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Enhanced Early Intervention: Better Support for Children with Developmental Needs

28 Jan 2019

1.    Families of children with developmental needs1 can look forward to more customised and affordable Early Intervention (EI) services to maximise their children’s potential. These enhancements are expected to benefit at least 4,500 children and their families each year, and build on the efforts of the Third Enabling Masterplan2.

2.    The Ministry of Social and Family Development (MSF) will invest around $60 million a year – a 30% increase from $45 million3 today – to provide two new EI programmes, and to make fees for EI services much more affordable.

More Customised EI

3.    Today, children under the age of 7 with developmental needs can receive intervention through Government-funded EI programmes. Children with mild developmental needs are supported by the Development Support (DS) and Learning Support (LS) programmes, in a preschool setting. For children with moderate to severe developmental needs, they are supported through the Early Intervention Programme for Infants and Children (EIPIC), provided at EI centres. These children receive the same model of EIPIC intervention across different ages and needs. Annex A provides more information on the current EI programmes.

4.    From July 2019, EI centres will move away from the one-size-fits-all EIPIC model. Instead, they will offer enhanced EI programmes that are better tailored to the varied needs of children as they develop over time. Two new programmes will also be introduced:

a)    EIPIC Under-2s: Under the new EIPIC Under-2s programme, all children under two years old enrolled in EIPIC will receive more targeted intervention. Unlike the existing EIPIC programme, the EIPIC Under-2s programme requires children to be accompanied by their parents/caregivers, who will receive training to carry out intervention strategies in the child’s daily routines at home. Such strategies embed learning opportunities throughout the children’s daily lives, and lead to more sustainable outcomes. At the age of two, the children will transit to the EIPIC@Centre programme.

b)    DS-Plus: Children who have made sufficient progress under EIPIC@Centre4 can now transit to receiving intervention in a preschool setting under a new Development Support Plus (DS-Plus) programme5. Currently, they receive continued intervention at their EI centre until they graduate to primary school6. EI professionals from the EI centre will work with the child in his/her preschool up to twice a week, co-teaching the child alongside the preschool teacher. This helps the child to adapt to the mainstream preschool setting, so that he/she can be equipped with skills within a larger class setting.

5.    The launch of EIPIC Under-2s and DS-Plus follows a two-year pilot to develop the enhanced EI programmes, involving approximately 700 children from three EI centres, i.e. Thye Hua Kwan (Ang Mo Kio), AWWA (Hougang) and SPD (Jurong East). Under the pilot, children with higher developmental needs received more intensive support at the EI centres. When they made sufficient progress, they were then supported within the preschool setting. The number of hours of intervention provided was based on each child’s specific needs. The pilot showed positive child and family outcomes. For example, children in DS-Plus developed better social and communication skills. Parents felt better supported as caregivers. Preschool teachers gave feedback that they were able to successfully apply the recommended strategies to help the children integrate and engage in classroom activities.

6.    The enhanced EI programmes will be rolled out across the sector in phases, with 13 of the 21 EI centres providing these services in July 2019. The remaining eight EI centres will progressively come on board by early 2021. Annex A provides details on the current and revised EI programmes, and Annex B provides a list of EI centres implementing these programmes. The enhanced EI programmes will give parents greater assurance that intervention is tailored to their child’s specific needs, thus building a stronger foundation for the child to develop to his or her fullest potential.

More Affordable EI

7.    Currently, families receive subsidies for EIPIC and DS-LS, based on per capita household income. After subsidies, fees for Singapore Citizen children range from $5 to $780 per month.

8.    To make EI services more affordable for families of children with developmental needs, MSF will (i) enhance EI subsidies and (ii) broaden the income criteria for means-tested subsidies so that more families qualify7. As a result, out-of-pocket expenses for EI services will be lowered across all EI programmes for most income groups from 1 April 2019, with reductions averaging between 30% to 70% depending on the EI programme8. After subsidies, fees for Singapore Citizen children will range from $5 to $430 per month. For example, for a child from a four-member family with a combined household income of $8,000 (i.e. a per capita household income of $2,000), the EIPIC out-of-pocket cost after subsidies for the child would be reduced by 68% from $410/month to $130/month. The changes to the fee caps and worked examples are in Annex C.

9.    MSF will continue to work with EI service providers to extend additional financial support to families who may require more help, for example, families with multiple children requiring EI services, or with multiple dependants who require long-term care.



  

1 Developmental needs refer to developmental conditions ranging from physical issues (e.g. muscular dystrophy), sensory issues (e.g. vision or hearing loss), and cognitive issues (e.g. autism spectrum disorder and intellectual disability), to learning needs without accompanying disabilities (e.g. mild language developmental delays).
2 The Third Enabling Masterplan is a set of recommendations developed through a partnership between the people, public and private sectors, for Singapore to build a more inclusive society where persons with disabilities are empowered and enabled to realise their true potential.
3 Estimated budget for FY18.
4 Children will be assessed through a standardised EI benchmarking framework which MSF will introduce across the EI providers from July 2019 onwards. Providers will follow standardised guidelines to identify children who may benefit from transiting to another EI programme.
5 The existing Development Support (DS) programme serves children with mild developmental needs and are not in EI Centres. These children receive once-weekly intervention session over 3-4 months in their preschools. The DS-Plus programme will cater to children who are receiving intervention at EI centres (and attending preschool concurrently), and who make sufficient progress to transit to DS-Plus. Under DS-Plus, these children with mild-moderate needs will receive an average of twice-weekly intervention over 6 months in their preschools.
6 Either mainstream primary schools or special education schools.
7 On top of the $500/month base subsidy received by all Singapore Citizen children attending Government-funded EI programmes, the eligible monthly per capita income for means-tested subsidies will be raised from $3,000 to $4,600.
8 The exception is the lowest income tier, where children already enjoy a nominal fee. These reductions apply to Singapore Citizen children.

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