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LCQ20: Pre-school rehabilitation services
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     Following is a question by the Hon Cheung Kwok-che and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (November 7):

Question:

     As at September 30 this year, there were respectively 913 and 1 072 children aged between two and six waiting for the services provided by "Special Child Care Centres" and "Integrated Programme in Kindergarten-cum-Child Care Centre". Some parents have relayed to me that their children with disabilities have been waiting for these two services for over one year. Some experts have pointed out that symptoms such as obstinate behaviour, impairments in social interaction and slow language development will manifest in autistic children and will impede their learning and psychological development; if early intervention can be provided, their chances of rehabilitation may be greatly increased. In this connection, will the Government inform this Council:

(a) of the respective numbers of places provided for the aforesaid two services, the respective numbers of children waiting for such services and the respective average waiting time, in each of the past five years;

(b) of the respective numbers of children who stopped waiting for the aforesaid two services in each of the past five years because they were admitted to primary schools;

(c) whether it has assessed the effect of early intervention on the rehabilitation progress of autistic children; if it has, of the details; if not, the reasons for that; of the number of autistic children aged between two and six in Hong Kong in the past five years; under the existing policy and services, how the authorities cater for the rehabilitation and training needs of autistic children and children with other disabilities who are waiting for the aforesaid services; whether the authorities will provide District Support Centres for Persons with Disabilities with additional resources to increase the support and assistance for children with these disabilities, and whether the authorities will provide cash allowance for them to purchase rehabilitation services provided in the private sector; and

(d) whether the authorities will increase the places for the aforesaid services in the coming five years; if they will, of the details; if not, the reasons for that?

Reply:

President,

     The Government strives to provide children with disabilities with early intervention through pre-school rehabilitation services, including Early Education and Training Centres (EETCs), Special Child Care Centres (SCCCs), and Integrated Programme in Kindergartens-cum-Child Care Centres (IP), to enhance their physical, psychological and social developments, thereby improving their opportunities for attending ordinary schools and participating in daily life activities and helping their families to meet their special needs.

     My reply to the question raised by the Hon Cheung Kwok-che is as follows -

(a) The numbers of places, numbers of children on the waiting lists and average waiting time for SCCCs and IP in the past five years are set out in the Annex. As of September 2012, the numbers of children on the waiting list for SCCCs and IP were 1 136 and 1 104 respectively.

(b) The service targets of SCCCs and IP are children with disabilities aged between two and six. From July 2010 to September 2012, the numbers of children who left the waiting lists for SCCC and IP upon reaching the age of six were as follows (note) -

     Number of children leaving the waiting list
            upon reaching the age of six

Service    7/2010-    1/2011-    1/2012-
Type      12/2010    12/2011     9/2012

SCCC          1          6          3
IP            5         22         24

(c) For most illnesses (including autism), early intervention enables patients to receive timely treatment and care, which in turn enhances rehabilitation progress of the patients. In this connection, we aim to provide children with autistic tendency or symptoms with the requisite support so as to ensure that they can obtain the proper treatment during their formative years.  The Child Assessment Centres (CACs) of the Department of Health (DH) provide suspected autistic children with comprehensive integrated assessment services, and arrange rehabilitation services for them as necessary. After preliminary assessments at CACs, autistic children will be referred to the Paediatrics and Adolescent Medicine or Child and Adolescent Psychiatric Specialist Outpatient Clinics of the Hospital Authority (HA) for further assessment and treatment. As a standing practice, both DH and HA closely monitor and review the progress of autistic children during their diagnosis and treatment process, and provide the required support according to their individual clinical situation.

     Based on the findings of the Survey on Persons with Disabilities and Chronic Diseases conducted by the Census and Statistics Department during 2006 and 2007, the estimated number of autistic persons aged below 15 was 2 500 at the time of enumeration. Owing to limited sample size of the survey, a breakdown of the number of autistic children aged between two and six was not available as the estimated figure would be subject to relatively large sampling error.

     According to the information collected by DH, the numbers of new cases in which children aged between two and six were diagnosed with autism spectrum disorders in the six CACs of DH in the past five years were as follows -

2007     2008     2009     2010     2011
 716      824    1 211    1 454    1 410

     We are mindful of timely provision of pre-school training for children with disabilities. The Social Welfare Department (SWD) has all along been monitoring the waiting time for pre-school rehabilitation services and making full use of resources available to facilitate early provision of services for children in need. Apart from steadily increasing the number of pre-school rehabilitation places, SWD has since December 2006 implemented a host of measures, including enhancing the computer system, simplifying application procedures and avoiding duplicate applications, etc, with a view to streamlining the waiting arrangement.

     Starting from January 2009, an additional funding of about $35 million has been allocated annually for setting up 16 District Support Centres for Persons with Disabilities (DSCs) through re-engineering the community support services. They provide district-based and one-stop support services for persons with disabilities, their family members and carers. DSCs adopt an activity-oriented approach to formulate appropriate training, care, social, psychological and personal development activities, etc, according to various needs of service users (including children with disabilities and their parents). DSCs also provide support and training services for carers of persons with disabilities to alleviate their burden and enhance their caring capacities.

     Furthermore, the Community Care Fund (CCF) has since January 2012 started to provide training subsidy for children who are on the waiting list of subvented pre-school rehabilitation services, with a view to providing training subsidy for not more than 12 months for pre-school children from low-income families who are in need of rehabilitation services, thereby enabling them to receive the necessary services as soon as possible and facilitating their learning and development. Administered by SWD, this assistance scheme provides a maximum monthly subsidy of $2,500 for each eligible child for receiving not less than four sessions of pre-school training and parent support services. These include not less than three hours of individual or group training/therapy service provided by special child care workers, psychologists or occupational therapists/ physiotherapists/speech therapists (including parallel groups with the concurrent participation of parents or guardians/carers) and family support services provided by special child care workers, psychologists, therapists or social workers. In view of the effectiveness of the scheme, SWD is considering incorporating it into its regular subvented services. Lead time is required for a comprehensive study and consultation with the stakeholders on regularisation of the scheme to ensure that the scheme will meet the needs of service users and achieve effective use of resources.  During the transitional period, the Steering Committee on the CCF has endorsed SWD's proposal to extend this assistance scheme so that the children in need may continue to receive appropriate training as early as possible.

(d) The Government has all along been steadily increasing the number of pre-school rehabilitation places. Over the past five years (2007-08 to 2011-12 financial year), we have allocated funding to provide a total of 1 393 additional places, representing an increase of nearly 30% (26%). There are currently a total of 6 230 pre-school rehabilitation places. We anticipate that about 607 additional places will come on stream in the coming two years, representing approximately 11% of the number of children with disabilities currently on the waiting list of pre-school rehabilitation services.

Note: The Central Referral System for Rehabilitation Services ¡V Subsystem for Disabled Pre-schoolers of SWD merged with a newly implemented "Client Information System" in mid June 2010. As the merged system has not retained previous information, SWD could only provide the required figures starting from July 2010.

Ends/Wednesday, November 7, 2012
Issued at HKT 14:46

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