It’s easy for a child to be diagnosed with autism or attention deficit hyperactivity disorder (ADHD) when they’re five. Well, not “easy”. Nothing about neurodivergence is really easy—I say this as the mother of two neurodivergent children. But at least there’s a defined, coherent, affordable path. When they’re five, someone in their preschool is trained to identify whether they might need an assessment, and where to refer them in the public system for assessment and diagnosis.

After being assessed, they can receive early intervention either at an EIPIC (Early Intervention Programme for Infants and Children) centre or at the preschool itself. Subsidies mean that even children from lower-income families have a good chance of getting help. 

But they’d better get diagnosed while still under seven. Because it’s not easy to be diagnosed with autism or ADHD once they cross that threshold. At eight, most of their teachers are no longer trained in early detection. The developmental paediatricians at NUH and KKH will likely no longer screen them. The webpage of the Ministry of Education (MOE) has useful information for families with children suspected of having developmental or Special Educational Needs (SEN) under seven, but is quiet on those older, apart from a list of private psychologists licensed to diagnose children, and a “Professional Practice Guidelines” document.

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Small wonder that more than half the families seeking SEN diagnosis for their children over seven via the public healthcare system report fragmented or unclear processes, “referral loops”, and/or confusion about next steps (compared to only 18 percent accessing private healthcare). Many report stress, burnout, marital strain, and isolation. Even should a diagnosis be obtained, the required support and intervention are hard to find. 

Considered together, the whole system rests on chance, not intentional design.

Why?

It’s not because autism or ADHD no longer matters at eight (it does), or because the adults in the child’s life have suddenly stopped caring (they haven’t). It’s simply because, by turning seven, the child has crossed a magical threshold in Singapore’s bureaucratic apparatus, passing from the “care” of one ministry—the Ministry of Social and Family Development/Early Childhood Development Agency (MSF/ ECDA) to another—MOE.

We have national strategies for AI, jobs, climate, and ageing. But there is no single, coherent strategy—and no clear leadership—responsible for children and young people (CYP). Apart from MOE and MSF, the Ministry of Health (MOH) and the Ministry of Culture, Community and Youth (MCCY) touch different parts of a CYP’s life, each with different KPIs and practices.

What Singapore desperately needs is a national children’s strategy that involves a coordinated whole-of-government approach, which will help us more comprehensively address everything from SEN diagnosis to the problem of youth vaping in schools.

It may sound like I’m blaming MOE. I’m not. MOE and MSF are different ministries, with different mandates. They have different priorities and offer different services, which is fine. What’s not fine is that, when it comes to children, there’s no “higher power” seeking to standardise services and subsidies across age groups, to prevent “cliff effects” when children transfer from one age group to another, or one ministry to another, or to otherwise ensure that children with complex needs don’t fall through the cracks. It’s not because “the system” doesn’t care. It’s simply that no one has been given the mandate to close the gaps. 

This leads to service fragmentation of the type discussed above: multiple agencies filled with well-intentioned, committed people but with no dedicated oversight body to ensure that they form a harmonious whole. Consider this: about 7 percent of students in mainstream schools have diagnosed SEN. Yet only 15 percent of them get a regular (and measly) half an hour every week with an SEN Officer at their primary school; half get some kind of irregular support; and nearly a third get no support at all. What’s more, SEN Officers only need nine months of training, and no prior experience with teaching or special needs is required.

It’s been more than a decade since the trend of sharply increasing special and developmental needs diagnoses among young children in our public hospitals (MOH) was recognised.  Yet, government-funded early intervention services (MSF), SPED schools (MOE), and SEN support systems in mainstream schools (MOE) have all struggled to keep up. One wonders if there is any regular joint planning and projections being done between the various Ministries involved?

The most vulnerable children—with developmental needs or from lower-income backgrounds—are the ones who suffer most, but the overall lack of strategic vision is a national problem.

The early introduction of screens and social media to children leading to overuse and/or addiction is another slow burn trend. Research is starting to show clear links of excessive screen use to developmental delays in younger children and mental health issues in teens. As a leader in tech adoption with a world-class health system, Singapore could have been at the forefront of studying and tackling this issue. Instead, we’re waiting to see what Australia, the EU, and others do first, because, again, no one agency has the authority to drive this issue fully.

Another key example is the PSLE. This dreaded (and dreadful) exam remains the main KPI of primary school education, even though our economy’s needs have moved well beyond the industrial age that the PSLE was designed for. In fact, the passive rote-learning machinery of primary school actively hurts the acquisition of critical 21st century skills. Any senior business leader can tell you this, but it seems as though no one has the power to get MOE to change their KPI for primary schools. Such delays in tackling emerging issues and trends have an economic cost, so one wonders how one ministry has been able to hold our economic future hostage for so long?

