Submission No 90
INQUIRY INTO FOUNDATIONAL AND DISABILITY SUPPORTS AVAILABLE FOR CHILDREN AND YOUNG PEOPLE IN NEW SOUTH WALES
Organisation: The Australian Music Therapy Association Date Received: 15 September 2026
Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales: Australian Music Therapy Association (AMTA) submission
15 September 2026
Australian Music Therapy Association PO Box 7345, Beaumaris VIC 3193
Australian Music Therapy Association submission to
Select Committee on Foundational and Disability Supports
Available for Children and Young People in New South Wales via web submission
About AMTA
The Australian Music Therapy Association (AMTA) is Australia’s peak body for music therapy. AMTA is the only government-recognised certifying body responsible for registering music therapists, accrediting music therapy courses, and maintaining professional standards and ethics.
AMTA is a member of Allied Health Professions Australia and the National Alliance of Self Regulating Health Professions (NASRHP). AMTA-certified registered music therapists (RMTs) are required to comply with strict regulatory standards established by NASRHP to ensure consumer safety. To become a member of NASRHP, organisations must demonstrate that they meet the 12 regulatory and accreditation standards of NASRHP which are benchmarked against Ahpra standards. AMTA has clearly defined membership criteria, national professional standards and assessment processes and a clearly defined scope of practice.
Music therapy is an evidence-based, allied health profession delivered by RMTs who hold qualifications at Australian Qualifications Framework (AQF) Levels 7 to 9.
RMTs graduate with specialist clinical skills in the use of music-based and psychological strategies to achieve therapeutic outcomes and are required to maintain ongoing continuing professional development and professional supervision standards.
Overview
AMTA welcomes the opportunity to respond to the extension of the Select Committee on Foundational and Disability Supports Available for Children and Young People in NSW Inquiry.
RMTs are an established and qualified workforce already supporting families and communities across disability, health, education and community sectors. RMTs design and deliver individualised, music- based interventions that support children’s development, communication, regulation, cognition, behaviour, and wellbeing.
Across NSW, RMTs work with infants, children and young people with developmental delay, disability and complex support needs. They support children within homes, early childhood services, schools, community settings and clinics, working alongside families, educators and multidisciplinary teams to help children participate more fully in everyday life. This work aligns closely with the objectives of Thriving Kids through:
- supporting early identification and intervention
- developing functional communication and social participation
- strengthening emotional regulation and engagement
- building the capability of parents, carers and educators
- collaborating across health, education and community services
- delivering supports within children’s everyday environments.
As a member organisation of Allied Health Professions Australia (AHPA), AMTA also supports the submission to the inquiry by AHPA and supports the call for:
- more flexible approaches to commissions, particularly in areas where existing services are limited;
- additional approaches to commissioning, such as including private providers, consortiums and grant schemes; and
- collaboration with the NSW Government in relation to transition supports
AMTA’s submission is informed by a series of de-identified case studies contributed by RMTs working with children and families across New South Wales. Rather than presenting individual client stories in isolation, the case studies have been structured around key policy themes relevant to the Inquiry, including early intervention, choice and control, family-centred supports, interdisciplinary collaboration, participation, capacity building, and equitable access to services. Collectively, these examples provide practical insight into the features of effective foundational, and disability supports and demonstrate the positive outcomes that can be achieved when children and families are able to access the right supports at the right time. These case studies also highlight the potential impacts on children, families, and communities when access to appropriate supports is reduced or unavailable.
This submission is structured in four parts, each supported by three de-identified case studies that illustrate key issues and opportunities for improving foundational and disability supports for children, young people and families. The four parts are:
- Part 1 – Accessing the Right Support
- Part 2 – What Effective Intervention Looks Like
- Part 3 – Building Participation
- Part 4 – Designing Better Systems
A summary of the case study themes and policy messages are provided on page 4.
