Disability/Early Intervention

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Overview & Synopsis

Knowledge Gaps

Current information mainly focused centered on intellectual disability and autism; do other disabilities face similar issues with detection and early intervention? Eg hearing loss or other forms of sensory disabilities.

Key Statistics & Figures

7,000 children aged 6 and below have developmental difficulties as of 2015

Between 2010 and 2014, KKH and NUS screenings show a 76% increase in children 6 and below with developmental issues such as development delays, speech and language delays, learning difficulties and autism spectrum disorders (ASD)

Theory of Change

Diagnostic Touchpoints & Referals	→	Detection, Diagnosis & Referrals
			↘
EIPIC programmes	→			Early Intervention
					↘
						Education

Areas of Needs

Detection, Diagnosis & Referral

Timely Detection, Accurate Diagnosis & Proper Referrals to Follow-Up Services

Programmes	Gaps	Ideas
Detection This is usually a problem only for less visible disabilities. [Knowledge gap: Where are the places or touchpoints that might detect disabilities	[Knowledge gap: Are early childhood educators equipped to identify clients for diagnosis?] [Anecdote: Some people don't get diagnosed until much later in life, especially less visible disabilities like dyslexia]
Diagnostic Touchpoints Psychologists from the Ministry of Education Professionals from government hospitals Registered educational psychologists (for psycho-educational assessment) Private psychologists	[Knowledge gap: Any issues with accuracy, cost, accessibility, or quality of diagnoses?]
Referrals	For caregivers of children with ASD, touchpoints are poorly equipped in advising parents on where to obtain reliable help during the post-diagnostic phase (see page 61 here)	Improve transition management (Recommendation 3, Strategic Direction 1 of EM3) For newly-diagnosed cases, to set up an agency to provide case referral, care planning and advisory services, and to facilitate smooth handover of information to other agencies Includes developing a standardised case management tool between primary support agency and other service providers Enhance network of touchpoints to ensure timely and effective detection of developmental needs (Recommendation 4, Strategic Direction 4: of EM3) To make information and training more available to touchpoints (e.g., family, hospitals, polyclinics, family medicine practitioners, community partners) such as using electronic platforms, training primary care practitioners

Early Intervention

• Synopsis: While EIPIC serves around 3,200 children with mod-severe special needs, waitlists can extend from 6 months to 1 year. Further, early intervention professionals tend to have high turnover and quick burnout, due to unattractive remuneration compared to the private sector.

Programmes	Gaps	Ideas
For mild developmental needs Development Support (DS) & Learning Support (LS)	[Knowledge gap: number of such children]
For moderate to severe developmental delays Early Intervention Programme for Infants & Children (EIPIC)	EIPIC Centres have long waiting lists (up to six months or a year) Early Intervention Professionals face quick burnout, unattractive salaries/benefits relative to the private sector and shortage of manpower	Long waiting lists at EIPIC Centres - (1) If disproportionately high at certain EIPIC Centres, to educate and counsel parents on their choice of centre or (2) scale up vacancies
Therapy Community Educational Support Services

Development Support (DS) & Learning Support (LS)

• For pre-school children with mild developmental needs [total number of such children?]
• Support and intervention in areas such as speech and language, social skills, motor skills, behaviour and literacy
• Rolled out to > 300 preschools, > 2,000 children and families, caa December 2015
• [outcomes information on how DS/LS has fared?]

Early Intervention Programme for Infants & Children (EIPIC)

• Therapy and educational support services for children below 6 years with special needs at risk of moderate to severe developmental delays [total number of such children?]
• 21 EIPIC Centres, caa July 2018
• Currently serving about 2,600 children, projected to grow to 3,200 places by 2018
• Enhanced Pilot for Private Intervention Providers to subsidise selected Private Intervention Centres
• SPD - Building Bridges @ EIPIC Centres are at Tiong Bahru, Jurong, Tampines & Bedok served a total of 465 children in FY16/17 - 41 graduated, 27 progressing to mainstream primary and the rest to SPED

Community Educational Support Services

• AWWA Community Integration Service
• Care Corner Educational Therapy Service
• Cerebral Palsy Alliance Singapore (CPAS)
• Down Syndrome Association's Children Education Services
• Handicaps Welfare Association (HWA) [confirmation required]
• iC2 PrepHouse
• SHINE Educational Psychology Service
• Singapore Association for the Deaf (SADeaf)
• Singapore Association of the Visually Handicapped (SAVH)
• SPD
• St Andrew’s Community Hospital
• THK Children’s Therapy Centre