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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 preventative care. In paediatric 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, behavioural distress, social isolation, and family stress. Preventative and relationship-based intervention is often more effective, less intensive, and more economically responsible than responding only once difficulties escalate.
The long-term societal and economic impacts of insufficient early support should also be carefully 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 attempting to coordinate care and manage increasing functional needs at home.
Another important concern is that children with moderate but significant support needs may fall into 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 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 paediatric 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 narrow 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
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