Submission No 105
INQUIRY INTO FOUNDATIONAL AND DISABILITY SUPPORTS AVAILABLE FOR CHILDREN AND YOUNG PEOPLE IN NEW SOUTH WALES
Organisation: Australian Physiotherapy Association Date Received: 18 September 2026
Select Committee Inquiry on Foundational and Disability Supports Available for Children and Young People in New South Wales
Submission by Australian Physiotherapy Association (APA) September 2026
Authorised by:
Rob LoPresti Chief Executive Officer Australian Physiotherapy Association Level 1, 1175 Toorak Rd Camberwell VIC 3124
Acknowledgement of Traditional Owners
The APA acknowledges the Traditional Custodians of Country throughout Australia and their connections to land, sea and community.
We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander Peoples today.
About the Australian Physiotherapy Association
The Australian Physiotherapy Association’s (APA) vision is that all Australians will have access to quality physiotherapy, when and where required, to optimise health and wellbeing, and that the community recognises the benefit of choosing physiotherapy. The APA is the peak body representing the interests of Australian physiotherapists and their patients. It is a national organisation with state and territory branches and specialty subgroups.
The APA represents more than 37,000 members. The APA corporate structure is one of a company limited by guarantee and is governed by a Board of Directors elected by representatives of all stakeholder groups within the Association. Of the potential nine Directors, seven must be financial members of the APA, and up to two may be external, non-physiotherapist Directors.
We are committed to professional excellence and career success for our members, which translates into better patient outcomes and improved health conditions for all Australians. Through our National Groups we offer advanced training and collegial support from physiotherapists working in similar areas and are committed to embedding cultural safety within the organisation, policy and education programs.
Table of Contents
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Table of Contents
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References
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Executive Summary
The Australian Physiotherapy Association (APA) welcomes the opportunity to provide updated
evidence to the Select Committee. This submission supplements APA’s April 2025 submission and
draws on APA’s October 2025 Commonwealth Thriving Kids submission and February 2026 NSW
Market Insights submission (APA 2025a; APA 2025b; APA 2026).
Thriving Kids is an important opportunity to identify developmental concerns earlier and provide
children and families with timely, evidence-based support. Its success should be measured not
simply by reduced demand for the NDIS, but by whether children are identified earlier, receive
appropriate support sooner and achieve better functional, participation and wellbeing outcomes.
Physiotherapy should be embedded throughout the Thriving Kids model, rather than positioned
primarily as a downstream targeted support. Movement differences are often among the earliest
signs of developmental concern. Physiotherapists can identify red flags, assess functional needs,
commence early intervention and support participation through approaches including caregiver
coaching. Clear pathways are particularly important during infancy and the first 1,000 days, when
intervention can have the greatest impact.
NSW should also build on the established paediatric physiotherapy workforce across public,
community-controlled, not-for-profit and private sectors. Commissioning must support coordinated
multidisciplinary care, outreach, workforce development and the full range of activities required to
deliver effective services, particularly in rural and regional communities.
The APA recommends that NSW:
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Embed and fund physiotherapy throughout the Thriving Kids model, including early identification, assessment, intervention and caregiver coaching.
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Establish clear infant and early childhood pathways so developmental concerns are identified and addressed as early as possible.
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Commission across sectors and fund coordinated care, drawing on existing local capacity and investing in workforce sustainability.
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Monitor and publicly report access, quality, outcomes and unmet need, with a funded response when service gaps are identified.
These measures will help ensure Thriving Kids delivers earlier identification, equitable access,
coordinated care and measurable improvements for children and families.
1. Fund timely physiotherapy access
Thriving Kids is designed to identify children with additional developmental needs as early as possible, when timely, evidence-based supports can make the greatest impact.
Movement differences are often among the earliest signs of developmental concern. Physiotherapists play a critical role in identifying developmental differences, assessing functional needs, supporting participation and improving trajectories, including through caregiver coaching.
Physiotherapists can triage children effectively, identify red flags that may indicate more complex conditions and refer for further investigation while commencing appropriate early intervention.
Without physiotherapy involvement in screening, neurological and musculoskeletal conditions may go unrecognised or be identified later than necessary. This can delay diagnosis, referral and access to appropriate intervention during a critical period of child development.
Thriving Kids should embed physiotherapy throughout the model rather than positioning it as a downstream, targeted support with access delayed until concerns have become more complex.
The APA’s previous submissions evidence the value of physiotherapy across infant health, community, early learning and school settings (APA 2025a; APA 2025b; APA 2026). NSW should harness this value within a delivery model guided by the National Best Practice Framework for Early Childhood Intervention.
The Framework, as well as associated tools and resources, should guide the development and delivery of Thriving Kids programs and services with commissioning enabling individual supports, groups, caregiver coaching and educator consultation.
2. Establish clear infant and early childhood pathways
Research indicates that the greatest opportunity to influence developmental outcomes occurs during the first 1,000 days, when neuroplasticity is greatest.
