4. Developing the Thriving Kids initiative
   1. The Committee received a significant volume of commentary about the critical design considerations and components for the development of the Thriving Kids initiative to make it fit for purpose for children and their carers, as well as for people working in the care sector.
   2. This chapter explores the three issues that were consistently raised in evidence:

• early intervention
• workforce capacity and service delivery
• transition from current systems to Thriving Kids.

Early identification and intervention

4.3This section builds on the discussion in Chapter 2 about early intervention processes and supports for children.

4.4Over the course of the inquiry, multiple witnesses highlighted the importance of screening tools for developmental delays and autism in helping to ensure the timely identification of potential issues.

4.5Australian families can access developmental screening in multiple different ways, including through maternal and child health services, general practitioner appointments, or within early childhood settings.[2] There is also a variety of different methods and tools that can be used to assist parents and healthcare professionals to identify potential issues. These tools include, for example:

• The Parents’ Evaluation of Developmental Status (PEDS), which is a 10-item questionnaire that allows parents to note any concerns in their child’s development, health and well-being
• The Ages and Stages Questionnaire (ASQ), which is administered by healthcare professionals and screens across multiple developmental areas
• Raising Children Network, an online milestone checklist and guide for parents that is used to identify development progress.[3]
  6. Submissions from entities such as Ashar Health, the Australian Primary Health Care Nurses Association (APNA), the Maternal, Child and Family Health Nurses Australia (MCaFHNA), the Australian College of Nurse Practitioners (ACNP), and the AEIOU Foundation, however, noted that the use and access to screening tools across Australia’s states and territories tends to be inconsistent.[4] This situation can result in confusion for children and parents, delayed diagnosis and missed opportunities for early support.
  7. In its submission, ACNP expressed concern at the absence of standardised screening:

Early recognition of developmental and behavioural concerns is critical to ensuring children receive timely support and intervention. However, these early signs are often overlooked or minimised, often described as “something the child will grow out of” or “just a quirk.” Without a consistent approach to a referral, supported by a simplified and universal indicator assessment tool, delays in referral, assessment, and treatment are more likely, and some children may not be identified at all.[5]

4.8APNA and MCaFHNA further highlighted that the lack of a standardised, national approach can have an adverse impact on professionals working in the field, presenting challenges for training, consistency of care, equitable development surveillance, timely referrals across the country, and overall levels of professional confidence.[6]

4.9ACNP recommended that a national, standardised approach to screening be developed, as this ‘would promote equity, ensure consistency, and enable streamlined assessment and timely referral for a more comprehensive paediatric development evaluation.’ This approach, ACNP further explained, would facilitate more consistency in ‘recognising red flags’ across maternal and child health, early education, and healthcare services, which may include:

…repetitive play, feeding difficulties, sensory sensitivities, limited food intake and variety, poor or delayed fine and gross motor skills, intense focus or restricted interest, rigid routines, delayed language development (including echolalia), limited eye contact, regression of skills, toe-walking, and unusual pattern of social play.[7]

4.10ACNP further emphasised the need to integrate screening results into digital systems such as MyHealthRecord or Services Australia platforms, to allow for better monitoring of developmental progress.[8]

4.11Many submitters also called for a more consistent approach in the level of training required to conduct developmental checks. In its submission, Family Paediatrics Nurse Practitioners noted that health professionals are not always equipped with sufficient knowledge to conduct these checks.[9] For example, practice nurses within general practice environments sometimes conduct the checks, but not all have adequate training in this field. Family Paediatrics Nurse Practitioners recommended establishing a minimum qualification requirement, such as a Graduate Certificate in Child and Family Health.

4.12In their joint submission, the Australian College of Nursing (ACN), the Australian College of Children and Young People’s Nurses (ACCYPN), Maternal, Child and Family Health Nurses Australia, and Professional Association of Nurses in Developmental Disability Australia (PANDDA) similarly noted:

While nurses working in primary care settings engage with children, particularly during immunisation visits, they are not typically trained in child health or developmental screening. Studies show that practice nurses often struggle to stay current with child health knowledge and lack confidence in advising parents…

We recommend upskilling primary care nurses in child health and developmental screening and removing barriers to enable more nurse practitioners to work in primary care settings.[10]

4.13Reflecting on the optimal time for screening, APNA and MCaFHNA drew attention to a recommendation by the American Academy of Pediatrics that all children should be screened for autism at both 18 and 24 months of age, in addition to development monitoring. APNA and MCaFHNA stated that:

[t]his recommendation supports global best practice and aligns with evidence showing that early intervention during periods of heightened neuroplasticity can lead to significant gains in social communication and cognitive functioning.[11]

4.14In its submission, Ashar Health recommended implementing screening at key developmental milestones, such as at 6, 12, 18, 24 and 36 months of age.[12] The Australian Medical Association (AMA), the Royal Australian College of General Practitioners (RACGP), and Family Paediatric Nurse Practitioners further highlighted the advantage of integrating developmental checks into immunisation schedules, to leverage the high attendance rates at healthcare settings on these occasions.[13]

4.15Multiple witnesses highlighted the fact that parents and carers are usually the first to notice issues with a child’s development.[14] ACNP noted, however, that sometimes concerns expressed by parents and carers are dismissed. Development of a standardised screening method would help validate their observations.[15]

4.16At the same time, standardised and regular screening would help to normalise developmental conversations, and reduce stigma associated with developmental delays and disorders. As one submitter observed:

Current approaches to developmental screening and early identification often perpetuate deficit-driven narratives that can harm rather than help families. We must fundamentally reframe developmental checks as supportive, strengths-based opportunities that celebrate diverse ways of being while identifying areas where additional support might be beneficial.[16]

4.17Acknowledging the important role of parents and carers in early identification, the Australian Council of State School Organisations (ACSSO) noted that while families often sense developmental issues early, they are unsure what might constitute a ‘red flag,’ where to go for advice, and what services may be available.[17] The ACSSO recommended the development of clear, accessible, and culturally appropriate resources for parents, along with ‘no wrong door pathways’ to ensure parents can access support at any touchpoint (including at maternal and child health services, early childhood education and care centres, schools, and community hubs).[18]

4.18Similarly, Ms Katherine Fotheringham, a mother of a child with autism and a nurse, noted:

A critical first step is empowering parents with accessible tools for identifying early developmental delays. A simple, stage-appropriate screening tool providing immediate feedback and clear next steps would enable earlier intervention and reduce parental uncertainty.[19]

4.19In its submission to the inquiry, Healthdirect Australia—a national call centre for health information, advice and triage—submitted that its existing infrastructure could be used to as a ‘virtual front door’ for families to seek advice on developmental delays. If a child is assessed as needing services, Healthdirect could assist families to find and book appropriate services. As Healthdirect submission explained:

Using the existing National Health Services Directory which has over 120,000 services listed, new categories of services could be included and pathways created from care plans. …

Furthermore, Healthdirect operates a legacy Pregnancy, Birth and Babies helpline which offers phone based advice from maternal health nurses. This could be repurposed to better reflect contemporary expectations from consumers. It could form an initial step in an integrated service for Australians planning to start a family, moving through the phases of conception and birth, and into early childhood development – including guidance on expected development and how to respond to perceived variations. Integrating this information and advice service with the My Health Record which includes immunisation records would start to provide a holistic record and service experience for families.[20]

4.20In its submission to the inquiry, Eating Disorders Neurodiversity Australia also highlighted the need for improved support and screening for avoidant/restrictive food intake disorder (ARFID), which involves persistent difficulty consuming adequate amounts and varied types of food. ARFID can cause severe weight loss, nutritional deficiencies, reliance on supplements or enteral feeding and poor psychosocial wellbeing, as well as serious impacts on bone, muscle, cardiovascular health, and vision. The organisation recommends incorporating ARFID-specific screening and diagnostic tools into Medicare eligibility assessment for eating disorder care.[21]

4.21Standardised, systematic developmental screening enhances early diagnosis rates and allows for timely access to early intervention services. Over the course the inquiry, early intervention was consistently recognised as being highly effective in supporting children with developmental differences. In their submission, APNA and MCaFHNA explained that higher levels of neuroplasticity (being the ability of the human brain to change and adapt) in younger children makes them especially responsive to different forms of intervention:

Neuroplasticity is a vital contributor to early intervention success rates and refers to the brain’s innate response to new information of experiences that allows it to restructure neural connections and pathways. Young children’s increased neuroplasticity makes them more likely to demonstrate significant gains from intervention compared to those who receive similar services later in development.[22]

4.22This point was reiterated by a wide range of entities including My Therapy House, the Australian Multicultural Action Network, the Australian College of Nurse Practitioners, the Australian Primary Principals Association, and South Burnett CTC, as well as a number of parents and carers who made submissions to the inquiry.[23] These submissions acknowledge that the first five years of childrens’ development are critical, as this is the time when children learn the most and develop important pathways in the brain, laying an intellectual foundation for the future. Early and individualised intervention is, in this context, vital for preventing the need for more complex and costly interventions in the adulthood.[24]

4.23Autism Spectrum Australia further emphasised that:

Current and previous programs demonstrate that early and integrated supports can have a significant positive impact on a child’s development. The effectiveness is maximised when programs are delivered in natural environments and are deeply embedded in community systems.[25]

The role of healthcare specialists in early identification and intervention

4.24The Committee received a substantial amount of evidence regarding the role of healthcare specialists in early identification and intervention, and the importance of building their expertise and experience into the design of the Thriving Kids initiative.

4.25In their submissions, both the RACGP and the AMA noted that general practice is the most accessible service across Australia, and often the first point of contact for families concerned about their child’s development.[26] As such, general practitioners (GPs) play a critical role in early identification and intervention:

Specialist GPs are usually the first point of contact for families, addressing concerns from parents and providing care through all stages of life. They are well placed to identify children with developmental delay or autism and to coordinate ongoing management, referrals, and supports.[27]

4.26Nurses, nurse practitioners, and midwives are vital in connecting families to health and developmental services. In their joint submission to the inquiry, ACN, ACCYPN, MCaFHNA, and PANDDA highlighted a recent Flinders University study demonstrating the strong effectiveness of paediatric nurse-led developmental checks for children from birth to five years of age.[28]

4.27In its submission, ACNP emphasised that nurse practitioners are a critical part of the primary care workforce. They are embedded across key service areas, including maternal and child health, general practice, and community health services. This position enabled them to play a pivotal role in early identification and intervention. Integrating this workforce into the Thriving Kids initiative, ACNP submitted, could help to reduce demand on other specialists and improve equity of access to care.[29]

4.28A significant portion of the evidence provided to the Committee also focused on the role of allied health care professions, such as exercise physiology, physiotherapy, occupational therapy, speech pathology, feeding and nutrition services, medical and nursing care, and psychology.

4.29In appearing before the Committee, MrsBronwyn Morris-Donovan, Chief Executive Officer of Allied Health Professions Australia (AHPA), noted that the entity represented some 30 professional associations and 200,000 allied health workers—about 35,000 of whom work in regional, rural and remote communities. Many allied health professionals focus on paediatric or early-child care.[30]

4.30In explaining the role of this workforce, Ms Morris-Donovan noted:

Allied health professionals work across the full continuum of care, beginning with early identification of developmental delay either directly or by building capacity of families and other professionals such as early childhood educators. The early-years window is a critical window for development. Timely access to allied health and high-quality assessment and support planning led by allied health practitioners are essential. GPs and nurses play an important role in identification of potential developmental delay, but it is allied health professionals who assess, plan and deliver tailored support programs in close collaboration with families. These assessments are most effective when they happen in natural settings, are multidisciplinary and are seamlessly linked to the support and intervention pathways.[31]

4.31Occupational Therapy Australia’s Chief Occupational Therapist, Mrs Michelle Oliver, described how allied health professionals often have more time than GPs to better understand the early developmental challenges that a child may be facing. She explained:

The way that allied health works is that we do have the privilege of having an opportunity to really work with individuals and with their families in their natural environments, so we get to understand how they interact, how they communicate and how they engage in their day-to-day occupations.[32]

4.32Emphasising the importance of the role played by allied health providers in early identification, Ms Lynette Brodie, Chief Executive Officer at Speech Pathology Australia, stated:

…in the cohort that we’re talking about, one in four children are not developed mentally on track with their communication skills when they start school. That’s why this is so critically important.[33]

4.33Ms Brodie further asserted:

…and we're such a critical part of the workforce, at the end of the day—all of us—around that really early identification that, within our own professions, we are the best placed, in that early identification.[34]

4.34In discussing the role of speech pathologists, Ms Olga Komadina highlighted Childhood Apraxia of Speech (CAS)—a rare, lifelong neurological speech disorder that affects one to two in 1,000 children. Ms Komadina noted that CAS is not ‘speech delay’, but rather a ‘complex motor-planning disorder’ that requires frequent, intense and one-on-one therapy delivered by speech pathologists. She emphasised the critical role of specialised speech pathologists in providing early and ongoing support for this small but highly vulnerable cohort.[35]

4.35Independent Audiology Australia (IAA) similarly underscored the importance of involving audiologists in identifying and supporting children with developmental difficulties. They explained that middle ear pathology and associated hearing loss can lead to speech and language delays, behaviour concerns, lack of eye contact to speech—presentations that are commonly associated with developmental delays and disorders, but that can be in fact symptoms of remediable hearing loss. Equally, IAA submitted that audiologists are vital in supporting children with autism, who tend to have higher rates of ear disease, Ear Nose and Throat procedures and hospital contacts. IAA recommended that an assessment of a child’s hearing profile be undertaken before any further therapies are introduced.[36]

4.36The Australian Physiotherapy Association (APA), representing Australia’s fourth-largest health workforce, told the Committee that physiotherapists also play a vital role in early identification and intervention:

Before a child speaks or learns to play, they move. Physiotherapists are first-contact movement experts. They identify early developmental concerns in infants, including early markers of autism and neuromotor conditions, often before a diagnosis is made.[37]

4.37The APA’s Chair of National Paediatric, Mrs Nicole Pates, highlighted how the early involvement of physiotherapists can make a difference to a child’s development:

I think embedding physiotherapy within supports that are already available, such as maternal and child health networks, playgroups—particularly, there are a number of playgroups set up that are already connecting and trusted by our CALD and ATSI groups. We can then act as a capacity builder for those systems. We can act as differential diagnostics. We can hopefully provide referrals straight to where they need to go—to speechies or to neurologists, if there are very clear asymmetries and hemiplegia or tone signs.[38]

But, all the while we're doing that detection and assessment, we're capacity building. We're building relationships with that family and looking at that child's strengths. What can they do? What do they want to do?[39]

4.38Understanding a child’s eye health is another key aspect of early identification and intervention. Vision Australia stated that children who are ‘blind or have low vision often require highly specialised supports, and that access to early intervention is critical in ensuring that they can achieve positive long-term outcomes’. The organisation further explained that:

Many of the young children that we work with currently access NDIS supports through the developmental delay pathway either because there is uncertainty about their exact level of functional vision or because their condition has not yet stabilised and is therefore difficult to diagnose.[40]

4.39Vision Australia argued that, due to the impact of vision impairment on all areas of development, it is essential that children are able to access vision specific services without delay.

Access to supports for this cohort also has to be supported by a clear pathway for families. Parents often have limited knowledge of how to identify developmental delay in vision impaired children and also lack knowledge of the services available to them at their child's point of diagnosis. They need to be supported with a referral pathway that operates effectively across both the health and disability sectors.[41]

4.40Furthermore, Vision Australia warned in the case of very young children, it may be quite difficult to determine visual acuity until the child is either able to communicate or starting to access information in their environment beyond arm’s length.

For this reason, many children do not meet the permanent disability requirements of the NDIS, but they will access support through the scheme through the early intervention pathway, pending further assessment later in childhood. In the event that these children are transitioned to foundational support programs such as Thriving Kids, it will be necessary to ensure that those programs are sufficiently flexible to meet their unique needs. Regardless of whether these children are later diagnosed with a permanent disability for NDIS purposes, early vision-specific services are crucial in ensuring that they can meet developmental milestones and have access to any strategies that will allow correction of visual function.[42]

4.41Throughout the inquiry, witnesses emphasised the importance of occupational therapists in supporting children with developmental disorder or delay. Ms Samantha Hunter, Chief Executive Officerof Occupational Therapy Australia, stated:

Occupational therapy brings a distinctive lens—one that connects health, education and participation—translating developmental progress into everyday activities that matter to children, families and their communities. They bring a participation focused contextual perspective that complements the work of other allied health professionals and help integrate supports across systems. Occupational therapy is always focused on function in context—what does a child need in order to take part in life?[43]

4.42The Australian Psychological Society highlighted the role of psychologists in this context:

We already work across health, education, disability and community settings, bringing expertise in how children think, learn and connect with others. This includes providing developmental and cognitive assessments, behaviour and learning support, family coaching and workforce capacity building—all key components of an early intervention system.[44]

4.43Evidence provided in support of the inquiry consistently highlighted the critical role of diverse health and allied health professionals in the early identification and intervention for children with developmental disorders or delays. Effective coordination across these disciplines is seen as essential to the success of Thriving Kids, and multiple professional groups emphasised the importance of being actively involved in the program’s design to ensure comprehensive and integrated support for children.

4.44Ms Brodie of Speech Pathology Australia stated that the organisation would welcome an opportunity for allied health representatives to have a say in how the NDIS and Thriving Kids might evolve. She further reflected on the success of the collaborative model of allied health care as a useful element in the design of Thriving Kids:

I think there's a general feeling that, when it comes to the NDIS and perhaps even Thriving Kids at this point, allied health haven't had the voice. ...

So we are very keen, because we do collaborate. You wouldn't necessarily be seeing a child that's just seeing one of our professions; they're seeing multiple. We're used to working in collaborative care models, and, perhaps, a little bit of that has been lost in more recent years compared to pre NDIS. That's not to say—NDIS has been an amazing thing, and we should be very proud of it, but it needs to evolve. We certainly feel that it's key to the success of Thriving Kids to have allied health at the table.[45]

4.45Speech Pathology Australia recommended leveraging information and communication technology systems to integrate services, providing families with a central database of providers and enabling them to track progress and access support more easily.[46]

4.46The APA representing Australia’s fourth-largest health workforce, comprising over 44,000 registered physiotherapists working across the health, disability, aged-care and education sectors in metropolitan, regional and remote settings, welcomed the Thriving Kids initiative.

The APA believes that thriving kids has the potential to be transformative for children with developmental delay and autism and their families by establishing a national system of supports that enables earlier identification and intervention. It can move us from a system that leaves families waiting during the critical first thousand days to one that acts early and equitably.[47]

4.47The APA’s Chair of National Paediatric, Mrs Pates, supported Thriving Kids taking a multipronged approach. She described an example of the collaboration between specialists in early intervention:

Paediatric physiotherapists are movement analysis experts, but also our differential diagnostic skills are amazing…So getting in early and being able to understand what is causing it—is it the hip dysplasia? Is it CP [cerebral palsy]? Is there something going on? Are there early communication signs referring on to speech pathologists?[48]

4.48The AMA submitted that the initiative represented a recognition of the need for additional foundation support outside existing systems. AMA noted that its members consistently ‘raise concerns that they cannot support children and families to access the necessary allied health and medical input for mild to moderate developmental delay unless the child is enrolled with the NDIS.’ The organisation highlighted, however, that the Thriving Kids initiative ‘must build on existing systems rather than creating parallel systems and programs,’ including by leveraging existing structures in general practice.[49]

4.49Occupational Therapy Australia’s Chief Occupational Therapist, Mrs Michelle Oliver, reflected on the opportunity to use the Thriving Kids initiative to better embed allied health models in critical locations:

That's why this is where this is a really great opportunity to set up a system in Australia that enables us to engage early. So let's embed our allied health in the community in places where our children already engage and don't require having to step out of that community or their day-to-day activities or occupations to seek that early interventional support or to build that knowledge. GPs are definitely a pathway, but, as you were saying, it's not the only pathway and it's not necessarily working now. So, if we can have our allied health embedded in our community centres, in our childcare services, in our kindergartens and in our preschools, we're going to be able to work, to be able to observe, to engage and work collaboratively to ensure that those children are picked up at intervention.[50]

4.50Ms Samantha Hunter, Occupational Therapy Australia’s Chief Executive Officer, outlined the three fundamentals that the Thriving Kids system must get right:

• inclusion and equity—so no child misses out simply because their needs don’t fit a diagnosis;
• services that are culturally safe and responsive to community needs; embedding supports where children live and learn—in classrooms, early learning centres and in community; and
• a capable and connected workforce with occupational therapists central to the design and delivery of foundational supports—an anchor in the multidisciplinary teams that are required for success.[51]

Concerns

4.51Multiple submitters raised a range of design and implementation concerns related to the proposed Thriving Kids initiative. These concerns tended to relate to language describing types of disability (such has mild and moderate), concerns regarding a loss of control and access to individualised support, and concerns regarding possible impact on pathways for some specific cohorts. The following section provides a snapshot of selected issues raised during the inquiry.