Case studies
Table 1: Quick Reference: Case Study Themes
| Part | Case Study | Theme | Policy Message |
|---|---|---|---|
| 1 | 1 | Early intervention is only effective if the right support is available at the right time. | Early intervention delivers the greatest benefit when children receive intervention that matches their developmental needs, strengths, interests and capacity to engage. |
| 2 | Children need genuine choice in therapeutic approaches. | Families should have access to a range of appropriate evidence-informed therapeutic approaches where those approaches address the child’s disability-related functional needs and are likely to produce beneficial outcomes. | |
| 3 | Children with high and complex support needs continue to develop. | Meaningful outcomes include functional communication, agency, participation, wellbeing and quality of life, even where substantial lifelong support remains necessary. | |
| 2 | 4 | Every child has the right to communicate. | Functional communication may include speech, AAC, gestures, vocalisations, movement and behaviour that serves a communicative function. |
| 5 | Families are essential partners in intervention. | Building parent and caregiver knowledge, confidence and capacity creates opportunities for development throughout everyday life. | |
| 6 | Collaboration across families and professionals improves outcomes. | Multidisciplinary care occurs when professionals and families share goals and deliberately use their different expertise to reinforce functional development. | |
| 3 | 7 | Social participation is a core developmental outcome. | Social participation can begin in individual therapy and progress towards reciprocal interaction, friendships and meaningful participation with peers. |
| 8 | Development is individual and support needs change over time. | Funding and service models should allow the frequency, intensity and focus of intervention to change in response to the child’s development and functional priorities. | |
| 9 | The goal of therapy is participation beyond the clinic. | Intervention should build capacity to participate in family, education, recreation and community life, rather than making successful participation in therapy the endpoint. | |
| 4 | 10 | Capacity building can reduce reliance on specialist supports over time. | Support should reduce where increased child and family capacity makes this appropriate, while remaining available when new developmental needs emerge. |
| 11 | Children deserve equitable access to appropriate intervention. | Children should be able to access appropriate evidence-informed intervention that addresses their disability-related functional needs, in a form they can meaningfully and safely participate in. | |
| 12 | Child-centred systems achieve better outcomes than service-centred systems. | Functional goals should remain rigorous while the therapeutic pathway is individualised around the child’s needs, strengths and capacity to engage. |
Part 1 – Accessing the Right Support
Case Study 1: Lucas (pseudonym)
Theme: Early intervention is only effective if the right support is available at the right time
Policy Implication
Early intervention is most effective when children can access an intervention that addresses their disability-related functional needs while also matching their strengths, interests and capacity to engage. Early access alone is not enough if a child cannot meaningfully participate in the intervention being offered.
Lucas’s case demonstrates how access to the right intervention during a critical developmental period can build functional capacity, increase participation and enable specialist support to reduce in intensity over time
Case Summary
Lucas was referred to music therapy shortly after his third birthday due to concerns regarding functional communication, emotional regulation, social interaction and readiness for preschool.
His parents had proactively accessed a range of allied health supports. However, maintaining Lucas’s attention and engagement during intervention was challenging, limiting opportunities to practise and develop new skills.
Lucas demonstrated a strong responsiveness to music and commenced one hour of individual music therapy weekly. Music was used as the therapeutic medium to target functional developmental goals including joint attention, communication, regulation, reciprocal interaction and social participation. Regular collaboration with his family and education team supported emerging skills to be reinforced within everyday environments.
His mother reported particularly noticeable week-to-week changes following the introduction of music therapy. Over the following years, Lucas demonstrated meaningful development in communication, regulation, confidence and social participation, with positive changes reported across home and school.
Importantly, as his capacity increased, individual music therapy reduced from 60 minutes weekly, to 30 minutes weekly, and later to 45 minutes fortnightly.
Lucas now attends mainstream school, participates in social music activities and is preparing to transition from individual intervention into a therapeutic social group focused on communication and interaction with peers.
Clinical Significance
Lucas’s progress demonstrates the distinction between access to early intervention and access to effective early intervention.
Engagement was initially a significant barrier to learning. Music provided a motivating and predictable therapeutic context through which Lucas could repeatedly practise communication, regulation and reciprocal interaction.
Music therapy did not replace functional developmental goals with musical goals. Music provided an accessible therapeutic medium through which those goals could be addressed.
As Lucas developed greater functional capacity, intervention evolved with him. Individual therapy became less frequent while opportunities for participation with peers and within everyday environments increased.
Policy Consideration
Early intervention systems require flexibility and genuine access to different evidence-informed therapeutic approaches.
Children engage and learn differently. Restricting intervention to a narrow range of approaches may limit access to another clinically appropriate intervention that is better suited to the child’s disability-related functional needs and capacity to engage.
Lucas also demonstrates that individualised specialist intervention and system sustainability are not competing objectives. Where effective intervention builds capacity, the intensity of specialist support may appropriately reduce over time.
Success should therefore be measured by whether intervention increases the child’s capacity to communicate, participate, learn and belong in everyday life, rather than simply by the amount of therapy delivered.
Case Study 2: Maya (pseudonym)
Theme: Children need genuine choice in therapeutic approaches
Policy Implication
Meaningful choice requires access to different appropriate therapeutic approaches where those approaches address the child’s disability-related functional needs and meet relevant funding and clinical criteria.
Children differ significantly in how they communicate, regulate, learn and engage. Effective early intervention must therefore preserve access to a range of evidence-informed therapeutic approaches so intervention can be matched to the child.
