2 October 2025
The Secretary
House Standing Committee on Health, Aged Care and Disability
Parliament House, Canberra, ACT, 2600
Dear Secretary
The Productivity Commission’s “Disability Care and Support” Inquiry Report of July 2011 set out the design of the National Disability Insurance Scheme (NDIS) by proposing three tiers of a future disability system: tier three as the NDIS for people with permanent and significant disability, tier two for those with mild to moderate disability, and tier one to enable social inclusion for people with disability across the entire Australian population.
The Inquiry into the Thriving Kids initiative is occurring in context of State and Territory Governments having mostly wound down their “tier two” services, previously delivered in support of people with mild to moderate disability never intended for enrolment in the NDIS. The shrinking in disability services for those with mild to moderate disability is the main cause of NDIS enrolment and cost blow outs. Reigning in NDIS cost blow outs can only be achieved by rebuilding programs for those with mild to moderate disability outside the NDIS itself, as was originally intended in the Productivity Commission’s design of the NDIS.
The not-for-profit sector, Ar’uma specifically, never ceased “tier two” programs to people with mild to moderate disability. Aruma delivered early intervention services to children and families before the NDIS, and over the last 20 years has developed its evidence based programs that build capacities for children and families across both metropolitan and rural regions.
Aruma’s message to the Inquiry is the not-for-profit sector has current and future capacity to deliver evidence based early intervention programs to children with mild to moderate developmental delay or disability. The Inquiry is encouraged to collate information on capacity of the not-for-profit sector to commence “Thriving Kids” program delivery from July 2026.
This submission of Aruma first provides case studies of Ar’uma’s current “Thriving Kids” type programs. The submission responds to the six Inquiry Terms of Reference. Annexure 1 lists Aruma’s current “Thriving Kids” type initiatives that can be adapted or expanded in future years.
redacted and my Early Intervention colleagues would welcome the opportunity to appear before the Inquiry to give evidence on the not-for-profit sector’s capacity to deliver “Thriving Kids” type programs. redacted additionally extend an invitation for the Inquiry to visit any of our early intervention services to see programs firsthand and speak to parents and caregivers about their benefits.
Yours sincerely
redacted
Dr Martin Laverty
Chief Executive
Summary
Aruma welcomes the opportunity to contribute to this important inquiry into how Australia can better support children with mild to moderate developmental delay, autism, or both. Our submission draws upon over 20 years of experience, particularly in early intervention and family support.
The Terms of Reference reflect a timely and necessary focus on early identification, community-based support, and inclusion, with an emphasis on equity for First Nations and culturally and linguistically diverse (CALD) families. Aruma supports a holistic, intradisciplinary, and inclusive approach, underpinned by evidence-based practice and aligned with international best practice.
Prior to the introduction of the National Disability Insurance Scheme, Aruma delivered community based early intervention services focused on supporting children and families through the provision of intentional supports and capacity building where the families and children lived, learned and played. Our teams were embedded in local communities delivering interdisciplinary support through early learning centres and schools with educators, allied health professionals and social workers working in partnership with families and communities to provide coordinated, collaborative care.
Aruma welcomes the opportunity for “Thriving Kids” to refocus support for children where they live, learn and play. The potential of the initiative is optimised by the recognition that children and families benefit from services that are joined-up, welcoming, knowledgeable and accessible.
Case Study One:\
Play Learn Connect!
Aruma delivers Play Learn Connect across NSW, Queensland and Victoria.
Play Learn Connect is a group-based program where children focus on functional skill development. Parents participate in targeted building of their confidence and capacity, and links to mainstream services are provided. Information and strategies that facilitate engagement, connection and learning are shared through parent or caregiver coaching.
The Play Learn Connect program starts by working with the child and family to understand their goals. Children participate in group-based sessions focused on skill building that facilitates goal achievement. Parents participate in the group program where strategies are coached to enable learning to continue at home.
The Aruma team connect with families at home or in the community and share strategies and support parents. The team also visit Early Learning Centres and support educators in modelling strategies to build learning and inclusion outcomes for children. This approach focuses on supporting the ability to transfer learning and skill development beyond a focused group environment to home and mainstream education services.