4.52The AEIOU Foundation cautioned against using broad diagnostic labels such as mild, moderate, or severe autism, noting that these terms fail to reflect functional needs and can stigmatise individuals. Families often report that so-called mildautism still presents significant barriers to participation and communication. AEIOU argued that severity labels are deficit-based, misrepresent needs, and risk overlooking children with less visible challenges. The organisation recommended removing severity labels and adopting a strengths-based, neuro-affirming approach that recognises diversity and prioritises individualised support.[52]

4.53In reflecting on the importance of individual choice and control when accessing support, Mr Neil Turton-Lane, the Convener of the Australian Psychosocial Disability Collective (APDC), noted that the experience of being neurodiverse and caring for children diagnosed with autism:

…can be a very lonely, isolating, challenging experience, where receiving recognition and accessing affirming support can be very, very hard. School refusal caused by rigid neurotypical education systems have further traumatised many children and have weakened our trust in our government’s willingness and commitment to supporting our kids in any real, meaningful way. For many parents, the choice and control offered by the NDIS has been a real game changer, providing opportunities to access targeted supports that are person- and family-centred at the right time and in the right way.[53]

4.54The APDC remained deeply concerned about the capacity of the Thriving Kids program to provide ‘early foundational supports to the Australian community safely, inclusively and in ways that reflect the individual needs of children and of families’.

We worry about the impact of these changes on children and families and the uncertain future that lies ahead when a shift in major social policy appears rushed. We ask: is Thriving Kids primarily a cost-saving measure? If so, what will end up being the cost to children and families—children who will be shifted from trusted, individualised, person-centred supports delivered by skilled practitioners to a block-funded, heavily manualised, one-size-fits-all, short-term, behaviouralist intervention.[54]

4.55When accessing support from the allied health workers, the APDC cautioned that choice and control were essential for people with disability:

Choice and control for parents and their children, whether it's for an OT, a speech therapist, a form of art or music therapy—anything that builds that connection for that child and develops their capacity to communicate more broadly. I feel we need a range of approaches.[55]

4.56The APDC acknowledged the importance of building ongoing relationships with specific service providers or practitioners:

I agree that there are barriers, particularly those introduced around travel, but I would say that psychology, OT, speech, music and art therapy, and anything else that supports the development of that child, builds that bridge and builds their own individual capacity, as well as supporting the family—it's very important that the family trusts the services that they receive. Many families are very wary of entering into that support with their child, the most precious person in their life. It's a huge leap of faith to put your trust in a practitioner.[56]

4.57Some witnesses raised concern about the proposed scope of the initiative. Vision Australia cautioned, for example, that crucial opportunities for early visual development could be lost if dedicated provisions are not included:

So we're concerned that the scope of Thriving Kids does not seem to anticipate the support of children with developmental delay arising from low-incidence disability, such as vision impairment. It will be important for this initiative to have a funding stream that enables specialist vision providers to work within mainstream settings to build the capacity of children with vision impairment and developmental delay. If this isn't within the scope of Thriving Kids, then a similar initiative must be developed to support children with vision impairment outside the NDIS.[57]

4.58Without a dedicated approach, Vision Australia feared children with vision impairment and developmental delay will not have access to supports outside the NDIS to the same degree as children with more prevalent conditions:

These programs must also be sufficiently flexible to allow services to be delivered across both home and community settings in order to maximise the benefits of specialised intervention services.[58]

4.59Vision Australia further observed that the lack of exposure most schools have of working with children with vision impairment typically means they do not have the necessary experience, knowledge and skills to provide appropriate supports for those students:

Almost every classroom in Australia will have a child with autism or a child who is neurodiverse, but the same school generally will not see a child who is blind or has low vision more than once in a decade. It’s therefore feasible for education settings to build the expertise in relation to high-prevalence disabilities; however, this is rarely possible with low-incidence cohorts, such as blindness and low vision. To address developmental delay and encourage good, functional vision skills, these children require a more individualised and specialised approach.[59]

4.60The APA, representing Australia’s fourth-largest health workforce, saw an important role for physiotherapists in Thriving Kids. The APA advised that motor screening identifies concerns and flows directly into funded, evidence-based therapy in children's natural environments. It cautioned:

…but embedding physiotherapy is not enough unless the broader model supports it with funding for case conferencing, non-face-to-face coordination, in situ environmental adaptations, outreach travel and telehealth. These components make early intervention work in real settings.[60]

4.61The APA outlined proven domestic and international models and case studies to support its recommendations to embed a role for physiotherapists in the Thriving Kids assessments and capacity building:

When motor divergence is identified and addressed early, it unlocks a cascade of gains in language, cognition and social participation. Physiotherapy in the first thousand days of life can change developmental trajectories. It can improve school readiness, strengthen family confidence and reduce reliance on higher tier supports. This is the vision of Thriving Kids. The government has signalled a new Medicare funded child health check and allied health items under Thriving Kids. Physiotherapy, we believe, must be named explicitly in those universal supports. Integrated physiotherapy across a range of universal platforms—including maternal and child health, early learning and schools—enables a genuine, no-wrong-door approach. With this, screening and early detection can occur at standard touchpoints, families avoid having to opt in or navigate multiple systems, and transitions to school or the NDIS are smoother because developmental history and supports travel with the child, ideally enabled by the expansion of My Health Record.[61]

4.62The Australian Association of Psychologists Inc shared its deep concern about the current gaps in developmental support services and the urgent need for reform:

Despite clear evidence that early intervention and identification dramatically improve developmental outcomes, access to psychological assessment and treatment remains severely limited, particularly for children with mild to moderate developmental delays.[62]

4.63The Australian Psychological Society welcomed Thriving Kids as an opportunity for children who fell behind under the existing NDIS system, ‘particularly those with development delays or low to moderate support needs, without a clear pathway to help’:

Psychologists are a critical part of that picture. Their inclusion is fundamental to ensuring Thriving Kids achieves its goals and delivers better outcomes for children and families.[63]

4.64Psychologists' expertise in early intervention, however, is often overlooked and narrowly interpreted as relating only to mental health, according to the Australian Psychological Society:

In recent policy design, including early Thriving Kids information, psychologists have been grouped under broad or imprecise categories such as psychosocial therapy, which risks diminishing recognition of their unique contributions to child development, assessment and family support. This pattern appears to have continued in the current composition of the Thriving Kids Advisory Group, where, unlike other key disciplines, psychologists do not appear to have direct representation. To deliver on its promise, Thriving Kids must explicitly recognise and include psychologists in all aspects of design, governance, workforce planning, and evaluation and review. This is not about professional boundaries. It's about ensuring that children and families have access to the full spectrum of skills needed for early identification and intervention to work.[64]

4.65The Australian Psychological Society’s Dr Linda De George-Walker outlined a number of key priorities to ensuring Thriving Kids realises its promise, beginning with the ‘need to explicitly recognise psychologists and their role in delivering effective early support’.

4.66Beyond this, Dr De George-Walker detailed several other priorities essential for success of the Thriving Kids initiative:

• First is establishing genuine consultation and co-production from the outset with families, children, practitioners and researchers in the broader disability sector.
• Second is ensuring Thriving Kids provides a continuum of support, from universal and low-intensity help to targeted and specialist intervention, delivered at the right intensity and right time in the settings where children and families already are.
• Third is embedding cultural safety and equity at every level by partnering with Aboriginal and Torres Strait Islander communities, investing in bicultural workforces and translation support, and ensuring rural and disadvantaged families are not left behind.
  67. Dr De George-Walker was concerned that Thriving Kids may confuse parents and fail to help the children who will need it.

If not done well, Thriving Kids risks adding another layer of complexity to an already fragmented system, one that confuses families, increases inequity and fails to reach the children and families who need support.[65]

4.68Mrs Rachel Green of SANE Australia noted there was an opportunity for governments to develop strategies or interventions to support children.

We're talking about little kids here. We've got to bear in mind that the data shows us that, for example, people who are autistic have a much higher incidence of anxiety and depression. So some of the things that could benefit young people while they're maybe still going through the process of receiving support and getting strategies, and while families are working on stuff…One of the big problems I think we've got with the way the system functions currently is that schools feel almost prevented from doing anything at all—even the basics like calm corners and fidget spinners—until there's been a diagnosis done, so we're losing extraordinary amounts of time.[66]

4.69The Australian Association of Psychologists Inc. recalled how the advent of the NDIS and changes to funding impacted on where psychologists chose to work.

I think with the addition of the NDIS a lot of the workforce that was embedded in not-for-profit organisations and community health moved out of those settings because funding changed. So we've got a situation now where a lot of psychologists are in private practice. But that actually works really well for families in that psychologists can be where families need them to be, whether that's going into schools, going into childcare settings or going into homes and doing these assessments. It makes them much more accessible for young children to participate. I think you see a very different picture of a child when you're observing them in a natural setting than you do if they're coming into a clinic or a community based organisation.[67]

4.70The APA saw an opportunity for more allied health professionals to work closer locally with early childhood centres, to assist families of all backgrounds.

With the new model of care coming into free child care that the government is working towards, I think that that's an opportunity to embed allied health within early childhood centres. Those centres are usually set up in local areas and families are accessing those as they fit with their family values. But the early childhood educators that I speak to do not feel confident on having discussions around potential delays or differences and they lack the knowledge and the skills to enrich the environments in a specific way if something is noted, so we—myself and my speechie and my OT colleagues—do a lot of coaching and capacity building.[68]

Universal screening

4.71Universal screening can play a critical role in early childhood health and development. These assessments are designed to identify potential delays or concerns in areas such as communication, motor skills, social-emotional development, and cognitive abilities. Several submissions to the inquiry indicated support for universal screening.[69]

4.72A National Framework for Universal Child and Family Health Services, agreed between the Commonwealth and each of the states and territories, recommends regular health and developmental checks from birth to school age.[70] Ms Janice Finlayson, Director, MCaFHNA noted that these checks have not been implemented at the same ages consistently in each state and territory, although each state does an 18-month development check:

I think I can probably say, with some level of certainty, that all jurisdictions would have a key 'age and stage' at 18 months. They would offer to a parent the opportunity to come to us so we can do an assessment on their child at 18 months. What you were talking about before—eye tests and things like that—is usually done at the 3½-year-old assessment time. Hearing used to be done at the 3½-year-old assessment time, but we don't do that anymore. There are similarities in the ages at which children are brought back in to be assessed, or when these assessments are offered to parents. Some jurisdictions offer more. The Territory certainly offers more. Some offer less. I know Western Australia has cut down the occasions of service that they offer. You'd probably need to start with: at what point do you bring them back? Eighteen months is also key because it's also a key immunisation time. If you can link something with immunisation, you're more likely to get people attending.[71]

4.73Childhood screening checks are generally undertaken by child health nurses. Family Paediatrics Nurse Practitioners noted that the shift away from community-based delivery has resulted in children missing out on critical supports:

Australia has an opportunity to fundamentally reshape how we identify and support children with developmental needs in the early years. Despite decades of evidence that the first five years are critical to long-term outcomes, child health and development services remain fragmented, inequitable, and inconsistently delivered across jurisdictions. Families frequently miss out on timely support because maternal and child health services have shifted away from community-based delivery, workforce standards vary nationally, and access to specialist services is defined more by waiting lists than by children’s needs.

A new approach is required, one that re-establishes place-based services in the community, integrates developmental checks with immunisation schedules, and creates a clear progression from universal screening to targeted interventions and specialist care. Nurse Practitioners and Child & Family Health Nurses are ideally positioned to deliver these services in childcare centres, kindergartens, and schools, building relationships with parents, supporting educators, and reducing unnecessary referrals to overburdened hospital systems.[72]

4.74Children’s Healthcare Australasia suggested that the Thriving Kids initiative should build on this capability:

With a consistent national framework and local flexibility, Thriving Kids can reduce wait times, improve access, and ensure all children, regardless of background, have the opportunity to thrive. It will be critical to ensure the public health sector remains the spine of such reform with a universal screen and respond function building on existing child health nursing services to ensure seamless transition through generalised and more targeted supports.[73]

4.75APM noted that a lack of universal screening checks results in missed opportunities to ensure success in all children. APM suggested:

While systems exist across the states and territories, for example national hearing screening at birth or free vision screening for pre-schoolers, there are no nationally consistent programs or approaches dedicated to speech, communication, and motor functioning. This is not only out of step with other OECD nations but also misses key opportunities to consistently identify children with developmental delays or disabilities early in life when we know interventions are most effective.[74]

4.76The Australian Clinical Neuropsychology Association strongly supported the focus on universal screening:

We strongly support the focus on universal screening, and emphasise that this must be backed by access to thorough, multidisciplinary diagnostic assessments, including comprehensive neuropsychology assessment for identification of cognitive disabilities, to ensure equitable identification and support for all children.[75]

4.77The William Campbell Foundation recommended that universal screening be embedded in family support, foster care and early childhood programs.[76]

Workforce capacity and development

4.78Throughout the course of the inquiry, witnesses stressed that the success of any health initiative depended on a skilled and well supported workforce. Persistent shortages, limited training pathways, retention challenges, and the impact of the NDIS on service delivery often hinder equitable access to health and developmental services for children and their families.

Medical, nursing, and allied health workforce

4.79The AMA highlighted that a strong workforce will be critical for the success of the Thriving Kids program. The organisation called for a sustained support of the existing workforce strategies, such as the National Medical Workforce Strategy 2021-31 and National Mental Health Workforce Strategy 2022-2032, to address shortages in general practice, paediatrics, and child and adolescent psychiatry.[77]

4.80Evidence to the inquiry consistently highlighted shortages of practitioners in psychiatry and psychology. Some witnesses suggested alleviating this pressure by expanding the scope of duties for allied health professionals. Associate Professor Clinton Schultz from the Black Dog Institute, for example, noted that:

At times, what happens is that, within systems and within certain initiatives that are put in place, certain professions are only capable of working with certain diagnoses or certain conditions, which I think at times limits the scope, the opportunity or the breadth of practitioners that we have available to us to actually open up access to more people in terms of working. I think that's quite common across most of the mental health space. We tend to really look towards psychologists and psychiatrists, and we often don't pay as much attention or give as much support to all the other practitioners that work within the allied health space in the fields of mental health or whatever the certain condition may actually be. I think that, by broadening our perspective on who we include in certain initiatives and empower to work within spaces and making sure that they actually have the training, the skills and the knowledge available to them to work in those spaces, we can more greatly increase access.[78]

4.81Mrs Amanda Curran, Chief Psychologist at the Australian Association of Psychologists, recommended strengthening workforce capacity through:

• targeted training and incentives and prioritising utilising appropriately skilled and trained allied health professionals, including psychologists
• funded parenting support
• expanded access to funded psychological assessments via Medicare so that children can receive the assessments they require
• ensured coverage for collaborative care
• Medicare rebates that cover the actual cost of assessment so that those who need it most are not locked out of access due to financial barriers
• elimination of unnecessary referral and diagnostic barriers, such as are seen in complex neurodevelopmental disorders and Better Access Medicare items
• embedding of neurodiversity-affirming, culturally safe and family centred models
• seamless transitions across mainstream systems through integrated partnerships.[79]
  82. In their joint submission ACN, ACCYPN, MCaFHNA and PANDDA highlighted the critical workforce shortages and gaps in nursing education and retention:

Australia is projected to face a shortfall of 79,473 nurses by 2035, with primary healthcare, including child and family nursing, among the most affected. Many nurses reconsider their careers around seven years post-graduation due to burnout, poor conditions, and limited career pathways. Despite the need for specialised training, structured support for child and family health nurses remains inadequate.[80]

4.83ACN, ACCYPN, MCaFHNA, and PANDDA recommended upskilling primary care nurses in child health and developmental screening, as well as removing barriers to enable more nurse practitioners to work in primary care settings. These measures, they argued, would strengthen the capacity of the primary health workforce to support early childhood development.[81] Additional recommendations included:

• implementing all recommendations from the Nurse Practitioner Workforce Plan, the Primary Care and Workforce Reviews, and the National Nursing Workforce Strategy
• expanding access to the Medicare Benefits Schedule, including nurse practitioner-led practices in MyMedicare, and removing regulatory and funding barriers that prevent nurse practitioners from working to their full scope of practice.[82]
  84. ACN, ACCYPN, MCaFHNA, and PANDDA also reflected on the state of the allied health workforce:

The allied health workforce, essential for children requiring therapy, is currently stretched thin, largely due to the impact of the NDIS, which has diverted resources away from mainstream services. Equitable access must be prioritised to ensure children with developmental delays have the opportunity to thrive, regardless of their location or socioeconomic background.[83]

4.85Autism Spectrum Australia similarly noted the prevalence of workforce shortages in allied health:

Australia faces a national shortage of key allied health professionals, including speech pathologists, occupational therapists, and psychologists. These shortages are most acute in the public health system and in regional and remote areas.[84]

4.86Mrs Ashlee Law, a mother of children with autism, reflected on her experience accessing services in regional New South Wales. She noted that there were few professionals available, with many rural towns having one or no paediatricians, and psychiatry services even harder to access. Families often struggle to find providers and are forced to wait between one to three years for autism assessments.[85]

4.87In its submission, the Therapy Room NQ reported similarly great challenges in rural and regional areas in Northern Queensland, where families wait for weeks for an appointment with a GP, and have limited access to community services and only occasional outreach from city-based providers.