Case Summary
Maya was six years old when she commenced music therapy. She was autistic with Level 2 support needs and experienced significant anxiety and selective mutism.
Her family had proactively accessed speech pathology, occupational therapy and psychology for more than two years. Despite substantial engagement with services, significant barriers to communication and emotional expression remained.
Funding flexibility allowed Maya’s family to change the mix of intervention. Speech pathology and occupational therapy reduced to fortnightly, psychology remained weekly, and music therapy was introduced.
Songwriting became a particularly accessible avenue for Maya to communicate experiences and emotions that were difficult to express through spontaneous speech. She progressed from individual songs to creating complete albums exploring experiences and social-emotional themes meaningful to her.
These outcomes extended beyond music therapy. Maya began taking her songs and albums into psychology sessions, where they became a bridge into conversations and therapeutic work she otherwise found difficult to initiate verbally.
Following review of Maya’s changing needs, speech pathology was subsequently discontinued, while intervention continued to focus on the anxiety and social-emotional barriers affecting her communication and participation.
Clinical Significance
Maya’s case highlights an important distinction: a child can possess communication skills while experiencing significant barriers to accessing those skills in particular environments or emotional states.
For Maya, requiring spontaneous verbal communication could itself become a barrier. Songwriting provided another route into communication, allowing her to organise, externalise and share experiences without making speech the only gateway to therapeutic participation.
Music therapy did not replace multidisciplinary intervention. Instead, it provided a different therapeutic pathway that complemented her psychological support.
The case also demonstrates that good intervention is not measured by the number of therapies a child receives. It requires continually identifying the functional barriers affecting participation and directing intervention towards those barriers.
Policy Considerations
A system that restricts access to a narrow set of therapeutic modalities risks requiring the child to adapt to the available intervention rather than adapting intervention to the child.
Genuine choice requires access to appropriately qualified, evidence-informed disciplines and therapeutic modalities where they address the child’s disability-related functional needs, with flexibility to change the type, combination and intensity of support as those needs evolve.
Maya’s case does not demonstrate that music therapy should replace speech pathology, occupational therapy or psychology. It demonstrates that no single profession or therapeutic approach can be assumed to provide the most accessible pathway for every child.
A child-centred system should ask: “What is preventing this child from participating, and which evidence-informed approach is best placed to address that barrier?”
Case Study 3: Jenny (pseudonym) Theme: Children with high and complex support needs continue to develop
Policy Implication Reduced reliance on support cannot be the universal measure of successful early intervention.
Children with profound and complex disabilities continue to learn, communicate, form relationships and develop agency even where substantial lifelong support is likely to remain necessary. Meaningful functional outcomes may include increased ability to communicate preferences, make choices, initiate interaction, participate with others and exercise greater agency in everyday life.
Case Summary Jenny is seven years old and has multiple and profound disabilities, including cerebral palsy, intellectual disability, chronic seizures and significant motor and medical complexity.
She is tube-fed and requires one-to-one assistance across everyday activities, including substantial physical support for positioning and movement. Her capacity fluctuates significantly, including periods of substantial seizure activity and regular medical care.
One of Jenny’s significant developmental priorities has been establishing reliable functional communication.
Music therapy initially incorporated simple accessible buttons within motivating musical interactions. Jenny learnt that intentionally activating a button could produce an immediate and predictable response, such as making a choice or requesting that a preferred musical experience continue.
Her communication therefore had an immediate consequence: she acted, another person responded, and what happened next changed.
As Jenny became increasingly consistent with button activation and choice-making, intervention progressed towards more complex AAC use alongside her vocalisations, gestures, facial expressions and other individual communication signals.
Over time, Jenny developed increasingly intentional ways of requesting, choosing, rejecting, initiating and directing interactions.
For Jenny, progression from activating a simple button towards increasingly purposeful AAC use represents significant functional development.
Clinical Significance Jenny’s progress demonstrates why developmental potential should not be underestimated because a child has profound disability.
Her communication development required skills to be built incrementally and accessibly.
Music was particularly useful because it provided immediate, predictable and motivating feedback.
When Jenny communicated, something meaningful happened: music started, stopped, changed or continued, or another person responded to her preference.
The therapeutic goal was not simply pressing a button. It was developing the relationship:
I act → I communicate → another person responds → I can influence what happens.
This is an important foundation for functional communication and agency.
Jenny may continue to require substantial lifelong assistance. That does not diminish the significance of becoming increasingly able to communicate “yes”, “no”, “more”, “stop”, “I choose this” or “I want to continue.”
Policy Consideration
Early intervention frameworks must not define success solely through increasing independence or reducing support intensity.