The program measures goal outcomes using the “Goal Attainment Scale Light,” to assure service efficacy of supports, coaching and interventions provided. The Team complete a review session with children and parents before program completion.
The cost effective model involves two staff (an educator, allied health professional or allied health assistant) working with a minimum of four children. The model delivers 24 hours of group supports, 3 hours of individual supports and 3 hours of targeted development and capacity building in the community.
The combined group and individualised supports have a unit cost of $110 per hour for 30 hours of overall support. (Travel to and from community connection and follow up is charged separately).
Parent Review
“Sam has been successful with his Play Learn Connect goals in the community. I have photos of Sam participating more with group activities in childcare, sitting with peers, and joining events like birthdays with joy and laughter, dancing, following and enjoying meals with peers. Sam is less fatigued at the end of term. We had a successful family holiday to Bali, with Sam happy to join another family with daily activities and meal. Sam shares a special connection with his younger brother, increasing eye contact and tolerating his ‘rough play’ and snatching of toys from him now that he is crawling. Sam is very gentle with him, and they are sharing moments of fun and laughter as he chases him.”
Case Study Two:\
Individual intervention - Capacity Building
Sally’s mum contacted Aruma looking for support to understand how she could support three year old Sally following her diagnoses of autism.
Sally’s mum indicated that she believed Sally required psychological intervention and behaviour support as she had an elevated level of behaviours which included: biting, kicking, pinching, pushing over furniture, verbal aggression and spending time in a darkened room.
Sally had been receiving Occupational Therapy Services from a clinic based private practice for some six months prior to contacting Aruma. Sally’s mum expressed a sense of being overwhelmed and suffering grief, and had recently resigned her employment as Sally was unable to consistently attend childcare, with the resignation placing the family under financial stress.
The Aruma Team started to work with Sally and her mum at home, building an understanding of their goals and needs. A lead practitioner model was used where Sally and her mum were supported by one practitioner who consulted with an interdisciplinary team to provide evidence-based play interventions and parent coaching.
Sally’s lead practitioner would work with Sally and her mum playing together at home or visiting the local park or shopping centre. It was in these places that Sally and her family live, play and learn that parent coaching occurred.
Parent Review
“I cannot believe that in less than 6 months my daughter is calm, talking to me, playing with her sister and can now wait for her turn. It’s life changing for us all.”
Sally and her family achieved their goals and no longer receive services from Aruma. Sally attends mainstream childcare regularly, and her parents report a high level of confidence in their knowledge of how to support Sally.
Response to Terms of Reference
Term of reference 1: Evidence-Based Information and Resources for Parents
Observations:
- Parents are often the first to notice developmental differences, but many lack access to timely, understandable, and culturally appropriate resources to inform their appropriate clinical interventions or parental responses to address mild to moderate childhood developmental matters.
- Tools such as the Ages and Stages Questionnaires (ASQ) and the Parents’ Evaluation of Developmental Status (PEDS) are valuable but not consistently available for access, use or supported application.
- There is a lack of coordinated distribution of developmental delay resources for parents through mainstream services such a General Practice, primary care, maternal and child health services, early childhood education providers and schools.
- Developmental delay information such as that available at Globaldevelopmentaldelay.com.au is illustrative of evidence based and freely accessible parental information that would benefit from being better promoted for awareness of parents utilising mainstream services.
- Inconsistencies in State and Territory developmental delay information and referral pathways detracts from benefits of a single, national, more visible gateway for information and parent support.
Recommendations:
- Establish a national, visible, multilingual developmental resource hub or gateway with clear, evidence-based milestones plans, accessible videos, and parent use tools.
- Embed developmental screening in mainstream universal touchpoints (e.g. immunisation visits, playgroups, preschool enrolment), and specifically through General Practice screening of all children at eighteen months and three years of age.
- Enable parent advocacy groups and lived experience organisations to better disseminate evidence based parent information. Illustrative organisations are Belongside Families, Kind, Parent to Parent.
