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More about preschoolers with additional needs

Children with special needs, or now termed as “children with additional needs” refer to children with disabilities. The Convention on the Rights of Persons with Disabilities defines disabilities as “a long-term physical, mental, intellectual or sensory impairment that – in interaction with the environment – hinders one’s participation in society on an equal basis with others”.

The statistics show that as high as fifteen percent of the world’s population have some form of disability (though some are discovered or may develop at later stages in life due to external reasons). Yet what we know about disabilities is very limited and our society is not well equipped to assist them or include them to be equally engaged in our community. While physical or sensory impairment may be more obvious to the eyes, mental or intellectual disabilities usually result in a form of stigma around them.

In this article, we will share some information related to this topic.

Autism Spectrum disorder (ASD), Attention Deficit Hyperactivity disorder (ADHD) and Dyslexia are common developmental disabilities that have been highlighted by our Ministry of Health. ASD, as the name mentioned, has a wide range of symptoms and severity and affects one’s communication and social behaviours. Some signs are the lack of eye contact and refusal of skinship.

The symptoms for this disorder can occur as early as in the first year and signs of developmental delays would occur before age 2 years. There is no single known cause for this disorder but it is caused by a change in the brain structure. ADHD affects one’s attention span and behavioural control.

There are 3 subtypes, predominantly inattentive, predominantly hyperactive/impulsive and a combined type. Symptoms can occur as young as 3 years old and may differ based on gender - boys tend to be more hyperactive while girls tend to be more inattentive. As it is normal for preschoolers to have a shorter attention span, it is perhaps difficult to make a diagnosis at an early age. The exact cause of ADHD is currently unclear.

Lastly, dyslexia is a learning disorder that results in a difficulty in reading due to the way the brain processes written and spoken language. It is characterised by the slower pace of learning how to read and speak and have troubles recognizing letters of the alphabet too. Dyslexia is a genetic disorder, therefore it is hereditary. If someone else in the family has, then it is highly likely you will also have it.

For these three common types of disabilities, the healthhub page has also included some pointers to check for developmental abnormalities that parents can refer to.

There are currently different programmes under the Early Childhood Development Agency (ECDA) that aim to support infants to preschoolers (birth to 6 years old) with additional needs.

Early discovery and intervention is important in all sickness and illness and it is the same for disabilities. Early intervention will allow professionals to come in to implement some therapy programmes that can enhance the child’s development and reduce the possibility of additional developmental delays or disabilities.

From the early 1990s, many child development units (CDU) in various hospitals, mainly KK Women’s and Children’s Hospital (KKH) and National University Hospital (NUH), provide assessment and diagnosis for early identification of disabilities. An assessment will be done by a paediatrician and children who are deemed to be at risk of a developmental, intellectual, sensory or physical disability, or a combination of disabilities will then be recommended to be part of the Early Intervention Programme for Infants & Children (EIPIC).

The EIPIC centre is a place that provides therapy and developmental support services but does not function like a childcare centre. There are currently 21 centres that are offering this programme, while there are other private intervention centres to choose from too.

These private intervention centres may also offer child care and pre-school services. As part of the teaching course, there is a module for early childhood teachers to gain some insight on this topic. However, not all preschool teachers are fully equipped to handle all the different cases of disabilities. A specific diploma course, currently known as Specialist Diploma in Early Childhood Intervention (Special Needs), is available for early childhood educators who wish to learn more in depth about it. It also helps to improve on the skills and knowledge for those already working in EIPIC centres, especially as our understanding of these disabilities may change as more discoveries are made.

After the recommendation, for infants and toddlers below the age of 2 who require medium to high levels of early intervention support, they will be placed under the EIPIC Under-2s programme, while toddlers to preschoolers, between 2 to 6, will be placed under the EIPIC@Centre programme.

There continues to be more work done in trying to include children with additional needs in preschools so that supporting these children can be viewed as part of our mainstream teaching. Therefore, there are programmes that integrate the early intervention programme within the preschool setting. For toddlers and preschoolers who require medium levels of early intervention support, they may be part of the Inclusive Support Programme (InSP).

It is currently a pilot programme that was launched in 2021, in hopes of bringing together both typically developing children and children with additional needs. For children who have progressed well under the EIPIC programme, they can be moved to the Development Support Plus (DS-Plus) programme, as they require lower levels of early intervention support. At this point, they will be integrated to attend preschool instead of attending at the EIPIC centre or at home.

The Development Support (DS) and Learning Support (LS) programme is offered by government-appointed preschool anchors and works to prepare these preschoolers for entry into mainstream primary school.

Disabilities is a very broad topic and encompasses many types of impairments. Only a few common ones have been mentioned here. As Singapore works to become a “Caring Nation and an Inclusive Society”, it is vital that we better equip ourselves with more information on this topic.

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Genesis Childcare 1989 (Playgroup to Kindergarten 2)

Blk 433 Tampines Street 43 #01-63/65 S(520433)

Nurture Infant House (2 to 18 months Infants)

Blk 433 Tampines Street 43 #01-61 S(520433)

Opening hours: Monday to Friday (7am to 7pm) & Saturday (7am to 2pm)

Public Bus services: 8 / 21 / 28 / 29 / 293



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