NDIA Accountability Project

Submission 130 — Mr Kai Meng Reuben Seah — Inquiry into the Thriving Kids initiative

‹ PrevPage 1 of 18 · Source p. 1Next ›

Submission to the Thriving Kids Inquiry

1. Executive Summary

This paper has been prepared in response to the Thriving Kids inquiry, to ensure the voices of families, practitioners, and communities are represented in shaping a system that is both evidence-based and equitable.

As provided in this submission research demonstrates that early intervention is most effective when it is tailored to the unique developmental profile of each child and embedded within family and cultural contexts. The Thriving Kids Initiative represents an important opportunity to build a more inclusive, responsive, and sustainable system of early supports. To realise this potential, it will be critical to ensure continuity of care, embed relationship-based approaches, and safeguard equity for all families.

Without incorporation of intensive individualised supports that are neurodiversity affirming, the initiative risks undermining children’s rights, limiting family choice and control, and reducing access to evidence-based, individualised support.

Key points emphasised in this submission include:

  • The importance of continuity between existing NDIS supports and Thriving Kids to avoid loss of essential support for children and families.
  • Ensuring family choice and control through flexible, individualised supports.
  • Embedding DIRFloortime as a developmental, relationship-based, and neurodiversity-affirming practice that directly aligns with Thriving Kids’ objectives.
  • Providing sufficient time to prioritise cultural safety and engage in genuine co-design with First Nations and Culturally and Linguistically Diverse (CALD) families.
  • Preparing and equipping educators and allied health with evidence-based, trauma-informed, and culturally responsive training.

Australia has the opportunity to design a world-leading system of early childhood support by ensuring a safe, staged transition and aligning Thriving Kids with developmental best practice.

1 of 18

TABLE OF CONTENTS

Introduction

We represent DIRFloortime certified practitioners and advocates in Australia with collective expertise in supporting Autistic children and children with developmental differences, alongside their families, to build capacity, inclusion, and participation in everyday life (see Appendix B for list of signees).

DIRFloortime (Developmental, Individual-differences, Relationship-based) is an evidence-based framework that focuses on building developmental capacities through nurturing relationships and following the child’s lead. For further detail on its alignment with national policy, refer to Appendix A.

We support the aims of providing earlier identification of support needs, strengthening mainstream supports, and establishing alternatives to the NDIS. To achieve these aims, the proposed initiative “Thriving Kids” must prioritise continuity of care, collaborative co-design, and evidence-based approaches including individualised supports that safeguard children’s rights and family wellbeing.

2 of 18

ToR 1 – Evidence-based information and resources for parents

  • Online resources and generalised training can be valuable complements, but direct, sustained early intervention from trained professionals is essential for long-term developmental progress. This is because children’s developmental needs are complex, and research consistently shows that personalised, relationship-based support produces stronger long-term outcomes than information alone (Jeong et al., 2021).
  • Families benefit most from flexible, individualised supports that recognise functional realities rather than broad diagnostic categories (e.g. mild, moderate severe). Research and autistic advocates critique sole reliance on these diagnostic levels as overly simplistic (Weitlauf et al., 2014; Kapp, 2023).
  • Individualised relationship-based supports such as DIRFloortime have demonstrated improvements in communication, emotional regulation, and developmental milestones with a strong emphasis on upskilling caregivers (Divya et al., 2023; Solomon et al., 2014).

Key Point: Caregiver capacity-building is central to DIRFloortime and directly supports Thriving Kids’ goals of strengthening family capability. Families cannot only rely on generalised supports that will not consider their individual profiles. DIRFloortime is an evidence based approach that meets this need.

ToR 2 – Effectiveness of current and previous programs

  • Universal programs are important but cannot fully address complex and diverse needs. It is important for them to assist alongside individualised support delivered by trained health professionals especially for CALD communities (Newton et al., 2025).
  • Empowering families to have choice and control over services they access is essential to family centered practice, which promotes stronger healthcare outcomes. Removing access to choice of individualised supports disempowers families and leads to further power imbalance in the therapeutic relationship.

3 of 18

  • Relationship-based models improve readiness for school and community participation (Divya et al., 2023; Solomon et al., 2014). This reduces long-term costs in education, mental health and family services.

