Preschoolers Diagnosed with Developmental Problems

Mr Ang Wei Neng asked the Acting Minister for Community Development, Youth and Sports in view of the doubling of new cases of preschoolers diagnosed with developmental problems from 2005 to 2010 (a) what is the number of such children being placed on early childhood intervention programmes for the past five years; (b) what is the current number of children on the waiting list and the average waiting time before such preschoolers can be placed on these programmes; and (c) what are the enrolment figures at Special Education (SPED) schools for this group of preschoolers in the past five years.

Page: 451

The Acting Minister for Community Development, Youth and Sports (MG [NS] Chan Chun Sing): Mr Speaker, Sir, MCYS shares Mr Ang Wei Neng's concern for the development of our young children, especially those with developmental challenges. Over the last five years, MCYS, the National Council of Social Service and the disability sector have worked together to provide more places in the Early Intervention Programme for Infants and Children (EIPIC). We have expanded capacity by 40%, growing from 1,350 places in 2006 to 1,900 today. The number of centres also increased from nine in 2006 to 14 today.

In recent years, there has been increasing awareness among parents on disability and developmental delays. At the same time, the MOH-Child Development Programme (CDP) has enhanced its capability and capacity on detection and diagnosis at a younger age. The number of pre-school children diagnosed with disability and developmental delays has almost doubled from about 1,300 in 2005 to 2,500 in 2010. Together, these factors have contributed to more children and younger children seeking intervention services.

For these reasons, there is still a shortage even though we have increased EIPIC places significantly. We now have about 500 children on the waitlist. The waiting time to enrol is on average six months. We recognise that it is important for the children to receive intervention services early, and are taking several steps to expand capacity urgently:

First, we are working with the Voluntary Welfare Organisations to open new EIPIC Centres. We have just opened a new centre last month with another new centre by April next year.

Second, we are working with existing EIPIC Centres to increasing their capacity by expanding their physical premises where possible, and increasing their manpower. To support them, my Ministry has introduced a new "Place-and-Train" scheme to allow centres to hire EIPIC teachers and therapists ahead of enrolment.

Third, MCYS and the Centre for Enabled Living have begun on a pilot this month to tap on selected private sector providers for EIPIC. We are starting with a small number of providers to evaluate the feasibility of tapping on the private sector for EIPIC in the longer term.

Sir, with these efforts, we will increase the number of EIPIC places by 700 more places by April next year. This should bring down the average time taken to enrol a child to three months. Incidentally, three months is also the period taken for the centre to work with the parents to assess a child's specific needs and discuss them with the parents before enrolment.

Page: 452

About 300 children enter SPED schools annually at the school-going age of seven years. Under the Enabling Masterplan, the committee will be studying how to enhance the transition process from EIPIC to SPED school for our children with developmental delays.

Mr Ang Wei Neng: I thank the Minister for the comprehensive reply as well as increasing capacity for the Early Intervention Programme. I note the Minister said that 2,500 children were diagnosed with developmental delay in 2010, but every year, about 300 to 500 of them enter the SPED schools. What happens to the rest? Have they received the Early Intervention Programme and become normal? Or did they not go to the SPED schools but went instead to the normal mainstream schools?

MG [NS] Chan Chun Sing: Mr Speaker, Sir, the answer to Mr Ang Wei Neng's question is that for those people who have gone through the programme and they are deemed to be able to join the normal schools, we will allow them to go to the normal schools. For some of our children that have gone through the programme, they may not be ready for the normal schools. They will then join the SPED schools. For another group of children, if they continue to need a bit more help to prepare them before going to the schools, we will continue to have them in the programme.

Mr Yeo Guat Kwang (Ang Mo Kio): Sir, the Minister said that the Ministry is working with the VWOs to set up more centres. I would like to just ask for clarification. In working with the VWOs, does it mean that the Government is going to give more support to incentivise this group and to sustain their efforts?

MG [NS] Chan Chun Sing: Sir, allow me to clarify the framework which the Government is at the moment using to support the VWOs. First of all, for all the children that are going to the EIPIC Programme, there is a baseline subsidy of $300 for them. On top of that, we provide means-tested subsidies to help the children from the lower-income group up to the family with the 50th percentile income. For the VWOs that are in this sector, we will do what we can at the backend to support and help them build up the capacity. We are working with the VWOs to make sure that the services provided to the children in need remain affordable, particularly for those in the lower-income group.

Ms Denise Phua Lay Peng (Moulmein-Kallang): Sir, I want to thank MCYS and commend MCYS for implementing and launching the hybrid funding formula in Early Intervention – the $300 fixed component plus the means-tested component. That is gracious and very appreciated by parents. I want to ask a supplementary question. Could the Minister consider looking into two key concerns in this space – one of which is the lack of scalability of the early intervention system, not just in trained manpower, but also in the management of early intervention, the whole works, in terms of the process and the system. The second concern is in making sure there is due diligence of the providers, as MCYS considers opening up more centres and also to extend this to the private providers. I think it is important that there is due diligence and that we do not look at capacity, just in terms of physical capacity, but also in terms of the actual intervention method so that it will really help the children and not harm the children

MG [NS] Chan Chun Sing: Mr Speaker, Sir, we thank Ms Denise Phua for her suggestions and we fully agree with her suggestions. The first issue raised was scalability. Indeed, this is a challenge, not just for the EIPIC sector, but it is also a challenge for the larger social service sector. One of the issues with the social service sector is that there seems to be a certain optimal scale which we can provide the services that retains the personal touch and yet balances efficiency considerations. We are studying the models of other countries to see if there are other ideas that we can adopt that can allow the scaling up, without the intensive use of manpower resources.

Page: 453

At the same time, we are very cognisant that when dealing with children with special needs, inevitably we cannot be too efficient because there is a certain person-to-person interaction. The child-teacher ratios cannot be too high in order to give them the quality help required. The other challenge, in terms of scalability, is the management attention. Unlike a normal school where we can have a higher ratio of students to teachers, for many of these special needs places, we need a lot of management attention, a lot of teachers' attention. So, we must be careful to make sure that as we scale up, we do not lose this personal touch given to the students with special needs.

On the second suggestion regarding due diligence, we completely agree with Ms Denise Phua's observation that as we expand, in terms of building greater capacity, we will never, never want to sacrifice this, in terms of the quality given to them. At this point in time, we would also acknowledge that in this sector for early intervention, there are many programmes in the market which purportedly help the children. Some are more effective in some areas; others are more effective in other areas. So, in expanding our capacity, we must put in due diligence to ensure the quality is not compromised. It is on this basis that as we expand the service to include some of the private sector providers, we want to make sure we do it at a progressive manner that MCYS, together with NCSS, and the other stakeholders in the disability sector are able to go in, look at the programmes, audit some of the programmes and make sure that they are indeed relevant to the people that we intend to help before we continue to scale up.

Just for information, indeed, there were many private sector providers who were very eager to come in to join this programme. But we have taken a progressive approach to do it systematically, to expand the capacity systematically rather than to bring in everybody at the same time without the necessary control measures put in place. So we thank Ms Denise Phua for her suggestion.