Therapy 101: Go Private or Subsidised?
There’s an update on Nadine’s development. I made an important decision that is a major turnaround from my previous stand.
Some time in April 2013 , I decided to put her through the official system of getting her diagnosed. This meant sending her to KK Women’s and Children’s Hospital.
For a long while, (in fact, I tell many people too!) my stand was: if you can afford therapy via the private route, go for it. Don’t go for government subsidised therapy.
Please don’t get me wrong. I’m not looking down on medical help from subsidised hospitals. But after much observation and talking to various medical professionals in both private and government sectors, there is a manpower shortage in government hospitals. This means, many many patients versus little medical professionals. Simply put, the wait is long.
In Nadine’s case, time is not on her side. As mentioned previously, early intervention is important. And we need consistent intervention to have any results. We all know that a therapy session every 4 months is not considered consistent intervention. (Sadly, that’s the best KK’s Department of Child Development (DCD) can offer) To be fair, you are given an option to have weekly therapy sessions, but only for 4 weeks. Thereafter, you have to join the queue and wait for the next available slot.
Here’s the timeline of my experience in KK Hospital thus far:
5 April 2013 – Visit to Polyclinic to get a referral letter to KK’s DCD
30 April 2013 – 1st visit to KK. Saw a consultant doctor in the DCD. This visit was to ascertain that Nadine has developmental issues. Once that was established, we were then assigned a Child Development Paediatrician. Earliest date? 3 months later!
17 July 2013 – The all important meeting with the expert. She accessed Nadine, made her do some tests, run here and there, check her reflexes, basically a very complete medical examination on her development. 1st conclusion: Nadine needs speech therapy. 1st advice: would you like to continue with your current therapist in the private sector?
Even the expert knew, for best consistent help, KK hospital is unable to support consistently for more that that initial 4 weeks.
Next, the expert advised that Nadine has to go for further tests to establish her development. This meant Occupational Therapy (OT) assessment, Physiotherapy assessment and Hearing Test. (Note: There were others in the list, but it wasn’t necessary for Nadine)
That first important meeting with the expert ended with us making our next appointment with her in February 2014. (Yes, that’s not a typo) Meanwhile, we will continue with the speech therapy, and follow through with whatever happens at the OT, Physio and Hearing assessment.
We just went for the Hearing Test last week. The other two OT and Physio ones are in September.
Thus, 4 months have passed since April, and effectively, Nadine has not started on any therapy with KK DCD. She has only completed a portion of the diagnostic tests, and we would only find out more next month after she completes the rest. Early intervention is happening, but really at a very slow pace.
So the question is, Why did you go and visit the KK DCD?
Friends have told me, it would mean that Nadine’s official records will state such developmental issues. It may be a stigma to her. It would also mean that the education system (read: EVERY teacher from Primary School to at least Secondary) would have access to her ‘state’. And it may be a problem for her getting insurance in future, if there’s any exclusions needed for pre-existing conditions.
If that’s the case, then WHY?
Only one reason. So that Nadine’s development issues are documented. Period.
It won’t be a stigma because anyone who spends time long enough with her would realise she is a little slower in expressing herself. I want EVERY teacher to know she has this issue so they extend grace when she can’t answer the question or is unable to comprehend certain instructions. I want her to have access to any Learning Support groups in the school, have best possible support from the Allied Educators in the school system.
Now if you ask, “should I send my child in for assessment or therapy at KK’s Department of Child Development?”
I wouldn’t be so quick to say DON’T. I also wouldn’t be so quick to say GO. There are factors to consider (as above). Think about it and make a decision fast. Although this is not a life & death scenario, for every delay, the window we have to help the child gets smaller and smaller. One comforting thought: the fact that a parent asks this question, is in itself, a big step forward in the child’s development.
This is part of a series I’ve started – Therapy 101, to document Nadine’s developmental struggles and victories, and to journal my own learning experiences as she goes through hers.
I very much doubt that her treatment at KKH would be reflected in her academic records. Patient confidentiality regulations are in place for a reason. Even another hospital would have to request for those records to be shared, if they wanted to refer to them. When it's time for her to go to primary school, the onus will be on you to highlight any issues pertinent to her schooling. That's what I did for Zoe when she entered P1 this year.
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Hi Jean! Ohh not in academic records. Friends have told me that it would be recorded in her personal file, which follows her thru the entire formal education system. That alone is what makes them feel would be a stigma. I would do like you did too, and a little more 🙂 I'd probably highlight at admission, remind at orientation, bring it up again at Meet Parents session.
By "academic records" I meant her school records. If you have concerns, you should clarify them with KKH as your friends might be mistaken.
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i been thru it. My son in KKH DCD since 3. He is going P1 next yr. U need to give consent to hospital if u wish to let the school know abt yr child condition, (some parent prefers keep quiet, not wanting the sch to know or treat their child 'diffentently'). KKH requires u sign a consent form to the sch name.
My comment on KKH therapies, my son go thru speech, physio and occupational therapies in KKH. The 1hr session is mainly to go thru some exercises( teach the parent "To-do-list" for parent to practise with child at home. The physio and occupational therapy at KKh is ok, but not the speech. I encourage u to go for private speech therapy. My 2-cents.
I wish you the best with what ever route you choose.
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Here in the US, our system is a bit different, but we still deal with similar issues – how to get effective treatment for your child with special needs. I actually found that one of the best private facilities in my area had similar wait times as the KK for appointments… and you had to go to 2 different intake appointments (scheduled weeks, if not months apart) before you could even get on the schedule for an actual evaluation.
The good news is that you are aware and doing your best to help your daughter – that means she has a head start on a lot of kids!
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I'm glad she's showing improvements and confidence. That's the most important!
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You know, private versus public therapies are not any different here in the states. Our son needed speech therapy for a while and our daughter needed physical therapy when she wasn't walking or crawling at 12 months. Both public therapies involved huge amounts of red tape and appointments months later. While the private route allowed us the chance to pick a therapist, get them in and get them better.
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Thank you for sharing your story. I hope you continue to see improvement with her therapy.
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Wow that's a lot of time! It's sad that she can't easily get the help she needs on a consistent basis. Deciding to get a child tested, and essentially labeled, is a hard choice for all parents. Every parent will likely have a different reason for deciding what they did too.
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Private therapy is so expensive but I believe it worked wonders for my daughter's speech!
I wish you the very best. Love is the best medicine but it's nice to have therapy when needed as well!
These decisions you never anticipate having to make before you become a parent can feel so overwhelming. We went for a combo of private for Dx and through our school for therapy.
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You are doing what you feel in your heart to be right and you know what…that is exactly what you should do. Never go against what you feel is right for your babies.
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It sounds like you're making the best possible decision for your child and that's really what matters!
Listen to your heart Mama, you know what's best for Nadine, if you feel it needs to be documented and so choose the public because of that, then you did right. If you feel both private for some things and public for others is what she needs then there's nothing wrong with that either!
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I am currently facing this very same situation for my 3yo son! Brought him to KKH DCD early March. Was informed that the next appt will be arranged within the next 6 mths! How effective is that? My son started stuttering when he was about 2yo and has been worse over last few months. So bad we felt bad when he speaks & ended up frustrated. We are currently checking on available clinics in the pte sector now. Can't be waiting months for each therapy!