the data gathered from Japanese students to data
from students in the USA to determine how similar
or different Japanese and US attitudes may be.
However, the fact that the data from Japanese
students could be fitted into a US model does not
necessarily mean that this is the best model for
describing Japanese attitudes. There may well be
aspects of Japanese attitudes toward people with ID
which are not apparent in this study because the
measures used did not contain questions to elicit
them. For a more complete understanding of
Japanese attitudes toward people with ID, these
attitudes should also be studied using measures
based in Japanese culture and specifically developed

to measure attitudes in Japan.
The measures used in the present study could
provide a starting point for developing more culturally anchored measures. For example, the items
with low factor loadings on the CLAS-MR and the
MRAI may be tapping aspects of Japanese attitudes
toward people with ID which were not represented
in the four-factor structure used in the USA. Additional items reflecting specifically Japanese values
and cultural influences (e.g. importance of social
structure, urban/rural cultural differences and religious beliefs) would need to be considered as possible additions. A measure of social desirability in
the context of Japanese society may also be needed
since the items of the MCSDS-SF may not fully
reflect socially desirable behaviour in Japan.
In addition to a need for more culturally based
theoretical research, additional research is needed
to determine the significance of the attitudes
expressed on paper-and-pencil measures. The
respondents in the present study expressed moderately positive attitudes toward people with ID and
these attitudes were consistent across measures.
Thus, the next issues to examine are to what extent
and in what ways, if any, do these attitudes manifest
themselves in behaviours toward people with ID.
Without additional research on how attitudes
toward people with ID are expressed in Japanese
society, few firm conclusions can be drawn regarding the implications of these attitudes for community inclusion and empowerment of Japanese people
with ID.
A first step in establishing a relationship between
these attitudes and behaviour would be to use attitude measures in conjunction with other measures
of readiness to begin work with people with ID and
performance reviews of those already in the field. If
a strong connection is apparent, attitude measures
could then be used as a tool to identify those who
might need additional training for working with
people with ID as well as those who are likely to be
advocates for the rights of people with ID.
A similar process was successful in developing a
selection instrument for counsellors at a US camp
for people with developmental disabilities (Keys
et al. ). Current camp staff were asked to
identify key values and attitudes which counsellors
should endorse. Based on this information, consul-

377
tants developed an interview to identify applicants

whose views were most consistent with the core
values of the camp. The counsellors selected by
means of this interview were later evaluated on
behaviourally anchored rating scales. As a result
of the use of this interview and related human
resource strategies in recruitment, training and
supervision, the quality of counsellor performance
increased and the turnover of counsellors decreased
from % to %. This type of process enables the
study of relationships between responses to a
screening interview or questionnaire on attitudes
and actual performance. The success of the camp in
question in hiring quality staff through the use of
the screening interview holds promise for the use
of measures of attitudes toward people with ID in
improving direct-care services for people with ID.
community inclusion for people with ID may

provide advocates with useful information to guide
their efforts to educate the public, thus enriching
the lives of people with and without disabilities.
The present authors hope that this study will also
serve as a first step in continued collaboration
and development of culturally anchored attitude
measures.
Acknowledgements
This article is based on the first authors Masters
Thesis, conducted under the direction of the
second and third authors, and Fabricio Balcazar.
The authors would like to thank Toshiaki
Tachibana, Institute for Developmental Research,
Aichi Human Service Centre, Japan, for his feedback on an earlier draft of this paper.
Distinctive contributions of the study

The present study sheds light on the conceptual
organization of Japanese attitudes toward people
with ID. The data were an acceptable fit to factor
structures found in the USA, establishing the existence of comparable attitude structures in the two
countries. This research opens the door for crosscultural comparison studies, enabling advocates to
share information about attitudes toward people
with ID on a larger scale.
In addition, studying attitudes toward people
with ID in other countries leads to a more complete understanding of the place of people with ID
in different cultures of the world. It may also lead
to a clearer understanding of the effects of cultural
values on attitudes toward people with ID. Furthermore, it is hoped that conducting such studies will
engender interest in continued attitude research
within each country. Future research in Japan may
capture additional dimensions of Japanese attitudes.
In the future, item-by-item analysis may also yield
additional useful information on Japanese perspectives regarding specific issues.
To the present authors knowledge, this is the
first study to systematically examine attitudes
toward the empowerment and inclusion of people
with ID in Japan. It is particularly salient to
conduct this research at a time when advocates and
people with ID are seeking increased rights and
community inclusion. Studying attitudes toward
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