Term of reference 2: Effectiveness of Programs and Initiatives
Observations:
- Significant variation exists across States and Territories in the delivery of universal services.
- Fragmentation between early education, health, and disability services creates delays in diagnosis and support.
- “Late intervention” for children with developmental delay, or the failure to provide sufficient early intervention resulting in later in life remedial cost responses, was found in O’Connell, M. 2025, The Cost of Late Intervention 2024, The Front Project, Melbourne, as contributing to longer term child protection, criminal justice and welfare costs. The image extracted from 2024 report below indicates these cost estimates.
The cost of late intervention continues to rise in Australia.
Our analysis shows that Australia spends $22.3 billion on late intervention for children and young people aged 0-24 each year. This is equivalent to $838 for every person in Australia every year or $2704 for every child and young person 0 to 24 years of age.
The greatest costs are for child protection (43%), the police, court and health costs of youth crime (14%); and welfare payments for unemployed young people (11%).
Since the first Cost of Late Intervention report was released in 2019, government spending on late intervention has continued to rise. In the following areas, spending has increased beyond what would be expected given inflation and population growth:
- Child Protection: 74% increase
- Youth Justice: 81% increase
- Family Violence: 110% increase
Recommendations:
- “Thriving Kids” resourcing should favour cross-sector early intervention using “lead” models guided by skilled professionals (allied health and social workers trained in child development and family capacity building) to support families build their own knowledge, skills and capacity in response to the specific needs of their child with a mild to moderate disability.
- The not-for-profit disability provider network has capacity, capability and national coverage to deliver “lead” model early intervention, and not-for-profit capacity should be utilised in addition to initiatives to be delivered by State and Territory Government services directly.
- Existing successful service models, such as ‘Child and Family Centres’ in Tasmania or Brighter Futures in NSW that offer wraparound supports from one location, should be maintained and expanded in response to evidence of their efficacy.
- Underrepresented communities subject to current or potential thin market failure warrant incentives to ensure a level of universal service access.
- Intergenerational socioeconomic disadvantage warrants targeting of services to support the interruption of future generational impacts.
Term of reference 3: Equity and Intersectional Issues
Observations:
- First Nations and CALD children continue to be under-identified and under-supported, often due to cultural stigma, language barriers, and lack of service visibility.
- Mainstream services are not consistently culturally safe or responsive.
- Mainstream Early Learning Services are not resourced to provide intentional learning supports for children and families in their everyday environment.
Recommendations:
- Prioritise support to community controlled First Nations-led early childhood services.
- Embed bilingual family liaison workers within universal child health and early education services.
- Mandate and fund ongoing cultural safety training for all professionals engaging with young children.
- Coordinate tiered service structures across life stages for those with mild to moderate disability: early childhood, primary school–aged, secondary school, and transition to employment. These services should be co-located within existing mainstream education, learning or community hubs.
Term of reference 4: Workforce Support and Training for Thriving Kids
Observations:
- There is a shortage of allied health professionals (particularly speech pathologists and occupational therapists) in regional and remote areas.
- Early childhood educators often lack confidence in recognising and supporting children with developmental delay.
- There is limited structured professional development pathways for allied health professionals involved in early interventions.
Recommendations:
- Develop a national professional development framework for early years professionals, aligned with Thriving Kids objectives, based on micro credentialling, peer mentors and ongoing practice supervision.
- Adopt incentives to attract and retain early childhood allied health professionals in rural areas.
- Expand use of interdisciplinary and key worker models to reduce workforce burden and improve family outcomes.
- Consider and trial a combined service model of allied health consultant practitioners and micro credentialed peer supports. Not-for-profit disability service providers operate governance and supervision frameworks and functional micro credentialing to skill workers in person centred capacity building supports for children and families.
Term of reference 5: Domestic and International Best Practice
Observations:
The following models offer examples of best practice:
- New Zealand’s Early Intervention Services (Ministry of Education): Government-funded, family-centred early intervention through a collaborative team model.