4.88The Therapy Room NQ further explained that since the NDIS reduced travel fees on 1 July 2025, outreach providers had to cut down their services, with many North Queensland services cancelling their outreach programs to rural and remote communities:

Delivering outreach carries significant overheads—including room hire in small towns, staff wages, superannuation, insurances, registrations, and rising fuel costs. With travel feeds halved, continuing to deliver outreach is becoming almost impossible … If providers pull back further, children in rural and regional towns will lose access to early intervention and ongoing therapy, widening the already significant gap between metropolitan and rural areas.[86]

4.89AHPA outlined the progress of the development of its allied health workforce strategy aimed at countering the staff shortages:

…the first National Allied Health Workforce Strategy is currently in the final stages of approval and that, with more than half of the allied health workforces in a national workforce shortage, the strategy needs to be adequately funded to ensure we secure the undergraduate pipeline, build a workforce that is equipped to work in the disability sector and establish better placement pathways that adequately fund the undergraduate sector via paid placements.[87]

4.90The Australian Psychological Society’s Dr Linda De George-Walker highlighted the importance of building up the capacity of the allied health workforce for families and to support their children as young as possible:

What's really important is also not underestimating the allied health workforce capacity to build the capabilities of early childhood educators—for example, educators in schools. Those trust points that families are going to naturally be in front of on a daily basis—child maternal health nurses are also very well skilled in these areas—are all working together to support and train each other in what to look for and how to support a family that is maybe not at the point of being quite able to articulate what their concerns are—how to work with them and support them at those early stages. That workforce capacity building and capability building is a really important part of this puzzle too.[88]

4.91The extent of staff shortages remained an ongoing issue according to Indigenous Allied Health Australia. As Mr Paul Gibson, the organisation’s CEO, explained:

I can share that we know that, across allied health, for most professions the workforce is probably about 0.8 per cent Aboriginal and Torres Strait Islander. If we take occupational therapists, for example, there are 199 nationally out of a workforce that's about 27,000 strong. So that's 0.75 per cent, I believe, of the workforce there. So underrepresentation and workforce challenges are really significant concerns.[89]

4.92The Kimberley Aboriginal Medical Services also raised the challenges of finding enough suitable staff to cover 200 communities in such a vast remote part of Western Australia:

There are never enough of them. I think in the Kimberley currently we've got 12 family support workers. That's not nearly enough for the around 200 communities we have in the region. We have them placed in the major communities and towns. But, to really reach out and to provide an equitable service that really services everyone, we would need to increase that workforce.[90]

Education workforce

4.93The Thriving Kids initiative positions schools as central hubs for supporting children with developmental disorders or delays. Multiple submitters, however, expressed concern regarding the capacity of schools to deliver the program. Inclusive Educators Australia cautioned, for example, that:

Simply layering new expectations on top of existing demands will undermine both teacher wellbeing and the effectiveness of the program.[91]

4.94Inclusive Educators Australia further noted that workforce shortages remain one of the most significant challenges for schools and early childhood education, with rural and regional areas especially affected:

The Review of Best Practice in Early Childhood Intervention identifies these shortages, alongside variable capability and lack of regulation, as major barriers to best practice. Thriving Kids must therefore treat workforce reform as a central pillar of its design.[92]

4.95Independent Schools Australia highlighted that both teaching and non-teaching school staff are currently required to provide a range of supports for students that extend beyond the traditional role of schools. This is particularly evident in regional and remote areas, where schools often function as community hubs providing students with disability or developmental delay support before, during, and after diagnosis and medical intervention.[93]

4.96Independent Schools Australia further expressed concern that:

Blurring the lines between education and therapy not only undermines professional boundaries but also places unrealistic expectations on teachers. Without dedicated funding to embed allied health professionals within school settings, collaboration remains ad hoc and inconsistent.[94]

4.97The Australian Primary Principals Association (APPA) submitted that ‘any increased expectations of schools must be matched with increased human resources on the school site.’[95] Among its key recommendations, APPA called for funding to support administrative and leadership roles in schools to coordinate services and manage staffing pressures; professional development for educators on early identification, trauma-informed practice, referral processes, and family engagement; and incentives to train teacher assistants to effectively respond to children’s needs.[96]

4.98In its submission to the inquiry, ACSSO observed that while educators are often the first to raise developmental concerns with families, many feel underprepared to identify the red flags, make referrals, or supporting children with additional needs in inclusive classrooms.[97]

4.99To strengthen the capacity of the education workforce, ACSSO recommended embedding nationally consistent training within the Thriving Kids initiative. This training would equip teachers, early childhood educators, and school leaders with practical skills in:

• Identifying developmental differences
• Using neurodiversity-affirming language
• Making reasonable adjustments in learning and play environments
• Communicating effectively with families
• Navigating referral processes.[98]
  100. The Early Learning and Care Council of Australia similarly stressed that building the knowledge and capacity of the early learning and care workforce is essential to the success of the Thriving Kids initiative. The organisation highlighted the importance of embedding time for planning and developing inclusion strategies; providing opportunities to learn about disability and developmental delay, effective communication, and cultural safety; and fostering stronger collaboration with training providers and universities to promote best practice and innovation.[99]
  101. The Home Education Network noted that some children with developmental delays or disorders are home-schooled, yet professionals often lack awareness of home education pathways. Many families are left to rely on their own research to navigate this option. The organisation recommended developing training for the education workforce—and other professionals—on home education pathways as a key component of upskilling.[100]

Service design and delivery models

4.102The Acting Group Manager of the Family Wellbeing Group at the Department of Social Services, Ms Jacqueline Hrast, saw an opportunity for government to rebuild an intermediary service system.

While we fund the broad based mainstream, who absolutely have an obligation to be accessible and to deliver a valuable service to people with disability and developmental delay, there is a need for an in-between space. The community sector can only do so much. You won't receive intensive one-on-one speech therapy through the programs we [DSS] fund.[101]

4.103Ms Hrast believed there was a ‘missing middle that Thriving Kids will provide’ for:

The ability for a service provider who is working with a family in a group setting to have a quiet conversation with that family and say: 'Hey, you know what? I think there's something else here that's worth looking at. How about you go and have this next level of intensive services?'—that's still to be designed, but it is things like 10 sessions with a speech therapist. That's something that won't be delivered within the community sector, and it's not yet something that requires all-the-way access to the NDIS. I think that's really critical and important.[102]

Integrated and multidisciplinary care

4.104AHPA claimed the NDIS has currently placed ‘significant barriers to collaborative care’.

For example, practitioners often lack access to a participant's plan and the broader care team. Families may believe that more individual therapy is the solution, when in fact coordination and collaboration often drive better outcomes. The NDIS has also fundamentally changed where and how allied health professionals work. The market based approach has pushed many into private practice, with providers setting up services where they are financially sustainable and not necessarily where they are needed most. navigate.[103]

4.105Despite sector advocacy, the AHPA continues to ‘lack mechanisms to identify where allied health professionals are located, where they are needed, and workforce or funding initiatives to address distribution gaps’.

Private provision will remain an important part of our system, but we must strengthen how private allied health professionals can work collaboratively across both the health and disability system. There are clear opportunities to improve service delivery through new block-funding models; new Medicare items that reflect the real cost and time involved in high-quality service provision; support for team based, multidisciplinary, family focused interventions; referral and access pathways that are streamlined; and delivery of services in natural settings.[104]

4.106The National Aboriginal Community Controlled Health Organisation outlined the key elements of a preferred integrated service delivery model for Thriving Kids to best suit First Nations children and their families.

I really do think it’s a very integrated approach that really supports trauma informed early screening, therapeutic intervention and diagnosis, enhanced and streamlined referral pathways, and improves service integration for children with developmental delays and the concerns. We're really urging government to fund, within that, the cultural supports required for us to streamline the navigation roles that we discussed just now, and invest in workforce development to ensure sustainable community led services.[105]

4.107Dr Sarah Hayton, from NACCHO, recalled how the South West Aboriginal Medical Service in Bunbury, WA, highlighted to her the opportunities playgroups and maternal and early childhood centres provide families and children to discuss about any concerns they may have.

The medical service spends so much time educating the families and demystifying some of the misinformation that's out there about early developmental delay. They spend a lot of time rebuilding that trust as well, because parents blame themselves for this and they feel very isolated. So then they do that, and then they're walking along that journey with the family, so the child's got continuity of care. They talked a lot about how they just move the family from that group to another group within the art show, so they don't need to repeat their stories all the time. They don't need to keep telling everyone what they do do and what they don't do. It's that very holistic model that is probably one of the most important areas for consideration.[106]

Navigator role

4.108Navigating complex systems such as the NDIS can be particularly challenging for families. Submitters emphasised the need for government-funded, locally based navigators—individuals who may not be health professionals but who understand community needs and can guide families through interconnected education, health, and disability systems.

4.109Medhealth Pty Limited suggested that ‘the Thriving Kids initiative presents an ideal opportunity to introduce the navigator function as recommended by the NDIS review’.[107]

4.110The Independent Review into the National Disability Insurance Scheme recommended a navigator function, stating:

Navigators should act as the central points of entry for linkages and referrals to foundational supports, mainstream services and community supports and activities for all people with disability (not just participants). Navigators must have the capability to:

• Support people with disability to determine their own goals and participate in activities in their community
• Connects and link people with disability to mainstream services, community supports and activities as well as foundational supports
• Develop working relationships with mainstream services, community organisations and foundational support organisations.[108]
  111. The National Rural Health Alliance believed the government should fund and support locally-based navigators, who may not necessarily be a therapist, doctor, or nurse, to help families in rural or remote communities navigate or manage a complex system such as Thriving Kids, and look for solutions that best suit their circumstances.[109]

We must fund navigators or local coordination roles and help families navigate complex systems and access the right support at the right time.[110]

They (navigators) will also understand the challenges that people face. And there won’t be that shame of, ‘I don't know how it works, so I'm not going to access it.’ Sometimes people are so overwhelmed they don't know how to do it. You almost find it hard to help yourself because it's so overwhelming. They're already struggling with the education system and all the other challenges. It's not because they're not intelligent. They just don't understand the system. And so a fund navigator or local coordinator that is linked up to the education system, health system and disability system is a way of supporting those people who cannot do it themselves.[111]

4.112Mrs Rachel Green, the Chief Executive Officer of SANE Australia, believed having people helping families navigate the system would be helpful, but ‘only if there’s something to navigate to, and only if it’s possible to find good, trustworthy information’.

[The Digital Navigation Project is] a solid piece of research and found that, for example, something like 85 per cent of directories—the kind of directories you might search if you were a navigator helping someone—are manually updated, and 37 per cent of the ones we looked at are Excel spreadsheets. Navigators can be helpful, but only if they've got a system and a set of information that's easily navigable.[112]

4.113ACSSO supported families receiving practical, timely support through family navigators:

…independent, trained staff who walk alongside families, helping them understand resources, make referrals, and coordinate plans across health, education, and community sectors.[113]

4.114Karitane, First Peoples Disability Network, Alliance of Registered Therapy Providers, Australian Rehabilitation and Assistive Technology Association and Amaze all advocated for establishing navigators to support families through complex health care and education systems.[114]

4.115National Rural Health Alliance commented on the importance of foundational supports and early intervention for children with developmental concerns or disabilities, stating that the navigator role should:

…be complemented by foundational supports, and expansion of universally available child development checks. These would ensure early identification of children with developmental concerns and disability and enable early intervention. Navigators will also have an important role in amplifying and giving voice to people with disability.

The Navigator should be appropriately funded and at a minimum include:

• Helping families navigate complex systems and providing accessible information and advice on the right support, whether to mainstream services, foundational supports or NDIS-funded services, thereby bridging the gap between families and services.
• Importantly for rural and remote areas, be locally embedded with strong knowledge and connections of existing support and services and understanding of the local context including barriers to access, e.g. services, education system.
• Coordinating the right mix of support and provide continuity of support as children move between services or life stages. This includes an understanding of federal vs state funded programs.
• Assisting people before they access the NDIS, through proactive screening, outreach and support, including accessing mental health services.
• Report on demand for services and unmet need, including gaps in local service systems.[115]
  116. Lifestart Disability Services highlighted the central role of navigators in the new connected system of support, through:

…helping all people with disability, including those not eligible for the NDIS, find and access the right supports at the right time. Positioned across mainstream services, foundational supports, and the NDIS, navigators will provide tailored guidance, connect families to local services, and support coordination of care. Different types of navigators will be available, including general navigators, specialist navigators for people with complex needs, and lead practitioners for children and families. Their role is to ensure no one falls through the cracks by bridging service systems and supporting early, inclusive, and community-based responses. Navigation supports should also be provided digitally, which are more scalable, streamlined and accessible for families and people with a disability or developmental concern.[116]

4.117The Front Project believed that service navigators were a crucial component for supporting families, especially those with complex needs.

Service navigators were identified as playing an important role in supporting families, particularly those with complex needs. Navigators could provide valuable, individualised assistance by helping families navigate multiple services, connecting them with the right supports, and advocating on their behalf. Even in systems working towards greater integration, service navigators can help ensure that vulnerable families receive coordinated, timely care. Their role can be particularly beneficial in reducing the burden on families who may find it difficult to engage with multiple, sometimes disconnected, services on their own.[117]

However, some cautioned against relying too heavily on navigator roles. While navigators can provide valuable support in some cases, there was concern that this could lead to an over-reliance on individuals to guide families through complex systems, rather than addressing the underlying issues of fragmentation.[118]

4.118Disability Advocacy Network Australia pointed out that navigators not only assist families but also provide valuable feedback to government:

Families having access to navigation support within Thriving Kids is critical to the success of the initiative. Navigators can provide tailored information and link families with local supports, reduce the administrative and emotional burden on families by finding and referring to them to services, and can capture and map the needs of the local communities they support.

Equally, Navigators can provide a critical role for Government in collecting intelligence and data on what supports are needed and how systems are working on the ground. There will be significant conflicting information about the performance of Thriving Kids as it ramps-up – whether it is truly meeting need, whether it can be improved, or whether a totally different approach is needed. This needs to be provided by Navigators who are alongside people – embedded in their communities – helping to navigate different systems. Navigators who won’t benefit financially from Thriving Kids or children or families.[119]

4.119Brisbane Children’s Therapy called on navigators to provide accessible information and early training programs to empower families:

…these navigators should also provide evidence-based information and resources to help parents recognise developmental differences early and understand practical next steps. This could include milestone checklists, early signs of autism and developmental delay presented in neuroaffirming, parent-friendly language, and guidance on how to support their child at home while waiting for services. Navigators should also be able to link families to early training programs such as Early Days workshops, which empower parents to understand their child’s developmental profile, build practical strategies at home, and feel more confident when engaging with therapists and educators.[120]

4.120National Aboriginal Community Controlled Health Organisation highlighted the increasing necessity of the navigator role:

Specialist Navigators should also be available for people with more complex support needs, certain population groups and people at key life transitions, such as preparing for education, employment and independent living. These Navigator roles will be increasingly necessary as Thriving Kids rolls out and the system becomes more complex and potentially fragmented.[121]

4.121Australian Psychological Society recommend embedding the key worker and navigator roles across various settings:

Key worker and navigator roles will be critical to ensuring continuity of care. These roles, embedded across hospitals, schools, maternal and child health, early childhood education, and community health centres, can act as first-line connectors and guides for families. Unlike case managers, they provide navigation, coordination and support, ensuring children access the right programs at the right time. Thriving Kids can build on existing international and domestic models that demonstrate the effectiveness of this approach, particularly for families who may face additional barriers, such as those in rural and remote areas or Aboriginal and Torres Strait Islander and culturally and linguistically diverse families.[122]

4.122Children’s Healthcare Australasia, however, questioned the purpose of the navigator role:

The rationale for the NDIA to have replaced care coordinators with ‘navigators’ remains unclear and from the point of view of Child Development Services trying to assist families to access support. Our members support the return of a “support coordinator type role” to assist the streamlining of supports for a family as they journey the system, simplifying the framework for families to move through with consistent, accessible support.[123]

Key worker role

4.123Similar to the navigator role, ‘a key worker is an early childhood professional who works alongside the family to support the child and helps coordinate a team of early childhood therapists and professionals. Key workers practice from a family-centred approach, supporting and empowering families.’[124]

4.124Early Childhood Intervention Coordination Program (ECICP – Inner West) stated that key workers:

• Hold professional qualifications in areas such as speech pathology, occupational therapy, psychology, social work, or early childhood education
• Work within a transdisciplinary team, drawing on the expertise of multiple professionals while providing consistent, relationship-based support to the family
• Build trust with parents and caregivers, coach them in evidence-based strategies, and coordinate services to avoid duplication and fragmentation
• Ensure interventions are tailored, goal-focused, and responsive as the child’s needs change.[125]
  125. Noah’s Ark Inc provided a description of the foundational elements of the Key Worker model:

Primary components of the Key Worker model include supports to families that recognise the complexity of having a child with a disability. These include emotional support, information and advice, identifying and addressing needs, advocacy, and service coordination. These components form the basics of a family-centred approach and enable services to be individualised to unique family circumstances.

Key Workers are educational and allied health professionals with specialist knowledge of child development; they are family-focused, strengths-based and work in a child’s natural environments and routines to build the capacity of parents, educators, and other important people in the child’s life (Alexander & Forster, 2012). While the NDIA recommend the Key Worker model (National Disability Insurance Agency, 2023), there is an absence of education, incentive, or regulation to support the implementation of the model.[126]

4.126Lifestart Disability Services outlined the practical role of key workers in everyday settings:

Working in everyday settings, the key worker builds the family’s capacity to support their child, coordinates services, and delivers responsive, goal oriented support. Key workers also provide emotional guidance, practical strategies, and help families develop advocacy skills and navigate systems to ensure their child’s needs are met holistically.[127]

4.127The APA put forward the Key Worker model as a proven approach for ensuring continuity of care:

One proven mechanism for continuity is the Key Worker model, also known as a lead practitioner or care coordinator. In this approach, one professional becomes the single point of contact for the family, coordinating services across health, education, and social sectors.

The key worker guides the family, helping them navigate the often complex system of appointments and supports.[128]

4.128The APA added that the role can be filled by professionals from various disciplines:

A key worker can come from various disciplines – frequently social work or nursing, but physiotherapists, occupational therapists, psychologists and teachers are also often in this role. A paediatric physiotherapist who knows the child well could act as the key worker, especially if the child’s primary needs are motor or physical. As key worker, the physiotherapist would not only deliver therapy but also liaise with speech therapists, educators, paediatricians, and any other involved providers to create a single integrated plan. This prevents fragmentation.[129]

4.129The APA identified research on the benefits of the key worker role, stating:

Research on key working shows families experience better coordinated and comprehensive care, quicker access to necessary services, and less stress when a key worker is involved. For example, a case coordinator might set up a joint case conference with the child’s preschool teacher, physiotherapist, and speech therapist to agree on shared goals and who will do what. They might help the parents prioritize goals (e.g. improving balance to join playground games) and then make sure each provider supports that aim in their own domain.

Studies find that parents strongly prefer having one go-to person rather than a multitude of contacts. This approach reduces the battle parents face in accessing information and services, thereby lowering family stress.[130]

4.130The APA believed that the key worker model could essentially act as a safety net:

For children with mild to moderate needs, a key worker model can ensure they stay on the radar even if they don’t qualify for intensive case management. The physiotherapist as key worker can periodically check on the child’s progress across settings and prompt referrals or supports as new needs arise, effectively bridging gaps between systems.[131]

4.131According to Koorana Child & Family Services Ltd ‘[the] Key Worker Model is well-evidenced and demonstrates excellent outcomes in practice.’[132]

4.132Multiple submitters to this inquiry put forward the view that the Key Worker model represents best practice and called for funding for key workers to support families across systems.[133]

4.133Occupational Therapy Australia acknowledged that while the Key Worker model is widely regarded as best practice, its implementation can sometimes fall short:

Key worker models are seen by many early childhood providers as best practice, and may be utilised as a default method of providing early childhood services. However, there is evidence to suggest that overreliance on these may jeopardise outcomes. In practice, the programs being delivered do not always align with the evidence underpinning a key worker approach. This may be due to several factors.

It may be that providers do not understand when and how to implement key worker models based on the needs and preferences of the child and family; or that staff working in key worker roles may lack the scope, training and professional characteristics to work effectively in interdisciplinary key worker roles, or similar roles. Perhaps most critically, key worker models may be offered as independent services rather than as part of a team; which is contrary to the intent underlying the model.

The Desktop Review of Best Practice in Early Childhood Intervention noted the scarcity of vigorous research about collaborative practice, including key worker models.[134]

Funding and contracting

4.134This section builds on evidence outlined in Chapter 3 about funding arrangements, where evidence related to the experience of First Nations people and those living in rural and remote communities was discussed.

4.135Noah’s Ark Inc suggested a ‘block funding approach supports the engagement of high-quality providers and ensures equity and consistency of service delivery for all families.’[135] They suggested that block funding could be a simpler funding model, stating:

The call is not for more funding but rather for existing funds to be channelled into best practice and earlier intervention through a simpler funding model such as block funding for best practice service providers or transdisciplinary key worker packages.[136]

4.136Learning Links stated that ‘evidence from programs such as Communities for Children and HIPPY shows that block-funded, place-based, and co-designed approaches strengthen families and communities, build parent confidence, and improve access to supports in ways that are locally relevant and trusted.’[137]

4.137Teach Speak Hear noted the benefits of establishing a block funding approach:

….block funding or tender-based approach, with robust reporting requirements and accountability measures, would ensure sustainability and allow us to focus on what we do best – supporting children with mild to moderate needs and their families. Without this financial commitment, we are increasingly reliant on nonguaranteed and uncertain funding to meet growing demand and to ensure equitable access to essential services.[138]

4.138Disability Advocacy Network of Australia believed that the block funding of services contained both opportunities and risks. The benefits of this model included:

• Government has better oversight of commissioned organisation[s] who deliver services
• Potential for more collaboration between different services and therapists as they are not competing in the market.[139]
  139. Potential risks they identified included:
• Significant shift away from the consumer directed care evolution that NDIS introduced
• Gives significant power to service providers as the contract holders compared to service users
• Funding and availability of the service is typically estimated which may not reflect actual need on the ground (creating service gaps or waitlists).[140]
  140. Every Australian Counts believed that ‘block funding leads to a lack of choice and reduced safety - where children and families are only able to access support through a single provider.’[141] Nobody Worse Off Coalition, Succeed Healthcare Solutions Pty Ltd, RAEN Tasmania, and Occupational Therapy Society for Invisible and Hidden Disabilities were also of the view that the block funding model risks reducing the choice of provider or professional support.[142]
  141. Dietitians Australia noted concerns raised by its members that:

…sole traders and small providers struggle to access block funding due to limited time, resources, and expertise in competitive applications, leaving most of the funding to flow to larger organisations. This risks smaller providers being pushed out, reducing choice and local access.[143]

4.142Occupational Therapy Australia agreed with the APA and saw an opportunity for the blended funded models.