Alignment with Thriving Kids: Embedding DIRFloortime into playgroups, health, and early education systems will strengthen mainstream pathways and ensure children are supported in natural contexts. This also aligns with the Early Years Strategy 2024–2034, which emphasises family empowerment, play-based learning, and relationship-driven approaches as foundations for thriving children and communities (see Appendix A).

Key Point: Relationship-based models like DIRFloortime complement universal programs by ensuring that children with developmental differences are not left behind.

ToR 3 – Equity and intersectional issues

The focus on First Nations and CALD families is essential. To ensure genuine equity:

  • Extended consultation and co-design are needed to build trust and cultural safety. We recommend extending consultation by at least 12 months beyond July 2026, with NDIS supports remaining in place during this period to avoid service gaps.
  • Community-led approaches consistently show improved outcomes for engagement and development (De Zilva et al., 2022).
  • Flexible, localised pathways are essential to reflect family and community contexts.

Alignment with Thriving Kids: By embedding cultural responsiveness as a non-negotiable principle, Thriving Kids can improve equity and engagement across diverse communities.

Key Point: Safe and extended consultation timelines, paired with continuity of NDIS supports, will build trust and avoid unintended gaps in care. Understanding cultural impacts on development and individualising support around this is core to DIRFloortime.

4 of 18

ToR 4 – Workforce support and training

  • General Practitioners GPs and educators, who need greater confidence and training in developmental supports to improve early identification (Coughlan et al., 2020; Eapen et al., 2022)
  • Workforce preparation should include developmental, relationship-based models such as DIRFloortime, alongside cultural competence and trauma-informed practice. This training is intended to upskill professionals so they can better recognise developmental differences and provide appropriate referrals, not to replace the role of allied health professionals.
  • Tiered training approaches can build capability across the sector while maintaining quality and trust for families.

Key Point: A workforce trained in relationship-based and culturally responsive approaches will build family trust and ensure Thriving Kids is implemented consistently. Providing time to adequately design these processes with the disability community is essential. Training must also utilise neuroaffirming approaches and be co-designed with the disability community, to prevent behavioural focused approaches that are unsupportive and harmful.

ToR 5 – Domestic and international policy experience

  • Australia’s obligations under the UN CRPD emphasise co-design, family inclusion, and access to individualised supports.
  • Transitioning children before alternative systems are adequately developed risks gaps in continuity of support and undermines family confidence. Without a robust system, this will only shift needs into other systems such as education and health creating greater long term economic strain.
  • Staged rollouts with overlap between NDIS and Thriving Kids will ensure continuity and allow for evaluation before full transition. We recommend a phased rollout over a minimum of 3 years, with robust independent evaluation built in at each stage.

Alignment with Thriving Kids: By adopting staged, safeguarded transitions, Thriving Kids can lead internationally in balancing systemic reform with children’s rights.

5 of 18

Conclusion and Recommendations

The Thriving Kids Initiative presents a valuable opportunity to create a more neuroaffirming, evidence-based early childhood support system where children with developmental differences can belong. To achieve this vision, it must:

  1. Ensure continuity of individualised supports during transition until new systems are proven effective and ready (see Recommendation 6).
  2. Formally embed developmental, relationship-based and neuroaffirming approaches such as DIRFloortime which respect the neurodivergent community over deficit-based, coercive approaches that promote conformity.
  3. Involve families and people with diverse abilities in all co-design processes.
  4. Place equity and cultural safety for First Nations and CALD families at the centre.
  5. Develop the workforce with evidence-based, trauma-informed, and culturally responsive training.
  6. Implement a staged rollout at least over 3 years where no child is transitioned from the NDIS until alternative systems are demonstrated to be effective.

It is important to note that DIRFloortime practitioners in Australia form a specialised workforce. Exclusion of specialist health professionals without due consideration of evidence and co-design has potential harmful impacts to the community through the loss of their expertise. By including DIRFloortime in policy and funding pathways, the government can strengthen and expand this workforce to more effectively meet the objectives underpinning the Thriving Kids initiative.

By adopting these safeguards, the Thriving Kids initiative can achieve its goals of building stronger families, inclusive communities, and sustainable pathways beyond the NDIS.

