Our Ref: CM 22/7046
Hon Dr Sally Talbot MLC Chair Select Committee into Child Development Services
E-mail: sccds@parliament.wa.gov.au
Dear Dr Talbot
Submission — Inquiry into child development services
Thank you for the opportunity to provide a submission to the Select Committee’s inquiry into child development services in Western Australia.
As Commissioner for Children and Young People, | am legislatively required to give priority, and have special regard to the interests and needs of vulnerable children and young people. The availability of easily accessed child development services that provide effective, evidence-based assessments, interventions and treatments in a timely manner is critical to the wellbeing of thousand of vulnerable Western Australian children. For this reason | welcome the Western Australian Parliament’s consideration of this important issue, and provide the following for consideration by the Committee:
Developmental stages
Children and young people have unique health needs at different developmental stages and require appropriate responses at each stage. Where there is an identified developmental delay or difficulty, child development services have a key role in ensuring effective interventions occur at the correct junctures in a child’s life.
Early years
Early intervention and prevention in the antenatal period, infancy and early childhood is critical to positively influence the future health and development of children. From before birth through early childhood a child’s physical, emotional and cognitive skills and capacities develop at a rate which exceeds that of any other stage of life. The neural connections formed through the interaction of genes and a baby’s environment and experiences has a major impact on the development of the brain - the foundation which influences all later learning, behaviour, and physical and mental health.[1,2]
[1] Center on the Developing Child at Harvard University 2017, Three Principles to Improve Outcomes for Children and Families - Science to policy and practice, Harvard University, p. 2.
Middle years
Interventions in the early years of a child’s life need to be reinforced through childhood. The middle years (from nine to 14 years), or early adolescence, is increasingly recognised as a critical stage in which major physiological, neurological, cognitive and psychosocial changes occur in a child’s life. The transition from primary to secondary school and changing relationship with parents, families and peers are of particular significance. It is also a time during which some children begin to engage in various risk-taking activities and when established symptoms of mental health disorders begin to emerge. Identifying and responding to issues arising in the middle years can prevent their escalation into adolescence, which has positive outcomes for the young person and can reduce the burden on acute services that would otherwise be needed in adolescence.
Adolescence
The period of adolescence is also a significant time of developmental change. Young people have specific needs that stem from the physical, behavioural, psychological and cognitive developments they are experiencing, including in areas such as sexual health and relationships, mental health, alcohol and drug use, body weight, nutrition and injury prevention. There are many opportunities for intervention at this stage to guide young people and create environments that facilitate a positive transition into young adulthood.
Developmentally vulnerable children and young people
In 2021 there were 6,852 Western Australian children commencing their first year of full-time schooling who were identified as developmentally vulnerable across one or more domains,[3] with 3,457 of these children exhibiting developmental vulnerabilities across two or more domains.[4] While the proportion of Western Australian children exhibiting these vulnerabilities has fallen since 2009, the data shows this is a result of the increased size of the cohorts commencing full time schooling. The actual number of children identified with some form of developmental vulnerability has remained essentially unchanged over the last decade.
Young children with developmental vulnerabilities cannot afford to wait extended periods to access child development services, as their window for effective early intervention is small. The years from birth to five are the most important developmental period in a child’s life. Early childhood development sets a child’s trajectory for physical health and cognitive, emotional and behavioural wellbeing through childhood, adolescence and into adulthood. As children get older the developmental pathways initiated in early childhood become more difficult to change. Early childhood is
[2] Royal Society of Canada & Canadian Academy of Health Sciences Expert Panel 2012, Early Childhood Development: adverse experiences and developmental health, eds M Boivin & C Hertzman, Royal Society of Canada, Ottawa, p. 7. [3] The development of children commencing full time schooling was assessed across five domains: physical health and wellbeing; social competence; emotional maturity; language and cognitive skills (school based); and communication skills and general knowledge. [4] Department of Education, Skills and Employment, Australian Early Development Census National Report 2021 — Early Childhood Development in Australia, 2022, pages 58-59
therefore the most effective time to intervene in the health, development and wellbeing of developmentally vulnerable children, and has the greatest potential to prevent or lessen problems that may arise as they enter their teenage years and adulthood.
The impact of extended wait times to access child development services are significant for developmentally vulnerable children. For example, child health and development checks are critical for the identification of developmental issues and referral of children to appropriate services. When these checks are not performed in a timely manner, developmental and health problems can remain undetected, and necessary interventions may be delayed or simply not occur at all. Without a completed assessment and subsequent diagnosis, children and their families are unable to access government funding and services for important early interventions that can greatly improve development outcomes for the child. In such instances the only option for parents may be to seek assistance from a private service provider, the cost of which is prohibitive for many families.
