If you’re concerned about your child’s academic development or communication skills, you might be wondering if they have an underlying condition, such as ADHD, dyslexia or autism.

Although completely different developmental disorders, these three conditions are often discussed together because they share several symptoms. Not only that, but people who have one condition can often also have another (e.g. ADHD + dyslexia).

If you suspect your kid is affected by autism, ADHD or dyslexia, take heart. In Singapore, there are not only several avenues to test for each, but also many places you can turn to for information, support and resources. Here’s a cost guide to how you can proceed.

Autism — symptoms, testing and treatment in Singapore

Autism is a lifelong disability with no known cause. For people on the autism spectrum, the different parts of the brain don’t “communicate” well with each other. As a result, they can’t make sense of the world or relate to other people, and often have problems with language, emotions and abstract concepts.

Asperger’s Syndrome is a form of autism. Although people with Asperger’s also find it difficult to communicate and socialise with others or participate in social imagination and creative play, they have fewer language difficulties.

As of 2013, Asperger’s has been considered by the World Health Organisation (WHO) as part of autism spectrum disorder and is no longer diagnosed separately.

In Singapore, 1 in 150 children has autism. Statistically, boys are up to 4 times more likely to have the condition.

Common autism symptoms in babies and toddlers

The earliest symptom of autism is usually delayed speech. That’s why even though babies have autism from birth, diagnosis only takes place when the child is 18 months and older, and can only be reliably confirmed by 24 to 36 months.

Other symptoms include a refusal to make eye contact or communicate, a tendency to ignore others, and difficulty responding to or using non-verbal cues (e.g. gestures, facial expressions, eye contact and body language).

Children on the autism spectrum sometimes also exhibit repetitive behaviours (e.g. flapping their hands) and uncommon, intense interests (e.g. collecting bottle caps, watching insects fight).

Another telltale sign is the “meltdown”. You might mistake it for a tantrum, because meltdowns often involve crying, rocking, and physical aggression. But unlike tantrums, these are involuntary reactions to a sensory overload from their surroundings (e.g. sounds, smells, tastes, lights) and can’t be calmed by rewards or discipline.

Autism test in Singapore (public route)

If you suspect your child has autism, get him diagnosed by a professional. Because the condition is complex, it usually takes 3 to 4 hours over a total of about 3 sessions to assess your child.

For a comprehensive assessment, your child may be evaluated by several healthcare professionals and specialists. These can include paediatricians, child psychologists, speech therapists, and even an audiologist to rule out hearing difficulty as a cause for limited communication. 

For younger kids who haven’t started primary school yet, the most affordable route is to go to a polyclinic to get a referral to a hospital (either to KK Hospital or NUH Child Development Unit). You will need to wait about 2 months or so to get an appointment though.

If your child has started primary school, you can go to the school counsellor to get a referral. You’ll be routed to a Child Guidance Clinic.

Alternatively, ask the counsellor to activate the REACH team (Response, Early intervention and Assessment in Community Mental Health, a mental healthcare service. Not to be confused with Reaching Everyone For Active Citizenry @ Home, the government’s feedback unit). REACH comprises doctors, psychologists, social workers, therapists and nurses who will work with the school to assess and help your child.

Cost: While the public health centres don’t publish their prices online, the good news is that you can use your child’s Child Development Account (CDA) to pay for the assessment.

Alternatively, the Dyslexia Association of Singapore (DAS) also provides assessments for autism, but it doesn’t come cheap. Expect to pay $2,400+ if your child is a Singaporean and $2900 if they’re a Singaporean PR or Foreigner. The DAS does, however, give subsidies based on income levels, and these range from 33 per cent to 100 per cent.

ALSO READ: Possible link between C-section and autism, ADHD

Autism test in Singapore (private route)

There are several private clinics, paediatricians and centres that run tests for autism. While it is more expensive, there are some advantages. You can get an appointment within days. And you can read up on the doctors or the institutions, or get recommendations to pick the right one for your child.

Here are some private centres in Singapore that specialise in developmental disorders like autism:

• Autism STEP
• Cheers Learning Services
• Clinical and Health Psychology Centre (NUS-affiliated)
• Lazarus Centre (screening only, not a formal diagnosis)
• Promises Healthcare
• Psych Connect
• SACAC Counselling
• The Centre for Psychology
• Therapy Alliance Singapore
• Think Kids
• Thomson Kids

Cost: Unfortunately, most clinics don’t publish their fees online. But for a rough idea, Cheers Learning Services charges $500-$700 for each test. Just bear in mind that diagnosing autism will probably involve 2-3 rounds of testing.