6 of 18

Appendix A: DIRFloortime Alignment with the Early Years Strategy (2024–2034)

Why This Matters

The Australian Government’s Early Years Strategy 2024–2034 sets out a national vision that all children thrive in their early years. The DIRFloortime model directly advances these priorities by providing developmental, relational, play-based, and culturally responsive support. By embedding DIRFloortime principles into the Thriving Kids Initiative, government can ensure alignment across reforms and avoid duplication or service gaps.

Shared Priorities and DIRFloortime Contributions

Early Years Strategy Goal Strategy Focus How DIRFloortime Aligns Practical Example
Thriving Children & Families All children flourish with strong family and community support. Sees every child as capable; builds growth through nurturing relationships and following the child’s lead. Parent coaching to join play, celebrate children’s ideas, and build confidence and connection.
Developmentally Appropriate Support Services respect children’s developmental stages, not just age. Follows emotional-developmental capacities and gently stretches abilities. Interactive play at a child’s level, extending problem-solving or communication abilities step-by-step.
Equity, Inclusion & Cultural Safety Services must honour diversity and individual needs. The “I” in DIR: Individual differences—sensory, emotional—are central. Adapt play spaces for sensory needs; integrate cultural play traditions into therapy.

7 of 18

Strong Relationships as Foundations Parents, carers, and trusted adults are key partners. The “R” in DIR: Relationship-based growth is core. Coaching families in co-regulation strategies to support safety and exploration.
Play-Based, Everyday Learning Play and everyday interactions are powerful for learning. Floortime uses child-led play to spark curiosity, flexible thinking, and problem-solving. Turning a child’s interest in cars into a story-building game to encourage language and social skills.
Family Empowerment & Community Partnership Families and communities shape the best solutions. Coaches parents to trust instincts and see strengths. Parent workshops on noticing cues and building interaction in daily routines.
Holistic Outcomes Beyond Academics Track wellbeing, belonging, and connection, not just literacy/numeracy. Measures success through emotional regulation, engagement, shared attention, and joy in interaction. Recording growth in regulation and social reciprocity as indicators of thriving.

Key Takeaway

The Early Years Strategy and DIRFloortime share a common vision of thriving, connected children and empowered families. Embedding DIRFloortime in Thriving Kids ensures:

  • Consistency with national policy directions.
  • Stronger family capacity and reduced reliance on later services.
  • Greater cultural safety, equity, and inclusion.
  • Practical, play-based interventions that make early learning joyful and effective.

By aligning Thriving Kids with the Early Years Strategy through relationship focused supports such as DIRFloortime, Australia is positioned to build a truly integrated, world-leading early childhood support system for the benefit of all.

Appendix B: Signees

This submission is endorsed by the 122 undersigned DIRFloortime Certified Practitioners and/or advocates of the model representing every state in Australia. Each signatory affirms support for the positions and recommendations outlined in this submission to the House Standing Committee on Health, Aged Care and Disability regarding the Thriving Kids Initiative.

Submitted by:

Kai Meng Reuben Seah Occupational Therapist Waypoint Occupational Therapy Sydney, NSW

redacted

Louisa Hunter Occupational Therapist/Owner Integrate Occupational Therapy Sydney, NSW

Georgina Ahrens Occupational Therapist Kids World Paediatric Therapy Sydney, NSW

Alyssa Murray Speech Pathologist PATC Bendigo, VIC

Samantha Foster Speech Pathologist Samantha Foster Speech Pathology Adelaide, SA

Megan King Early Intervention Practitioner & Key Worker, Engaging Interactions Central Coast, NSW

Dana Baltutis Speech Pathologist My Therapy House Adelaide, SA

Kirsty-Lee Behaviour Support Practitioner YTG Sale, VIC

Fionna Bottroff Speech Pathologist SA Health & Tailored Developmental Therapies, Adelaide, SA

Bronwyn Walker Early Intervention Practitioner ShineMP Group Melbourne, VIC

Ashleigh Dunn Occupational Therapist OpportunOT Kids Therapy Wollongong, NSW

Carmen Ip Occupational Therapist Mustard Seed Occupational Therapy Perth, WA

Dr. Anita Connell Postdoctoral Research Fellow & Registered Music Therapist Tuned in Connections Sydney, NSW

