National Disability Services Submission

House Standing Committee on Health, Aged Care and Disability Inquiry into the Thriving Kids initiative

About National Disability Services

National Disability Services (NDS™) is Australia’s peak body for disability service organisations, and Australia’s biggest and most diverse network of disability service providers. Our valued members collectively operate several thousand services for more than 300,000 Australians with disability and employ a workforce of more than 100,000 people.

NDS is committed to a sustainable and diverse disability service sector, underpinned by the provision of high-quality, evidence-based practices and supports that strengthen, safeguard and provide greater choice for people with disability in Australia.

Contents

• About National Disability Services
• 1.0 Executive summary
• Essential enablers for the effective design and implementation of foundational supports for children across Australia
• Summary responses to the Terms of Reference
• 2.0 Scope of submission
• 3.0 Context and principles
• 4.0 Responses to the Terms of Reference
• 5.0 Conclusion
• Contact
• Key References

1.0 Executive summary

National Disability Services (NDS) welcomes the opportunity to contribute to the Thriving Kids initiative—a once-in-a-generation reform to embed foundational supports for children with developmental concerns, delay or disability.

To succeed, Thriving Kids must:

1. Embed best practice and functional assessments Supports must be available as soon as developmental concerns are identified — without delays for diagnosis. Functional, not diagnostic, access and best practice delivery in the environments where children live, learn and play must guide design and implementation.
2. Commission quality providers with proven expertise Providers must demonstrate strong governance, inclusive practices, and a history of collaboration with families, government, and community systems. Commissioning must maintain and grow sector capability.
3. Establish a nationally consistent strategy that leverages existing systems Fragmentation across jurisdictions is a major risk. A unified strategy agreed by Commonwealth and states and territories must leverage and integrate existing service systems across jurisdictions to ensure seamless access and continuity of care.
4. Build genuine partnerships—or risk failure Families must lead system design in partnership with providers and governments. Seamless transitions, and entry points and access points that work for children and families are essential to ensure no child is left behind.

NDS and its members stand ready to partner with government to design, implement and co-deliver a sustainable, inclusive system that delivers better outcomes for children and families.

Essential enablers for the effective design and implementation of foundational supports for children across Australia

NDS supports the momentum and urgent need for foundational supports for children to be implemented so that children receive appropriate support as early as possible in life. Effective outcomes for children and their families, carers and kin will require the following critical success factors:

• Quality providers delivering supports through commissioning approaches that prioritise best practice and quality service provision.
• Integrated service ecosystems that reduce fragmentation and gaps across service systems and improve outcomes. A national strategy and intergovernmental agreed responsibilities are needed to avoid fragmentation across state and territories and Commonwealth responsibilities for mainstream/foundational supports and NDIS supports.
• Seamless transitions for children and families by designing multiple entry = and access points that work for children and their families.
• Sustainable funding models that support collaboration and long-term impact.
• Partner with families and providers to ensure Thriving Kids is trusted and responsive.
• Functional, not diagnostic, access to supports and as early as possible.
• Culturally safe, place-based services for First Nations and CALD communities are essential for equity and effectiveness.
• Investment in workforce development, especially in regional areas.
• Robust governance and accountability aligned with national best practice frameworks, like the National Best Practice Framework for Early Childhood Intervention. An outcomes focused monitoring system should be in place.
• Sector leadership NDS is ready to support governments in design and implementation, leveraging its national reach and provider engagement.

Summary responses to the Terms of Reference

NDS makes the following recommendations relating to the terms of reference:

Term of Reference	Recommendations
a) Evidence-based resources to help families identify and support children with mild to moderate developmental delay	- Clear, accessible navigation and information tools - Supports embedded in natural environments - Use of evidence-based early identification tools - Functional (not diagnostic) access criteria - Family-centred, strengths-based approaches
b) Effectiveness of current and previous programs	- Address jurisdictional gaps between NDIS and state services - Flexible, targeted funding aligned with best practice - Commission quality providers with strong governance and workforce development - Map service availability, especially in regional areas - Strengthen integration across health, education, disability, and child protection - Improve service delivery in schools - Invest in culturally safe diagnostic and support services
c) Equity and intersectionality (First Nations and CALD children)	- Implement place-based models tailored to community needs - Address visa-related service exclusions - Address allied health shortages, especially in regional areas
d) Workforce support and training	- Enhance paediatric content in university courses - Provide professional development for educators - Develop a national workforce strategy including peer workforce models

2.0 Scope of submission

This submission draws on sector consultation, best practice research, and the lived experience of families and providers to outline the critical elements required for a sustainable, equitable, and effective foundational supports system for children with developmental concerns, delay, or disability.