Autism treatment—what are the options?

There is no medicine for autism. Sometimes medication may be given to manage the symptoms related to the condition such as depression, seizures or irritability. Autism isn’t an illness that needs to be cured, but a condition that can and should be managed. 

Early intervention helps a child on the autism spectrum to reach their maximum development potential. To manage autism, the child usually undergoes a programme focusing on managing the condition through education and therapy.

If your child is under 7, you can enrol him at an EIPIC (Early Intervention Programme for Infants & Children) centre run by SG Enable, a government agency that supports Persons with Disabilities (PwDs). These centres provide therapy and educational support for very young children to help them develop better.

Your child can attend mainstream schools if his autism is mild. Once he begins primary school, he may be given an allied educator or special needs-trained teachers to support him during lessons.

Alternatively, he can attend a special education school. There are 2 types of schools supporting children with autism—those with no intellectual impairment and those with some intellectual impairment. Here’s a summary of the schools available in each category:

In addition, there are lots of private centres that focus on therapy. Whether these programmes would benefit your child really depends on your child’s needs— every child is different, and no two persons with autism present with the same symptoms and behaviour patterns. After getting a formal diagnosis by a healthcare professional, you’ll also receive advice on the best next steps for your child.

ADHD—symptoms, testing and treatment in Singapore

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects brain development—specifically, the parts of the brain responsible for focusing, planning and organisation.

While it’s pretty normal for kids to be easily distracted and very active, children with ADHD are particularly hyperactive and unfocused to the extent that it can affect their academic learning and social relationships. The condition is thus usually diagnosed when the child begins school and can’t seem to pay attention or sit still.

ADHD tends to run in the family, with boys being 3 times more likely to have it than girls. Children who were born premature, have low birth weights or mothers who smoked or drank during pregnancy also have a higher chance of developing ADHD.

Common ADHD symptoms in children

The three main symptoms of ADHD are:

• Hyperactive (e.g. can’t sit still, fidgets)
• Unable to control impulses (e.g. blurting out answers before the asker has finished the question)
• Trouble paying attention (e.g. easily distracted, often forgetful)

As a result, people with ADHD may have trouble managing time, setting goals, focusing on activities, following orders, exercising self-control and managing emotions. They may be forgetful, moody, daydreamy and/or excessively talkative (e.g. interrupts other people).

ADHD test in Singapore

It’s sometimes difficult for parents to recognise ADHD in very young children because the inability to sit still, the lack of impulse control and the short attention span are classic toddler behaviours. But if you suspect your child has ADHD, consult a professional for a proper diagnosis.

Like autism, ADHD can be tested at a subsidy if you visit a polyclinic and get a referral to a public hospital. Additionally, you can visit the following providers directly for subsidised rates:

• Child Guidance Clinic (HPB)
• Department of Child Development (DCD) (KK Women’s and Children’s Hospital)
• Developmental & Behavioural Paediatric Services (NUH)
• James Cook University Psychology Clinic

The Dyslexia Association of Singapore (DAS) also provides assessments for ADHD. This will cost $1,300+ if your child is a Singaporean and $1600+ if they’re a Singaporean PR or Foreigner.

If you opt for a private centre, ,most of the places that test for autism listed above will also test for ADHD, as the procedure is similar.

• Clinical and Health Psychology Centre (NUS-affiliated)
• Cheers Learning Services
• Promises Healthcare
• Psych Connect
• SACAC Counselling
• Therapy Alliance Singapore
• The Gifted Lab
• Think Kids
• Thomson Kids

Cost: Not all the centres above publish their fees online. However, The Gifted Lab charges $500+, while Cheers Learning Services prices each test at $500-$700. 

ALSO READ: Autism didn't stop him from performing and he now organises talent shows for those with special needs

ADHD medication & treatment options

With ADHD, a multi-pronged treatment is usually required. Therapy and medication work hand-in-hand with lifestyle changes like diet, school and exercise.

Because ADHD is a neurological disorder, medication is often given to regulate the chemicals in the brain. They work by stimulating the parts of the brain that control focus and self-control so they can function properly.

Additionally, behaviour, cognitive and psychological therapies along with counselling have been found to be helpful. These target specific actions, emotions or social interactions.

Often, the therapies involve structuring time at home, creating routines and increasing positive attention. The same places that diagnosed your child’s ADHD can also provide such programmes and behavioural interventions.