Courtenay Sherwood Occupational Therapist NextSense Sydney, NSW

Melinda Cassells Speech Pathologist Speech & Language Support Services Clontarf, QLD

Nikita Pinto Speech Pathologist My Therapy House Adelaide, SA

Carly Coleman Occupational Therapist Northern Beaches Children’s OT Sydney, NSW

Maria Radimissis Speech Pathologist My Therapy House Adelaide, SA

Nicola Dolan Occupational Therapist Brighter Futures Consulting Dawin, NT

Kelly Treggalles Occupational Therapist Apricus Health Townsville, QLD

Sophie Jakimyszyn Occupational Therapist Adventure OT Watersleigh, NSW

Sarah Gilbert Occupational Therapist Senses WA Perth, WA

Leanne Hopkins Occupational Therapist Succeed Healthcare Solutions North Lakes, QLD

Miranda Van Styn Speech Pathologist KidsRISE Brunswick, VIC

Jane Wilson Speech Pathologist DECYP Launceston, TAS

Dorothy Debono Speech-Language Pathologist Smithfield Speech Pathology Sydney, NSW

Rebecca Lockyer Occupational Therapist Little Therapeas Baringa, QLD

Mel Holbrook Speech Pathologist About You Speech Pathology Toukley, NSW

Janie Echt Occupational Therapist North Shore Occupational Therapy Sydney, NSW

Natalie Brown Occupational Therapist Occumax Mackay, QLD

Michelle Lauchlan Occupational Therapist Milton TLC Milton, NSW

Dianne Townsend Occupational Therapist Foundations Paediatric Occupational Therapy Melbourne, VIC

Jessica Thackeray Occupational Therapist University of Queensland Brisbane, QLD

Brittany Wiebe Psychology, Behaviour Support Practitioner One Step Ahead Allied Health Mid North Coast, NSW

Caroline Dunham Occupational Therapist Dignity OT Croydon, VIC

Jenny Lawrence Occupational Therapist Canberra, ACT

Isabelle Speech Pathologist Chat Play Snack Brisbane, QLD

Alyssa Cummings Occupational Therapist Alyssa Cummings Occupational Therapy Adelaide, SA

Divya Narangali Rajan Occupational Therapist Umbrella Therapy Services Hobart, TAS

Lisa Johnson Occupational Therapist Evolving Mind Body and Soul South Coast, NSW

Lisa Foster Occupational Therapist SPOT on! Kids Allied Health Melbourne, VIC

Shauna Carter Occupational Therapist Ladybug House Healthcare Hervey Bay, QLD

Katerina Peters Occupational Therapist Little Buds Therapy Beaconsfield, VIC

Gail Baildon Speech Pathologist Gail Baildon Speech Pathology Cairns, QLD

David Jereb Occupational Therapist MoveAbout Therapy Services Avoca Beach, NSW

Belinda Robertson Occupational Therapist DOTS OT for Children Melbourne, VIC

Alison Smedley Social Worker West Play Adelaide, SA

Riandri Roux Occupational Therapist Domain Health Kids Melbourne, VIC

Aaisha Deo Speech Pathologist Domain Health Kids Melbourne, VIC

Sarah Moran Speech Pathologist Domain Health Kids Melbourne, VIC

Dania Qamar Occupational Therapist Domain Health Kids Melbourne, VIC

Grace Mueller Occupational Therapist Domain Health Kids Melbourne, VIC

Micaela van Tonder Occupational Therapist New Perpective OT Services Kalgoorlie, WA

Camilla Jean Casoal Occupational Therapist Calm & Mindful Kids Skye, VIC

Megan Heffernan Occupational Therapist Megan Heffernan Occupational Therapy Naracoorte, SA

Kerri-anne Telford Occupational Therapist Kerri-anne Telford Paed OT VIC

Tieri Osborn Occupational Therapist Brisbane, QLD

Hayley Carmichael Occupational Therapist Beaconsfield, VIC

Amy Occupational Therapist Early Bird Therapy Canberra, ACT

Kiara Hyland Speech Pathologist North West Speech Services Devonport, TAS

Lauren Osborne Speech Pathologist Remarkable Speech & Movement Sydney, NSW

Katherine Ashelford Leyden Occupational Therapist Wollongong, NSW

Michelle Louise Cunningham Speech Pathologist Reynella, SA

Monique Palmer Speech Pathologist Articulate Kids Adelaide, SA

Kimberley Hollander Speech Pathologist Speech and Language Support Service Brisbane, QLD