- Canada’s Infant Development Program (IDP): Provides home-based developmental support and coaching to families with children under 3.
- Sure Start (UK): Multi-agency centres offering early education, health, and parenting support in disadvantaged areas.
Common features include:
- Seamless integration of health, education, and disability support.
- Localised service delivery with community leadership.
- Strong focus on parental empowerment and capacity-building
Best practice early intervention supports parent capacity building and community inclusion in mainstream settings. Aruma has an extended history in NSW, Queensland, the ACT and Victoria in delivering supports that align to the child’s developmental needs while building parent capacity and enabling connection where children and families play, learn and live.
Recommendation:
- The “Thriving Kids” initiative should adopt as a design objective enabling access to parent capacity building services where children and families learn, grow, and play. A growing body of research supports multi-tiered systems of support in early childhood intervention and care which organise practices based on the level of support each child and their family require in the setting of their daily lives. Tiered models of support typically include:
- Universal practices used with all children to support their learning and development.
- Targeted practices focusing on specific skills for children who need additional support.
- Individualised, intensive support for children with the highest levels of need.
These tiers of support incorporate explicit instruction, delivered by practitioners focused on outcomes able to be measured. Aruma has invested in its teams to have the necessary skill and capability to deliver effective evidence based tiered services and supports.
Term of reference 6: Seamless Transition Through Mainstream Systems
Observations
- Families report the process of accessing early supports and capacity building as overwhelming, with repeated assessments and lack of continuity.
- Poor communication between early childhood, primary school, and health providers contributes to service gaps. These service gaps continue and widen through secondary school, further learning and employment.
- Access to community-based programs for children with developmental delays can be complex with community facilitators and coaches lacking the training and support to build inclusion
Recommendations:
- Enable development of transition plans for all children identified with developmental delay by age 3, co-developed with families, ideally facilitated through a specific Medical Benefits Schedule item number for administration by credentialed allied health practitioners.
- Improve data sharing and referral pathways across health, education, and disability systems, with appropriate safeguards, through use of either systems navigators or a early childhood gateway.
- Coordinate access to universal, targeted and individualised supports in different communities through identification of either systems navigators or early childhood gateway providers from the existing network of not-for-profit providers of early childhood and disability services.
- Expand visibility of telehealth access in rural and remote communities.
Conclusion
The “Thriving Kids” initiative has opportunity to:
- Focus on evidence-based coaching to build parent capacity to respond to the developmental needs of children with mild to moderate disability in mainstream settings where children and families live, work and play.
- Utilise the existing and future capacities of the not-for-profit early childhood intervention and disability sector to raise visibility of current and new service options outside the NDIS.
- Expand existing programs with evidence of efficacy, rather than replicate, while targeting new initiatives into underserved thin markets.
Annexure 1 - Aruma’s current “Thriving Kids” type programs
Aruma is a human rights charity, that operates disability services nationally across 550 locations. With 5,500 staff, it supports 5,000 people with disability in services inclusive of:
- Early childhood intervention services;
- Allied health therapies and Behavioural Support;
- Out-of-home care for children and young people;
- Transition from school to work;
- Supported employment in social enterprises inclusive of hospitality, agriculture, metal fabrication, facilities maintenance, commercial laundry services. commercial baking and medical packaging;
- Community inclusion;
- Individual and group accommodation options.
The following tables illustrate Aruma’s “Thriving Kids” type programs that have capacity to be expanded in future years.