Our submission identifies essential enablers that we believe necessary to support the effective design and implementation of foundational supports for children and provides responses to each of the terms of reference. We make recommendations throughout this submission to support the work of the Committee and all governments to design and implement effective foundational supports for children across Australia.

NDS will use the original commonly used definition of this cohort as children under 9 with development delay or autism, and with low to moderate support needs. NDS notes that the sector seeks clarity on the cohort definition and that there have been some variations in language used over recent months. The recently published National Best Practice Framework for Early Childhood Intervention (the Best Practice Framework) uses the terms ‘for children with development concerns, delay or disability,..’ There is a need for a clear definition of this cohort. Our members have identified that there is also a need to clearly define the terms ‘low’ and ‘moderate’ support needs.

NDS has structured its response with the following objectives:

• Targeted feedback against the Terms of Reference of the Inquiry.
• Essential enablers to support the effective design and implementation of foundational supports for children across Australia.

NDS looks forward to the opportunity to appear before the Committee to expand on its submission priorities.

3.0 Context and principles

National Disability Services’ (NDS) vision is for an inclusive Australia where all people with disability live safely and equitably. To achieve this people with disability, need to access the right supports, at the right time, from the right people, services, and systems. The implementation of foundational supports for children across Australia is a further world leading step in the Australian disability ecosystem. For children with development concerns, delay or disability, the best outcomes are achieved when supports are provided as early as possible in life.

The introduction of the National Disability Insurance Scheme (NDIS, the Scheme) transformed and continues to transform the lives of many people with disability in Australia. It is a landmark.

The Independent Review of the NDIS – Final Report (2023) (the NDIS Review), NDS and our members agree that the current system is not providing good outcomes for children with disability or emerging development concerns and their families. A medical model has emerged focussed on treatment of children as opposed to a model that is family led and where supports occur in everyday settings. There is a robust body of evidence underpinning best practice approaches to early childhood intervention and the sector is well equipped to deliver this.

The NDIS Review identified that the NDIS has become the only source of support for many children and their families. The report stated that the current ecosystem for young children had major gaps and was not meeting family needs or best practice standards. It noted that children with disabilities or developmental concerns are often not identified early enough, and once identified, families struggle to find supports outside the NDIS. As a result, many turn to the NDIS even for mild delays because mainstream services are insufficient or hard to access. The Review’s recommendation was a “new connected system of support”: more inclusive mainstream services (like health, childcare, schools), better developmental screening in places like maternal child health and preschools, and investment in “foundational supports” (information, peer support, family services) outside

the NDIS. Only children with higher needs would use a redesigned early childhood stream of the NDIS.

The Review identified the importance of best practice early intervention. Early childhood intervention should be family-centred and happen in everyday natural environments (home, early childhood education centres, community), not just clinics. The report warns that the absence of such supports put pressure on the NDIS and emphasises early developmental screening and inclusive mainstream programs as critical elements to adopt in foundational supports for children.

The focus on early identification and a “national system of supports” for this cohort (e.g. through health and education services) underscores the need for robust mainstream services and clear pathways for families as the program is designed.

NDS consultations with providers of early childhood supports have identified the following issues. Many of these have been recognised in the work of the NDIS Review.

• Plans currently developed for children often do not include adequate resources to assist families with the complex needs of their young children (particularly for those young children with high medical support needs). The focus on early intervention supports often clouds what personal care assistance is needed by the families of children with high medical support needs.
• Many families are unable to find a place for their child with disability in an early childhood learning centre. It appears that young children with disability are increasingly seen as the responsibility of the NDIS, allowing mainstream services to avoid their universal service obligations (with children with the most substantial disability the most likely to have difficulty obtaining access).
• While acknowledging issues related to sustainability, measures related to children and families must be aimed at improving outcomes not at reducing NDIS costs.
• The introduction of the NDIS has resulted in some mainstream services increasing barriers for young children with disability or, in the case of some state and territory governments, reducing support for children who are ineligible; this demands urgent attention.