There is also a great opportunity for us to really invest in our allied health workforce to ensure we are embedded in schools, we are embedded in community health, we are embedded in disability services and we also have a thriving private practice area…but there is absolutely some gaps. This is a great opportunity for us to reset the scene and create systems and services that enable us to thrive, which will enable the young people and families that we work with to thrive.[144]

4.143Outside the NDIS, access to all allied health services can be inconsistent, and according to the APA, those ‘inconsistencies are greatest for people in rural settings, Aboriginal and Torres Strait Islander communities, and culturally and linguistically diverse communities’.

This is why we really need equity focused measures within Thriving Kids to make sure that it doesn't widen those existing gaps and to make sure that it fills those gaps really thoroughly.[145]

4.144Services for Australian Rural and Remote Allied Health Ltd outlined how recent changes made by the NDIS to allied health professionals claiming for travel impacted on their clients in regional areas.

This is why we looked at the driving distance to an occupational therapist as a marker of that. The travel caps meant that, if you had an hour’s round trip to visit a child and their family in their home, you were only going to be able to claim for half of that time. So immediately, if you are a small provider located in a Modified Monash Model 4 or 5 town, that's going to limit your capacity to travel to see some of these children in their home context.[146]

4.145The Department of Social Services highlighted how its financial support for playgroups and toy libraries created opportunities for mutual support as well as ‘conversation that might lead to a referral to a more intensive or targeted service and so forth’.

Probably the key service offerings are Children and Parenting Support Program—CAPS for short… The other one I'd probably draw attention to is Communities for Children Facilitating Partners, which is a place based initiative where the facilitating partner establishes a committee and a strategic plan based on the needs of the community in respect of children aged nought to 12…complemented by what's needed—reach into the important consultation and engagement with the local schools, preschools, childcare facilities and so forth.[147]

4.146The National Aboriginal Community Controlled Health Organisation claimed only some of their member services seek to access the Department of Social Services’ Communities for Children funding and other financial support due to the complexity of applying and onerous reporting requirements.

Some of them have got up to 72 funding streams that they need to report to. I think Thriving Kids, for it to be incredibly successful, has got this great opportunity at a system level to bring that all together and consider how one funding model could actually integrate a number of different areas. It puts a huge burden on our sector, and they're not funded to manage all the grant guidelines and the constant things that they have to do to receive those pockets of money.[148]

Education and school-based supports

4.147The Committee heard evidence that mainstream education settings, which are attended by nearly all children including those with developmental delays or disabilities, play a vital role in fostering inclusion and enabling early identification of developmental challenges. When accessible and supported by appropriate interventions, these environments can promote positive developmental outcomes.

4.148Occupational Therapy Australia set out that:

There is emerging evidence from current mainstream education programs that embedding occupational therapists within education systems leads to positive outcomes and is the most effective way to support children with developmental delay and disability in those settings. Occupational therapists are well established in many mainstream education settings and there is significant capacity to ensure consistent access to occupational therapists across jurisdictions and settings.[149]

4.149AHPA acknowledged that mainstream education settings have played a crucial role in the early identification of children who need support, and that Thriving Kids will need to be integrated with schools and early childhood centres.

Mainstream education settings…not only support early identification but also provide a consistent base for delivering services. However, access to allied health professionals in these settings varies significantly by location. In some places, it is non-existent. We need a nationally consistent approach to embedding allied health supports into mainstream education with a multidisciplinary model that enables educators to deliver day-to-day support backed by allied health professionals. Mainstream education is only one part of the equation. Children also develop and thrive in their homes and communities. A successful Thriving Kids initiative must create an ecosystem of supports outside of schools that is well integrated across systems, including education; family inclusive; and easy to navigate.[150]

4.150The Australian Psychological Society believed there would be great demand for the presence of more psychologists in schools and early childhood settings.

And for school psychologists, their broader workforce issues aside, that ratio is about one to 1,500 students. Ideally it would be about one to 500. So at this point we need to build capacity and to resource school psychologists so they can do just that, so they can act on one part of the problem—certainly not the whole offset. So yes—very much so. We also need some resourcing, not just for the broader workforce issues but also for the aspects that can make a real difference to kids in their everyday settings.[151]

4.151The APDC warned provision also needed to be made for access to psychologists for children not attending schools.

While school psychologists are a great idea, if your child is not attending school—which many children aren't; they're refusing school—then what do you do? From my own personal experience, from the age of 11 my child stopped attending school for six months. So all those kinds of things have a huge impact on families, on the child, and the child feeling less than, when really they basically haven't had the support when they've needed it within the school system.[152]

4.152SANE Australia saw a significant role for schools and the education system, in helping to identify students with challenges that Thriving Kids could support with appropriate services.

…services that will be funded under it from the principle of making it as easy as possible to get more help without relying on families being able to spot that there's an issue or get themselves help, then it means we need to be looking at all the possible settings.[153]

4.153Mrs Green recalled a history of counselling services being under-funded at most public schools.

For me, that means looking at schools—investment in school-accessible or school-located services or practitioners. For example, in schools around Australia, most schools would be lucky to have one or maybe two counsellors available. That's in a public school system. We should be looking at how we actually group services and interventions together around the school. That should include strategies like place based approaches to how this intervention is rolled out and things like getting the primary health networks working together with the local health districts or the state-run health infrastructure with private providers.[154]

4.154Noting the success of some great pilot programs in schools already such as the Murdoch children's mental health professionals in schools and doctors in schools, SANE Australia supported packaging together all supports that could make a difference, including psychosocial support for families and carers.

Because, more often than not, if you're trying to support a child or a young person with developmental or mental health issues or disability, then there's often work that needs to be done with the whole family, yet most services are still offered and delivered in a model that's driven by the way they're funded rather than the way people might need them. So they're delivered as this one over here and that one over there, and the people will run between.[155]

4.155Mrs Green saw an opportunity for Thriving Kids to provide more packaged care options at schools to help with the early identification of children with an issue needing support.=

…to envisage a future where, at the earliest point that someone in the school system in early childhood or a parent or a caregiver might realise there’s an issue, you want the help to appear as fast as possible and you want it to be as comprehensive as possible, because that's the essence of early intervention.[156]

4.156Aware of past issues with earlier programs for mental health support, SANE Australia warned that schools and their staff will need plenty of government support if they are to play a useful role.

Schools are a particularly challenging environment because there are still a lot of snake-oil programs sold into schools, and schools don't necessarily have the resources to do an evidence review. And then you need to have local delivery arrangements, local coordination on how to best put these things together based on the local context, which might be very different in terms of whether there is a workforce available and whether there is housing available for a workforce.[157]

4.157Associate Professor Schultz from the Black Dog Institute cautioned against having unfair expectations of school teachers having the necessary experience or the time to deal with the different challenges presented by neurodiverse students.

I fully support that teachers are integral in outcomes of children and the way that we work with any child, and they do an amazing job. What I would suggest is that with the range of neurodiverse experiences that may present within a classroom, teachers are unlikely to have the professional capacity to be able to pick up and necessarily distinguish between different presentations or diagnoses that kids may be presenting with. For instance, if we look at some of the well-spoken-about neurodivergent conditions, like FASD versus ASD versus ADHD, each may have some overlaps in terms of behaviours and presentations, but each is unique in terms of (1) the way it is diagnosed and the history that has led to that, and (2) the responses that are best practice for ensuring we get the best outcomes for that particular person. Early intervention is absolutely required, and a lot more training and support could be provided to teachers and to schools to bolster that everyday serviceability and support for children, but I wouldn't suggest that teachers are best placed to be necessarily picking up on diagnoses and, therefore, coming up with treatment plans et cetera.[158]

4.158The Australian Council for Education Research explained that international research and reviews highlight that:

…effective provision for children with mild to moderate support needs within mainstream education settings relies on a highly coordinated and responsive system of prevention, targeted support, and intensive intervention.[159]

4.159Queensland Catholic Education pointed out that:

Lack of dedicated funding for allied health services in education settings leads to inconsistent and informal collaboration.[160]

4.160Emerging Minds cautioned against using any program as a one size fits all to address the ‘complex and interconnected needs of children and families.’ They explained that Thriving Kids:

…should be positioned not as a standalone initiative, but as a strategic enabler within a broader ecosystem of support. This framing helps avoid the perception that programs alone can resolve systemic challenges, particularly within education settings, and instead highlights the importance of integrated, developmentally informed approaches.[161]

Inclusive education

4.161The Inclusive Educators Australia (IEA) ‘considers that inclusive education, as an educational practice, means that all students with disability.’

• learn in a regular education environment (that has been sufficiently transformed to be accommodate all learners), alongside their same-age peers
• access the core curriculum, with appropriate adjustments and supports
• fully and effectively participate in their school community as valued members.[162]
  162. IEA suggested that the following elements were critical to the success of inclusive education:
• Shared understanding amongst all stakeholders of inclusive education, including its guiding philosophy, fundamental concepts, frameworks and practices
• System-level support from state/territory and regional stakeholders and Departments of Education
• School leadership and commitment from principals and broader leadership teams
• Strategic planning to develop a robust plan for achieving inclusive education in the school’s unique context
• Professional development opportunities for teachers and support staff to become more confident in providing inclusive education, with sufficient time allocated to enable this
• Community education of the broader school community about inclusive education and the benefits for all students
• Family collaboration with parents/carers and supporters in planning and decision-making
• Inclusive culture that actively fosters inclusive attitudes and behaviours and building a school culture based on respect for diversity
• Empowering the leadership and voice of students with disability
• Ongoing, continuous review and monitoring of inclusive education implementation.[163]
  163. Submitters suggested that embedding inclusive education principles within Thriving Kids could enhance mainstream capacity and lead to better outcomes for all children.
  164. Square Peg Round Whole commented that inclusive education requires a variety of teaching methods to remove barriers to learning, i.e., Universal Design for Learning:

A cornerstone of workforce development must be Universal Design for Learning (UDL). UDL provides teachers with the tools to design learning environments that are inclusive from the outset, reducing reliance on retrofitted adjustments and one-to-one supports. Embedding UDL across professional standards and teacher training creates systemic capacity for inclusion, benefitting all students while particularly addressing inequities faced by neurodivergent and disabled children.

The UN Committee on the Rights of Persons with Disabilities (CRPD General Comment No. 4, 2016) identifies UDL as a requirement for inclusive education.[164]

4.165JFA Purple Orange believed that the Thriving Kids initiative could act as a catalyst for Australia to commit to a comprehensive Inclusive Education Strategy:

…we strongly believe the development of the Thriving Kids initiative creates another impetus for Australia to commit to develop, fund, and implement an Inclusive Education Strategy across all education settings and to embrace the opportunities this would provide for all children to receive a high-quality inclusive education throughout their years of schooling. This is in line with the recommendations of all the Disability Royal Commission commissioners with lived experience of disability.[165]

4.166Autistic Self Advocacy Network of Australia and New Zealand called for adopting programs that have been independently evaluated for effectiveness and safety:

Anchor Thriving Kids in inclusive education and family centred models, rejecting segregation/normalisation, and only adopt programs once independent, long-term evaluations confirm effectiveness and no net harm.[166]

4.167The Australian Childcare Alliance was of the view that, while support for children with additional needs has been underfunded for a substantial amount of time, the Thriving Kids initiative had the potential to be a turning point in improving outcomes:

Inclusive education is a core and critical component of our sector. The commitment and support required for children with additional needs has been underfunded and has failed to address children's and families' material needs for nearly a decade. We have been advocating for such changes to improve inclusive education for many years and hope Thriving Kids could be a domino in fixing all the systems aimed at improving child outcomes.[167]

4.168Children and Young People with Disability Australia commented that research shows that inclusive education delivers equal or better outcomes for all children, families, teachers, and society.[168]

4.169I CAN Network Ltd noted steps being taken by the Victorian Government to inclusive education:

Government-led initiatives such as the Victorian Disability Inclusion Reform offer a strong foundation of co-design. This reform is enhancing inclusive education by providing schools with additional resources, a tiered support model, and a stronger workforce trained to meet the needs of students with disability. Aligning Thriving Kids with these efforts through co-design ensures policy cohesion and program sustainability.[169]

4.170The National Rural Health Alliance believed the education system needed to work closer with the mainstream health and disability services, to help identify children needing support.

The first thing is that there needs to be an integration of the education system into mainstream health and disability services so that school and early childhood centres become active partners in identifying and supporting children with development needs and those people that look after them are also supported. The intervention needs to start early with coordinated, family centred care, and investment in workforce capacity has to occur. As you heard before, we need to invest in rural and remote multidisciplinary teams.[170]

4.171Settlement Services International, Mrs Smith, supported providing greater access to supported classrooms for CALD students at their primary schools.

If there is such a big gap in access to therapists, for example, and the cost of the NDIS is so high, I do that blue-sky thinking around imagining if that was available in those settings alongside the educators, alongside the families, and even more so in CALD communities, where you can build the capacity of that support around that child as well. So it’s not that hour of therapy that you get once a fortnight just with that child, which is often the model we're seeing at the moment. It's really embedding in the system, alongside education and also those community supports, so that it's working collectively rather than in a siloed fashion.[171]

4.172Services for Australian Rural and Remote Allied Health Ltd explained schools can play a role in referring a student for further checks, but the education system can also raise obstacles.

Referrals into some of these checks and screening programs come from everywhere. They can come from family members or from schools, but there are significant challenges to being able to use school infrastructure to provide services to children who have these needs. For example, we understand that some of our members are being charged to go into schools to provide disability services.[172]

4.173Ms Maloney highlighted that some schools may charge allied health professionals to come in to see children who might be being funded under a disability program.

I think that just speaks to the lack of communication between health and education. And if the service is being targeted to the child and not supporting the school community—not uplifting the skills and capacity of the teachers and the assistant workers within that school—then I can see that there might be that cultural question of, 'What's this person doing coming in and seeing this child?' There's a lot of work to be done to improve the way that health and education work together.[173]

4.174The Department of Education noted that the Autism CRC is leading the development of National Guidance for Best Practice in Inclusive Education for Autistic Students:

The Autism CRC is developing National Guidance for Best Practice in Inclusive Education for Autistic Students and will draw on both domestic and international policy experience and practice. The guidance will be developed through a co-production model involving over 20 community, professional, and government organisations and will integrate systematic reviews of global research evidence with insights from Australian educators, health professionals, autistic individuals, and families.[174]

Challenges providing inclusive education

4.175Ms Karavolos, Disability Advocacy and Complaints Service of South Australia, noted that despite progressive policies and government support for autism inclusion in South Australia, there remains a significant gap between policy and practice.

South Australia has one of the most forward thinking governments in the country. We have a premier and ministers who have strongly backed autism inclusion, established an office for autism and invested in autism inclusion teachers. We have the minister for autism. However, at the grassroots, families report a different reality. Teachers and schools still too often interpret behaviours of distress as naughty or defiant, reinforcing stigma and exclusion. In the past year alone, advocacy services have seen a threefold increase at our organisation in requests for support due to vilification and discrimination in schools. With a statistic of autistic children being expelled permanently from preschool 10 times more often than their peers, it says a lot. So often behaviour is a concern in education settings. They are still reported as being defiant rather than having a disability. These stories aren't isolated.

So here is the paradox. We've got progressive policy at the top but discrimination at the classroom level. It shows us what is at stake.[175]

4.176Ms Nicole Avery, CEO of South West Autism Network, was of the view that availability and quality of autism training for school staff varied:

There needs to be a lot of upskilling. There's no mandatory training on autism in schools. It's entirely optional. I don't know about other states, but, in WA, professional development for school staff on autism is entirely optional. It's very much luck of the draw whether you attend a school that is very inclusive and understanding of autism and developmental delays or you don't. Because of catchment areas, you might just happen to be living on the wrong side of the street and wind up in a school that is not supportive, whereas if you were on the opposite side of the street, you could go to a school that is.[176]

4.177Broome Regional Aboriginal Medical Service noted that, in Broome, schools are ill-equipped to provide adequate support:

We have lots of kids in our Broome schools with special needs, and the schools still don't seem to be equipped to understand around that person-centredness for children, and children are quite often judged as being naughty or other things when there are developmental delays happening. We do a lot of advocacy in schools and other early childhood providers to ensure that other people have a good understanding of how to look at kids as individuals and not label them with a diagnosis or a developmental delay and how we have a strength based approach to working.[177]

4.178Mrs Green, from SANE Australia, while very supportive of teachers, suggested that schools often felt constrained from implementing basic support strategies:

Yes, we have amazing teachers, and they have a whole classroom of kids. It's a bit like the emergency department in that the resources can often get drawn to the most acute need. And so kids that have a softer signal or a flag that they might benefit from some support are going to be less in line to be able to be supported that way because there aren't enough resources. Sure, let's look at how we're training teachers and make sure that they're getting great professional development around the best ways to support children and young people with different needs, but I think you've still got one teacher in a classroom and maybe one counsellor in a school and a whole lot of kids in a public school with needs. And so those resources, that time, that planning, that making of the plan—that goes to the kids with the most acute needs. And so, if you've got a kid who's presenting a bit—maybe there are some signs of autism, maybe there's some ADHD—and they're struggling to make friends, but they're not the most noticeable behaviourally, then at least my experience has been that schools are not going to get you to the front of that queue, because there's only one counsellor.[178]

4.179Children and Young People with Disability Australia provided information on two education surveys they had conducted for young people and one for families which found:

• 72 per cent of students with a disability said they'd been excluded from school activities or events in the last 12 months
• 75 per cent of the students who responded to the survey reported being bullied in the last year
• fewer than two in five students had been involved in shaping their own individual education plan
• 72 per cent of parents of children with disabilities said that care of the children lacked any kind of personalisation or effective execution.[179]
  180. Mrs Catherine McAlpine, from Inclusion Australia, commented that acceptance of students with intellectual disabilities remains a persistent challenge:

In terms of acceptance in school, it's been an ongoing issue. We've got a review of the Disability Discrimination Act at the moment, where we need to look at acceptance into school and the subtle pressure that's put on families to go elsewhere. I think one of the things that's lost in the debate is, we would say very strongly, that the resources currently in special school systems need to not be stopped; they need to be transitioned across into schools so that we have inclusive strategies. We know there are a whole lot of inclusive education strategies that work well for all students if they are implemented.[180]

4.181Ms Nicole Rogerson, from Autism Association of Australia pointed out that school expulsion and exclusion remain significant issues for children on the autism spectrum, often stemming from a lack of understanding and inadequate teacher training.[181]

4.182Ms Lynette Brodie, from Speech Pathology Australia, noted that service availability in schools is inconsistent across states and territories, with some employing speech pathologists and others not. They called for a more uniform approach to support services in education.[182]

4.183Mr Jonathon Guy, from the Australian Education Union, held the view that scarce funding limits the ability to make necessary changes

…in order for a student to receive adjusted funding under the NCCD, the school must demonstrate they had made that adjustment for 10 weeks in the previous year. We have a situation in public schools where funding is very scarce. They don't have the money to make the adjustment and then they can't demonstrate that they've made it to get the money to make the adjustment in the future.[183]

Transitioning between programs

4.184There was widespread concern about the transition from the NDIS to the Thriving Kids initiative, particularly regarding the risk of exclusion and loss of supports for children and families. Submissions emphasised the need for a clear timeline for the Thriving Kids rollout and transparent communication to reduce anxiety and confusion.

4.185Highlighting the importance of a clear transition for young children with ongoing diagnoses, Inclusion Australia emphasised the need for government collaboration with the disability sector.

