From: Lucy ST Sent: Wednesday, 20 May 2026 14:18 To:
Subject: NSW Thriving Kids - Importance of Including Private Paediatric Providers in the NSW Thriving Kids Reform
Dear Ministers, MPs, department representatives, Speech Pathology Australia, and stakeholders,
I am writing as an early career Speech Pathologist working within a private multidisciplinary paediatric practice in metropolitan Australia. Prior to becoming a Speech Pathologist, I worked for two years as an Allied Health Assistant in speech pathology while completing both undergraduate (3 years) and postgraduate (2 years) studies.
I currently support children and young people from culturally and linguistically diverse communities with a broad range of developmental, communication, swallowing, feeding, learning, behavioural, and psychosocial needs, including autism, developmental language disorder, dyslexia, ADHD, intellectual disability, mental health challenges, and complex communication difficulties.
I appreciate the importance of ensuring the long-term sustainability of the NDIS and recognise the need for reform. However, I would like to express concern regarding proposed changes that will likely reduce, delay, and narrow access to early intervention and ongoing allied health supports for children and young people with communication and swallowing/feeding difficulties.
From a clinical perspective, early intervention and maintenance supports are not simply short- term therapies. They are protective and preventative supports that help children participate meaningfully in daily life, education, relationships, communication, emotional regulation, and community engagement. In many cases, consistent support reduces the likelihood of more intensive needs later in life.
In practice, I regularly see children who appear to cope reasonably well in one environment but experience significant functional challenges across the full demands of daily life. This is particularly relevant for children with autism, ADHD, psychosocial disability, sensory processing challenges, learning difficulties, and fluctuating functional capacity. Many children mask difficulties at school or during formal assessments, often at considerable emotional and cognitive cost. Families frequently report that after school, children experience shutdowns, meltdowns, exhaustion, anxiety, emotional dysregulation, or an inability to participate in basic daily routines.
This raises concern regarding highly standardised or snapshot-style reassessments being used to determine ongoing support eligibility. Functional capacity cannot always be accurately captured within a brief assessment environment. These assessments may not reflect the cumulative
demands placed on a child across home, school, social, and community settings, nor the significant effort required to maintain participation. There is a risk that children and young people with genuine and ongoing functional challenges may lose access to supports simply because their difficulties are less visible in structured settings.
Repeated reassessment processes can also place substantial emotional and financial strain on families. Many parents describe the experience of continually needing to “prove” their child’s disability as exhausting, distressing, and demoralising. This can undermine trust in systems that are intended to support participation and wellbeing.
I am also concerned that funding systems may unintentionally reward visible crisis over infrastructure preventative care. In pediatric practice, we often see that when supports are reduced too early, children may later present with more significant educational disengagement, school refusal, mental health concerns, behavioral distress, social isolation, and family stress. Preventative and elationship-based intervention is often more effective, less intensive, and more economically esponsible than responding only once difficulties escalate.
The long-term societal and economic impacts of insufficient early support should also be caredfully considered. Reduced access to timely intervention may contribute to: • lower workforce participation across the lifespan, • increased reliance on welfare and income support, • higher mental health and healthcare costs, greater pressure on schools and public systems, • reduced independence and community participation, and the loss of individual potential, productivity, and contribution.
There are also significant impacts on parents and carers. When children cannot access adequate supports, parents often reduce work hours, leave employment, or experience burnout while tempting to coordinate care and manage increasing functional needs at home.
Another important concern is that children with moderate but significant support needs may fall to service gaps if eligibility thresholds become too restrictive. Many children may not meet criteria for acute or severe disability supports, yet still experience substantial barriers to infrastructure participation, communication, learning, emotional regulation, and independence. Without support, these challenges often compound over time.
I also wish to highlight the importance of continuity of care and trusted therapeutic relationships. effective pediatric therapy is built on consistency, rapport, collaboration with families and schools, and an understanding of the child’s individual strengths, needs, culture, and environment. Flexible and neuroaffirming support models allow clinicians to respond to functional participation goals in meaningful and practical ways, rather than relying solely on arrow deficit-based measures.
Finally, I would like to acknowledge the role of the private allied health sector within the broader disability system. Many experienced paediatric clinicians now work in private practice settings, often due to workforce pressures across public systems. If reforms destabilise the viability of
-
private allied health services, this may worsen existing workforce shortages, increase waitlists,
-
and further reduce access to care, particularly for families already experiencing disadvantage or
-
barriers to support.
I support balanced and sustainable reform of the NDIS. However, I strongly encourage that reforms remain grounded in real-world functional outcomes, early intervention principles, and the long-term social and economic benefits of supporting children early and consistently. Sustainable systems should not only manage immediate costs, but also protect the future participation, wellbeing, and independence of children and young people with disability.
Thank you for considering this submission and the experiences of clinicians, children, and families working within the current system.
I am very looking forward to hearing your response.
Kind regards, Lucy McLean
Speech Pathologist (CPSP, MSLP) Leapfrog Therapy
Office Phone: P| Lucey Office Fait: McLean (she/her ( ) Website: www.leapfrogtherapy.com.au
Speech Therapist
**“THI
SPEECH AND OCCUPATIONAL THERAPY FOR**
Leapfrog Therapy would like to acknowledge and show their respects to the Wurundjeri Woi-wurrung and Wallumedegal people, who are the Traditional Custodians of the Land on which our clinics are situated.
The information contained in this e-mail message and any attached files may be confidential information. If you are not the intended recipient for any use, disclosure or copying of this e-mail is unauthorized. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and delete all copies of this transmission together with any attachments