Singapore, 26 January 2022 — PAP Community Foundation (PCF), KK Women’s and Children’s Hospital (KKH) and Lien Foundation have come together to launch Mission I’mPossible 2 (MIP2), a pilot programme that seeks to demonstrate how education, healthcare, and social services can be integrated and delivered within the community, and to provide earlier identification and intervention for children with developmental needs. It builds on Mission I’mPossible1 (MIP1), a three-year pilot programme launched in 2009 by PCF, KKH and Lien Foundation at 25 preschools. Upon its completion, MIP1 was adapted by the government, renamed as the Development Support and Learning Support Programme (DS-LS Programme), and scaled up to more than 600 preschools today and is available to over 40% of preschoolers aged 5 to 6. It is planned for the DS-LS programme to be expanded to more preschools, covering 60% of preschoolers by 2025, and 80% at steady-state.

Coming more than a decade after MIP1, the MIP2 pilot will be launched first in 16 preschools operated by PCF, Singapore’s largest preschool operator, in Punggol and Sengkang gradually over four years. MIP2 will cost S$12.1 million, of which $9.27m is a gift from the Lien Foundation, with the balance funded by PCF and KKH. MIP2 will comprise a combination of initiatives, such as the establishment of a School-based Child Development Unit (SCDU) at PCF with the support of KKH; the Parents’ Circle of Support, a support network run by the preschool’s social workers; and new processes for the universal surveillance and systematic screening of growth and development in children, from as young as 2 months old.

Earlier screenings and referrals

The early childhood period is an important time for optimisation of child growth and development. During this time, early detection of developmental issues improves outcomes through early intervention and support.

Currently, children attending preschools where the DS-LS Programme is conducted are screened for developmental needs at the ages of 5 and 6. Children who are identified to have developmental needs through the screening are then provided with short-term intervention at the preschool itself or referred to other early intervention services such as the EIPIC programme.

Typically, these children have a runway of about one or two years for intervention before graduating from preschool. However, there will be some children with higher needs who may require the EIPIC intervention programme, which usually requires a longer runway. The waiting time to enroll in an EIPIC intervention programme, which may take months, also takes up part of this runway.

In MIP2, the age of screening will be lowered to as early as 2 months old. For children who require attention, the most appropriate support programme will be identified. The selected intervention can be what is provided as part of the MIP2 programme or outside of it, such as an existing government-funded programme. As far as feasible, the support for the child will be conducted inside the preschool classroom alongside his or her peers as part of a routine lesson, as a classroom is often the more natural – and thereby more effective – environment for a child requiring support.

The MIP2 team will also explore ways to reduce the logistical challenges faced by concerned parents, who generally need to visit a primary care doctor (such as one at a polyclinic) for a preliminary assessment first, before a further evaluation at the KKH Department of Child Development (DCD) if deemed needed by the doctor.

An evaluation study will be conducted to assess the lessons from this pilot at the end of four years.

In effect, MIP2 will seek ways to more closely integrate the education, healthcare, and social services, and deliver them out of the location that is central and natural to the lives of young families – the preschool. It will streamline processes that facilitate screening, formal evaluation or follow-ups and provision of timely appropriate support, and at a convenient location. It will also focus on the training that will be provided to empower early childhood educators to identify and support children with developmental needs, as they are well-placed to monitor and detect developmental issues in young children. In doing so, MIP2 aims to strengthen child development practices in the early childhood landscape, and co-design and implement family-centred detection and support practices in the preschools.

Mission I’mPossible 2 Programme Details

i) Training and Implementation Plans under Mission I’mPossible 2

MIP2 will be launched in two stages, with a training phase in the first stage and an implementation phase in the second stage.

Set-up and Training phase (First half of 2022)

• PCF and KKH will work together to set up a School-based Child Development Unit (SCDU) at PCF which will comprise of an inter-disciplinary team of therapists, nurses, early interventionists, social workers, nutritionists and curriculum specialists who will rove around the preschools to work alongside teachers in providing integrated and holistic support for children with developmental needs. The setup of the SCDU will be supported by a consultancy team from KKH, which will gradually scale down its involvement and exit after four years.
  
