Senate Inquiry submission regarding the National Disability Insurance
Scheme Amendment (Securing the NDIS for Future Generations) Bill
2026
I am a paediatric occupational therapist working in regional Queensland. Through my work with children and families across rural and remote communities, I have significant concerns about the potential unintended consequences of reforms that reduce access to developmental and capacity-building supports for children with disability and developmental challenges, particularly children older than eight years of age who may not be eligible for Thriving Kids but who continue to have substantial functional support needs.
Developmental needs do not end at eight years of age
A major concern is the creation of a service gap for children older than eight years who require ongoing intervention but may not qualify for Thriving Kids supports.
While early childhood intervention is critically important, developmental progress does not stop when a child turns eight. Children continue to develop essential skills throughout late childhood and adolescence, including emotional regulation, executive functioning, social participation, self-care, independence, community access, and daily living skills.
In clinical practice, many families do not seek support until their child is older and challenges become more apparent as environmental demands increase. Some children receive diagnoses later in childhood, while others experience increasing diƯiculties as social, academic, and independence expectations grow. These children may not meet Thriving Kids eligibility requirements, yet still require skilled intervention to build functional capacity and support meaningful participation in everyday life.
Creating a funding cliƯ at eight years of age risks excluding children who continue to require intervention during critical developmental periods. The developmental needs of children do not disappear when they turn eight, and reducing access to supports at this stage may have lifelong consequences.
Early intervention and capacity building reduce future support needs
Occupational therapy and other allied health interventions support the development of skills that promote independence and participation across the lifespan. These interventions target communication, self-care, emotional regulation, social participation, motor skills, executive functioning, and daily living skills.
Many children who access therapy are not receiving treatment for a temporary issue; they are building foundational skills that can reduce their long-term reliance on support
systems. The purpose of these interventions is often to increase independence and reduce future support needs.
Children who are likely to access the NDIS as adults are particularly aƯected by this issue. Without opportunities to build functional skills throughout childhood and adolescence, there is a risk that they will enter adulthood with greater support needs than they otherwise would have had.
Rather than reducing demand on the NDIS, limiting access to capacity-building supports may simply delay that demand until individuals present with more significant and complex needs when they are older. This risks increasing long-term costs across disability, health, education, and mental health systems.
Cost-shifting to families creates inequitable outcomes
Families raising children with disability often face substantial financial pressures. Therapy costs, travel expenses, specialist appointments, educational supports, assistive equipment, and reduced workforce participation can create significant financial strain.
Families with greater financial resources may still be able to privately access occupational therapy and other interventions. Families experiencing financial hardship often cannot.
This creates a situation where access to developmental support becomes dependent on a family’s financial circumstances rather than a child’s functional needs.
As costs increase, some families are likely to delay seeking support or cease accessing services altogether. In practice, many families already access services only when challenges have become significant and are aƯecting multiple areas of life. Delayed intervention frequently results in poorer outcomes and more intensive support requirements later.
Some children cannot access school-based supports
There is often an assumption that schools can provide alternative support pathways for children who are unable to access community-based intervention. However, this assumption does not reflect the reality faced by many families.
The goals of paediatric occupational therapy commonly extend beyond educational participation and include self-care, emotional regulation, independence, community participation, family routines, safety, sensory processing, and daily living skills. These needs are often outside the scope of school-based supports.
It is also important to recognise that not all children with disability are able to access educational services.
In my clinical experience, I have worked with children whose disabilities and functional challenges are so significant that they are unable to participate not only in mainstream schooling but also in distance education programs. Some families pursue homeschooling because their child is unable to engage with available educational models due to the impact of their disability.
These children are among the most vulnerable and functionally impacted members of the community. Because they are unable to access traditional schooling or distance education, they may also be unable to access supports linked to the education system.
For these families, community-based allied health services may be the primary source of specialised developmental support. Reducing access to these services risks leaving some children with no meaningful pathway to intervention.
Parents are not therapists
Families play an essential role in supporting their children, and eƯective therapy relies on collaboration between therapists and caregivers. However, parents are not therapists and should not be expected to independently deliver specialised interventions without professional guidance.
Many families require direct coaching, modelling, observation, and problem-solving tailored to their child’s specific needs. Written resources, handouts, or general advice are often insuƯicient for children with complex developmental, behavioural, sensory, or functional challenges.
Reducing access to professional intervention places increasing responsibility on families without providing them with the expertise, capacity, or support necessary to meet their child’s needs.
Impacts on family wellbeing and mental health
The eƯects of reduced support extend beyond the child. Families caring for children with disability frequently experience high levels of stress, social isolation, financial pressure, and caregiver burnout.
When children are unable to access timely supports, challenges within the home often increase. DiƯiculties with emotional regulation, behaviour, communication, participation in daily activities, and family routines can place significant strain on parents and siblings.
The financial burden associated with privately funding therapy can further increase family stress and may result in some families foregoing support altogether.
Over time, these pressures can contribute to poorer mental health outcomes for caregivers and children. Children and young people with disability already experience
elevated rates of mental health diƯiculties compared with their peers. Reduced access to capacity-building supports may further increase this vulnerability.
Regional and rural communities are particularly vulnerable
Workforce shortages already present a significant challenge in regional and rural Queensland. Access to paediatric occupational therapists is limited, and waiting lists can be extensive. At my current workplace, waiting lists have frequently exceeded two years.
If funding reforms reduce access to paediatric therapy services, there is a substantial risk that therapists will seek employment in other areas of occupational therapy or leave paediatric practice entirely.
This would have significant consequences for regional and remote communities, where recruitment and retention of skilled clinicians is already diƯicult. Once experienced therapists leave the sector, rebuilding that workforce may take years.
There is also a risk that fewer students and graduates will choose careers in paediatric disability services if opportunities within the sector become less viable. This may further reduce the availability of skilled clinicians for children and families living outside metropolitan areas.
Conclusion
While reforms may aim to improve sustainability within the disability system, there is a significant risk that reducing access to developmental and capacity-building supports for children older than eight years will create unintended long-term consequences.
Children continue to develop critical functional skills throughout childhood and adolescence. Limiting access to intervention during these years risks increasing future support needs, worsening outcomes for children and families, and shifting costs to other government systems rather than reducing them.
The impacts are likely to be particularly severe for families experiencing financial hardship, children who cannot access educational support pathways, and communities in regional and remote Australia where workforce shortages already limit access to services.
I encourage policymakers to carefully consider the long-term economic, workforce, developmental, and mental health implications of creating a service gap for children who continue to require support after eight years of age. Investment in capacity-building interventions during childhood and adolescence is not only beneficial for children and families—it is also a critical investment in reducing future support needs and promoting long-term participation, independence, and wellbeing.