| PROGRAM NAME: | Lismore Transition Program |
|---|---|
| TARGET CLIENT: | 4–5 year olds in Transition to School year with developmental delays or behavioural challenges, and families with complex needs. Children are supported to be ready to make a happy and successful start at school. The program builds school readiness through social and emotional self-regulation skills, together with communication, physical and cognitive skills. The program coaches families to respond to their child’s needs and enable their child to feel confident about starting school. |
| PROGRAM GOALS & OUTCOMES: | - Families have knowledge, skills and support to address children’s needs. - Families support child development through secure attachments, social connectedness and play. - Children and families experience positive, healthy relationships. - Families have knowledge of and are connected to housing, social support and family and domestic violence services. - Children and families experience streamlined, integrated and responsive, culturally informed services. - Services have knowledge of, and connect with local Elders, cultural knowledge holders and community leaders. Services and programs provide opportunities for children and families to connect to culture. Aboriginal and Torres Strait Islander children and families experience social and emotional wellbeing. |
| IMPACT DATA OR EVIDENCE BASE: | Score data from DSS DEX for 2024 cohort indicates overall increased school readiness outcomes achieved. |
| PROGRAM NAME: | MyTime playgroup — Lismore and Tamworth |
|---|---|
| TARGET CLIENT: | Families with children with developmental delay or disability, or chronic medical condition |
| PROGRAM GOALS & OUTCOMES: | MyTime 5 principles are: - I am inclusive - I create a safe space - I am member-led - I am strengths-based - I build members’ knowledge and skills |
| IMPACT DATA OR EVIDENCE BASE: | MyTime, supported by Playgroups NSW, has guiding principles aligned with evidence-informed practices such as Motivational Interviewing, strength-based practice, and inclusive practice. |
| PROGRAM NAME: | Specialist (Positive) Behaviour Support |
|---|---|
| TARGET CLIENT: | Children, young people and adults with mild, moderate or significant disability demonstrating persistent behaviours of concern that significantly limit their quality of life or pose a risk of harm to themselves or others. |
| PROGRAM GOALS & OUTCOMES: | - Reduce the frequency and intensity of behaviours of concern through proactive and person-centred coaching strategies for family members and caregivers by trained behavioural support practitioners. - Enhance the client’s quality of life, autonomy, and participation in meaningful activities. - Support staff and carers with clear, evidence-based strategies to respond safely and effectively. - Implement safeguards, including restrictive practices where clinically justified, to prevent harm while working toward reduction and elimination. - Promote skill development and environmental adjustments that reduce triggers and increase coping mechanisms. |
| IMPACT DATA OR EVIDENCE BASE: | - Grounded in clinical justification and functional behaviour assessment (FBA). - Evidence-based interventions include environmental modifications, proactive support strategies, reactive response protocols, and restrictive practices when necessary. |
- Data collected through incident reports, behaviour tracking, and quality-of-life measures demonstrate reductions in harm and improvements in engagement.
- Practitioner capability across the program supports high-quality implementation:
- Core: 43 practitioners (72.88%)
- Proficient: 13 practitioners (22.03%)
- Advanced/Specialist: 5 practitioners (8.47%)
COVERAGE
- Queensland (QLD): Windsor, Brisbane, Gold Coast, Sunshine Coast, Toowoomba, Loganholme, Beenleigh
- New South Wales (NSW): Central Coast, Sydney, Western Sydney, Southern Highlands, South Coast, Illawarra, Mid North Coast, Newcastle
- Australian Capital Territory (ACT)
- Victoria (VIC): Metro Melbourne and selected regional areas including Swan Hill through to Ballarat
| PROGRAM NAME: | Play Learn Connect |
|---|---|
| TARGET CLIENT: | Children with developmental delay or disability. Aged between 3–6 years old, children are allocated to a group of peers (4–6 others) based on age and participation requirements. |
| PROGRAM GOALS & OUTCOMES: | Designed to support children to participate in daily activities, achieving functional outcomes: - Improved social and communication skills with peers - Improved participation and inclusion in activities. - Improved understanding of emotions both in themselves and others. - Expanding on cognitive skills including problem solving, attention and focus. Developing motor skills, including body-awareness and strength. Carer coaching and support for capacity building, providing opportunities for carers to learn strategies to support their child’s development at home and in the community. |
| IMPACT DATA OR EVIDENCE BASE: | The group focus on developing skills in a child and family’s everyday life and is based on a hybrid model which includes: - Group-based programs - Support within the home and community Play Learn Connect is based on evidence informed programs and incorporates aspects of social thinking, emotional regulation, play focused learning and fine and gross motor skill development. |