Data on Persons with Autism Spectrum Disorder on Waitlist for Placement at Day Activity Centres

16 Ms Kuah Boon Theng asked the Minister for Social and Family Development (a) how many persons with autism spectrum disorder (ASD) are currently waitlisted for placement with a Day Activity Centre (DAC); (b) what is the average waitlist time before an applicant with ASD is offered a place at a DAC; and (c) are there any plans to make more DAC places available for persons with ASD.

The Senior Parliamentary Secretary to the Minister for Social and Family Development (Mr Eric Chua) (for the Minister for Social and Family Development): Sir, there are eight Day Activity Centres (DACs) that specialise in serving clients with autism spectrum disorder (ASD); 130 are on the waitlist for placement in these centres and the average waiting time for enrolment is nine months.

The Ministry of Social and Family Development (MSF) is ramping up DAC capacity by 500 places to address the demand for DACs, as announced in MSF’s Committee of Supply in 2024.

Mr Speaker: Ms Kuah.

Ms Kuah Boon Theng (Nominated Member): I thank the Senior Parliamentary Secretary for his answer. I should declare, first of all, that I am a parent with a child with ASD, who would be classified as requiring high support needs.

I am grateful for the data that has been supplied. My understanding, though, is that average number or wait time, can vary widely depending on which type of DAC we are referring to. And in some of the larger ones with more facilities, I understand, that the wait time can be up to five years or more. Is that correct, may I ask?

And really, I have two main supplementary questions.

The first is whether there are any concerns that what we see on the waitlist may not really be a true reflection of the actual demand and need for these services. And I say this for two factors: one, parents with ASD children want predictability in terms of the arrangements for their care, the environment that they are in. And sometimes, when they are on the waitlist for too long, they can decide to take the child off the waitlist because the child has gotten used to being kept at home, even though it is not ideal. So, that is one factor.

The other factor is that DAC costs for ASD, in particular, are quite high. I know that there were announcements less than two years ago that with the fee caps introduced, families that earn $2,800 or less will have their costs managed. But those who earn more than $2,800 a month can pay up to $1,900. So, if you have a family that has a household income of $5,000, they are being asked to commit 40% of the household income to pay for DAC. So, there is a concern that the waitlist does not look so bad because it is not affordable. So, that is the first question.

The other question I have is, are there any plans to work and collaborate with private providers of special education for young adults with ASD, to explore if more places can be made available to address the short- to middle-term critical shortage of DAC places and possibly to extend subsidies to help more families afford those fees.

Mr Eric Chua: Sir, I thank the Member for her supplementary questions. I think we most certainly look at the issue of capacity, not just in the uni-dimension of number of places alone. We do look at the different disability types, the demand under each category, and also we take an island-wide view of where the availability of these centres are for each of these disability types. It is a more nuanced approach than my main reply would suggest. But at the back-end with MSF and also with SG Enable, we do work very closely with our partners, with our colleagues in SG Enable as well as our social service agencies to understand, drill down to what are the real needs in terms of the heat map around the island. So, rest assured that we are doing a much more nuanced analysis than just capacity alone.

With regard to whether we are prepared to work with private providers, the short answer is yes. We are looking at options to see how we can vary the different service models that we are looking at today.

I think one of the key principles that I really want to hark back to is to take a step back to see what is our end objective for persons with disabilities, persons who are living with autism. And one of the key objectives is to make sure that they can continue to live in the community with the families for as long as possible. That is to say we want to delay institutionalisation for as long as possible.

Hence, that is why in the past few years, we have worked vigorously on various pilots. Pilots like the Enabled Living Programme, the Home Support Programme, which will start in the second half of this year. These provide community living options for persons with disabilities and special needs.

And then, there is the Enabling Services Hub (ESH), for which we have set up three across the island now. Progressively over the next few years we will be setting up more of these ESHs to make sure that we can provide community connections through the provision of social activities, caregiver support, as well as referral services. Because we are not dealing with a situation where there is a lack of services for persons with disabilities; rather, sometimes is that navigation of this quite complex landscape that is the issue.

And also the Enabled Enabling Skills for Life Programme (ESLP) which is fundamentally a new service model that we are looking at which integrates the current DAC, as well as shelter workshop models to provide and equip persons with disabilities for independent living, for community participation, as well as for employability.

It sounds like there are many pilots and there indeed are. But the end goal is this: that we want our persons with disabilities and special needs, we want them to not just make do in life, but we want them to be able to thrive and flourish.

On the related issue of affordability, rest assured that through the inter-agency task force that is currently headed up by Minister of State Goh Pei Ming, we are looking at that deeply in terms of affordability of services, not just the availability of services.

And I think I want to close by making a call to our Members of this Chamber, as well as to the larger society, that our vision is for our persons with disabilities to flourish, to thrive and not just to survive in the community. We can be closer to our vision when more in our society can embrace our fellow workers, our fellow students, fellow members of a community. I call upon all Members of this Chamber to be part of this movement so that we can move the needle towards making Singapore a more caring and inclusive society.

Mr Speaker: Ms Kuah.

Ms Kuah Boon Theng: Just a quick further question. I appreciate the Senior Parliamentary Secretary's point about understanding different needs. But the question I raised was actually specifically for those who require high support needs. And although every parent wants to see their child learn to be more independent, the reality is that for those with high support needs, that is the most challenging category, they are going to need a lot more care. And yes, we all want to delay institutionalised care, but the earlier we are able to get them into a DAC where they are stimulated and they are exposed to activities, the better. So, at the end of the day it does come down to capacity and I know that we have a shortage of people willing to work in this area. I do hope that the Ministry will do more to provide more resources for that.

Mr Eric Chua: Sir, I thank the Member for her supplementary question. We are in agreement, total agreement. As I mentioned, we will increase DAC spaces by 500 over the next few years by 2030; and we are prepared to ramp up even more if there is an assessed need to do so.