SUBMISSION TO THE HOUSE STANDING COMMITTEE ON HEALTH, AGED CARE AND DISABILITY: PARLIAMENTARY INQUIRY INTO THRIVING KIDS INITIATIVE
Dr Jacqui Barfoot, The University of Queensland
Email: redacted
3 October 2025
Suggested citation: Including a relational approach in Thriving Kids. (2025, October 2). Submission to the House Standing Committee on Health, Aged Care and Disability: Parliamentary inquiry into the Thriving Kids initiative.
1. Introduction
I thank the Committee for the opportunity to provide input into the Inquiry into the Thriving Kids Initiative.
I am Dr Jacqui Barfoot, an Occupational Therapist with over 20 years’ experience working with children with developmental difficulties and their families in a variety of settings across Australia. I am currently a Postdoctoral Research Fellow at the University of Queensland’s Child Health Research Centre. My research focuses on strengthening parent-child interactions to optimise developmental outcomes, particularly for children with developmental delay and disability. I am the developer of the PAIR Model (Phased Approach to Including a Relational Focus) and the Connect Play Learn training program for allied health practitioners. To date I have provided training to more than 1500 early childhood therapists and practitioners across Australia in including a relational approach in early childhood supports for children with developmental delays. I have also worked in a consultancy role with a number of NDIS partner organisations.
I make this submission as both a clinician–researcher and as someone with lived experience of parenting children with additional needs. My goal is to support Thriving Kids to become a nationally consistent, equitable, and evidence-based model of early intervention.
2. Executive Summary & Key Recommendations
The Thriving Kids Initiative is a landmark opportunity to re-design early childhood intervention (ECI) in Australia. To succeed, the program must:
- Embed a relational focus: ensure services and practitioners are equipped to support parent-child interactions as the foundation of child development.
- Strengthen parent capacity: position parents as active partners in early childhood interventions and supports, with accessible and culturally relevant resources.
- Address workforce gaps: invest in training, reflective supervision, and retention strategies to build workforce capability, especially in rural and regional areas.
- Ensure equity for priority groups: co-design approaches with First Nations communities, culturally and linguistically diverse (CALD) families, and families living in rural and remote locations.
- Integrate with existing systems: align Thriving Kids with the NDIS Early Childhood Approach, maternal and child health, primary care, and education to avoid fragmentation.
- Commit to evaluation and knowledge translation: embed continuous improvement mechanisms into program design from the outset.
3. Relational Practice and Parent Capacity
The Problem
One in five Australian children are developmentally vulnerable at school entry, with rates of developmental delay, autism, and ADHD rising. Parents are key agents in their child’s development, yet most early childhood interventions (ECI) delivered by allied health practitioners remain child-focused and therapist-led. This misses the opportunity to empower parents.
Despite strong evidence that responsive parent interactions are critical for child development, these approaches are rarely embedded in Australian ECI. The introduction of the NDIS unintentionally deprioritised parenting support, reducing capacity to deliver parent-mediated interventions at scale. Clinicians report low confidence and insufficient training to involve parents meaningfully, leading to a disconnect between best practice and what is delivered. The 2023 NDIS Review highlighted the need for scalable, family-empowering models. Yet, parent-mediated interventions have received only 0.25% of national research funding.
The Solution
The PAIR Model is a flexible, evidence-informed framework that equips practitioners to embed relational strategies into everyday therapy. These include parent–child interaction techniques, collaborative goal-setting, and video-based reflection. Unlike traditional child-focused models, PAIR emphasises parent-child interaction quality, therapist–parent coaching, and family resilience: elements known to underpin improved long-term outcomes.
Pilot implementation with NDIS service partners demonstrated increased therapist confidence, stronger parent engagement, and improved child developmental outcomes in six session service models. Because the PAIR Model is grounded in universal relational principles, it is adaptable across cultures, contexts, and service systems, including early childhood education. Embedding relational approaches such as PAIR within Thriving Kids would strengthen parent capacity, practitioner capability, and system sustainability.
Consumer Involvement
Consumer and community involvement has been central to the development of the PAIR Model. Co-design with parents, practitioners, and First Nations representatives has ensured cultural safety, inclusivity, and relevance. Embedding structured consumer advisory processes within Thriving Kids will be critical for ensuring that the initiative reflects lived experience and responds to diverse community needs.