Diet, nutrition and exercise are also helpful. A healthy diet with unprocessed foods alleviates some people’s symptoms, while exercise releases feel-good chemicals to help kids with depressive tendencies.

ADHD in Singapore—support from schools and organisations

Kids with ADHD can choose to be in mainstream schools with the option to have an allied educator or specially-trained teacher to support them when they start primary school.

In addition, there are not-for-profit organisations you can turn to for aid or support:

• Care Corner Educational Therapy Service
• Kampung Senang Charity & Education Foundation
• Shine Children & Youth Services
• Society for the Promotion of ADHD Research and Knowledge (SPARK) 

Dyslexia—symptoms, testing and treatment in Singapore

Unlike autism and ADHD, dyslexia isn’t a neuro-behavioural disorder. Dyslexia is a lifelong learning difficulty and cannot be cured. However, dyslexics can learn to cope with their language difficulties  with the help of early intervention, teaching them skills and methods to cope with dyslexia.

Dyslexia is a specific type of learning difficulty identifiable as a developmental difficulty of language learning and cognition. It primarily affects the skills involved in accurate and fluent word reading and spelling.

Characteristic features of dyslexia include difficulties in phonological awareness (related to sounds), verbal memory and processing speed.

Co-occurring difficulties may be seen in aspects of language, motor coordination, mental calculation, concentration and personal organisation. However, these are not, by themselves, markers of dyslexia.

No one knows what causes dyslexia, though it tends to run in the family and is more common in males than females. Contrary to what some may believe, dyslexia is neither caused by nor leads to a lower IQ.  Children with dyslexia may do poorly in school due to their difficulties reading and writing, but can be of average and above intelligence.

Common dyslexia symptoms in kids

Dyslexic children often have trouble with their letters. They may confuse similar-looking letters (e.g. b and p) and words that look similar, such as “was” and “saw”.Because of this, people with dyslexia tend to have reading problems. They may skip words/lines when they read, complain that words/lines on a page seem to move, or simply can’t understand what they’re reading.

The same language problem spills over to the written and spoken word as well. Dyslexics often have difficulty copying things down, writing words even if someone spells out the letters, and expressing themselves verbally.

Additionally, children with dyslexia may have poor handwriting due to their difficulty with recognising and reproducing letters.

ALSO READ: Children with dyslexia have greater emotional responses than those without: Study

Dyslexia test in Singapore

Different kids show different symptoms of dyslexia, and these symptoms may change as they get older. Thus, it’s difficult to know for certain if your child is dyslexic without professional assessment.

MOE conducts a systematic screening for primary school children to identify those who might need to be professionally assessed for dyslexia. In Primary One, all students with weaker language skills are given additional support through the Learning Support Programme (LSP). If the LSP fails to help, the student undergoes more tests.

But what if you suspect your child might have dyslexia even before they start primary school? The process to get your child tested for dyslexia is the same as that for testing for autism and ADHD, involving a public or private route with input from parents and school.

If you opt for the public route, you can visit a polyclinic or Community Health Assist Scheme (CHAS) clinic to get a referral to the Department of Child Development at KKH or the Child Development Unit at NUH.

Cost: Prices for a dyslexia assessment at public hospitals aren’t currently available, but we can expect they’d be more affordable than the private centre options below.

Most of the private centres that test for autism or ADHD also provide tests for dyslexia.  Apart from those centres, you can also turn to the Dyslexia Association of Singapore (DAS).

Cost: Expect to pay  $900 and up at the DAS if your child is a Singaporean, and $1,080 or so if they’re a Singapore PR/Foreigner. However, fees at DAS can be 33per cent to 100per cent subsidised for those who are eligible for bursaries. Private centres may cost even higher, starting from $1300 at The Gifted Lab.

Dyslexia treatment — what are the options?

Dyslexia can’t be cured and your child won’t outgrow it. However, it can be managed so that your child can overcome the learning challenges and maximise their learning potential.

Treatment involves equipping him with mechanisms to cope with dyslexia. Usually this comprises a reading programme to improve his language skills, plus general learning strategies to help him cope in school.

You can find these programmes at these centres:

• Care Corner Educational Therapy Service
• Dyslexia Association of Singapore (subsidised for Singaporeans)
• SACAC Counselling
• Shine Children & Youth Services
• Spectrum Learning
• The Gifted Lab
• Therapy Alliance Singapore
• Think Kids

Cost: If your child is a Singapore Citizen, literacy programme fees at the DAS will set you back by $505+ per term if your child attends off-peak classes, and $556+ if they attend during the “super peak” period.