Jenny’s physical support needs remain substantial. Her communication capacity has nevertheless developed.
Policy should recognise incremental development in communication, agency, participation and quality of life as legitimate outcomes, including where specialist and everyday support remains necessary.
For children with profound disability, greater agency may coexist with lifelong dependence. That does not make the developmental gain smaller. It makes access to effective communication even more important.
Part 2 — What Effective Intervention Looks Like
Case Study 4: Tom (pseudonym) Theme: Every child has the right to communicate
Policy Implication
Every child needs an effective way to communicate, not simply a system for adults to communicate with them.
Functional communication may include speech, AAC, pictures, gestures, vocalisations, movement and behaviour that may serve a communicative function. Intervention should support the communication forms that are accessible and meaningful for the individual child.
Case Summary
Tom is a primary-school-aged child with Angelman syndrome, intellectual disability and significant communication needs. He is predominantly non-speaking.
When Tom commenced music therapy, visual supports were available, but many focused on adult directions such as “stop”, “hands to self” and “no hitting.”
Tom had fewer reliable ways to communicate “help”, “more”, “no”, “finished”, “stop” or “I need a break.”
Tom frequently communicated distress or unmet needs through vocalisations and behaviours including throwing objects or hitting, which could restrict safe participation with peers.
Music therapy provided another pathway.
Songs were paused for Tom to request “more”; instruments provided opportunities to choose and reject; and musical interactions stopped, continued or changed in direct response to his communication.
Speech was not required. Pictures, gestures, vocalisations and intentional movements were recognised and developed as valid forms of communication.
Over time, Tom developed increasingly purposeful ways to choose, request, refuse, stop and direct interactions. These gains supported increased participation with peers, including successful participation in supported school holiday music groups.
Clinical Significance
Tom’s strong engagement with music enabled the RMT to create repeated, structured opportunities to
practise disability-related functional communication goals, with an immediate and meaningful response to his communication.
The therapeutic sequence was: I communicate → I am understood → something happens because of what I communicated.
Rather than focusing only on stopping behaviour, intervention gave Tom more effective ways to influence his environment and have his intentions understood.
This demonstrates how specialist music therapy can support disability-related functional communication goals where a child may not readily access speech-dependent approaches.
Policy Consideration
Communication outcomes should not be measured by speech alone, nor by whether a child has simply been provided with an AAC device or visual resources.
The meaningful outcome is whether the child can communicate intentionally, be understood and influence what happens around them. For Tom, music therapy transformed communication from something largely directed towards him into something he could actively use to choose, refuse, request and participate.
Having communication supports is not the same as having a voice. Effective intervention should give children meaningful ways to use that voice.
Case Study 5: Lily (pseudonym)
Theme: Families are essential partners in intervention
Policy Implication
A child may spend one hour a week in therapy, but development happens every day.
Effective early intervention should build parents’ capacity to use practical, evidence-informed strategies within everyday routines, relationships and environments. This does not mean turning parents into therapists. It means giving families the knowledge, tools and confidence to reinforce developmental goals between sessions.
Case Summary
Lily was five years old with Level 3 autism and significant communication, regulation, learning and social support needs. Her childhood had also involved trauma, family disruption and socioeconomic disadvantage.
Her mother was highly committed to supporting her but found everyday routines and periods of dysregulation challenging.
Music therapy therefore extended beyond direct intervention with Lily to actively supporting her mother.
Simple songs were developed for everyday tasks including brushing teeth, getting dressed, packing away and transitions, using rhythm, repetition and predictable musical cues to support understanding, sequencing and participation.
Music was also incorporated into Lily’s regulation plan. Her mother learnt to recognise regulation cues and use individualised playlists and familiar music intentionally for co-regulation, transitions, calming and preparation for sleep.
During joint sessions, the therapist modelled how to follow Lily’s lead, offer choices, reduce demands when dysregulated and use music to support connection and engagement.
Over time, Lily’s mother became increasingly confident adapting these strategies herself. Lily increasingly accepted her mother’s support, participated in shared routines, requested help and engaged in music-making and songwriting at home.
Clinical Significance
The intervention was not simply a home program. It involved translating clinical knowledge into
practical strategies that a parent could confidently use in everyday life.
Music could be embedded naturally into routines:
- Brushing teeth → routine song and sequencing
- Getting dressed → predictable musical cues
- Transitions → familiar songs signalling what happens next
- Dysregulation → individualised music for co-regulation
- Bedtime → consistent playlist supporting the sleep routine
The therapist could assess, model, support, review and adapt these strategies as Lily’s needs changed.
Policy Consideration
Family capacity building should be recognised as a legitimate component of intervention where it directly supports the child’s disability-related functional goals.