We mention the need for young children that will go on to have an ongoing diagnosis to have a clear pathway onto the NDIS, particularly from age nine, and it's critical that the government works with the disability sector to determine which cohorts of children may be at the highest risk of losing supports or may be left worse off in any way in the transition to Thriving Kids. This process can assess community need to determine what safeguards and alternative arrangements are required to ensure sufficient supports are in place before and after the transition.[184]

4.186Children and Young People with Disability Australia stressed the need for transparent communication from all levels of government, so families can understand and trust the transition to Thriving Kids:

Families have been bombarded over the last few years with messaging that change is coming and change is happening, but each time change it's announced it is not accompanied by any level of detail. You marry that with families who are experiencing NDIS eligibility reassessments, having plans cut or having children removed from the scheme, the cost-of-living crisis—families are in a really uncertain state at the moment. The more communication that federal, state and territory governments can provide to families about what Thriving Kids will be in their area and how families can access them—that will help, as well as making sure that the community is able to see what they've told the government they need reflected back to them.[185]

4.187Drawing on results from its national survey, the South West Autism Network voiced widespread concern among families that children currently supported by the NDIS may lose access under proposed changes:

92.5 per cent of respondents were concerned that kids currently supported by the NDIS could lose access under the proposed changes, and 77.4 per cent of those were very concerned. Only 5.1 per cent believed Thriving Kids should replace NDIS supports for autistic kids and kids with developmental delay. So 84 per cent of families are not confident that Thriving Kids will deliver timely, affordable or appropriate support in their community, especially outside metropolitan areas.[186]

4.188Ms Karavolos, from the Disability Advocacy and Complaints Service of South Australia, pointed out that a safe and well-communicated transition period was essential, stating:

The reality is that if families know there is a safe transition period, we can actually build in some safeguards.

I believe that we could do it in a way so that there's a transition. You're still in the NDIS. While you're transitioning over this period, the government picks up the responsibility for education or community settings. It builds a transition plan to be funded so that there's a transition of knowledge over a period of time. We've then got a much bigger chance of success. We're not relying on the child to transfer knowledge or the parent and overburdening the parent.[187]

4.189The AEIOU Foundation expressed anxiety about the potential loss of vital supports for children and families during the handover period between NDIS and Thriving Kids, calling for a tiered, interconnected model:

AEIOU supports a tiered and interconnected model, where children are not permanently locked into one stream. If a child accessing Thriving Kids is not making progress, they must be able to transition into NDIS-funded intensive supports. Likewise, children making gains in intensive programs should be supported to transition into Thriving Kids, with continuity of care and transition planning embedded across pathways.[188]

4.190ACSSO believed that:

…seamless transitions are not an optional extra. They are the defining feature that will determine whether families experience Thriving Kids as a supportive reform or as another system that fails them.[189]

4.191ACSSO was supportive of phased implementation, including pilot programs and an overlap period, to ensure families are not left without support, including:

• Pilot programs in selected regions, co-designed and independently evaluated, before scaling nationally.
• A 12–18 month overlap period where both NDIS and Thriving Kids operate concurrently, giving families time to transition at their own pace.
• Clear public timelines with milestones for workforce recruitment, service commissioning, and family resource development.[190]
  192. Monash University highlighted the need for families to experience seamless transitions across services:

For Thriving Kids to succeed, families must experience seamless transitions across services — moving from first concerns to identification, to support within mainstream settings, and, where necessary, referral to specialist care. Too often, families face fragmented pathways and long waits across health, education, and community systems.[191]

4.193Pop Family Ltd believed that there were significant risks if children are transitioned from the NDIS before robust mainstream supports are established:

…there are significant risks in transitioning children from the NDIS before equivalent, funded, and robust mainstream supports and regulatory frameworks are in place. Without these safeguards, the Thriving Kids initiative risks creating a service vacuum that will fail the very children and families it intends to support.[192]

4.194The South West Autism Network emphasised the importance of bridging services for effective transition through systems:

To enable a seamless transition through mainstream systems for children with low (mild) support needs, it is essential for Thriving Kids to bridge services across early childhood, school, community health, and the NDIS using clear referral pathways, integrated planning, and wraparound communication.[193]

4.195SNAICC recommend establishing transition safeguards to avoid any disruptions to supports:

…utmost care needs to be taken to ensure that parents and children currently accessing the NDIS do not face any disruption in their supports. This can be done through transition safeguards, including pausing adverse reviews until the Thriving Kids Initiative is live.[194]

4.196Inclusive Educators Australia called for ‘nationally consistent transition planning frameworks, ensuring every child and family has a structured plan for key points of change.’[195]

4.197MedHealth Pty Ltd called for a clear transition process stating:

We strongly recommend that the Department ensures that the NDIA is not exiting children requiring ongoing supports from the scheme until a new ecosystem of Thriving Kids supports and services are funded and readily available nationally.

Additionally, on commencement of Thriving Kids services there must be a clear transition process for children who are exiting the scheme.[196]

4.198The Australian Youth Affairs Coalition echoed concerns from the Australian Autism Alliance about vulnerabilities of children who don’t fit the new criteria:

There is risk of some children falling through the cracks during the transition between NDIS and the Thriving Kids Initiative, as voiced by Australian Autism Alliance (2025). Older children, those with unclear diagnoses, those who don’t fit new criteria, or families with who would experience financial strain in acquiring a review of their diagnoses in order to access the initiative, are most at risk.[197]

4.199The National Centre of Excellence in Intellectual Disability Health suggested preparation, crossover periods, and a focus on children’s strengths were key to ensuring successful changes:

I think transition is a really important concept for lots of different changes. It's the change into kindy. It's the change from kindy or pre-primary into school. It's the change from one developmental and disability support into another. I think the fundamental components are being clear on strengths—not just weaknesses and impairments—needs and gains and having a crossover period so that there is introduction before the change and then follow-up. So there's preparation for the change. They're touchpoints that are extremely stressful for both children and families. I can imagine that the crossover, the meeting and the preparation before changes actually happen are critical ingredients to that success that includes strengths and preferences.[198]

4.200The APA recommended that Thriving Kids include protocols for referral to the NDIS when needed ‘and also to coordinate if a child is small supports from both the Scheme and initiative – those should be complementary, not working at cross-purposes.’[199]

4.201The Disability Advocacy Network Australia sought clarity on whether Thriving Kids will be aligned with the NDIS or embedded as a mainstream model, and whether ‘grandfathering’ provisions will be used to support a smooth transition.[200]

4.202The Australian Federation of Disability Organisations suggested that no child or family should be transitioned off the NDIS until Thriving Kids supports are fully accessible:

Crucially, no child or family should be transitioned off the NDIS until the Thriving Kids foundational supports are fully operational and accessible across all relevant jurisdictions. This includes completion of the phased rollout, establishment of sufficient service capacity, workforce readiness, and the resolution of policy and procedural arrangements across Commonwealth and state/territory governments. Premature transition risks gaps in essential supports and disrupts care continuity, undermining families' trust, and well-being.[201]

4.203The Autistic Self Advocacy Network of Australia and New Zealand caution against rigid criteria, stating:

Children who are not eligible for the NDIS should be able to access free, high-quality, trauma-responsive, neuroaffirming, culturally safe supports through Thriving Kids, including short-term transition “bridge” supports delivered via health or education. Rigid criteria can inadvertently cause regressions; flexible support based on actual needs at transition points is better and must not involve moving eligible autistic children out of the NDIS.[202]

4.204The William Campbell Foundation called for a guarantee in continuity between Thriving Kids and the NDIS, including:

• Stage NDIS eligibility changes only after Thriving Kids rollout.
• Establish clear transition protocols and escalation pathways.
• Provide safety nets for children with higher support needs.[203]
  205. The Murrumbidgee Primary Health Network and Murrumbidgee Local Health District put forward several key requirements for a seamless transition:
• Clear systems and referral pathways
• Care navigators to guide families and clinicians
• Integration between health, education, and social services
• School readiness programs that align with early intervention efforts
• Removal of cost barriers to access services.

A tiered model supports these factors by allowing children to move between levels of care based on need. However, successful implementation depends on investment in Tier 1 and Tier 2 workforce, care coordination, and access to allied health.[204]

4.206Lifestart Disability Services emphasised the need for a coordinated, inclusive, and flexible ecosystem of support:

A seamless transition through mainstream systems for children with mild to moderate support needs requires a coordinated, inclusive, and flexible ecosystem of support, one that recognises the diversity of children’s cultural backgrounds, experiences and needs, and supports them across multiple environments, including health, education, and community settings.[205]

4.207Inclusion Australia reiterated the need for government collaboration with the disability community:

It is critical that government works with the disability community to determine which cohorts of children may be at highest risk of losing supports or being left worse off in any way in the transition to Thriving Kids.[206]

Co-design and lived experience

4.208Mrs Rachel Green the Chief Executive Officer of SANE Australia highlighted some of the challenges faced by families seeking help from the current system for high needs children with autism.

There is good data to show that people who are autistic and people who have an intellectual disability have a higher prevalence of anxiety and depression. They also have a much harder time accessing mental health support. We also know that families and parents who are the primary caregivers, trying to essentially fight a system to get help for their kids, are, in turn, also facing high levels of stress, anxiety, depression and relationship issues.[207]

4.209Mrs Green recalled a family that SANE Australia supported and engaged with who had a son with very high needs.

He didn't fit the criteria for NDIS, and they were spending $30,000 to $40,000 a year out of pocket. Some of that was for the compounding effect of trying to support their son, who had very difficult behavioural issues. He was a lovely boy, but they were experiencing significant depression and anxiety themselves. Imagine what that's like for a family… They had the experience of regularly being let go by private psychologists and psychiatrists for having a kid whose needs were too difficult and did not fit the mould of any particular program.[208]

4.210Ms Wade also cautioned how reviews of the NDIS are conducted.

I think that review plays a very important role in that, though, when we do review the NDIS, we must do so in a way that is respectful of people with disability and their families and their sense of self in the scheme. It’s unfair when we review the NDIS and lose sight of that and cause distress, uncertainty or unpredictability in the lives of people with disability.[209]

4.211The Australian Psychosocial Disability Collective, an independent group of NDIS psychosocial participants, acknowledged problems with the operation and sustainability of the NDIS but urged caution when making changes.

…in the interests of the disability community, we ask that great care be taken in how any reforms to the NDIS are carried out. We believe that the decision by the Australian government to remove children with mild to moderate neurodevelopmental delays—their term, not ours—and autism from the NDIS and place them in the newly hatched Thriving Kids program is poor and ill considered.[210]

4.212The Chief Psychologist at the Australian Association of Psychologists Inc, Mrs Amanda Curran, warned that the ‘current funding models, including Medicare and NDIS pathways, are fragmented, restrictive and inequitable’.

Many families are left navigating long waitlists, prohibitive costs, inappropriate referral requirements and inadequate session caps, while children miss out on timely support. Psychologists play a vital role not only in assessment but in empowering parents, supporting educators and delivering therapeutic interventions that build resilience and developmental capacity, yet our workforce is constrained by underfunding, lack of incentive for rural and remote practice and barriers to collaborative care.[211]

4.213The APDC warned that for children with neurodevelopmental delays and autism and their families, there was much at stake in the NDIS process.[212]

There is much evidence that children with neurodevelopmental delays and autism who fail to receive appropriate support run a much higher risk of experiencing mental ill health later in life. Many of the concerns voiced by members of the autistic community about autistic people being subject to coercive practices resonate with the APDC.[213]

Role of families and people with disability

4.214The Chief Psychologist at the Australian Association of Psychologists Inc; Mrs Amanda Curran, described ‘a lot of support for parents as currently ad hoc’.[214]

We provide it as we go, often unpaid. Parents are highly distressed by the time they get to us. They're very concerned about their child and what their life is going to look like. They've often raised concerns with multiple people by the time somebody's listened to them and actually gone through and done an assessment. Often, there's a need for them to be really well supported as well. There are high levels of carer burnout.[215]

4.215Mrs Curran described children’s support needs as not being adequately covered currently, even within the NDIS.

Parents are doing a lot; they're stretched absolutely thin. I've had parents who have given up their own meal in order to feed their child and try to save for the cost of assessment. There's a need for them to be given a lot of support, a lot of assistance, in finding their way and being confident in how they might need to change parenting practices to better support their children, advocate and navigate very complex health and disability and education systems.[216]

4.216As a start for improving the situation for parents and the children, the Australian Association of Psychologists Inc believed that the government needed to provide parents with Medicare-funded psychology sessions:

Currently, they can get parenting support only if they've got a diagnosed mental health condition and they're receiving parenting training under Better Access. There needs to be a better support system to help them learn how to support their children and to provide them emotional support as well embedding lived experience in leadership.[217]

Governance and complaints process for the NDIS

4.217The NDIS is governed through shared arrangements with the Commonwealth and the states and territories. The Disability Reform Ministerial Council (DRMC) comprises the state and territory ministers responsible for disability policy, the Minister for Health and Ageing, and the Minister for the NDIS.[218]

4.218The NDIS provides quarterly reports to the disability ministers, with information (including statistics) about participants in each jurisdiction and the funding or provision of supports by the NDIA in each jurisdiction. These quarterly reports are reviewed by the Board, then published on the NDIS website.[219]

4.219The NDIA is governed by a Board consisting of 11 members. The Board assists with the NDIA’s statutory requirements, manages risk and ensures the agency achieves best-practice governance. The membership of the board and its work is published in the NDIA Annual report.[220]

Complaints system available to NDIS participants

4.220Complaints about the NDIS can be made by participants in the scheme, or their representatives, and others including members of the public. Complaints can also be referred by parliamentarians, other government agencies and community organisations.[221]

4.221The most recent quarterly report noted that the volume of complaints had increased

During the September 2025 quarter, there was an increase in complaints from participants to 14,061, compared to 12,161 in the June 2025 quarter. While we received a small number of complaints from participants about the Annual Pricing Review this quarter, the growth reflects a general increase in contacts from participants about all complaint topics.[222]

The report also noted the most common focus of complaints

When exploring both participant and provider and other complains, participant plans are the most common focus of complaints, in particular:

• the type and amount of funding approved
• communication about changes to participant plans
• the plan review process
• delays in receiving payment.[223]
  222. NDIS Quality and Safeguards Commission Commissioner Ms Louise Glanville confirmed that the Commission received thousands of complaints, and codifies them under various categories such as ‘provider practice, worker conduct and capability, alleged abuse and neglect, provider policies and procedures, and others’.[224]

We received over 30,000 complaints in the 2024-25 financial year, which is a significant number, and it continues to grow as the number of participants in the scheme grow and people know that they can come to us to raise concerns around the delivery of NDIS services.[225]

4.223Associate Commissioner Ms Natalie Wade, from the NDIS Quality and Safeguards Commission, detailed how the complaints system worked as a statutory function carried out by the Commission:

It is available to people with disability, their families and the public more broadly, where complaints can be made about NDIS providers. They can be unregistered or registered providers. If a complaint is made, we have specific powers, as the regulator, to respond to those complaints. We can decide to take it as intelligence and refer the matter out or continue to keep it in our intelligence holdings, right through to bringing the complaint for investigation and compliance and enforcement action. This is a really key way in which we receive information about NDIS services and the way in which they're delivering for people.[226]

4.224Ms Wade explained that the breadth and width of the nature of complaints that the Commission receive about the NDIS was quite significant.

It might be something like a person with a disability not receiving their support service on time, and they may complain to us about that, right through to serious allegations of physical and sexual assault. Our role in that, as opposed to the police or an ombudsman or otherwise, is to regulate the NDIS market. We are the only body that has the power in response to a complaint to ban a worker or ban a provider, to stop them from providing those services once those allegations have been made.[227]

4.225The complaints system is the key way in which the Commission received information and what regulatory tools to use, according to Ms Wade.

Really importantly, they apply to both registered and unregistered providers, and, with respect to early childhood supports, families can make complaints to us. Children could too, although it probably would be families who make those complaints. Providers might also make complaints about the quality and safety of the services.

Most prudently, it's important to highlight that we only have jurisdiction for providers, so not with respect to other allegations of abuse of other family members or things like that.[228]

Other review mechanisms

4.226An NDIS participant may also request a plan reassessment or variation at any time; a reassessment is a complete review of the plan, whereas a variation is often a minor adjustment to a plan.

4.227Participants can request a review of a reviewable decision (RoRDs). The NDIS reported that the proportion of plan reassessments that became RoRDs increased from 8.5 per cent (5,860 RoRDs) in the September 2023 quarter to 10.7 per cent (5,835 RoRDs) in the March 2025 quarter.[229]

4.228If a person is not satisfied with the outcome of their review by the NDIA, they may apply to the Administrative Review Tribunal (ART) for review of a decision made by a reviewer. The NDIA reported there were 2,481 new ART cases in the September 2025 quarter, relating to 2,441 participants. The number of new ART cases (as a proportion of active participants) increased from 0.67 per cent in the September 2023 quarter to 1.33 per cent in the September 2025 quarter. The September 2025 quarter saw an increase from 0.89 per cent recorded in the June 2025 quarter.[230]

NDIS worker-screening checks

4.229Deputy Commissioner at the NDIS Quality and Safeguards Commission Ms Alisa Chambers outlined that the NDIS worker-screening check was a check that’s ‘only required for workers who are in risk assessed roles’ with a registered provider.

The only requirement for a worker-screening check is if you are working with a registered provider, but we do encourage all participants who might be self-managed and who are engaging workers to ask their worker to go through that worker screening. It runs a range of different criteria over the person—a criminal record check and a check for any adverse findings about that person—and it flags that in the system. We run the database, but the worker-screening check itself occurs in the states and territories.[231]

4.230Ms Wade wanted to stress, however, that ‘whether you are registered or unregistered, you are regulated by us through the code of conduct’.

There is no NDIS provider in the market that is not regulated. Everyone is by us. When we look at when there are increased numbers of unregistered providers behaving poorly proportionately to the market—if 93 per cent of the market is them and seven per cent is registered—then of course we see significant numbers of unregistered providers being subject to complaints and coming through our door in various ways.[232]

4.231The Commission had identified that risk occurs according to the service delivery and the service type, which would be important to mitigate in any programs for children.

We know from the Disability Royal Commission that, when people receive certain types of services, they are statistically more likely to be subject to violence, abuse, neglect and exploitation. There are absolutely risk-proportionate elements of service delivery that a registration system needs to respond to and recognise, because, ultimately, registration does two things for us as a regulator. It gives us visibility and it gives us an ability to set standards in quality and safety of service delivery… So that's an example where you look to the highest service delivery and then overlay registration, but there is already mandatory registration in place now with regard to specialist disability accommodation and also behaviour support for restricted practice, which is very pertinent for children with regard to restricted practice.[233]

Data, regulation and quality assurance

4.232Submissions to the Committee spent some time focusing on the importance of data in shaping effective health policy and funding models for neurodivergent children and people with disability.

Data collection and transparency

The importance of data collection

4.233The importance of data collecting was identified by AHPA, which highlighted the need to share improved data to help guide the provision of services and with the Thriving Kids initiative.[234]

…the importance of shared digital infrastructure to ensure that allied health clinical data is freely exchanged across the health and disability interface. If there is the expectation of operating in a multidisciplinary team, we need to ensure all members of that care team upload and share their clinical data.[235]

4.234The Murdoch Children’s Research Institute stated that:

Thriving Kids should be underpinned by a consistent national data framework that includes consistent definitions of lead indicators for service quality, quantity, and participation, alongside impact and outcome measures. Lead indicators are essential to enable data-driven decision making to make inequities visible and guide early action. Clear, consistent definition and indicators developed in consultation with priority groups is also needed to ensure Thriving Kids can monitor reach, participation, equity and progress. System-wide delivery requires services to be equipped with the tools and capabilities to collect and act on these data routinely.[236]

4.235Similarly, Amaze set out that ‘measuring the success of the Thriving Kids initiative is crucial to ensuring it delivers meaningful, lasting benefits for children with disability and their families and carers’ and that ‘Thriving Kids must be anchored by a comprehensive Outcomes Framework that prioritizes robust and reliable data collection.’[237] Amaze stated that this framework should:

…track progress towards meaningful short- and long-term outcomes such as education, employment, mental health, and overall wellbeing. This data must be broken down by disability type, including autism, and priority cohorts to ensure equity in service delivery and outcomes for all eligible children.[238]

4.236The Bryan Foundation stated that a proper support structure should include:

Robust data and monitoring to guide design, delivery, improvement, and evaluation, including multidisciplinary data frameworks and data sharing protocols.[239]

4.237As a mother of a child who received early intervention on the NDIS, Ms Priyanka Rai, from the Australian Multicultural Health Collaborative highlighted the importance of governments collecting more suitable data from CALD families to give more insight on whether a child’s language skills may indicate any possible developmental delay.

