Towards a lifetime of being enabled

SINGAPORE - An island-wide development screening programme to spot toddlers displaying signs of developmental problems and a network of pre-school teachers, family physicians and family service centres equipped with skills to detect and refer these children for medical help if necessary.

Such early intervention, which experts noted could make a difference for some children with developmental issues, is one of the key recommendations by a committee tasked to chart the way forward - for the next five years - to empower the disabled and provide better care for them.

Yesterday, the Enabling Masterplan 2012-2016 steering committee unveiled a raft of proposals - covering a person's lifespan - including the suggestion to establish a network of "early detection touch points" in the community with the support of different stakeholders. It also called for funding to be provided for a nation-wide developmental screening programme for children at the age of nine months, 18 months, and between 24 and 30 months.

In its recommendations, doctors would also be equipped with resources to make referrals for intervention services, and parents and caregivers would have information and early intervention know-how.

In its 300-page report, the committee - which was chaired by Centre for Enabled Living chairman Chua Chin Kiat - noted: "The current screening gap between 18 months and three years for children in Singapore needs to be corrected to include an additional screening at 24 to 30 months."

Associate Professor Winnie Goh, a senior consultant at KK Women's and Children's Hospital and chairman of the Early Intervention sub-committee, reiterated that public education and primary healthcare partners in polyclinics and the private sector will be important in detecting developmental problems at an earlier stage.

For instance, general practitioners could conduct developmental screenings for children who come in with runny noses or coughs, she said.

Responding to Today's queries, the Ministry of Health said the current system of detection is based on identification by people closest to the child, who may then approach trained professionals such as child psychologists for assessment, diagnosis and, subsequently, intervention and treatment.

Early childhood and special needs education expert Noel Chia Kok Hwee, who is not part of the committee, explained that early detection can make a difference for children with conditions such as global developmental delay, which ranges in severity from learning disadvantages to learning disorders.

Still, Dr Chia pointed out that some parents are unable to accept that their child may have a disability.

But general practitioner Clarence Yeo felt that parents in denial are now "few and far between". He was supportive of GPs becoming better equipped to detect potential disabilities in children. "We should also have knowledge of avenues to refer the patient," said Dr Yeo.

Ms Christina Lee, whose son was diagnosed with autism at three, welcomed the proposal to better train community partners. She had detected learning difficulties in her son at the age of two, but a doctor had said the boy was too young to be diagnosed.

Steering committee deputy chairman Milton Ong's eight-year-old son has global developmental delay, including autism, and experiences seizures due to benign tumours in his body. Mr Ong said parents need some directions and "sign-posting" when they first learn of their child having special needs, followed by sufficient and affordable services.

"More importantly … we want our children to grow up in an environment where they're not kept separate; (where) they will feel their differences are being respected, being embraced," he said.

This, the steering committee has strived to achieve in the proposed Enabling Masterplan: Other recommendations include a special education governance structure with the Ministry of Education leading policy and programmes, an inter-agency taskforce to study the provision of incentives and legislation to promote employment of people with disabilities, the development of group homes for the disabled with low family support, and having a few dedicated transport providers catering to the needs of the elderly and disabled.

The steering committee's report was submitted yesterday to Acting Minister for Community Development, Youth and Sports Chan Chun Sing. Mr Chan said his ministry has begun looking at ways to implement some of the recommendations and would respond fully to the report at the coming Committee of Supply debate.

Some recommendations from the Enabling Masterplan
Early intervention

  • Establish early detection network touch points in the community and provide funding for a nationwide developmental screening programme for children at ages nine months, 18 months and 24 to 30 months
  • Establish a list of disability types and resources that enable doctors to make timely referrals for intervention services
  • Broaden Medisave framework to encompass some of the more essential early intervention support services
  • Institute a governance structure for SPED schools, led by MOE and supported by National Council of Social Service, comprising representatives with proven track records from special and mainstream education, disability groups and families
  • Study and address the implications of including children with special needs within the Compulsory Education Act with the aim of including them under the Act by 2016
  • Set up a Human Resource Steering Committee to establish a framework and policies to promote the attraction, development and retention of professional staff
  • Enhance the Open Door Fund to better encourage and support employers in hiring persons with disabilities
  • Institute a clearer and more stringent placement process in all sheltered workshops to ensure the appropriate right-siting of clients
Improve care for adults with disabilities
  • Widen and deepen the use of technology to enhance quality of services and safety in adult disability services.
  • Develop group homes in the community for persons with disabilities who have low or no family support but are able to live independently with support


2013 Strategic Partners
2013 Supporting Organisations