Physiotherapists are trained in anatomical, musculoskeletal, respiratory and neurological examination. This broad scope positions them as essential first-line supports for children with movement and developmental differences.
Early motor delays can emerge well before a formal diagnosis and provide the first indication of severity and need for additional support. Physiotherapists use recognised assessments, including the General Movements Assessment and Hammersmith Infant Neurological Examination, to identify children who may require targeted referral or investigation.
NSW should prioritise clear pathways from infant health contacts, primary care and early childhood services, so motor concerns identified earlier receive a timely response ensuring identification and support is available in infancy before the planned age-three Medicare Healthy Kids Check.
Physiotherapists are able to identify concerns and commence appropriate intervention in these early days while a child is awaiting further investigations. Screening and support with appropriate professionals in the first 1,000 days is critical to the delivering on the intent of Thriving Kids (APA 2025a; APA 2025b; APA 2026).
3. Commission across sectors, and fund coordinated care
Commissioning should draw on the expertise and established relationships of public, community-controlled, not-for-profit and private providers. The objective is timely access to quality early intervention for children and families. Commissioning arrangements should reflect that objective.
NSW currently permits only time-limited subcontracting with for-profit allied health providers. NSW should assess whether these arrangements risk reducing local capacity or disrupting established care relationships.
An established paediatric physiotherapy workforce currently delivers supports in communities across NSW. If the new system fails to utilise this workforce, existing capacity will be lost as demand grows, undermining the reform’s ability to deliver timely early intervention.
Existing providers are already embedded within local health systems and maintain established relationships with referrers, families and other health professionals. Commissioning arrangements should build on these networks rather than duplicate them.
The APA’s February Market Insights submission outlined the value of coordinated networks that connect physiotherapists and other allied health professionals with early childhood services, including playgroups, preschools and schools and recommends funding the activities necessary for effective multidisciplinary care. To deliver on best practice early intervention, funding must cover assessment and intervention as well as case conferences, educator consultation, documentation, travel, interpreting and supervision where required.
The need for investment in paediatric training, supervised placements, mentoring and retention, with particular attention to rural and regional capacity were further identified through the NSW community consultation findings (Insight Consulting Australia 2026).
The Government’s response to the committees interim report identifies travel subsidies as outside the program’s scope. NSW should therefore explain and fund how children unable to travel will receive appropriate care, including through outreach or other identified arrangements (NSW Government 2026). Outreach should also reach children outside early childhood settings and families facing barriers to formal referral pathways.
4. Make access, quality and unmet need visible
NSW’s announced funding is capped over five years to June 2031. Transparent demand monitoring is essential to show whether that allocation meets needs.
A small set of measures should track uptake as well as time from referral to assessment and first support; progress towards child and family goals; and family experience.
Access measures should identify regional disparities and barriers affecting priority populations.
NSW should establish a funded response to identified gaps, with criteria for adjusting capacity, outreach or support arrangements. Independent evaluation should examine service quality, equity, participation and family wellbeing, including unintended consequences of reform across health, education and disability systems.
References
Australian Physiotherapy Association (APA) 2025a. Submission to the NSW Select Committee on Foundational and Disability Supports Available for Children and Young People. April. https://australian.physio/sites/default/files/submission-2025- 04/APA_Submission_NSW%20Foundational%20Supports_%20April%202025.pdf
APA 2025b. Submission to the Inquiry into the Thriving Kids initiative. October. https://australian.physio/sites/default/files/submission-2025- 11/APA_Submission_Inquiry_into_the_Thriving_Kids_initiative_Oct_2025.pdf
APA 2026. NSW Market Insights regarding Foundational Supports for Children. Submission to the NSW Department of Communities and Justice. February. https://australian.physio/sites/default/files/submission-2026- 02/APA_%20NSW_Market_Insights_Foundational_Supports_Submission_Feb_26.pdf
Australian Government Department of Health, Disability and Ageing 2025. About the National Best Practice Framework for Early Childhood Intervention. Updated 2 October. https://www.health.gov.au/our-work/national-best-practice-framework-for-early-childhood-intervention/about
Insight Consulting Australia 2026. NSW community consultation report – Foundational supports for children. https://dcj.nsw.gov.au/documents/community-inclusion/disability-inclusion/thriving- kids/Foundational_Supports_for_Children_Community_Consultation_Report_-_January_2026.pdf
NSW Government 2026. Response to the first report of the Select Committee on Foundational and Disability Supports Available for Children and Young People in NSW. https://files.parliament.nsw.gov.au/fileapi/ParlFiles/GetArtifact?serverRelativeUrl=/lcdocs/inquiries/3080/Government+response+o n+interim+report+- +Foundational+and+Disability+Supports+Available+for+Children+and+Young+People+in+New+South+Wales.pdf
Select Committee 2026. Foundational and Disability Supports Available for Children and Young People in New South Wales. Report 1. https://files.parliament.nsw.gov.au/fileapi/ParlFiles/GetArtifact?serverRelativeUrl=/lcdocs/inquiries/3080/Report+No+1+-+SC+-+Disability+support+-+FINAL.pdf