One of the issues for us, because we are obviously a multilingual household, was that, during his pre-kindy days, they didn't know if he wasn't socialising because there was a language difference—there wasn't; he was born in Canberra—or because it was a developmental delay.[240]

There are obviously children from multilingual households who take a bit longer to start speaking because they're trying to pick up different languages. But then there's also the issue that we don't actually know what percentage of multicultural children have developmental delays because we're not collecting that data. In general, ethnicity data is not collected across Australia.[241]

4.238Ms Rai claimed the NDIS doesn’t know how many of those children with a disability are from an ethnically diverse background.

What we know is that one-in-four children who go to school is from a family that speaks a different language. We're assuming that that filters through, but we don't have the granularity of data to actually tell us what the inequity really is.[242]

4.239Ms Rai also pointed to the benefits data collection has brought in other areas of health inequality:

One of the things we've learnt from other areas where we're trying to bridge inequity, like with Closing the Gap, the first step was collecting that data—actually seeing where our Indigenous communities were falling back in terms of health outcomes or other metrics. When we didn't have that data, we heard anecdotally that communities were falling behind but we didn't know it. Now, when we have those metrics, which we benchmark and check, we have more-granular information about where they're falling behind and what we need to step up. It's the same with multicultural communities, and more so because we know that the fabric of Australia is going to be more diverse. It just makes sense to collect this data. If you look at comparable countries, like the US and the UK, the UK has its own health observatory such that it's looking at multicultural data specifically. So if we want Australia to continue to be seen as the bastion of universal health care, that's definitely a step we need to take.[243]

4.240The National Rural Health Alliance pointed out that:

Thriving Kids will require meaningful data to facilitate insights and inform policy, reform and evaluation. The disability ecosystem, more broadly, needs to be supported by comprehensive disability data and data improvements that reflect the experience of all people with disability. As noted by the NDIS Review, investment in integrated and longitudinal data is needed now so we can respond to the needs of children with developmental needs. This will also require cross-portfolio understanding and collaboration in the health, disability and education sectors.[244]

4.241An important component of data collection is the collection of data on complaints. Ms Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, stated that:

Complaints are a key way in which we receive information and determine the statutory use of our regulatory tools. Really importantly, they apply to both registered and unregistered providers, and, with respect to early childhood supports, families can make complaints to us. Children could too, although it probably would be families who make those complaints. Providers might also make complaints about the quality and safety of the services.[245]

4.242Ms Ailsa Chamber, Deputy Commissioner, Regulatory Policy, Insights and Review, NDIS Quality and Safeguards Commission, informed the Committee that the Commissions had:

…received about $164 million in budget uplift for us to implement the data and regulatory transformation program, which is allowing us to better capture data and better use the data so that we can construct risk profiles. That will enable us to capture more information about children and other cohorts, and we will understand those risks that we're seeing through the system in a much better way.[246]

4.243Mr Philipp Hermann also from Allied Health Professionals Australia set out that data collection need not be expensive. When asked what data should be captured, he explained that:

…we have massive data gaps and we need to invest in developing solutions to those. I don't think those are necessarily enormously expensive solutions. I think there are things we can start doing if we put at least a little bit of money into thinking about: What are minimum data sets? What's the information that we actually need? How are we using it? That's work that really needs to progress, and that will be the next step, actually saying, 'How do we develop an implementation plan off the back of the strategy?[247]

Current data collection and issues arising

4.244Ms Winslow, a First Assistant Secretary from the Department of Education set out the existence of the Australian Early Development Census and the usefulness of the information it collects:

We have the Australian Early Development Census, and that is a population measure of early childhood development. It's collected in the first year that children attend full-time schooling, and it is undertaken every three years. The latest results were with respect to the 2024 collection. That is a really comprehensive analysis of how all children are tracking across five key developmental areas. I'm certainly happy to go into what those areas are. We look very closely at those results as an indicator for school readiness. It collects information with respect to physical health and wellbeing, emotional maturity, social competence, language and cognitive skills—which is critical in school settings—and communication skills and general knowledge. That is collected every three years and that is supported through our department.[248]

4.245Ms Sadikshya Dulai, a Project and Policy Officer from the National Ethnic Disability Alliance, explained to the Committee that a lack of disaggregation of data impacted on the Alliance’s ability to ascertain if promised outcome were being met.

In terms of the data collection, we fail to see disaggregation of data, which is, again, what makes it difficult for us to identify whether the inclusion outcomes, the equity outcomes, that were promised were met. There's nothing we can measure that against—not what was done but also not what was set out in the beginning. So there's no baseline for us to compare that to.[249]

4.246Dr Esmeralda Rocha, an Assistant Secretary from the Department of Education, set out information in relation to the Disability Standards for Education (DSE), which apply to all schools which ensures that schools make adjustments for students so that they can access and participate. Dt Rocha then set out the importance of data collection to assist with ensuring DSE outcomes are being met:

The way that we ensure that the adjustments are being provided is through something called the nationally consistent collection of data for students with disability—I'm going to call that the NCCD for short. In the NCCD what happens, essentially, is that we base our student with disability loading contributions from the Commonwealth on that data. Every school in Australia completes a survey each year for census. That's how we get the total recurrent funding. The NCCD is a part of that.[250]

4.247Importantly, Dr Rocha explained that adjustments are based on a child’s needs in the classroom and are not diagnosis-dependent:

As soon as a child's functional need becomes apparent, they can document it. They need to have evidence of the child's disability, but it can be something like an individual learning plan, for example. They document the level of adjustment that has been required. There are four levels of adjustment. Three of them attract different levels of funding and one is unfunded—we call that the quality differentiated teaching practice level of adjustment. Then, based on the information that's been provided, it goes through to our system, and that's how we calculate how much student with disability loading is required each year.[251]

4.248For the non-government sector, Dr Rocha explained that there is a post-enumeration census process where every non-government school is not audited but there is a:

…quality assurance mechanism, which is risk based to some extent, and then there are just random schools that we will go and audit each year to make sure that the evidence is in place and that the adjustments were in alignment with the level of adjustment that is being claimed.[252]

4.249Achieving Health Equality for All Australians with Disability stated that the:

…research and data infrastructure surrounding the NDIS is not fit for purpose and this poses a significant barrier in engaging in evidence-informed reform. The NDIS data currently has information on budget allocation and payments but lacks rigorous information on the types and quality of services provided and outcomes achieved. Furthermore, while the NDIA is now making data available to external researchers, which theoretically should enable greater oversight, there are still major issues in terms of information about the data so researchers are ‘in the dark’ about the meaning of data items and whether all the information is in the dataset. Moreover, beyond the NDIS there is a complex infrastructure of different evidence sources across different sectors that is not always joined up making it difficult to understand how children and their families navigate service systems.[253]

Indigenous Data Sovereignty

4.250Indigenous Data Sovereignty (IDS) is:

…the right of Indigenous peoples to govern the collection, ownership and application of data about Indigenous communities, peoples, lands, and resources. Its enactment mechanism Indigenous data governance is built around two central premises: the rights of Indigenous nations over data about them, regardless of where it is held and by whom; and the right to the data Indigenous peoples require to support nation rebuilding.[254]

4.251SNAICC commented that ‘existing administrative datasets often reinforce deficit-based narratives, framing Aboriginal and Torres Strait Islander children and families through lenses of deficiency and disadvantage. As noted in national health reporting, such data frequently perpetuates a narrative of ‘negativity, deficiency, and failure.’’[255]

4.252The principles of IDS must be acknowledged when collecting data with SNAICC – National Voice for our Children emphasising the importance of ‘giving Aboriginal and Torres Strait Islander people ownership over data so they can exercise sovereignty in relation to data creation, collection, access, analysis, interpretation, stewardship, dissemination, reuse and infrastructure.’[256] They added:

To be effective, data collected through Thriving Kids must be co-designed with communities. Codesign enables the generation of insights that reflect holistic understandings of child development, encompassing connection to culture, Country, kinship, and language.[257]

4.253Indigenous Allied Health Australia stated that data should be ‘accessible to community and be co-designed with relevant communities that centre around Indigenous data sovereignty and cultural intellectual property.’[258]

4.254Referring to sharing data and information to support decision making as a priority area of reform, the National Aboriginal Community Controlled Health Organisation noted that it ‘supports principles of Indigenous Data Sovereignty’.[259]

4.255Northcott linked IDS to the need to ‘disaggregate outcomes for Aboriginal and Torres Strait Islander children.’[260] Griffith University also mentioned to the importance of IDS principles.[261]

Data interoperability

4.256An important aspect of data collection, the ability to provide that data to a central area so that it can be accessed by other was addressed Mrs Morris-Donovan, Chief Executive Officer of the AHPA, who stated that one of the barriers to collaborative care is:

…a barrier towards the sharing of an uploading of appropriate clinical data across the health-disability interface. Private practitioners and allied health work in private practices and create literally thousands of individual data silos, none of which can be shared with each other, nor with the broader health ecosystem. In my view, that's a significant barrier to collaborative care, regardless of setting.[262]

4.257Ms Catherine Maloney, Chief Executive Officer, Services for Australian Rural and Remote Allied Health Ltd, pointed out the importance of data interoperability; being able to access data from a range of health services and states and territories:

When we're talking about families who are at the interface between health, education and disability, the inability to access information across those systems is a significant one. An example of that is that a child might be born on a remote station in one state but is having to access services in another. It's next to impossible for that health service to access the data on that child. Trying to fix that interoperability issue would be our priority.[263]

4.258Ms Glanville, Commissioner, NDIS Quality and Safeguards Commission, speaking to the budget uplift mentioned above to implement the data and regulatory transformation program also spoke to the data interoperability aspect – informing the Committee that this should help with sharing data with other organisations.[264]

4.259Indigenous Allied Health Australia identified data interoperability as an important part of a system that should allow for seamless transition through mainstream systems for all children with mild and moderate support needs.[265]

4.260Speech Pathology Australia elaborated on its claim that an Australian study reveals one in four children are not on track in terms of their development goals, and to data showing differences between children from regional, rural, remote and metropolitan areas.

The stat that I was using is that they’re not developmentally on track with their communication skills…But we're talking about children who potentially don't have that opportunity. They can’t actually understand the language around them and they need the opportunity to get their message across in a way that suits them best of all.[266]

4.261Occupational Therapy Australia’s Mrs Michelle Oliver identified that a core part of what OTs and other allied health professionals do, is working with the child but also with the family members.

When we're talking about early identification and early intervention, it is about working with that child but also with the really important people who sit around that child: the caregivers, the educators and the community who support that child and that family to thrive as well. So we can use technology to assist us with that, whether it be in building databases, in community education or in developing an app that enables families to improve their own knowledge of or access to services. This is really a great opportunity for us and for the allied health workforce to really help support, drive and lead a pathway to better access to disability services, particularly in our regional and remote areas.[267]

Provider registration and oversight

4.262The Committee received many submissions setting out that provider registration and oversight are fundamental pillars in ensuring the integrity, equity, and effectiveness of health policy and funding for neurodivergent children, people with disability and their families.

4.263MedHealth Pty Ltd (MedHealth) noted that it saw an opportunity at the outset with Thriving Kids to ensure the regulatory framework learns from the experiences of the NDIS stating that:

This would ensure it is proportionate, consistent and responsive to the needs of children, families, and providers when supporting these children. It should include

• Mandatory registration of all providers.
• Appropriate registration requirements and obligations- clear guidelines to reduce subjectivity and ensure a focus on outcomes rather than administrative preferences.
• National consistency regardless of state led programs. This should include transition to a National Working with Children Check.
• Timeliness and efficiency: minimise administrative delays in regulatory processes by reviewing internal workflows and resourcing to ensure timely decision-making.[268]
  264. MedHealth made the following recommendations in relation to registration:
• Registration should be simple, centralised and follow a transparent process that is consistent across the board yet is not onerous from a governance perspective. In doing so it will achieve the necessary quality and safeguarding for participants whilst reducing the cost burden.
• Concessions should be explored to reduce registration requirements for organisations holding ISO 9001 certification ensuring overlapping audit requirements require one review.
• Worker Registration: where duplications exist with professional registrations these should have mutual recognition.
• WWCC - we strongly recommend the introduction of a national Working with Children Check especially as a national organisation we frequently have staff working across multiple states and territories.
• Panel Arrangements: improvements in quality regulation and pricing to reward quality would result in a reduction in volume of poor providers and result in better outcomes for participants and financial viability of the scheme. The introduction of panel arrangements would improve quality focus and enhance participant informed choice and control.[269]
  265. Ms Glanville also commented on the importance of a registration system:

…that tells you who's in your market and where they are, it's very difficult to not only see what's happening but also be able to shape the market to perhaps attend to places where there are thin markets or areas where there is a lack of services in some spaces.[270]

4.266Ms Wade made it clear to the Committee that being unregistered did not mean conduct was unregulated:

I think it's prudent to highlight that, whether you are registered or unregistered, you are regulated by us through the code of conduct. There is no NDIS provider in the market that is not regulated. Everyone is by us.[271]

4.267Lifestart Disability Services told the Committee that there is inconsistency between registered and unregistered providers. They stated that:

Registered providers are required to adhere to the NDIS Practice Standards and are subject to oversight by the NDIS Quality and Safeguards Commission. In contrast, unregistered providers are not held to the same standards, creating variability in service quality and safety. For Thriving Kids to be a trusted and effective initiative, clear guidelines around workforce registration and external quality assurance are essential. All providers delivering services under Thriving Kids should be subject to a unified quality framework, regardless of their professional background, whether in allied health, education, or disability services.[272]

4.268Autism Spectrum Australia highlighted the importance of registration for ‘oversighting best practice’ to ‘ensure provider accountability in service provision and maintain the safety and wellbeing of vulnerable children and families’[273] The Whole Child explained to the Committee that the ‘the NDIS registration framework has often been complex and difficult to interpret’ whilst:

…systems such as CAETI, Better Start, Helping Children with Autism, and CheckUp applied proportionate, workable registration that recognised existing regulation of allied health professionals.[274]

4.269Similarly Occupational Therapy Australia commented on the need for a registration scheme stating that any scheme should ensure that:

…registration requirements across early childhood settings are proportionate and recognise existing Australian Health Practitioner Registration Authority (AHPRA) registration requirements. Current NDIS registration requirements are financially prohibitive and administratively onerous and there is little evidence to suggest they increase the safety or quality of the services provided by AHPRA-registered occupational therapists. Governments must commit to ensuring registration processes are fit for purpose, and balance participant safety with access to quality service provision in all geographic settings through the development of requirements that are proportionate and complementary to existing regulatory requirements. In addition to imposing registration requirements, governments must ensure that early childhood supports are delivered by suitability qualified and experienced professionals.[275]

Committee comment

4.270The Committee acknowledges the strong and consistent message from stakeholders that genuine co-design is essential to the success of the Thriving Kids initiative. Witnesses emphasised that co-design must go beyond consultation to embed lived experience in leadership and decision-making. This includes partnering with disability advocates, and First Nations communities ensuring cultural safety, and incorporating CALD, regional, rural and remote communities voices in governance and evaluation.

4.271Families and advocacy groups expressed concern about rushed timelines and the risk of moving children into generic, under-resourced services. They called for transparency in distinguishing consultation from true co-design and recommended phased implementation to safeguard continuity of supports. Witnesses highlighted the need for place-based flexibility, family-led approaches, and integration with existing evidence-based programs rather than creating parallel systems.

4.272The Committee notes that workforce development and governance structures are critical enablers of co-design. A national workforce strategy, clear standards of practice, and pathways for Aboriginal governance and peer workers were identified as priorities. The Committee supports embedding navigators and peer workers to assist families and reduce complexity, and leveraging local partnerships to ensure Thriving Kids reflects community needs.

4.273It is critical to include early childhood education and care and primary education providers to ensure that inclusive education is captured in the co-design process.

4.274The Committee considers genuine co-design—rooted in cultural safety, family leadership, and community control—to be a non-negotiable foundation for Thriving Kids. Without these elements, the initiative risks failing to deliver equitable and effective outcomes for children and families.

4.275The Committee therefore recommends that Thriving Kids Advisory Group undertakes a genuine co-design process and sets up an ongoing Thriving Kids Advisory Council to continue to ensure that the initiative drives actions and improvements for children with disability.

4.276The Advisory Council could be modelled on Australia’s Disability Strategy Advisory Council. Its role would be to advise Australian governments and disability ministers on the implementation of Thriving Kids. It would also be responsible for reviewing and advising on its progress.

4.277The Advisory Council should be established before the commencement of the Thriving Kids initiative.

4.278The Committee recommends that the Thriving Kids Advisory Group undertake an inclusive co-design process and embed evidence-based policies and interventions, as well as the ability to formally review progress on these processes.

4.279Included in this process should be recognised organisations and peak bodies with an established history in providing services and support for children with physical or psychosocial disabilities and intellectual disability, as well as individuals with lived experience of disability or care of persons with disability, First Nations, and culturally and linguistically diverse backgrounds.

4.280The Committee recommends that the Australian Government establish a Thriving Kids Advisory Council, to advise Federal, State and Territory governments, and disability ministers, on the implementation of the Thriving Kids initiative.

4.281The Committee notes the evidence that there is strong support for a phased and flexible approach to implementation, including pilot programs, as well as overlap periods where both NDIS and Thriving Kids operate concurrently, and clear public timelines for workforce and service development. Such measures are seen as critical to ensuring that no family is left without support during the transition.

4.282The Committee also recognises calls for government collaboration with the disability sector and the broader community to identify cohorts most at risk of losing supports, and to ensure that Thriving Kids foundational supports are fully operational and accessible before any transition occurs.

4.283The Committee recommends that the transition to the Thriving Kids initiative be underpinned by:

• transparent and ongoing communication with families and stakeholders
• phased implementation with overlap and pilot periods
• robust safeguards to prevent loss of support
• clear referral pathways and integrated planning across services
• full operational readiness of Thriving Kids supports before changes to NDIS eligibility
• ongoing collaboration with the disability sector to monitor and address emerging risks.
  284. The Committee urges all levels of government to prioritise the needs and voices of children and families throughout this process, ensuring that no child is worse off as a result of these reforms.
  285. The Committee therefore recommends the transition period only commence once foundational supports are fully operational and accessible. The Committee also recommends that families and carers have the option to request a review of decisions about a child participant of the NDIS. The Committee recommends that the National Disability Insurance Scheme Act 2013 be amended to provide that a decision made under a specified provision of the rules associated with the Thriving Kids initiative be a reviewable decision.

4.286The Committee recommends that the Thriving Kids initiative be implemented in phases and that the Thriving Kids Advisory Group consider appropriate safeguards to prevent loss of supports for children.

4.287The Committee also recommends that the National Disability Insurance Scheme Act 2013 be amended to ensure that foundational supports are appropriately implemented.

4.288In addition to the concerns outlined above, the Committee notes that the number of complaints about the NDIS is increasing. The Committee also notes the evidence by the NDIS Quality and Safeguards Commission about the volume and type of complaints it receives about providers and other matters.

4.289The Committee acknowledges the current governance and oversight arrangements in place for the NDIS. Robust governance and oversight arrangements provide a framework that supports informed decision-making, improve the quality and standards of services to Australians and provide assurance that the NDIS and related supports are functioning as intended.

4.290The Committee considers that the current oversight system can appear fragmented or siloed and could benefit from a holistic oversight body able to monitor governance and compliance, examine trends in complaints, and provide guidance on improving practices to better meet the expectations of Australians in participating in the NDIS.

4.291The Committee recommends the Australian Government appoint an Inspector-General of the NDIS. The Inspector-General would have the ability to coordinate the complaints system currently managed by the NDIA and the NDIS Quality and Safeguards Commission, provide guidance on practice and process improvements, and have visibility of the quality and integrity of the NDIS. The Inspector-General could also be charged with improving data collection and transparency, discussed further below.

