More preschoolers diagnosed with developmental issues

SINGAPORE — The number of preschoolers diagnosed with developmental issues is on an upward trend as doctors cited better awareness among parents and preschool teachers, leading to early referrals for diagnosis.

Latest figures provided by the KK Women’s and Children’s Hospital (KKH) and the National University Hospital (NUH) — the two public healthcare institutions which screen and treat children aged six and below for issues including development delays, speech and language delays, learning difficulties and autism spectrum disorders (ASD) — showed a 76 per cent jump in cases between 2010 and 2014.

In 2014, KKH diagnosed around 3,500 new cases, while NUH had 900 new cases. Comparatively, there were about 2,500 new cases reported in total in 2010.

The top two conditions diagnosed among preschoolers are speech and language delays and ASD. For instance, children with ASD make up around two in 10 new cases seen at KKH annually. For NUH, this figure is around 25 per cent.

While doctors said that early diagnosis means these preschoolers can get timely and appropriate intervention in managing their conditions and even let them advance into mainstream schools, the waiting times to see a doctor and receive treatment remains considerably long, even though the situation has improved over the years.

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In 2011, the reported waiting time to see a doctor was two months. Last month, the Ministry of Social and Family Development (MSF) told Parliament this waiting time has shortened to between seven days and approximately three weeks as of October last year. The average time taken between referral and assessment for suitability to be enrolled for Early Intervention Programme for Infants and Children (EIPIC) services has also improved from about half a year — at popular centres — in 2011, to about three months last year, the ministry added.

Parents with children diagnosed with developmental disorders can opt for therapy or pre-school education at the 17 EIPIC centres and receive means-tested subsidies.

The number of spaces available in EIPIC centres has almost doubled from 1,200 places in 2010 to 2,200 in 2014. The MSF aims to provide 3,200 places in total by 2018.

Globally, the incidence rate for ASD cases has been on the rise. The World Health Organisation, for instance, said one in 160 children has ASD due to factors ranging from better awareness to improved reporting of symptoms. Singapore’s rates stands at one in 150 children.

Research is ongoing to prove if there are links between environmental factors and ASD incidence rates.

Professor Ho Lai Yun, senior consultant at KKH’s child development department, said the “majority” of cases of ASD and speech and language delays among preschoolers here are of mild severity. These children have generally advanced to mainstream schools after timely and appropriate intervention.

“We have definitely come a long way from 10 to 15 years ago when there was little awareness of developmental problems in children, when treatment services were very limited, and where many preschool children with mild or moderate developmental problems might not have been diagnosed,” said Prof Ho.

Besides better awareness among parents, NUH’s head of child development unit Chong Shang Chee added: “Increasingly, preschools are also referring cases ... (there is) awareness among preschool teachers now for developmental disorders.”

Partnerships between hospitals and the community and preschools is one reason for better public knowledge on where to seek help, added Dr Chong.

But reaching out to low-income families remains tricky, she said, as children of such households may not be attending preschools or tend to miss medical appointments for assessments and check-ups.

“In the special needs landscape, awareness is not the only factor but there is also a need for a social environment that is inclusive of these children, supportive of their parents and flexible to their education needs,” said Dr Chong.

A parent who wanted to be known only as Ms Wong, 44, agreed that preschool teachers play an important role in detecting developmental issues among charges, adding that there is a need for these teachers to be trained in caring for children with special needs. Her son was previously turned away from a mainstream school after being diagnosed with autism and he is attending a special needs school now.

Noting that developmental conditions can still be a taboo topic among parents, Ms Wong said government-funded preschools “should ensure they have sufficiently-trained teachers and set the tone by admitting children with development issues”.

She added: “This will not only help parents with children with developmental issues to gain acceptance and seek treatment but also send a signal to other parents to be inclusive of other children as well.”