Special Needs Children

Ms Ellen Lee asked the Acting Minister for Community Development, Youth and Sports in the last five years (a) how many special needs children below the age of 21 years are there in Singapore; (b) how many families have more than one special needs child in the family; and (c) how many of these children come from lower-middle income families and from families in the lowest 20% in terms of household income.

Ms Ellen Lee asked the Acting Minister for Community Development, Youth and Sports (a) what is the expected lifespan of special needs children; (b) how many of these outlive their expected lifespan and to what age generally; (c) what is the average cost needed per month to maintain a special needs child; (d) how do their parents generally meet such costs; and (e) how much is the Government subsidy for each special needs child.

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MG [NS] Chan Chun Sing: The number of preschoolers (aged 0 to 6 years) diagnosed with developmental delay or disability is approximately 7,000. For those with developmental delay, some of them would overcome them by the time they are in school. There are about 13,000 children with special needs known to MOE in SPED schools and mainstream primary and secondary schools. Hence, there are about 20,000 children with special needs below the age of 18.

Currently, MCYS and MOE do not have comprehensive income and other data on families with children with special needs. The Centre for Enabled Living (CEL) has started to track children who need the Early Intervention Programme for Infants & Children (EIPIC) run by the Voluntary Welfare Organisations. Based on 1,600 children in EIPIC, about 2% belong to families who have more than one special needs child. Also, based on EIPIC data, some 13% come from the lowest 10th household income percentile, 16% are from the 10th-30th percentile and 20% are from the 30th - 50th percentile 1 . I must caution that these figures come from a small base and are not fully representative. The income levels might also be skewed towards the lower income because EIPIC is run by VWOs and some higher income parents might use private services instead.

I understand and appreciate the Honourable MP's concern. I want to assure her that the Government is aware that families with special needs children face greater costs because of the need for early intervention services, education, as well as care arrangements. This is why Government has provided significant subsidies for EIPIC, integrated child care centres and SPED. Families that have more than one special needs child in EIPIC can get additional financial help on a case-by-case basis.

Let me now address the Member's concerns regarding persons with disabilities who outlive their parents. There are many types of disabilities and for each disability type, there is also a range in terms of severity, which affect their health condition and expected lifespan. The "World Report on Disability" produced in 2011 by the World Health Organisation (WHO) and World Bank reported that the mortality rates for people with disabilities vary depending on the health condition. Thus we cannot be definitive on the expected life span of people with disabilities. However, it is likely that those with learning disabilities, mild Autism Spectrum Disorder, mild intellectual disabilities and sensory impairments have life spans similar to the rest of us and are likely to outlive their parents. Some are also more able to work and live lives similar to us.

There would be a smaller group who will require to be cared for all their lives. The cost of care for such a disabled adult varies, depending on whether he is cared for by family, a maid, at a day activity centre in the community or in a residential home. Cost for a maid is about $600 per month, day care about $800 a month, and that for Homes is about $1,600 per month. Government provides a monthly foreign domestic worker levy concession of $95 per month. Means-tested subsidies for day care go up to $615 per month and for institutional care, it is up to $1,200 per month. This works out to be up to $7,000-$15,000 per annum for the adult disabled from the lowest income tier. While it is difficult to put a single dollar value on Government subsidies, as families can switch between different care arrangements, the subsidies are sizeable. Over and above this, the Community Chest and VWOs also raise funds to help defray costs.

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We understand and empathise with parents' concerns. This is why my Ministry formed and acted on recommendations from the Parents' Workgroup led by MP Denise Phua in 2006 and the last Enabling Masterplan Steering Committee in 2007. We have begun to put in place the legal and financial security framework to provide for persons with special needs if they outlive their parents. The Mental Capacity Act passed in 2008 allows parents to appoint trusted persons as decision makers for their mentally incapacitated children when they pass on. The Special Needs Trust Company (SNTC) launched in 2009 provides non-profit trust services and also enables parents to lodge a care plan for their children when they pass on. MCYS and CPF Board are also implementing the Special Needs Savings Scheme, so that parents can use their Central Provident Fund accounts to provide a stream of income to their children upon their demise. The ongoing Enabling Masterplan exercise will look at many issues related to the disabled, including how we can provide better support and care for the adult and ageing disabled and their families.