4.292The Committee recommends the Australian Government establish an Inspector-General of the National Disability Insurance Scheme.

4.293The Committee notes that a structured registration system establishes clear standards for qualifications, service delivery, and accountability, creating a trusted network of providers who meet evidence-based and ethical requirements.

4.294The Committee considers that any registration requirements and processes must be streamlined and proportionate to the objectives of the Thriving Kids initiative. Specifically, the system should:

• minimise administrative burdens by avoiding unnecessary complexity or duplication, ensuring registration is not overly onerous for providers.
• recognise existing registrations for providers already registered under the NDIS and similar schemes.
• be designed to encourage participation by capable providers, thereby supporting timely and effective service delivery to families and children who need additional support.
  295. The Committee recommends that the Thriving Kids initiative include a provider registration process that is streamlined and proportionate, ensuring it is not overly onerous for providers. The process should recognise and leverage existing registrations under other schemes for similar services, reducing duplication and administrative burden while maintaining appropriate safeguards and quality standards. This approach will encourage participation by qualified providers and support timely delivery of services to families and children in need.

4.296The Committee recommends that Thriving Kids initiative include a provider registration process that is streamlined and proportionate. The process should recognise and leverage existing registrations under other schemes for similar services, reducing duplication and administrative burden while maintaining appropriate safeguards and quality standards.

4.297Block funding presents a compelling solution for addressing the unique challenges faced by service providers and communities, particularly in regional, rural, and remote areas.

4.298Evidence to this inquiry highlighted that block funding enables more equitable and targeted resource allocation, helping to meet the higher costs of service delivery in areas where market-based models often fall short. By supporting high-quality providers and simplifying funding models, block funding can foster consistency and equity in service delivery for families, while also enabling earlier intervention and best practice approaches.

4.299Block funding arrangements can also help address workforce challenges by supporting workforce retention and growth, particularly of professionals in rural and regional areas, supporting investment in local training, and enabling communities to develop solutions tailored to their needs.

4.300Block funding also offers the government better oversight of commissioned organisations and encourages collaboration between services, reducing competition and fostering multidisciplinary teamwork. This model can help ensure sustainability and allow providers to focus on supporting children and families, rather than relying on uncertain or fragmented funding streams.

4.301The Committee therefore recommends that that the government adopt a commissioned service model for the Thriving Kids initiative.

4.302The Committee recommends that that the government adopt a commissioned service model for the Thriving Kids initiative to ensure appropriate and quality services are delivered across all jurisdictions. Wherever possible already existing services with appropriate regulation and safeguards should be used.

4.303As discussed in Chapter 3, the Committee notes the challenges faced by rural, regional and remote communities in accessing support services. Despite the growth, advancement and improved access to telehealth services, especially over the past five years, the Committee heard the evidence provided by witnesses that access to remote supports still needs improvement. The Committee also notes the evidence that remote supports will not suit all participants in the Thriving Kids initiative.

4.304However, the Committee notes that access to technology-based supports can be of significant benefit to those with disability, developmental delay and autism, including for those who are based in cities and regional centres which generally have better access to health, including allied health, supports. The Committee considers that the opportunity to access online and telehealth supports improves choice and self-determination for people with disability, developmental delay and autism.

4.305The Committee acknowledges that the need to overcome the tyranny of distance in Australia is not unique to the health or disability sector and is a consistent theme in public policy. However, when considering the development of the Thriving Kids initiative and other foundational supports, the Committee considers that the Australian Government consider how access to remote support services could be improved.

4.306The Committee recommends that the Australian Government consider funding and implementing improvements to technology for online and telehealth services. The Committee considers that it is appropriate that these efforts support people in cities and regional centres to access online health supports. The Committee also recommends that the Australian Government provide additional funding to implement improvements to access technology and telehealth services in regional, rural and remote areas.

4.307The Committee recommends that the Australian Government fund and implement improvements to technology for access to online and health advice services, with additional focus on improving these services in regional, rural and remote areas.

4.308The Committee notes that it received consistent evidence in the course of its inquiry about the need for access to accurate and comprehensive data to support the delivery of services through the NDIS.

4.309The Committee considers that accurate and comprehensive data enables policymakers to identify needs, allocate resources equitably, and monitor outcomes, while regulation ensures that services adhere to ethical standards and evidence-based practices. Robust data provides safeguards for consistency and accountability, promoting interventions that genuinely improve health and developmental outcomes. Together, these elements form the foundation for sustainable, transparent, and inclusive health strategies that address the unique challenges faced by people with disability, developmental delay and autism, as well as their families.

4.310The Committee acknowledges that the National Disability Insurance Scheme Act 2013 already requires the NDIS to provide regular reporting. However, the Committee also considers that there is an opportunity to enhance the integrity and effectiveness of data collection to support the delivery of the NDIS, the Thriving Kids initiative and other foundational supports.

4.311The Committee recommends that dedicated staffing and funding be allocated to ensure the effectiveness and integrity of data collection to support the Thriving Kids initiative. Consideration should be given to expanding focus on data management to the NDIS and other foundational supports. The Committee recommends that in implementing this recommendation, the Australian Government should ensure robust and verifiable data collection, interoperability, and that the overall purpose of data collection to assist in informing decision-making and improve outcomes for Australian families. The Committee also recommends that the principles of Indigenous Data Sovereignty be considered in implementing this recommendation.

4.312The Committee recommends that dedicated funding and staffing be allocated in the development of the Thriving Kids initiative to ensure the integrity and effectiveness of data management. Specifically:

• Adequate resources should be provided to implement systems and processes that guarantee data accuracy, reliability, transparency and adherence to Indigenous Data Sovereignty principles.
• Data infrastructure must support interoperability, enabling seamless sharing and integration across relevant platforms and agencies to avoid duplication and enhance efficiency.
• Data collection and analysis should be structured to inform decision-making and drive best possible outcomes for families and children in need.
  313. The Committee notes the concerns raised by witnesses to the inquiry that accessing existing non-NDIS related supports and programs can preclude an individual from accessing support through the NDIS at a later time. It is the view of the Committee that participating in the Thriving Kids initiative should not preclude a person from being able to participate in the NDIS should they require additional and individualised supports not provided by the initiative.
  314. The Committee considers that just as a child who is accessing early childhood supports can transition to the NDIS where a diagnosis is received and there is a requirement for significant support, a child who is or has participated in the Thriving Kids initiative should be able to participate in the NDIS where their needs change. This should also be considered for other foundational support programs.
  315. The Committee therefore recommends that the Thriving Kids Advisory Group ensure that participation in the Thriving Kids initiative will not preclude a child from participating in the NDIS once their participation in the initiative has concluded.

4.316The Committee recommends that there should be a single portal of entry with multiple referral pathways for all children with developmental concerns whether they are in the NDIS or not.

4.317The Committee also recommends that the Thriving Kids Advisory Group ensures that participation in the Thriving Kids initiative will not preclude an individual from seeking to participate in the National Disability Insurance Scheme, once their time in the Thriving Kids initiative has concluded.

4.318The Committee considers that a transparent, independent rapid review after twenty-four months of operation is essential to assess whether the Thriving Kids initiative is meeting its stated objectives across early identification, integrated supports and culturally safe, evidence‑based delivery; to test implementation in school and community settings; and to ensure the program complements—rather than displaces—the NDIS.

4.319It is essential that the review:

• measures outcomes for children and families, and compares delivery across jurisdictions, sectors and school settings
• assesses workforce availability, capability and local delivery arrangements (including digital and place‑based models)
• assesses inequities (particularly for Aboriginal and Torres Strait islander, culturally and linguistically diverse, and regional, rural and remote communities)
• assesses the provider registration process
• examines integration with the NDIS and other foundational supports to avoid duplication or substitution effects
• includes structured co‑design with parents, carers and people with lived experience, and reports on participation and findings
• identifies risks of non‑evidence‑based practices and proposes accountability mechanisms, including fraud and quality safeguards.
  320. The Committee therefore recommends, that to enable timely parliamentary and public scrutiny, the Australian Government refer an inquiry to the Committee to undertake a rapid review of the Thriving Kids initiative after twenty-four months in operation.

4.321The Committee recommends that the Australian Government refer an inquiry to the Committee to undertake a rapid review of the Thriving Kids initiative after twenty-four months in operation. The Committee further recommends that the review be presented to the House in accordance with Standing Orders.

4.322The Committee recommends that a consultative group of professional organisations (including allied health peak bodies, paediatricians, child psychiatrists, child & family nurses, early childhood educators, and school educators) and parents involved in the system themselves, be part of the review process.

4.323The Committee recognises that the key transition points in a child’s education—entering early childhood education, moving from early education into primary school, and progressing from primary to secondary—are periods when families often face fragmented services, unclear referral pathways and gaps in funded supports. Strengthening navigation assistance and continuity of care at these junctures would reduce drop‑offs, improve participation and outcomes, and lessen stress on parents and carers.

4.324Evidence to the inquiry consistently emphasised the value of co‑ordination across jurisdictions and systems. Coordinated frameworks ensure that policies complement rather than conflict, and that families experience seamless support when moving between systems.

4.325The Committee therefore recommends that the Federal, State and Territory governments work collaboratively to fund practical improvements for children and families during times of transition, including:

• family‑centred navigation and case coordination
• place‑based, multidisciplinary teams that can operate in mainstream settings
• culturally safe and inclusive services, with focused attention to Aboriginal and Torres Strait Islander children, children from culturally and linguistically diverse communities, and those in regional, rural and remote areas
• shared data and referral protocols between health, education and community services, and
• clear performance measures to track outcomes and equity across jurisdictions.

4.326The Committee recommends that the Australian Government works with the States and Territories to fund support improvements for children and families during times of transition. These would support families when children is transitioning into early education, from early education into primary education, or from primary education to higher education, as appropriate.

4.327A lack of specialised support, inconsistent service availability, limited telehealth and outreach and workforce shortages in regional, rural and remote areas, was identified as a significant problem by most submitters to this inquiry.

4.328Submitters suggested that Thriving Kids can meet demand for access to diagnostic services, particularly allied health services in regional and remote areas by utilising a hub-and-spoke model in which, specialists provide consultation where there are geographic or workforce challenges, while generalists manage cases locally.

4.329This approach facilitates access for children in rural and remote communities to an experienced allied health team and a paediatrician, working collaboratively with families within their local context. The fully integrated healthcare model ensures that the paediatrician arrives equipped with detailed information, enabling timely care and accurate diagnosis.

4.330Each child receives an individualised care plan and is connected to their general practitioner and ongoing local supports. This continuity of care ensures that children receive the assistance necessary to succeed both academically and socially. The service provides access to a broad range of supports, including specialist health professionals, ongoing allied health services, and tailored educational support within the school environment.

4.331The ‘Hub-and-Spoke’ model is a service delivery framework where:

• a central ‘Hub’ provides specialised, multidisciplinary services (e.g., allied health, early intervention, autism-specific programs)
• the ‘Spokes’ are local sites—such as mainstream childcare, schools, or community clinics—linked to the hub, extending the hub’s services into surrounding regions, and
• support is delivered by training local staff in mainstream sites, augmented with regular supervision, visits, telehealth, and ongoing consultation from the hub creating equitable access across regions.
  332. The Committee recommends that the Federal government work with States and Territories to increase funding and resources to already existing organisations able to deliver supports through ‘hub and spoke’ systems.

4.333The Committee recommends that the Australian Government use both existing and new resources to work with the States and Territories to support children and their families in regional, rural and remote areas.

4.334This is particularly important for children in regional, rural, and remote areas who have developmental issues and who can be supported through various means, such as using multidisciplinary teams using a hub and spoke system in regional, rural and remote areas.

4.335By increasing funding and resources to already existing organisations who can deliver through a hub-and-spoke system, these supports can be made more readily available and therefore can improve equitable access for these children and their families, thereby ensuring that cost and distance is not a barrier.

4.336The NDIS is a highly complex system involving multiple pathways (early childhood, mainstream services, foundational supports, and NDIS-funded supports). Families often struggle to understand eligibility, funding categories, and service coordination. Without comprehensive resources across all areas, families risk falling through gaps or duplicating efforts, which leads to confusion and poorer outcomes.

4.337Families from diverse backgrounds—such as First Nations, culturally and linguistically diverse communities, and those in rural or remote areas—face additional barriers. Developing resources across all support areas ensures equitable access and culturally safe practices, reducing systemic disadvantage and promoting inclusion

4.338Children and families often move between different systems. Developing resources that span all areas will help maintain continuity of care during transitions, preventing service gaps and ensuring that supports remain aligned with best practice standards.

4.339Comprehensive resources empower families to make informed decisions, advocate for their needs, and manage plans effectively. This includes practical tools, clear communication, and strategies for goal setting, which reduce stress and improve outcomes for children with disabilities.

4.340The Committee recommends that resources be developed across all areas of support for families to navigate the health and education systems; and that support be provided by a range of workers to ensure equitable access for all.

4.341The Committee recommends that workforce and resources be developed across all areas of support for families to navigate an extremely complex system and that, wherever possible, support should be provided by a range of workers to ensure equitable access for all, including:

• regional, rural and remote areas, CALD and Indigenous communities, children in out-of-home care, parents and carers with disabilities themselves, and other high-risk communities.
  342. The Committee recommends the introduction of a separate Medicare Benefits Schedule (MBS) item number for paediatricians to conduct an annual comprehensive review of their patients, mirroring the process currently available to geriatricians. This measure is essential to ensure continuity of care for children with complex health and developmental needs.
  343. A yearly review, combined with structured case conferencing, will enable paediatricians to collaborate effectively with allied health professionals, educators, and other specialists involved in the child’s care. Such multidisciplinary engagement promotes holistic planning, reduces duplication of services, and ensures that interventions remain aligned with the child’s evolving needs.
  344. The Committee notes that paediatric patients often require coordinated input across health, education, and social systems. Embedding this review within the MBS framework will incentivise best practice, improve communication between providers, and deliver better outcomes for children and families.

4.345The Committee recommends that a separate item number, identical to the yearly review process available to geriatricians, be made available to paediatricians to conduct a yearly review for their patients, with case conferencing with other health professionals and educators involved.

4.346The Committee also recommends that a child development check item number be available for GP’s and allied health professionals, as well as similar childhood development checks be made available for early childhood educators, child and family nurses and community nurses in regional, rural and remote areas. This way, all children can have this as another portal of entry into the Thriving Kids initiative.

4.347The Committee recommends that the Australian Government work with state and territory governments and the non-government school sector to increase transparency of the Nationally Consistent Collection of Data and the Schooling Resource Standard (SRS) – Students with Disability loading to better identify the need for this funding and ensure it is effectively targeted and used as intended.

Dr Mike Freelander MP

Chair

Footnotes

[1]Department of Health, Disability and Ageing, Foundational supports for people with disability, www.health.gov.au/our-work/foundational-supports-for-people-with-disability, (accessed 7 October 2025).

[2]Ashar Health Pty Ltd, Submission 16, p. 1.

[3]Autism Spectrum Australia, Submission 67, p. 5; see also AEIOU Foundation, Submission 70, p. 5 and Raising Children Network, Submission 110.

[4]Australian Primary Health Care Nurses Association and the Maternal, Child and Family Health Nurses Australia, Submission 74, p. 5; Ashar Health Pty Ltd, Submission 16, p. 1; The Australian College of Nurse Practitioners, Submission 30, p. 5; AEIOU Foundation, Submission 70, p. 5.

[5]Australian College of Nurse Practitioners, Submission 30, p. 3.

[6]Australian Primary Health Care Nurses and Maternal, Child and Family Health Nurses Australia, Submission 74, p. 5.

[7]Australian College of Nurse Practitioners, Submission 30, p. 4.

[8]Australian College of Nurse Practitioners, Submission 30, p. 5; see also Ashar Health, Submission 16.

[9]Family Paediatrics Nurse Practitioners Pty Ltd, Submission 52, p. 5; see also Kids I Can, Submission 51, p. 2.

[10]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 7.

[11]Australian Primary Health Care Nurses and Maternal, Child and Family Health Nurses Australia, Submission 74, p. 7.

[12]Ashar Health Pty Ltd, Submission 16, p. 2.

[13]Australian Medical Association, Submission 209, p. 1; The Royal Australian College of General Practitioners, Submission 211, p. 3 and Family Paediatric Nurse Practitioners, Submission 52, p. 5.

[14]See for example, Catholic Schools Parents Australia, Submission 317, p. 3; Learning Links, Submission 103, p. 10; Dr Jacqui Barfoot, Submission 194, p. 3; Monash University, Submission 291, p. 8; ADHD Foundation, Submission 71, p. 7.

[15]Australian College of Nurse Practitioners, Submission 30, p. 4. See also Academy of Child and Adolescent Health, Submission 76, p. 1.

[16]Name withheld, Submission 47, p. 5.

[17]Australian Council of State School Organisations, Submission 46, p. 2.

[18]Australian Council of State School Organisations, Submission 46, pp. 2-3. See also Australian Primary Principals Association, Submission 31, p. 1.

[19]Ms Katherine Fotheringham, Submission 82, p. 1.

[20]Healthcare Direct Australia, Submission 83, p. 2.

[21]Eating Disorders Neurodiversity Australia, Submission 23, p. 1.

[22]Australian Primary Health Care Nurses and Maternal, Child and Family Health Nurses Australia, Submission 74, p. 6.

[23]My Therapy House, Submission 3; Australian Multicultural Action Network, Submission 17; Australian College of Nurse Practitioners, Submission 30; Australian Primary Principals Association, Submission 31, South Burnett CTC, Submission 41; Name withheld, Submission 33; Ms Katherine Fotheringham, Submission 82, p. 1.

[24]See, for example, Unbound Minds, Submission 66.

[25]Autism Spectrum Australia, Submission 67, p. 6.

[26]The Royal Australian College of General Practitioners, Submission 211, p. 1 and Australian Medical Association, Submission 209, p. 1.

[27]The Royal Australian College of General Practitioners, Submission 211, p. 5.

[28]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 4.

[29]Australian College of Nurse Practitioners, Submission 30, p. 3..

[30]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 25.

[31]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 25.

[32]Mrs Michelle Oliver, Chief Occupational Therapist, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 23.

[33]Ms Lynette Brodie, Chief Executive Officer, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 20.

[34]Ms Lynette Brodie, Chief Executive Officer, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 23.

[35]Olga Komadina Apraxia Therapy, Submission 53, pp. 1-2; See also Name withheld, Submission 33.

[36]Independent Audiologists Australia, Submission 65, p. 1.

[37]Ms Katherine Utry, General Manager, Policy and Government Relations, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[38]Mrs Nicole Pates, Chair, National Paediatric, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[39]Mrs Nicole Pates, Chair, National Paediatric, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[40]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, p. 26.

[41]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, pp. 26-27.

[42]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, p. 26.

[43]Ms Samantha Hunter, Chief Executive Officer, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 18.

[44]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 11.

[45]Ms Lynette Brodie, Chief Executive Officer, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 23.

[46]Ms Lynette Brodie, Chief Executive Officer, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 20.

[47]Ms Katherine Utry, General Manager, Policy and Government Relations, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, pp. 18-19.

[48]Mrs Nicole Pates, Chair, National Paediatric, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[49]Australian Medical Association, Submission 209, p. 1; p. 3.

[50]Mrs Michelle Oliver, Chief Occupational Therapist, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 23.

[51]Ms Samantha Hunter, Chief Executive Officer, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 18.

[52]AEIOU Foundation, Submission 70, p. 14.

[53]Mr Neil Turton-Lane, Convener, Australian Psychosocial Disability Collective; Committee Hansard, 20 October 2025, p. 13.

[54]Mr Neil Turton-Lane, Convener, Australian Psychosocial Disability Collective; Committee Hansard, 20 October 2025, p. 13.

[55]Mr Neil Turton-Lane Convener, Australian Psychosocial Disability Collective, Committee Hansard, 20 October 2025, p. 15-16.

[56]Mr Neil Turton-Lane Convener, Australian Psychosocial Disability Collective, Committee Hansard, 20 October 2025, p. 16.

[57]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, p. 27.

[58]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, p. 27.