Why Relational Practice Matters
Warm, responsive, and attuned interactions support language, cognition, and emotional regulation. When a child has developmental difficulties, their cues are often less salient or harder to read. In addition, when a parent has concerns about their child’s development we know it can be much harder for them to be tuned in to their child’s cues. When parents are supported to embed therapeutic strategies into daily routines, children make greater developmental gains than through therapist-delivered sessions alone. Relational practice also strengthens parents’ confidence and agency, enabling them to:
- articulate their child’s strengths and needs;
- participate in collaborative goal-setting;
- advocate for supports across health, education, and disability systems;
- sustain their child’s progress across contexts.
This is essential in Australia’s fragmented service landscape, where parents often act as the primary coordinators of care. Embedding relational practice in Thriving Kids will not only improve child outcomes but also reduce parental stress, service disengagement, and inequities in access.
4. Addressing the Terms of Reference
4.1 Supporting parents to identify developmental delay
Parents are often the first to notice differences in their child’s development, yet they face barriers in accessing timely advice and support.
The Committee should:
- Provide accessible, evidence-based resources for parents in multiple languages and formats.
- Train practitioners to validate parent concerns, avoid “watch and wait” approaches, and use structured screening tools.
- Implement relational models that explicitly include parent reflection and capacity-building.
4.2 Effectiveness of existing programs
Parent-mediated interventions improve developmental outcomes, particularly in communication and social domains. However, child-focused therapy remains dominant.
The Committee should:
- Fund and scale programs that embed relational practice.
- Resource practitioner training and reflective supervision to sustain practice change.
4.3 Equity and priority populations
Thriving Kids must be co-designed with First Nations, CALD, and rural/remote communities.
The Committee should:
- Resource co-design processes with diverse communities.
- Embed cultural liaison roles and interpreters in services.
- Support hybrid service models combining outreach and tele-health practice.
4.4 Workforce capacity and training
Australia faces critical shortages of allied health practitioners in paediatrics. Without workforce development, Thriving Kids will not succeed.
The Committee should:
- Invest in national training and reflective supervision in relational practice.
- Incentivise workforce retention in rural/regional areas.
- Support “grow-your-own” strategies, including scholarships and mentoring.
4.5 Seamless transitions
Families experience fragmentation across health, education, and disability systems. Relational practice supports smoother transitions.
The Committee should:
- Fund care coordination roles (“navigators”).
- Invest in interoperable information-sharing systems.
- Align Thriving Kids with the NDIS Early Childhood Approach.
5. Implementation & Evaluation
Implementation should be phased, beginning with co-designed pilots in urban, rural, and remote settings. Evaluation must measure:
- child developmental outcomes;
- parent confidence and wellbeing;
- practitioner capability and retention;
- equity of access.
Knowledge translation is essential. Findings should be shared not only in academic journals but in practice guides, community forums, and parent-friendly resources.
6. Conclusion
Thriving Kids is a once-in-a-generation opportunity to transform early childhood developmental support in Australia. By embedding relational practice, supporting parents, building workforce capability, and ensuring equity, the initiative can deliver meaningful change for children, families, and society.
I would welcome the opportunity to provide oral evidence to the Committee or to contribute further expertise as Thriving Kids is developed.
Contact
Dr Jacqui Barfoot
Research Fellow, Child Health Research Centre, University of Queensland
Ph: redacted
Email: redacted
References
AEDC (2021). Australian Early Development Census National Report. www.education.gov.au/early-childhood/data-and-reports/australian-early-development-census
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Barfoot, J. et al. (2024). Including a relationship-focus in paediatric occupational therapy interventions: Introducing the PAIR Model. Jnl of OT Schools and Early Int, 17(2), 331-347.
Barfoot, J. et al, (2021). PlayConnections: relationship-focussed early childhood intervention training for allied health practitioners. Int Jrnl of Disability, Dev and Edn, 69 (1), 217-238.
Barfoot, J., et al. (Submitted 2025). Activating Parents in Early Childhood Intervention: Piloting the PAIR Model for goal attainment. Journal of OT, Schools, and Early Intervention
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