• Initiating training to early childhood educators, including those who look after the development of infants and toddlers and preschool educators, to empower them to identify and support children with developmental needs.

Implementation phase (Second half of 2022)

• Universal surveillance and monitoring for all children in participating preschools from 2 months old. This means educators will survey all children in a preschool class for the risk of developmental needs, not only the few displaying clear signs of developmental needs who have come to the attention of educators. This pre-emptive approach is what enables screening and referrals to be brought upstream.
  
• Children identified to have developmental needs will be further evaluated and offered support within the preschools or early intervention centres. The most appropriate intervention programme will be identified for the child.
  
• A Parents’ Circle of Support managed by social workers to provide general and tiered support for parents, in areas such as parenting, self-care, family and parent-child activities, and navigation of government schemes and processes. The set up will be incremental, with participation gradually moving upstream. In time, it is planned that parents will be able to take part in the Parents’ Circle of Support before their child’s due date, when the parents register interest in enrolling their unborn child at a PCF preschool where MIP2 is conducted.
  
• Support will be provided for children from pilot preschools transitioning to the next leg of their education journey.

ii) Mission I’mPossible 2 Service Model

MIP2: Service Model

The service model for MIP2 will comprise tiered levels of support to ensure children in each tier receive age-appropriate care, early detection, support and intervention as needed in a systematic and efficient manner. It also provides a smooth transition system across tiers and schools to minimise disruption, as well as family involvement and community commitment as the foundation of the service model, with shared knowledge and decision-making between parents and multi-disciplinary professionals.

With this service model, MIP2 seeks to enhance early childhood professionals with the skills needed to identify and support children with developmental needs. In the long run, it hopes to provide holistic support for families that have children with developmental needs, encouraging them to receive the support provided to facilitate early support for children with developmental issues. MIP2 will be implemented over four years in the North-East region from 2022 to 2025, with the number of centres increasing from six in the first year to a total of 16 by the end of the fourth year.

A joint community effort towards a holistic and inclusive early childhood development sector

Dr Honey Ng, Deputy Director, Inclusive Education, PCF, said, “Mission I’mPossible 2 enhances the identification and holistic support for children with developmental needs as young as 2 months old, with the goal of supporting them in their naturalistic classroom environment. This is key for PCF as we believe that every child deserves a good start with quality preschool education, despite their diverse learning abilities. An inclusive environment also encourages children to be more empathetic and loving, and embracing of others with different abilities.”

Associate Professor Chan Yoke Hwee, Chairman of the Division of Medicine at KK Women’s and Children’s Hospital and Programme Director of MIP2, said, “Early childhood is a period of vulnerability and also opportunity. Studies have demonstrated that attendance in a high quality preschool programme and therefore attention to a child’s physical and cognitive development in early childhood are associated with better metabolic and mental health, as well as academic and socio-economic outcomes later in life. It is therefore imperative that children with developmental needs are identified early and be provided early intervention and support. To enable this, KKH will leverage our expertise to support the delivery of integrated education, health and social services through the preschools under Mission I’mPossible 2.”

“The programme is aligned with what KKH hopes to achieve with the recently launched SingHealth Duke-NUS Maternal and Child Health Research Institute to support the growth and development of every woman and child to their fullest, and laying the foundation for the future health of our population,” Associate Professor Chan added.

Mr Ng Tze Yong, Programme Director of Lien Foundation, said, “By going upstream, MIP2 aims to reduce costs. Not just financial costs through lowering downstream demand for early intervention and disability services but more importantly, the emotional costs to families and societal costs of lost human potential incurred when intervention comes too late for children to catch up.”

For more information on MIP2, please refer to Annex A.

The media kit containing useful information can also be accessed here.