Effective early intervention requires capacity for parent coaching, modelling, individualised resource development and review, not only direct face-to-face intervention with the child.
Capacity building must not transfer clinical responsibility onto families. Parents do not need to become therapists. They need therapists who can translate specialist knowledge into strategies that work in their child’s real life.
For Lily, the value of one hour of professional intervention was that it became relevant to the other 167 hours of her week.
Case Study 6: Laurie (pseudonym)
Theme: Collaboration across families and professionals improves outcomes
Policy Implication
Multiple professionals do not automatically create multidisciplinary care. Collaboration does.
Children can achieve stronger functional outcomes when professionals share goals, contribute their distinct expertise and create consistent opportunities for skills to be practised across therapy and everyday life.
Case Summary
Laurie is a young child with Level 3 autism and significant communication and regulation support
needs.
His speech pathologist was targeting areas including speech clarity, increasing utterances and specific speech sounds, but dysregulation and difficulty sustaining attention could limit opportunities for repeated practice.
Recognising Laurie’s strong interest in singing, his speech pathologist referred him to music therapy. Rather than establishing separate communication goals, the clinicians shared targets. Speech pathology identified specific speech targets, and music therapy embedded these into individualised songs and musical activities.
This created distinct but complementary clinical roles:
- Speech pathology identified and refined the speech target.
- Music therapy created the motivation, engagement and repetition needed to practise it.
A target that was difficult to repeat through isolated practice could occur multiple times within a preferred song while Laurie remained actively engaged.
Individualised recordings were also provided to his family for use between appointments and could be incorporated back into speech pathology sessions.
The same communication target was therefore reinforced across speech pathology, music therapy and home.
Clinical Significance Identifying the right developmental target is only one part of effective intervention. The child also needs sufficient opportunities to engage with and practise that skill.
Music therapy addressed Laurie’s engagement and repetition barrier by reinforcing, rather than duplicating or replacing, the specialist intervention provided by speech pathology.
The collaborative cycle became: Speech pathology identifies and refines the target → music therapy embeds it into motivating repeated practice → family reinforces it at home → clinicians review and adapt.
The result was not simply more therapy. It was better connected therapy.
Policy Consideration Multidisciplinary intervention should not be defined by the number of professionals involved. It should reflect whether those professionals are enabled to work together towards shared functional outcomes.
Funding models should recognise clinically necessary communication, shared goal-setting, resource development, parent collaboration and coordination between disciplines where these activities directly contribute to the child’s functional outcomes and avoid unnecessary duplication.
Collaboration does not make disciplines interchangeable. It makes their distinct expertise more effective.
For Laurie, a speech target did not have to remain inside the speech therapy room. Once appropriately identified, it could be reinforced through music therapy and at home while remaining under specialist speech pathology oversight.
Part 3 — Building Participation
Case Study 7: Sophie (pseudonym) Theme: Social participation is a core developmental outcome
Policy Implication Social participation can begin in individual therapy.
Some children first need to develop foundational capacities in shared attention, turn-taking, communication, regulation, flexibility and reciprocity within the safety and predictability of a 1:1 therapeutic relationship.
Social participation should therefore be understood as a developmental pathway towards increasingly complex relationships with peers and participation in community life.
Case Summary
Sophie is a primary-school-aged autistic child with significant social communication, flexibility and emotional regulation needs.
Sophie initially required individual music therapy. Within a predictable 1:1 therapeutic relationship, music provided repeated opportunities to practise sharing attention, taking turns, listening and responding, tolerating another person’s ideas, communicating preferences and managing changes within an interaction.
Interactive music-making allowed Sophie and her therapist to play together, copy one another, take musical turns, improvise, make decisions and repair interactions when something did not go to plan.
As Sophie’s capacity developed, the social demands increased.
She progressed into a clinician-led group music therapy program with individualised functional social-participation goals, therapeutic facilitation and ongoing review of outcomes. Forming a band required her to share control, listen to other children’s ideas, negotiate songs and instruments, manage disagreement and adapt when the group did something unexpected.
The therapist continued to scaffold interactions while progressively creating more opportunities for Sophie to communicate and problem-solve directly with peers.
Clinical Significance
Social participation is not simply being physically present around other children. It requires integration of communication, regulation, flexibility, perspective-taking and reciprocity.
For some children, expecting these capacities to emerge for the first time within a busy classroom, playground or group places the social demand too high.
Individual music therapy can provide the developmental foundation.
Interactive music-making is particularly suited to this work because it creates structured opportunities to notice, listen, wait, respond, synchronise, lead, follow and adapt with another person, without relying solely on conversation.
