EARLY INTERVENTION AT PRE-SCHOOLS

EARLY INTERVENTION AT PRE-SCHOOLS: 3.

Ms Denise Phua Lay Peng asked the Minister for Community Development, Youth and Sports if he will commission a study on the efficacy of (i) early intervention for special-needs children; and (ii) general pre-school education for children before primary school age.

The Minister for Community Development, Youth and Sports (Dr Vivian Balakrishnan): I am pleased to inform Ms Denise Phua that the Ministry of Community Development, Youth and Sports (MCYS) is commissioning the National Institute of Education (NIE) to embark on an impact study for early intervention programmes for children with special needs. Presently, the Government provides funding to eight Voluntary Welfare Organisations to run 12 Early Intervention Programme for Infants & Children (EIPIC) centres.

The initial phase of the study aims to develop standardised disability coding and assessment tools for evaluating children’s outcomes in five developmental domains. These domains include: (i) fine and gross motor skills; (ii) cognition and perception; (iii) communication and language: (iv) social; and (v) self-help skills.

Once we have established these tools, they will help us to assess how well the children are progressing in EIPIC programmes in each of these five dimensions. This, in turn, will allow us to assess the efficacy of the programmes and the sub-components within each of these programmes in EIPIC centres.

MCYS will involve key stakeholders namely, MOE, MOH and the hospitals under MOH’s Child Development Programme (KKH and NUH) in order to tap their expertise in providing guidance and inputs for the study. There will be several phases and it will take several years for this study to be completed. I hope to commence the first phase some time next year.

The second part of the Member's question is really related to general pre-school education which is outside my ambit and should be addressed by MOE. Anyway, there will be a whole motion on pre-school education later today.

Ms Denise Phua Lay Peng (Jalan Besar): Thank you, Minister for the good news. I want to officially commend MCYS and NCSS for having put a lot of resources into the early intervention programmes for the children in the last few years and I thank the Minister for that. I am also pleased to note that MCYS has commissioned the National Institute of Education to conduct the efficacy study on early intervention programmes for special-needs children. May I ask Minister to consider perhaps conducting some due diligence on the composition of the team members? Perhaps MCYS can get feedback or nominations from the sector so that we are able to incorporate different disabilities and to get inputs from disability experts on the ground. The composition of the team would also be respected by the different players.

May I also ask the Minister what is likely to be the course of action that he will take, depending on whether the results are beneficial or not? If yes, would MCYS commit to give even greater commitment to the current programmes? If no, would MCYS then recommend that these services be terminated?

Dr Vivian Balakrishnan: The answer to the Member's first supplementary question, clearly, is "yes". We do need a multi-disciplinary team and we will certainly be open to participation from those on the ground who have experience and expertise. The key objective is to come up with a more evidence-based approach to the way we manage these children. As a former doctor who had to look after many children and parents who had disabled children, it breaks my heart to see parents desperately trying all kinds of therapies, some of which are completely unproven, some in fact maybe unhelpful. A lot of these therapies are expensive and have tremendous impact on the parents' stress level and on their finances. I want to have a system where we can truly assess and then based on those assessments, advise parents what works, what does not work, what is useful, what is speculative, so that all of us – parents, service providers, the volunteer sector providing those services, the donors donating the money and the Government co-investing in the services – know which areas to invest in.

This leads me to the Member's second supplementary question. Based on the results of this study, we will have to make necessary adjustments. There may be some programmes which we will expand and in which it will be justified for us to invest more. There may be other programmes which we need to cut back on or to redirect. But let us not pre-judge the issue. As I have said, I want a more evidence-based approach to this very sensitive area.

Ms Denise Phua Lay Peng: I would like to ask the Minister if the said efficacy study will build also on the foundation that is already laid by the current studies that are completed by the MOH team comprising people from MCYS and different service providers, on the clinical practice guidelines for some of these disabilities. Would the said study be based on the completed studies I just mentioned, so that we do not have to re-invent the wheel?

Dr Vivian Balakrishnan: The answer is "yes". The Member is referring to the baseline study that was performed by KK Hospital's Child Development Unit, some VWOs and MCYS. I have gone through the results of their study. As a baseline, it exposed a lot of what we do not know. These are known-unknowns, and I am trying to track down all these known-unknowns. We will certainly not re-invent the wheel, but we will build upon the past studies.