There are terrible social costs to this service fragmentation too. The Independent Review Panel (IRP) looking into Megan Khung’s death found delays, diffuse responsibility, and slow multi-agency coordination across MSF, ECDA, the police, and social service agencies. This makes it difficult even for dedicated professionals to act quickly and consistently to help children. No one wants a child to slip through the cracks—but cracks appear when accountability is diffuse. 

The IRP was a courageous step, hopefully leading to better protection for our children. The government’s promise to try and make education less of an “arms race” for parents is encouraging too. However, on a wide range of issues relating to children, parents, caregivers, and paediatric professionals are still struggling with policies, practices, and services fragmented between multiple ministries and agencies. 

Modern parenting is challenging, as suggested by our sharply declining birthrates. Mental health statistics suggest children and youth are struggling too: on average, one child dies by suicide every 10 days in Singapore, and one in three youths aged 15-35 report severe symptoms of stress, anxiety, or depression.In a country as well-resourced as ours, the system must be able to “see” every child—early, clearly, and consistently. And it must be able to train, resource, and support all others—parents, caregivers, and professionals—who look after them. So, how do we build this system?

The ministry should be empowered to set shared, whole-of-government goals for the well-being, support and safety of children and young people; drive rapid cross-agency action when risks escalate; and transparently track system performance—from trends and referrals to outcomes—so bottlenecks can be fixed quickly. 

In practice, this means a single, pooled cross-agency budget under one decision-maker funding child-centred interventions based on life-course outcomes and value rather than ministerial silos; clear legal and administrative authority to set cross-agency KPIs, standards, and protocols; the power to trigger time-bound responses, compel staff deployment and data-sharing; and regular public reporting of referral-to-first-contact times, assessment waits, therapy starts, and relapse or re-entry rates. When everyone knows who is ultimately responsible, urgent decisions get made, accountability is shared, and help arrives sooner.

Under this proposed ministry would sit an Agency for Integrated Care (AIC) akin to the one created over a decade ago to help seniors navigate the maze of healthcare and community support. That AIC was featured in an Asian Development Bank case study lauding Singapore’s approach to dealing with an ageing society. The new “AIC for Children” would be a similar single “front door” through which anyone looking for help or highlighted as being at risk will enter the system. A multidisciplinary team would then triage the case—assessing needs, assigning case leads, and co-ordinating across schools, healthcare, social services, police, and the courts as necessary. Such an agency, if thoughtfully designed, could close current service gaps by prioritising children with complex needs, and ensure fees, distance, and caregiver awareness or capabilities never block access. One obvious improvement would be to make government-subsidised developmental assessment and therapy services easily accessible for children older than seven.

Another example could be to ensure that the passing of an adult automatically triggers the provision of subsidised counselling for their surviving children, rather than risk unprocessed grief leading to more serious behavioural or mental health issues later. For national crises like vaping or excessive screentime, an AIC would be able to more coherently implement policy set by the relevant minister or ministries. 

Aptly for a “Smart Nation”, data should play a vital role in this apparatus, with system-wide visibility of waitlists, time-to-help, and outcomes, so funding, manpower and capability building can follow real needs. Vulnerable children, and those with multiple risk factors or complex needs should be tracked from birth to at least 21, with milestone check-ins and offers of support, so no child falls through the cracks.

Whether the issue is SEN, complex family backgrounds, caregiver mental health needs, or other challenges, finding help for CYP shouldn’t be so confusing that it causes emotional distress. With this one “front door”, parents, professionals, and children themselves would know exactly where to turn when they needed help.

Finally, let’s establish clearly articulated evidence-based, child-development-aligned guidelines and practice standards for everyone who interacts with children and young persons—caregivers, teachers student-care staff, social workers, youth workers, the medical system, police, MINDEF, the justice system—and train to those standards consistently. For instance, currently, MOE’s school-based caning policies and MSF’s protection-from-harm guidance publicly diverge on physical punishment, sending mixed signals to parents.

Finland has taken this approach with parents, creating a shared, evidence-based parenting culture through proactive caregiver education. In Singapore, the minister or ministry for children could do this, and more, ensuring that they can get consistent, nurturing responses wherever they are—home, school, clinic, or community. We’ve made a start, the parent resources on Grow Well SG for instance, but we need to go much deeper, and try to reach all parents and professionals working with CYP.

Let’s make child well-being a national priority, starting in 2026—backed by structure, standards, and leadership that sees every child, early and clearly. By 2027, we should have a coordinating minister for children (if not a Ministry for Children), and all the relevant ministries and government agencies should be able to articulate their ‘Children’s Strategy’.

Because a strategy for children is a strategy for Singapore’s future.

Pooja Bhandari is the founder of EveryChild.SG, a non-profit working towards a loving and nurturing upbringing for every child in Singapore through research, public education and advocacy. She also consults on impact and special projects for AWWA, a large multi-service charity. Prior to that, Pooja spent six years at the Ministry of Social and Family Development, heading policy on disability early intervention for children, and then manpower planning for the social service sector.

Letters in response to this piece can be sent to sudhir@jom.media. All will be considered for publication on our “Letters to the editor” page.

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