Once those foundations are established, therapeutic group music can progressively increase the social complexity.
Policy Consideration
Social participation should be recognised as a core developmental outcome, not an optional benefit occurring after therapy.
Some children require individual specialist intervention before successful peer participation becomes accessible. Others may require individual and group intervention concurrently.
Individual and group music therapy can provide a clinically structured pathway from connecting with one person, to sustaining reciprocal interaction, collaborating with peers and participating more meaningfully in community life.
The goal is not simply to teach “social skills”. It is to build the capacity to connect, form relationships and belong.
Case Study 8: Noah (pseudonym)
Theme: Developmental is individual and support needs change over time
Policy Implication
Children progress at different rates, and the level of intervention they require may increase or decrease at different stages of development.
Flexible early intervention should allow the frequency, intensity and focus of support to change in response to the child’s disability-related functional needs, developmental trajectory and immediate priorities.
Case Summary
Noah is a young child with significant developmental delay whose developmental needs became increasingly apparent later in early childhood.
As Noah approached school age, his parents’ greatest concern was developing the disability-related functional capacities he would need to participate successfully in the transition to school. They wanted to maximise his capacity to communicate, engage, participate, follow routines and learn alongside others before commencing school.
Noah initially attended 30-minute individual music therapy once per week.
Intervention targeted disability-related functional capacities relevant across home, community and the transition to school, including joint attention, functional communication, regulation, sustained engagement, transitions, turn-taking and participation in structured activities.
As Noah began making gains, it became clear that he was responding strongly to intervention and benefiting from repetition. His program therefore increased, on a clinically reviewed and time-limited basis, to two 30-minute sessions per week to consolidate emerging functional skills during this developmental period.
Emerging skills introduced in one session could be revisited and reinforced several days later rather than waiting another full week.
During this period, Noah demonstrated significant gains in his developing school-readiness capacities, while activities could be rapidly adjusted as new abilities and areas requiring support emerged.
Clinical Significance
Progress should inform intervention, not automatically trigger its reduction. When a child is responding strongly, there may be an important developmental opportunity to consolidate and extend emerging skills.
For Noah, increasing from one to two sessions weekly was a deliberate clinical response to his developmental trajectory, response to intervention and approaching transition to school.
Music therapy allowed multiple school-readiness capacities to be integrated within motivating structured experiences. Noah needed to listen, anticipate, communicate, wait, respond, follow sequences, regulate his actions and sustain shared attention.
His pathway became: 30 minutes weekly → emerging gains → increased frequency → greater repetition and reinforcement → consolidation and extension of school-readiness skills.
Policy Consideration Early intervention should not assume a universal pathway of: more support → progress → less support.
Sometimes progress indicates an opportunity to maintain or temporarily increase intervention during an important developmental window.
Funding and service models should therefore allow intervention to increase, decrease or change according to the child’s current needs and functional priorities.
The right amount of support today may not be the right amount six months from now. Effective intervention must be flexible enough to respond to both.
Case Study 9: Mia (pseudonym) Theme: The goal of therapy is participation beyond the clinic
Policy Implication A child becoming successful at therapy is not the ultimate outcome of early intervention.
The goal is for capacities developed through therapy to increase participation in family, education, recreation, relationships and community life.
Case Summary Mia is an eight-year-old autistic child who initially accessed individual music therapy to support communication, emotional regulation, confidence and social participation.
Within 1:1 sessions, musical experiences were deliberately used to build functional capacities including sustaining engagement, managing challenge and mistakes, communicating preferences, adapting to change and participating reciprocally.
Over time, Mia developed both functional capacity and clear musical strengths. The focus increasingly shifted from what Mia could achieve within therapy to where those developing skills could take her outside it.
Mia progressed into regular instrumental music lessons, where the purpose was primarily learning an instrument rather than therapy. She subsequently joined her school choir and school band. Once Mia was able to access instrumental learning primarily as an educational and recreational activity, these lessons were no longer being provided as music therapy.
These environments allowed Mia to use her strengths alongside peers, contribute to her school community, build connections around a shared interest and experience herself as a musician.
Music had progressed from a therapeutic medium to a meaningful part of Mia’s everyday life.
Clinical Significance
Mia demonstrates how a child’s strength can become a pathway into participation.
Her progression was: Individual music therapy → functional and musical development → instrumental lessons → school choir and band → broader educational and social participation.
Importantly, the later activities were not therapy.
Mia could increasingly access ordinary childhood experiences because she had developed the capacity and confidence required to participate.
Her musical strength also became a social asset: something she could contribute, share and be recognised for, rather than social participation being organised only around areas of difficulty.