[59]Ms Caitlin McMurrow, Vision Australia, Committee Hansard, 10 October 2025, p. 27.

[60]Ms Katherine Utry, General Manager, Policy and Government Relations, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[61]Ms Katherine Utry, General Manager, Policy and Government Relations, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 19.

[62]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 12.

[63]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 11.

[64]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 11.

[65]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 11.

[66]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 42.

[67]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 14.

[68]Mrs Nicole Pates, Chair, National Paediatric, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 22.

[69]National Organisation for Fetal Alcohol Spectrum Disorder, Submission 106, p. 13; Lion and Mouse Australia Ltd, Submission 140, p. 4; Kid Link Occupational Therapy, Submission 169, p. 4; National Catholic Education Commission, Submission 183, p. 3; Mission Australia, Submission 217, p. 12; Autism Association of Australia, Submission 232, p. 3; Triple P International Pty Ltd, Submission 310, p. 5;

[70]Australian Health Ministers’ Advisory Council, National Framework for Universal Child and Family Health Services, July 2021.

[71]Ms Janice Finlayson, Director, Maternal, Child and Family Health Nurses Australia, Committee Hansard, 21 October 2025, p. 29.

[72]Family Paediatrics Nurse Practitioners, Submission 52, p. 3.

[73]Children’s Healthcare Australasia, Submission 290, p. 2.

[74]APM, Submission 322, p. 10

[75]Australian Clinical Neuropsychology Association, Submission 152, p. 2.

[76]William Campbell Foundation, Submission 159, p. 3.

[77]Australian Medical Association, Submission 209, p. 3.

[78]Associate Professor Clinton Schultz, Director, First Nations Strategy and Partnerships, Black Dog Institute, Committee Hansard, 10 October 2025, pp. 45-46.

[79]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 12.

[80]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 4.

[81]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 7. See also Ashar Health, Submission 16.

[82]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 7.

[83]Australian College of Nursing, Australian College of Children & Young People’s Nurses, Maternal, Child and Family Health Nurses Australia, Professional Association of Nurses in Developmental Disability Australia, Submission 96, p. 6. See also Australian Primary Principals Association, Submission 31, p. 3.

[84]Autism Spectrum Australia, Submission 67, p. 8.

[85]Mrs Ashlee Law, Submission 14, p. 2.

[86]The Therapy Room NQ, Submission 6, p. 2.

[87]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, pp. 25-26.

[88]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 17.

[89]Mr Paul Gibson, CEO, Indigenous Allied Health Australia, Committee Hansard, 10 October 2025, pp. 12-13.

[90]Mr Oskar Stenseke, Senior Manager, Kimberley Aboriginal Medical Services, Committee Hansard, 10 October 2025, p. 12.

[91]Inclusive Educators Australia, Submission 132, p. 10.

[92]Inclusive Educators Australia, Submission 132, p. 10.

[93]Independent Schools Australia, Submission 68, p. 10.

[94]Independent Schools Australia, Submission 68, p. 10.

[95]Australian Primary Principals Association, Submission 31, p. 3.

[96]Australian Primary Principals Association, Submission 31, p. 3.

[97]Australian Council of State School Organisations, Submission 46, p. 9.

[98]Australian Council of State School Organisations, Submission 46, pp. 9-10.

[99]Early Learning and Care Council of Australia, Submission 166, p. 4.

[100]Home Education Network, Submission 143, p. 3.

[101]Ms Jacqueline Hrast, Family Wellbeing Group, Department of Social Services, Committee Hansard, 10 October 2025, p. 3.

[102]Ms Jacqueline Hrast, Family Wellbeing Group, Department of Social Services, Committee Hansard, 10 October 2025, p. 3.

[103]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 25.

[104]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 25.

[105]Dr Sarah Hayton, Executive Director, Policy and Programs, National Aboriginal Community Controlled Health Organisation, Committee Hansard, 10 October 2025, p. 17.

[106]Dr Sarah Hayton, Executive Director, Policy and Programs, National Aboriginal Community Controlled Health Organisation, Committee Hansard, 10 October 2025, p. 17.

[107]MedHealth Pty Ltd, Submission 399, p. 6.

[108]Independent Review into the National Disability Insurance Scheme, Final Report, 30 July 2025, p. 20.

[109]Ms Susanne Tegen, Chief Executive, National Rural Health Alliance, Committee Hansard, 10 October 2025, p. 38.

[110]Ms Susanne Tegen, Chief Executive, National Rural Health Alliance, Committee Hansard, 10 October 2025, p. 35.

[111]Ms Susanne Tegen, Chief Executive, National Rural Health Alliance, Committee Hansard, 10 October 2025, pp. 38-39.

[112]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 42.

[113]Australian Council of State School Organisations, Submission 46, p. 11.

[114]Karitane, Submission 282, p. 7; First Peoples Disability Network, Submission 294, p. 1; Alliance of Registered Therapy Providers, Submission 301, p. 2; Australian Rehabilitation and Assistive Technology Association, Submission 398, p. 5; Amaze, Submission 129, p. 3.

[115]National Rural Health Alliance, Submission 379, p. 6.

[116]Lifestart Disability Services, Submission 245, p. 8.

[117]The Front Project, Submission 109, pp. 12-13.

[118]The Front Project Submission 109, p. 13.

[119]Disability Advocacy Network Australia, Submission 251, p. 5.

[120]Brisbane Children’s Therapy, Submission 85, p. 2.

[121]National Aboriginal Community Controlled Health Organisations, Submission 154, p. 2.

[122]Australian Psychological Society, Submission 160, p. 14.

[123]Children’s Healthcare Australasia, Submission 290, p. 12.

[124]Independent Review into the National Disability Insurance Scheme, Final Report, 30 July 2025, p. 411.

[125]Early Childhood Intervention Coordination Program (ECICP – Inner West), Submission 314, p. 4.

[126]Noah’s Ark Inc., Submission 311, p. 12.

[127]Lifestart Disability Services, Submission 245, p. 8.

[128]Australian Physiotherapy Association, Submission 171, p. 35.

[129]Australian Physiotherapy Association, Submission 171, p. 35.

[130]Australian Physiotherapy Association, Submission 171, p. 35.

[131]Australian Physiotherapy Association, Submission 171, p. 35.

[132]Koorana Child & Family Services Ltd, Submission 345, p. 13.

[133]See, for example: National Child and Family Hubs Network, Submission 402, p. 12; Autism Queensland, Submission 346, p. 18; APM, Submission 322, p. 3; National Disability Services, Submission 200, p. 18; Speech Pathology Australia, Submission 224, p. 8; Learn My Way, Submission 125, p. 1; Learning for Life Autism Centre, Submission 88, p. 3; Bathurst Early Childhood Intervention Service, Submission 240, p. 3; MedHealth Pty Limited, Submission 399, p. 25; NDIS Independent Advisory Council, Submission 248, p. 2.

[134]Occupational Therapy Australia, Submission 304, p. 39.

[135]Noah’s Ark Inc, Submission 311, p. 24.

[136]Noah’s Ark Inc, Submission 311, p. 29.

[137]Learning Links, Submission 103, p. 22.

[138]Teach Speak Hear, Submission 89, p. 6.

[139]Disability Advocacy Network of Australia, Submission 251, p. 4.

[140]Disability Advocacy Network of Australia, Submission 251, p. 4.

[141]Every Australian Counts, Submission 273, p. 10.

[142]Nobody Worse Off Coalition, Submission 242, p. 11; Succeed Healthcare Solutions Pty Ltd, Submission 150, p. 7; RAEN Tasmania, Submission 389, p. 12; Occupational Therapy Society for Invisible and Hidden Disabilities, Submission 365, p. 6.

[143]Dietitians Australia, Submission 329, p. 22.

[144]Mrs Michelle Oliver, Chief Occupational Therapist, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 20.

[145]Ms Katherine Utry, General Manager, Policy and Government Relations, Australian Physiotherapy Association, Committee Hansard, 20 October 2025, p. 21.

[146]Ms Catherine Maloney, Chief Executive Officer, Services for Australian Rural and Remote Allied Health Ltd, Committee Hansard, 10 October 2025, p. 36.

[147]Mr John Riley, Family Wellbeing Group, Department of Social Services, Committee Hansard, 10 October 2025, p. 2.

[148]Dr Sarah Hayton, Executive Director, Policy and Programs, National Aboriginal Community Controlled Health Organisation, Committee Hansard, 10 October 2025, p. 18.

[149]Occupational Therapy Australia, Submission 304, p. 22.

[150]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 25.

[151]Dr Linda De George-Walker, Senior Policy Adviser, Australian Psychological Society, Committee Hansard, 20 October 2025, p. 14.

[152]Mr Neil Turton-Lane Convener, Australian Psychosocial Disability Collective, Committee Hansard, 20 October 2025, p. 14.

[153]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 40.

[154]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 40.

[155]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 41.

[156]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 41.

[157]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 41.

[158]Associate Professor Clinton Schultz, Director, First Nations Strategy and Partnerships, Black Dog Institute, Committee Hansard, 10 October 2025, p. 44.

[159]Australian Council for Education Research, Submission 394, p. 2.

[160]Queensland Catholic Education, Submission 246, p. 3.

[161]Emerging Minds, Submission 306, p. 5.

[162]Inclusive Educators Australia, Submission 132, p. 5.

[163]Inclusive Educators Australia, Submission 132, pp. 6-7.

[164]Square Peg Round Whole, Submission 318, p. 11.

[165]JFA Purple Orange, Submission 376, pp. 20-21.

[166]Autistic Self Advocacy Network of Australia and New Zealand, Submission 181, p. 3.

[167]Mr Paul, President, Australian Childcare Alliance, Committee Hansard, 28 November 2025, p. 1.

[168]Associate Professor Kathy, Associate Director, Children's Voices Centre, Charles Sturt University, Committee Hansard, 28 November 2025, p. 20.

[169]I CAN Network Ltd, Submission 285, p. 8.

[170]Ms Susanne Tegen, Chief Executive, National Rural Health Alliance, Committee Hansard, 10 October 2025, p. 34.

[171]Mrs Nicole Smith, Head of Disability Supports, Settlement Services International, Committee Hansard, 10 October 2025, p. 25.

[172]Ms Catherine Maloney, Chief Executive Officer, Services for Australian Rural and Remote Allied Health Ltd, Committee Hansard, 10 October 2025, p. 37.

[173]Ms Catherine Maloney, Chief Executive Officer, Services for Australian Rural and Remote Allied Health Ltd, Committee Hansard, 10 October 2025, p. 38.

[174]Department of Education, Submission 363, p. 16.

[175]Ms Jenny Karavolos, Chief Executive, Disability Advocacy and Complaints Service of South Australia; and Independent Co-Chair, Australian Autism Alliance, Committee Hansard, 3 October 2025, pp. 25-26.

[176]Ms Nicole Avery, Chief Executive Officer, South West Autism Network, Committee Hansard, 3 October 2025, p. 37

[177]Ms Cassie Atchison, Chief Executive Officer, Broome Regional Aboriginal Medical Service, Committee Hansard, 10 October 2025, p. 13.

[178]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 44.

[179]Ms Skye Kakoschke-Moore, Chief Executive Officer, Children and Young People with Disability Australia, Committee Hansard, 20 October 2025, p. 40.

[180]Mrs Catherine McAlpine, Chief Executive Officer, Inclusion Australia, Committee Hansard, 20 October 2025, p. 36.

[181]Ms Nicole Rogerson, Chief Executive Officer, Autism Association of Australia, Committee Hansard, 21 October 2025, p. 36.

[182]Ms Lynette Brodie, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 20.

[183]Mr Jonathon Guy, Federal Strategic Research Officer, Australian Education Union, Committee Hansard, 28 November 2025, p. 40.

[184]Mrs Catherine McAlpine, Chief Executive Officer, Inclusion Australia, Committee Hansard, 20 October 2025, p. 35.

[185]Ms Skye Kakoschke-Moore, Chief Executive Officer, Children and Young People with Disability Australia, Committee Hansard, 20 October 2025, p. 38.

[186]Ms Nicole Avery, Chief Executive Officer, South West Autism Network, Committee Hansard, 3 October 2025, p. 33.

[187]Ms Jenny Karavolos, Chief Executive, Disability Advocacy and Complaints Service of South Australia; and Independent Co-Chair, Australian Autism Alliance, 3 October 2025, p. 26.

[188]AEIOU Foundation, Submission 70, p. 4.

[189]Australian Council of State School Organisations, Submission 46, p. 14.

[190]Australian Council of State School Organisations, Submission 46, p. 15.

[191]Monash University Submission 291, p. 17.

[192]Pop Family Ltd, Submission 156, p. 2.

[193]South West Autism Network, Submission 131, p. 22.

[194]SNAICC – National Voice for our Children, Submission 327, p. 24.

[195]Inclusive Educators Australia, Submission 132, p. 15.

[196]MedHealth Pty Ltd, Submission 399, p. 6.

[197]Australian Youth Affairs Coalition, Submission 344, p. 2.

[198]Professor Jenny, Consortium Member Lead, National Centre of Excellence in Intellectual Disability Health, Committee Hansard, 21 October 2025, p. 46.

[199]Australian Physiotherapy Association, Submission 171, p. 33.

[200]Disability Advocacy Network Australia, Submission 251, p. 6.

[201]Australian Federation of Disability Organisations, Submission 275, p. 7.

[202]Autistic Self Advocacy Network of Australia and New Zealand, Submission 181, p. 31.

[203]William Campbell Foundation, Submission 159, p. 3.

[204]Murrumbidgee Primary Health Network and Murrumbidgee Local Health District, Submission 191, pp. 7-8.

[205]Lifestart Disability Services, Submission 245, p. 26.

[206]Inclusion Australia, Submission 55, p. 3.

[207]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 43.

[208]Mrs Rachel Green, Chief Executive Officer, SANE Australia, Committee Hansard, 10 October 2025, p. 43.

[209]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 8.

[210]Mr Neil Turton-Lane, Convener, Australian Psychosocial Disability Collective; Committee Hansard, 20 October 2025, p. 12.

[211]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 12.

[212]Mr Neil Turton-Lane, Convener, Australian Psychosocial Disability Collective; Committee Hansard, 20 October 2025, p. 12.

[213]Mr Neil Turton-Lane, Convener, Australian Psychosocial Disability Collective; Committee Hansard, 20 October 2025, p. 12.

[214]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 16.

[215]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 16.

[216]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 16.

[217]Mrs Amanda Curran, Chief Psychologist, Australian Association of Psychologists Inc; Committee Hansard, 20 October 2025, p. 16.

[218]Department of Health, Disability and Ageing, Disability Reform Ministerial Council, 28 August 2025, https://www.health.gov.au/committees-and-groups/disability-reform-ministerial-council?language=en (accessed 4 December 2025)

[219]National Disability Insurance Scheme, Quarterly Reports, www.ndis.gov.au/publications/quarterly-reports, (accessed 1 October 2025).

[220]National Disability Insurance Scheme, Board, 6 May 2025, www.ndis.gov.au/governance/board#board-members-of-the-ndia (accessed 30 September 2025).

[221]National Disability Insurance Scheme, Quarterly Report to Disability Ministers, Q1 2025-26, Full Report, September 2025, p. 47.

[222]National Disability Insurance Scheme, Quarterly Report to Disability Ministers, Q1 2025-26, Full Report, September 2025, p. 47.

[223]National Disability Insurance Scheme, Quarterly Report to Disability Ministers, Q1 2025-26, Full Report, September 2025, p. 48.

[224]Ms Louise Glanville, Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 3.

[225]Ms Louise Glanville, Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, pp. 2-3.

[226]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 2.

[227]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 2.

[228]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 2.

[229]National Disability Insurance Scheme, Quarterly Report to Disability Ministers, Q1 2025-26, Full Report, September 2025, p. 53.

[230]National Disability Insurance Scheme, Quarterly Report to Disability Ministers, Q1 2025-26, Full Report, September 2025, p. 54.

[231]Ms Alisa Chambers, Deputy Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 4.

[232]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 6.

[233]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 6.

[234]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 26.

[235]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 26.

[236]Murdoch Children’s Research Institute, Submission 234, p. 24.

[237]Amaze, Submission 129, p. 24.

[238]Amaze, Submission 129, p. 24.

[239]The Bryan Foundation, Submission 333, p. 6.

[240]Ms Priyanka Rai, Executive Director, Australian Multicultural Health Collaborative, Committee Hansard, 10 October 2025, p. 23.

[241]Ms Priyanka Rai, Executive Director, Australian Multicultural Health Collaborative, Committee Hansard, 10 October 2025, p. 23.

[242]Ms Priyanka Rai, Executive Director, Australian Multicultural Health Collaborative, Committee Hansard, 10 October 2025, p. 23.

[243]Ms Priyanka Rai, Executive Director, Australian Multicultural Health Collaborative, Committee Hansard, 20 October 2025, p. 24.

[244]National Rural Health Alliance, Submission 379, p. 7.

[245]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 2.

[246]Ms Alisa Chamber, Deputy Commissioner, Regulatory Policy, Insights and Review, NDIS Quality and Safeguards Commission, Committee Hansard, 10 October 2025, p. 2.

[247]Mr Philipp Hermann, Policy and Advocacy, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 32.

[248]Ms Alana, Winslow Acting First Assistant Secretary, Early Learning, Programs and Youth Division, Department of Education Committee Hansard, 10 October 2025, p. 57.

[249]Ms Sadikshya Dulai, Policy and Project Officer, National Ethnic Disability Alliance Committee Hansard, 10 October 2025, p. 28.

[250]Dr Esmeralda Rocha Assistant Secretary, Inclusion and Disability Branch, Department of Education Committee Hansard, 10 October 2025, p. 56.

[251]Dr Esmeralda Rocha Assistant Secretary, Inclusion and Disability Branch, Department of Education Committee Hansard, 10 October 2025, p. 56.

[252]Dr Esmeralda Rocha Assistant Secretary, Inclusion and Disability Branch, Department of Education Committee Hansard, 10 October 2025, p. 56.

[253]Achieving Health Equality for All Australians with Disability, Submission 235, p. 4.

[254]Associate Prof Gawaian Bodkin-Andrews, Prof Maggie Walter, Dr Vanessa Lee, Prof Tahu Kukutai, Dr Ray Lovett, Delivering Indigenous Data Sovereignty, https://aiatsis.gov.au/publication/116530 accessed 1 December 2025.

[255]SNAICC – National Voice for our Children, Submission 327, pp. 28-29.

[256]SNAICC – National Voice for our Children, Submission 327, p. 8.

[257]SNAICC – National Voice for our Children, Submission 327, p. 28.

[258]Indigenous Allied Health Australia, Submission 271, p. 6.

[259]National Aboriginal Community Controlled Health Organisation, Submission 154, p. 5.

[260]Northcott, Submission 133, p. 8.

[261]Griffith University, Submission 222, p. 4.

[262]Mrs Bronwyn Morris-Donovan, Chief Executive Officer, Allied Health Professions Australia, Committee Hansard, 20 October 2025, p. 27.

[263]Ms Catherine Maloney, Chief Executive Officer, Services for Australian Rural and Remote Allied Health Ltd, Committee Hansard, 10 October 2025, p. 37.

[264]Ms Louise Glanville, Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 3.

[265]Indigenous Allied Health Australia, Submission 271, p. 5.

[266]Ms Lynette Brodie, Chief Executive Officer, Speech Pathology Australia, Committee Hansard, 20 October 2025, p. 21.

[267]Mrs Michelle Oliver, Chief Occupational Therapist, Occupational Therapy Australia, Committee Hansard, 20 October 2025, p. 21.

[268]MedHealth Pty Ltd, Submission 399, p. 20.

[269]MedHealth Pty Ltd, Submission 399, p. 21.

[270]Ms Louise Glanville, Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 3.

[271]Ms Natalie Wade, Associate Commissioner, NDIS Quality and Safeguards Commission, Committee Hansard, 20 October 2025, p. 6.

[272]Lifestart Disability Services, Submission 245, p. 21.

[273]Autism Spectrum Australia, Submission 67, p. 4. See also Autism Advisory and Support Services, Submission 180, p. 6.

[274]The Whole Child, Submission 355, pp. 11-12.

[275]Occupational Therapy Australia, Submission 304, p. 4.