Access to child development services
Regardless of where they live in Western Australia, children and young people are entitled not only to the highest standard of developmental supports and services, but also to receive these supports and services in a timely manner. This is particularly important where early assessment, intervention and treatment can have a significant impact on the future development of a child. The reported size of wait lists for children and young people to access child development services, particularly in regional and remote areas of the State, is therefore of great concern.
Unfortunately, this is an issue that has been repeatedly brought to the attention of successive governments and remained inadequately addressed. In 2010 the Education and Health Standing Committee found in relation to the State Child Development Service and other community child health services that:
The situation for Western Australia’s children is unacceptable and it will continue to deteriorate unless there is an immediate and significant increase in community child health resources. The current situation has developed over a number of years and there have been a range of contributing factors including:
- Western Australia’s strong population growth which has resulted in a significant increase in demand for services;
- A chronic lack of investment in community child health services over the last two decades; and
- The lack of an adequate resource allocation model for community child health services that reflects population growth and service demand.[5]
These findings by the Education and Health Standing Committee were echoed later that same year by the Auditor General, who noted that the State Child Development Service had historically significant waitlists for therapy and treatment of identified developmental delays.[6]
[5] Education and Health Standing Committee 2010, Invest now or pay later: Securing the future of Western Australia’s children, Legislative Assembly, Western Australian Parliament, Perth, p. 46. [6] Office of the Auditor General WA 2010, Universal Child Health Checks, Report 11, November 2010, p. 14-15.
In 2011 the then Commissioner for Children and Young People published the findings and recommendations of her Inquiry into the Mental Health and Wellbeing of Children and Young People in Western Australia.[7] The Inquiry confirmed that years of underinvestment had left the Child Development Service struggling to service the requirements of those children who most needed it. The Commissioner went on to make a specific recommendation calling for the State Child Development Service to “receive significant investment in order to increase its services to an appropriate level and reduce waiting times.”
It is unacceptable that in 2022 significant gaps still exist in the health services and supports available for children and young people living in our WA. Compounding these decade-old concerns is the fact that any delays in receiving treatment in the metropolitan area can generally be multiplied in regional and remote parts of the state. By ensuring child development services are accessible across WA and that children identified as developmentally vulnerable have access to necessary supports, the WA Government can improve lifetime outcomes for individuals, increase social and economic participation across the community, and reduce the rate of less effective crisis-initiated responses and their associated higher costs.
Required response
With all that we know about the benefits of early intervention, the difficulties children and families have and are still experiencing when trying to access child development services are untenable. The benefits of investing early in child health is conclusive, and there is increasing urgency for resources in this area.
It is therefore once again the recommendation of this office that the State Government make available the funding required to enable vulnerable children across Western Australia to access child development assessments, interventions and supports they need, and to ensure these children receive services at the point they will have the greatest impact on their long-term development, health and wellbeing.
More broadly, the issues raised throughout this submission reinforce the need for a WA Child Wellbeing Strategy. In the context of child development services, such a strategy would facilitate a whole-of-government approach that prioritises the following:
- The development of models of engagement that identify children and young people with developmental vulnerabilities.
- Investment in targeted early intervention for children and young people who are developmentally vulnerable.
- The provision of interventions and supports that build family and community capacity to provide a supportive and nurturing environment for vulnerable children and young people.
- The critical need for early identification of neuro-divergence in children and young people such as Autism and ADHD and access to early treatment and support to support their wellbeing and development.
My predecessor, Mr Colin Pettit, recommended in his report Improving the Odds for WA’s vulnerable children and young people (April 2019), that the Department of Premier and Cabinet, on behalf of government lead the development of the Child Wellbeing Strategy.
[7] Available at https://www.ccyp.wa.gov.au/media/1452/report-mental-health-inquiry-april-2011.pdf.
There is significant evidence that we need to develop a holistic Child Wellbeing Strategy that provides critical support and services across the life course for all children and young people in WA.
A Child Wellbeing Strategy should set whole-of-government targets to improve wellbeing outcomes among children and young people. Targets should be long-term, extend beyond election cycles and span individual agency responsibilities. This recommendation was accepted in principle by the Department of Premier and Cabinet in 2019, but has not been implemented to date.
Thank you again for the opportunity to contribute to this inquiry. If you have any queries regarding this submission, please contact Mr Lynton Bennett, Manager Legislation and Legal, on 6213 2205 or via lynton.bennett@ccyp.wa.gov.au.
Yours sincerely,
Jacqueline McGowan-Jones Commissioner
25 OCT 2022