Policy Consideration
Early intervention systems should look beyond whether a child is progressing within therapy and consider what that intervention enables them to do in everyday life.
For some children, greater participation may eventually reduce reliance on therapy. For others, specialist intervention may continue alongside increasing involvement in school and community life.
Reduced therapy should not be imposed as the outcome. The primary outcome should be increased functional participation, with specialist support reducing where this becomes clinically appropriate.
For Mia, success was being able to learn as a student, sing in a choir, play in a band and participate alongside her peers.
Part 4 – Designing Better Systems
Case Study 10: Ethan (pseudonym)
Theme: Capacity building can reduce reliance on intensive supports over time
Policy Implication
The goal of capacity building is to increase functional capacity and participation, which may reduce reliance on specialist therapy where clinically appropriate.
It is to develop skills that allow children to participate with less specialist support where appropriate, while retaining access to targeted intervention when new developmental needs emerge.
Children’s needs change as they grow. Services should therefore be able to increase, reduce, cease and be re-accessed according to functional need.
Case Summary
Ethan commenced music therapy as a young child and continued receiving support throughout his early childhood.
Individual music therapy targeted areas including communication, emotional regulation, confidence, social interaction, flexibility and participation.
As Ethan developed, skills were progressively consolidated and applied beyond therapy. Eventually, he developed sufficient capacity that regular music therapy was no longer required and services ceased.
For several years, Ethan did not require music therapy.
Later, the transition towards high school introduced new social, emotional and developmental demands. Ethan began experiencing challenges that had not required specialist intervention during the intervening years.
He re-accessed music therapy through a short-term targeted program focused on resilience, emotional regulation, coping strategies and navigating this new developmental transition.
The intention is again to build capacity and discontinue intervention when this period of specialist support is no longer required.
Clinical Significance
Ethan demonstrates what sustainable capacity building can look like across childhood.
His early intervention was not successful because he remained engaged with services. It was successful because he developed enough capacity to leave them. However, development continued after therapy ended. A later developmental transition introduced new expectations, relationships and emotional demands.
Re-accessing intervention does not mean earlier therapy failed. It reflects the reality that the relationship between a child’s capacity and the demands of their environment changes as they grow.
His pathway became: Early specialist intervention → increased functional capacity → discharge → several years without music therapy → new developmental transition → short-term targeted support → planned discharge.
Policy Consideration
Capacity building should not be measured by reducing services as quickly as possible.
Support may appropriately reduce when functional capacity has increased, while remaining accessible when a new disability-related functional need or developmental transition requires targeted intervention.
Ethan’s experience demonstrates a sustainable model in which specialist intervention is available when needed, reduced when capacity develops and reintroduced when circumstances change.
The goal is not permanent therapy or permanent discharge. It is the right level of support at the right stage of development.
Case Study 11: Jonah (pseudonym)
Theme: Children deserve equitable access to appropriate intervention
Policy Implication
Equitable access means access not only to a service, but to a clinically appropriate intervention that addresses the child’s disability-related functional needs and can be meaningfully and safely accessed.
Children with disability and significant medical histories may face additional barriers because of fluctuating capacity, health considerations and developmental complexity.
Early intervention must preserve access to different evidence-informed therapeutic approaches and flexible methods of delivery, including home-based intervention where clinically appropriate.
Case Summary
Jonah is a young child with autism and significant developmental delay who is in remission following treatment for brain cancer.
Although cancer treatment has ended, Jonah continues to have substantial developmental needs across communication, attention, regulation, movement, play, learning and social interaction.
Jonah also experiences fluctuations in energy, engagement and capacity that need to be accommodated within intervention. Music therapy was selected because it provided an accessible way to address multiple developmental areas through a medium Jonah could meaningfully engage with.
Songs, rhythm, instruments and musical interaction create purposeful opportunities to initiate communication, make choices, anticipate sequences, sustain attention, imitate actions and sounds, coordinate movement, take turns and interact reciprocally.
For example, an instrument activity can incorporate reaching and motor planning alongside attention, choice-making and turn-taking. A familiar song can provide predictable opportunities for anticipation, communication and memory.
Home-based music therapy was selected because it reduced health- and disability-related barriers associated with travel and clinic attendance while allowing effective intervention to continue in a setting Jonah could safely access.
The intervention can adapt to Jonah, and the service can come to him.
Clinical Significance
Music therapy is particularly appropriate because Jonah’s developmental needs do not occur in isolation.
Communication, movement, attention, regulation, learning and social engagement interact with one another. Music provides a structured but adaptable therapeutic medium through which these capacities can be addressed within shared functional activities.