Hope Oliver Speech Pathologist Pop Speech Therapy Melbourne, VIC

Rutu Dilipkumar Patel Occupational Therapist Hop and Learn Children’s Therapy Truganina, VIC

Cheryl Bladen Occupational Therapist North Shore Occupational Therapy Sydney, NSW

Amelia Butcher Occupational Therapist Moment by Moment Occupational Therapy Sydney, NSW

Siobhan Clery Speech Pathologist Speech Your Way Perth, WA

Diana Quinones Occupational Therapist Adelaide, SA

Stephanie Clements Occupational Therapist Nurtured Potential Sydney, NSW

Mina Pastore Speech Pathologist Purely Speaking Williamstown, VIC

Nour Alsayyed Occupational Therapist Beehive OT for Kids Sydney, NSW

Prajwal Singh Pradhan Occupational Therapist Umbrella Therapy Services Hobart, TAS

Samantha Karro Occupational Therapist WA

Keira Roffery-Mitchell Psychologist Modpsych Psychology Brisbane, QLD

Kate Boyce Occupational Therapist Quickstepz Paediatric Therapy Sydney, NSW

Carmel McConkey Occupational Therapist Quickstepz Paediatric Therapy Sydney, NSW

Noot - Occupational Therapy Relate First Therapy Sydney, NSW

Nicola Hamilton Occupational Therapist Griffith Aboriginal Medical Service Griffith, NSW

Nadine Mackay Occupational Therapist Anchored Occupational Therapy Wollongong, NSW

Jacqueline Luff Occupational Therapist Grass Roots OT Sydney, Australia

Francine Nicholson Speech Pathologist Sensational Kids Cheltenham, VIC

Bertie McMahon Music Therapist In Groove Music Therapy Penrose, NSW

Shannon Pearse Occupational Therapist Domain Health Melbourne, VIC

Francesca Arlotta Occupational Therapist Domain Health Melbourne, VIC

Jessica De Duonni Speech Pathologist Louder than Words Speech Pathology Adelaide, SA

Judy Au Occupational Therapist My Therapy House Michell Park, SA

Nicole Maskell Occupational Therapist Inside Out Occupational Therapy Coffs Harbour, NSW

Macala Linford Speech Pathologist Campaspe Kids Speech Pathology Elmore, VIC

Joellen Bevilaqua Occupational Therapist Maylands, WA

Genevieve Ward Speech Pathologist The Speech Express Chirnside Park, VIC

Sophie Blaich Occupational Therapist OT4CHANGE Lake Macquarie, NSW

Amy Vallentine Occupational Therapist Vallentine Occupational Health Port Macquarie, NSW

Jenny Truong Speech Pathologist VIC

Hayley Wade Early Childhood Teacher Wollongong, NSW

Jessica Levien Speech Pathologist The Speech Corner Sydney, NSW

Rachel McKeever Occupational Therapist Southern NSW

Sarah Falconbridge Occupational Therapist Sydney, NSW

Jacky Peile Occupational Therapist Early Links Sydney, NSW

Josephine Wackrow Occupational Therapist Sandhurst, VIC

Loren Gerdis Occupational Therapist Smiling Star OT Sydney, NSW

Stephanie Williams Speech Pathologist Flourish Allied Health Service Maclean, NSW

Alicia Bellert Occupational Therapist Together We Grow Kids OT Sydney, NSW

Emma Lloydd-Wright Occupational Therapist Connecting Dots 4 Kids Yorke Peninsula, SA

Kylie Marquenie Occupational Therapist QLD

Kelly Powell Occupational Therapy Amazing Kids OT Geelong, VIC

Diana Gonzalez Occupational Therapist Diana Gonzalez, Occupational Therapy Brisbane, QLD

