SINGAPORE – Mr Chye Kiat Keng first suspected his son, Bob, had autism spectrum disorder because the boy could not walk or talk when he was 1½ years old.

“He wasn’t interested in class at all,” recounted the 49-year-old, who is in the private education sector. “We didn’t know why... whether he was purely not interested or if he didn’t understand.”

Mr Chye and his wife, an account manager, tried to enrol Bob, now aged four, in the Early Intervention Programme for Infants and Children (Eipic). This scheme supports children with developmental needs in a group setting.

They were told the wait would be five or six months, but ended up waiting more than a year with no news from the centre they had applied to.

The couple eventually turned to private service providers for early intervention support, as well as occupational and speech therapy.

Bob currently has an educational therapist who goes to his childcare centre to guide him four times a month. This costs about $300 per session.

In addition, his occupational and speech therapists each cost $230 per session, which takes place once a month. In total, his parents spend more than $1,600 per month on his needs.

“We could not wait any more,” said Mr Chye’s wife, 39-year-old Nguyen Thu Trang. She added that the long wait had eaten into the “golden time” for early intervention. “Private vendors are very expensive, but there is no choice for us.”

Industry experts say long wait times for subsidised programmes such as Eipic mean it is not uncommon for parents to seek help from the private sector.

In 2023, there were 2,600 children on the waitlist for Eipic, which is run by social service agency operators, and Eipic-P, run by selected private sector operators whose fees are partially offset by government subsidies.

This was a decrease from 3,100 waitlisted children in 2022.

In response to queries from The Straits Times, the Ministry of Social and Family Development (MSF) said the average waiting time in 2023 was 7.5 months, a slight drop from 7.6 months in 2022.

As at end-2023, there were a total of 5,700 Eipic and Eipic-P places across 23 Eipic centres and 29 Eipic-P centres. This was after adding 1,200 Eipic places that year.

On March 6, Minister of State for Social and Family Development Sun Xueling announced that another 1,500 places will be added to Eipic and Eipic-P in 2024, with the addition of four new early intervention centres.

This will ensure more children with developmental needs can receive timely support, she said.

The aim is to have government-funded places serve 80 per cent of children requiring medium to high levels of early intervention by 2027, up from 63 per cent in 2023.

MSF told ST that the annual number of referrals for Eipic services has increased significantly over the past four years, consistently exceeding enrolments and resulting in longer wait times.

This is partly due to enhanced early screening and detection for children with developmental needs, it said.

Why are wait times so long? 

The longer wait times are due to several factors, said Jalan Besar GRC MP Denise Phua, who is president of the Autism Resource Centre and chairs Autism Association (Singapore).

While the special needs sector is facing an increase in demand due to higher public awareness of autism, it is also dealing with a general shortage in trained and skilled professionals, she added. “This is both a local and global phenomenon.”

Relatively high staff turnover also results in longer wait times, she noted.

In addition, children are typically referred to Eipic centres through public hospitals or private paediatric clinics, a process that involves several steps. These include discussing one’s choice of centre with a case worker, formally applying to the centre, and having the child undergo a screening interview.

But no referral letters are needed for those enrolling as private clients, said Ms Beatrice Teo, a speech therapist and director of Eipic-P centre Headstart for Life.

Under Eipic-P, the wait time for Headstart for Life is about six to 18 months, with 11 children currently on the waitlist, she added. But if a child enrols privately, they can enter the programme immediately.

The difference is cost: At Headstart for Life, the private early intervention programme costs start from $900 a month. In contrast, the same programme under Eipic-P can cost as little as $9 a month for low-income Singaporeans.

“If you wait for a year for an Eipic placement, you are losing one year of your precious child’s developmental time, which can result in an even bigger delay as your child grows older,” said Ms Teo.

Every year makes a difference, especially for children with developmental needs.

“The first three years of life are crucial for all children, due to the rapid development of the brain during this period,” said Professor Kenneth Poon, director of the National Institute of Education’s Centre for Research in Child Development at Nanyang Technological University.

“For children with developmental needs, this phase is particularly important as the brain’s ability to change and adapt is at its highest during this period.”

Ms Weng Yiyao, lead educational therapist at the Dyslexia Association of Singapore, said that children who are struggling with literacy can benefit from intervention at a young age, even before any formal diagnosis is made.

The association’s pre-school early literacy programme helps such children improve these skills, she added, noting that pre-school years are the most critical period of a child’s development.

However, Dr Poon emphasised that any time is a good time for a child to learn.

“Parents do not need to feel like they have missed a window if early intervention does not occur within the first three years.”

Other challenges

Mr Chye said his son finally got a spot at an Eipic centre after about 1½ years, but he eventually decided against enrolling him there because it did not suit the working couple’s schedule.

“It could mean travelling one week, four or five times to inconvenient locations,” said Mr Chye, with his wife saying that would have been “a logistical nightmare”.

Mr Chye said: “That led us to finding services that are win-win, meaning parents can still contribute and work, while the child gets the best support in the most conducive environment.”

He also hopes that the Government can provide more subsidies for private vendors who can bring services to the children’s homes and schools.

Another parent, whose son has autism spectrum disorder, told ST that early intervention sessions in the public sector are not long enough.

The woman, who declined to be named, waited nearly two years for a subsidised spot for her son. She also hired a private therapist for her son, who turns seven in 2024, to supplement his time in the early intervention programme, which also allows for convenience.

“The time he spends there is obviously too short. There was not much improvement,” said the woman in her 30s, who is in sales.

However, Ms Phua noted that going to the private sector is not something every parent can do. “Parents who can afford private schools and therapy have the choice of taking that option. Not everyone has that option.

“The root solution is to grow our own timber and build a strong local pool of Sped (special education) educators and other professionals such as psychologists, speech and occupational therapists – and in the interim allow for more qualified foreign professionals to serve in Singapore.”