Submission 1745

To Whom It May Concern,

I am writing as a Grade 2 Occupational Therapist working in private paediatrics in metropolitan Australia. Over the past three and a half years, I have supported neurodivergent children and young people, including autistic children, ADHD children, children accessing early intervention supports, and children with developmental delays.

I recognise the importance of ensuring the long-term sustainability of the NDIS and support thoughtful reform. However, I have significant concerns regarding the potential impact of reducing or delaying access to early intervention and allied health supports for children and young people with disability and developmental differences.

In paediatric practice, disability and functional capacity are rarely static. Many children experience fluctuating challenges that may not be fully captured through brief or highly standardised reassessments. Neurodivergent children in particular may mask difficulties in unfamiliar environments, while continuing to experience significant sensory overload, emotional exhaustion, executive functioning difficulties, and reduced participation across daily life.

There is concern that children with moderate but meaningful support needs may increasingly fall through service gaps if thresholds become more restrictive. These children may not always present in visible crisis; however, without timely support their functioning, mental health, school engagement, and long-term independence can deteriorate significantly over time.

As clinicians, we regularly see the benefits of early and preventative intervention. Supports that strengthen emotional regulation, communication, sensory processing, daily living skills, and participation can reduce the need for more intensive supports later. In contrast, delayed intervention often results in escalating distress for children and families, increased school difficulties, and greater reliance on health, education, and social systems over time.

Submission 1745

There is also concern that funding systems may unintentionally reward crisis rather than prevention. Families should not have to wait until a child reaches significant burnout, disengagement, or mental health decline before support is considered necessary.

The repeated need for families to continually “prove” disability through reassessments can also place considerable emotional and financial strain on parents and carers. Many families are already navigating complex advocacy demands across healthcare, school, and community systems while managing their child’s support needs.

The broader economic impacts should also be carefully considered. Insufficient early support may contribute to:

• reduced workforce participation for both children and parents over time,
• increased reliance on welfare and mental health systems,
• greater pressure on schools and public services, and increased long-term societal costs.

From a workforce perspective, many experienced paediatric clinicians now work within private practice settings. Significant instability within the private allied health sector risks worsening workforce shortages, increasing waitlists, and reducing access to care for children and families.

Finally, continuity of care and trusted therapeutic relationships are essential in paediatric practice. Neuroaffirming, relationship-based, and flexible supports are often what enable children to participate meaningfully in therapy, school, family life, and the community.

I support balanced reform that protects the sustainability of the NDIS while also recognising the long-term value of early intervention, preventative supports, and functional participation-based care. Investment in appropriate supports early is not only beneficial for children and families, but also economically responsible in the long term.

Submission 1745

Kind Regards,

Emily Engelbrecht (she/her)

Occupational Therapist