Kimberley Burling Occupational Therapist Be Me Kids OT Blaxland, NSW

Phillippa Cullen Occupational Therapist All Together Therapy Port Macquarie, NSW

Kahlie McLennan Practice Manager Adventure OT Nowra, NSW

Courtney Bishop Occupational Therapist Adventure OT Shoalhaven, NSW

Elizabeth Bailey Speech Pathologist Evolving Mind Body and Soul Sunshine Coast, QLD

Driscilla Neri Occupational Therapist Belle Occupational Therapy Lennox Head, NSW

Amie Jakimyszyn Speech Pathologist Adventure OT Nowra, NSW

Tina Moisidis Speech Pathologist Connect & Communicate Speech Sydney, NSW

Mia Norman-Hall Speech Pathologist Thornbury, VIC

Gabrielle Higgins Key Worker Noah’s Inclusion Services Illawarra, NSW

Tess Pritchard Key Worker Noah’s Inclusion Services Illawarra, NSW

Phuong Nguye Speech Pathologist Maidstone, VIC

Brianna Pemberton Occupational Therapist Better Rehab WA

Justine Shircore Occupational Therapist Thriving Through Nature Perth, WA

Leisa King Key worker Noah’s Inclusion Service Nowra, NSW

References

Coughlan, B., Duschinsky, R., O’Connor, M. E., & Woolgar, M. (2020). Identifying and managing care for children with autism spectrum disorders in general practice: A systematic review and narrative synthesis. Health & social care in the community, 28(6), 1928–1941. https://doi.org/10.1111/hsc.13098

De Zilva, S., Walker, T., Palermo, C., & Brimblecombe, J. (2022). Culturally safe health care practice for Indigenous Peoples in Australia: A systematic meta-ethnographic review. Journal of health services research & policy, 27(1), 74–84. https://doi.org/10.1177/13558196211041835

Divya, K. Y., Begum, F., John, S. E., & Francis, F. (2023). DIR/Floor Time in Engaging Autism: A Systematic Review. Iranian journal of nursing and midwifery research, 28(2), 132–138. https://doi.org/10.4103/ijnmr.ijnmr_272_21

Eapen, V., Winata, T., Gilbert, M., Nair, R., Khan, F., Lucien, A., Islam, R., Masi, A., Lam-Cassettari, C., Mendoza Diaz, A., Dissanayake, C., Karlov, L., Descallar, J., Eastwood, J., Hasan, I., Jalaludin, B., Kohlhoff, J., Liaw, S. T., Lingam, R., Ong, N., … Barbaro, J. (2022). Parental experience of an early developmental surveillance programme for autism within Australian general practice: a qualitative study. BMJ open, 12(11), e064375. https://doi.org/10.1136/bmjopen-2022-064375

Jeong, J., Franchett, E. E., Ramos de Oliveira, C. V., Rehmani, K., & Yousafzai, A. K. (2021). Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Medicine, 18(5), e1003602. https://doi.org/10.1371/journal.pmed.1003602

Kapp, S. K. (2023). Profound Concerns about “Profound Autism”: Dangers of Severity Scales and Functioning Labels for Support Needs. Education Sciences, 13(2), 106. https://doi.org/10.3390/educsci13020106

Newton, C., Hudry, K., Aulich, A., Bent, C., Constantine, C., Franks, K., Goonetilleke, N., Green, C. C., Lee, P., Ma, E., Said, H., Wang, R., Wood, S., & Smith, J. (2025). “Individualisation is key”: Autism intervention professionals’ experiences of working with minority ethnic families in Australia. Research in Autism Spectrum Disorders, 126, Article 102227. https://doi.org/10.1016/j.reia.2025.202655

Solomon, R., Van Egeren, L., Mahoney, G., Quon Huber, M., & Zimmerman, P. (2014). PLAY Project Home Consultation intervention program for young children with autism spectrum disorders: A randomized controlled trial. Journal of Developmental & Behavioral Pediatrics, 35(8), 475–485. https://doi.org/10.1097/DBP.0000000000000096

Weitlauf, A. S., Gotham, K. O., Vehorn, A. C., & Warren, Z. E. (2014). Brief report: DSM-5 “levels of support:” a comment on discrepant conceptualizations of severity in ASD. Journal of autism and developmental disorders, 44(2), 471–476. https://doi.org/10.1007/s10803-013-1882-z