The therapist can also modify the level of demand while retaining the developmental opportunity. Activities can be simplified, slowed, made more predictable or physically adapted according to Jonah’s capacity.
Music therapy is not justified simply because Jonah enjoys music or engages with it. It is being used clinically because the RMT can use musical interaction to address identified disability-related functional goals across communication, regulation, movement, attention and social participation.
Policy Consideration
Children with complex medical and developmental needs should not have fewer therapeutic options because conventional service models are difficult for them to access.
For Jonah, equitable intervention requires both an appropriate therapeutic approach and an accessible method of delivery.
Music therapy provides an accessible pathway towards his functional developmental goals, while home-based delivery reduces barriers to participation.
Equity is not giving every child the same intervention in the same setting. It is ensuring each child can access appropriate intervention in a form they can meaningfully participate in.
Case Study 12: Charlie (pseudonym)
Theme: Child-centred systems achieve better outcomes than service-centred systems
Policy Implication
Child-centred intervention starts with the child’s functional needs and then asks what therapeutic approach will give that individual child the best opportunity to develop them.
Children with similar developmental difficulties may learn and engage very differently. The clinical goals should remain rigorous. The pathway to achieving them should be individualised.
Case Summary
Charlie is a primary-school-aged child with developmental and motor difficulties affecting fine motor control, bilateral coordination, motor planning, sequencing, memory and problem-solving.
He also has significant strengths and interests in music, piano, Minecraft and science. Rather than treating these interests as separate from intervention, they became part of the clinical design of his music therapy program.
Minecraft symbols representing different items and “ingredients” were positioned across the piano. Charlie was given increasingly complex challenges requiring him to remember combinations, locate corresponding symbols, sequence actions and coordinate both hands to create Minecraft “recipes”. As his capacity increased, the therapist progressively increased the demands through longer sequences, more complex combinations, bilateral tasks and increasingly challenging problem-solving activities.
Minecraft music was incorporated into piano activities to create purposeful opportunities to practise functional use of the hands, bilateral participation, sequencing and coordinated movement within music-based tasks.
To Charlie, the activities involved Minecraft and music. Clinically, they provided repeated, purposeful opportunities to practise the functional motor and cognitive capacities being targeted.
Because the activities were meaningful to Charlie, he was motivated to persist and repeatedly attempt tasks he found challenging.
Clinical Significance
Charlie’s case demonstrates an important principle of child-centred intervention.
The child’s interests are not the therapeutic outcome. They are a pathway into therapeutic work. Music therapy integrated multiple functional capacities within meaningful musical activity, including: functional hand use and finger control; bilateral participation and coordinated movement; sequencing and working memory; attention and problem-solving; cognitive flexibility and persistence.
These skills require repetition and increasing challenge.
Rather than lowering expectations to accommodate Charlie’s interests, his interests were used strategically to help him access and persist with the clinical challenge.
Policy Consideration
A service-centred system asks: “Which service does a child with this difficulty usually receive?”
A child-centred system asks: ‘What is the child’s disability-related functional need, what supports their engagement and learning, and which appropriately qualified professional and evidence-informed therapeutic approach are best suited to address that need?’
For Charlie, music therapy provided a clinically appropriate pathway for addressing interconnected motor, cognitive and participation goals while using strengths that supported sustained engagement and repetition.
Genuine child-centred early intervention therefore requires access to a diverse range of appropriately qualified professionals and therapeutic approaches, selected according to identified functional need, professional scope and likely benefit for the individual child.
The goal should be consistent: meaningful functional development. The pathway should be individualised.
Conclusion
AMTA welcomes the NSW Government’s focus on strengthening foundational and disability supports for children and young people in New South Wales. This Inquiry, and the development of Thriving Kids, provides an important opportunity to design a system that is practical, child-centred and responsive to the diverse ways children communicate, learn, regulate, participate and develop.
The de-identified case studies in this submission highlight several consistent themes for policy design. Children and families benefit when early intervention is available at the right time and matched to functional need, when families have genuine access to a range of appropriate evidence-informed therapeutic approaches, and when support can flex in frequency, intensity and focus as children’s needs change. The case studies also show that meaningful outcomes extend beyond service access or therapy attendance. They include communication, agency, regulation, participation, family confidence, collaboration across settings, and increased capacity to participate in home, education, recreation and community life.
A sustainable foundational supports system should therefore preserve flexibility, recognise the value of qualified allied health professionals including registered music therapists, and enable supports to be delivered in ways that are accessible, safe and meaningful for each child.
AMTA welcomes the opportunity to work collaboratively with the NSW Government to support children and families through the successful implementation of Thriving Kids.
Contact Details
Amanda Quealy Chief Executive Officer Australian Music Therapy Association