More young children diagnosed with developmental delays

More young children have been diagnosed with developmental delays, with new cases rising by about 25 per cent in the last five years and doubling since 2010.

The trend is set to grow, with experts observing disconcerting signs among children because of pandemic-induced habits.

Last year, KKH Women's and Children's Hospital and the National University Hospital diagnosed about 5,000 new cases of developmental delays in pre-schoolers, said the Ministry of Health (MOH) in response to questions from The Straits Times.

In comparison, there were some 4,000 new cases in 2015, and about 2,500 new cases in 2010, according to a previous report in ST in 2016.

MOH attributed the increase to several factors, including parents and caregivers having better awareness of developmental issues in early childhood.

The improved developmental surveillance and screening system in the community and at childcare centres have also resulted in more referrals to child development services, it added.

Autism spectrum disorder (ASD) as well as speech and language delay and disorders accounted for about 60 per cent of developmental issues diagnosed among pre-schoolers, the ministry said.

KK Women's and Children's Hospital, which saw the bulk of new cases - nearly 3,600 children - has noted a "doubling in the number of children below two years of age", said Dr Christelle Tan, an associate consultant in its department of child development.

SCREENING

Punggol Polyclinic started a structured two-tier developmental screening in its Temasek Foundation Integrated Maternal and Child Wellness Hub in July 2019.

It has since seen a doubling of referrals for children aged 18 months and above, from 4 per cent to 6 per cent initially to 11 per cent to 14 per cent in June this year, Dr Tan said.

However, health experts say the impact of the pandemic on developmental delays is still unfolding.

"We are already seeing alarming signs of adverse child development outcomes due to movement restrictions in the past 18 months," said Dr Jennifer Kiing, a senior consultant from the child development unit at the department of paediatrics in Khoo Teck Puat - National University Children's Medical Institute in the National University Hospital (NUH).

"At the child development unit at NUH, we are seeing more referrals for speech delay, poor social engagement, ASD features, and short attention span during this pandemic. Many of these conditions are associated with excessive screen time," she said.

During the circuit breaker last year when schools closed for two months, parents resorted to screen time to occupy their children while they worked from home, said Dr Kiing.

Because of Covid-19, many parents have avoided playdates and playground visits, while some have removed their children from infant care or childcare centres to limit their exposure to others, said Dr Tan.

"The reduction in social interaction, cognitive stimulation and increased screen use may result in language delays and delays in social development in toddlers," she said.

She is also seeing more children who are unable to regulate their emotions, throwing frequent tantrums and exhibiting shorter attention spans with impulsivity.

At the same time, experts said that parents are not seeking help early enough.

"The pandemic has resulted in a generalised fear among parents of visiting hospitals. And we have seen many parents reschedule and delay their visit to our Child Development Clinic for evaluation of these developmental delays and behavioural concerns in their children, as parents viewed these as less urgent," said Dr Tan.

"The same goes for appointments for relevant therapies for children with developmental delays."

Dr Tan said KKH has pivoted to using telehealth services, such as consultations via phone and video, to follow up with children and their parents.

She believes the "true impact will only likely be seen in the years to come as developmental delays and behavioural concerns take time to manifest and may not be obvious till many months later".

Left unchecked, they will continue to develop into children's schooling years, she added.

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