• The individualised NDIS funding model appears to be driving greater use of one-on-one therapy within an office rather than supports in natural and community environments. It is recognised that foundational supports will be focused on a broader cohort and will be designed differently through commissioning providers. The design should enable best practice evidence-based practice such as delivery in natural settings, and early intervention as soon as development concerns are identified.
• Greater effort needs to be made to reach young children with disability in marginalised families.
• Targeted commissioning should be tested in thin markets, including those living in remote and very remote areas.
• Short-term early invention to children is widely supported but the sector is reluctant to see this important work confined to NDIS funded early childhood partner organisations; some of these children would be better supported by specialist providers.
• More research on the outcomes for young children after receiving early intervention support is needed; the NDIS is well-placed to facilitate (but not undertake) this.

Minister Butler’s Press Club address on 20 August 2025 announced the Thriving Kids program which is the Federal government’s response to the need for foundational supports for children. The Department of Health, Disability and Ageing Thriving Kids Fact Sheet (2025) states that the new “Thriving Kids” national program for children under 8 with mild to moderate developmental delay or autism. It is a joint federal/state initiative with a $2 billion commitment, aiming to provide targeted early supports outside the NDIS. The fact sheet highlights that Thriving Kids is explicitly designed to identify developmental concerns earlier and divert children with lower support needs away from the NDIS into appropriate mainstream and community supports.

Principles for design and implementation

Whilst the stated direction from the Federal government and implementation timeline of July 2026 is welcome it comes with several challenges and risks. There are only nine months from the timing of writing this submission to the target implementation date of

foundational supports for children. Design, commissioning and implementation planning will be required and there is currently no public agreement yet from all jurisdictional governments on the way forward.

Effective reform should be grounded in two core principles:

• Genuine partnership: All elements of reform—standards, systems, registration, and reporting—must be designed with children with disability, their families, carers, and service providers. This ensures cultural safety, relevance, and practical feasibility.
• Best practice: Implementation of sector-specific best practice such as the Best Practice Framework.

The Early Childhood Intervention Best Practice Network – Foundational Supports and the Disability Ecosystem White Paper (July 2024) is a sector-authored paper (by 19 non-profit early childhood providers across Australia). The paper outlines principles for an effective support system for children with developmental delays. It stresses that all foundational supports must be grounded in proven best practices of early childhood intervention and delivered in community settings.

Key principles include promoting inclusion (children should participate in ordinary settings with peers), collaboration across sectors (health, education, community services working together), and fair, equitable access for diverse communities (culturally appropriate and locally available services). Community capacity building should be designed into the system.

The paper also highlights the role of “Navigators” and “Lead Practitioners” (key workers) to guide families: as soon as concerns are identified, a trusted local professional can help families navigate services and deliver support in everyday environments.

NDS highlights several key risks and considerations for successful implementation:

• Uncertainty and financial stress: Providers are experiencing high levels of uncertainty and exhaustion. New frameworks should be introduced with sensitivity and appropriate lead times to avoid compounding financial stress. Effective change management is required.

• Sequenced rollout and pilots: Ideally phased implementation through pilots and transition periods will allow for testing, feedback, and refinement—especially critical for smaller and regional providers.
• Digital inclusion: Tailored support is needed for providers to engage with new digital systems, including training and consideration of subsidised access to technology (particularly for small providers and sole traders).
• Avoiding duplication: Clear transitional arrangements that prevent providers from having to comply with parallel reporting or audit regimes.
• Monitoring and evaluation: Robust mechanisms are needed to assess impact, identify unintended consequences, and support continuous improvement.

NDS remains committed to working collaboratively to ensure reforms are inclusive, practical, and deliver stronger outcomes for children and their families.

NDS recommends a nationally consistent, adequately funded, and culturally safe foundational supports system, jointly commissioned by federal and state governments.

This submission highlights the need for robust governance, integration with mainstream services, investment in workforce development, and a strong focus on equity and inclusion. It also calls for innovation, robust evaluation, and careful transition planning to ensure no child or family is left without support.

NDS strongly advocates for:

• Functional, not diagnostic, access to supports and as early as possible.
• Urgency and opportunity: The current reform is a “once in a lifetime” opportunity to co-design a sustainable, inclusive system across Australia. The right commissioning approach to maintain and gain quality providers is critical.
• Sustainable funding models that support collaboration and long-term impact.
• Partnering with families and providers to ensure Thriving Kids is trusted and responsive.
• Integrated service ecosystems that reduce fragmentation and improve outcomes.
• Culturally safe, place-based services for First Nations and CALD communities are essential for equity and effectiveness.

• Investment in workforce development especially in regional areas.
• Robust governance and accountability aligned with national best practice frameworks, strategies and initiatives. A national strategy and intergovernmental agreed responsibilities are needed to avoid fragmentation. An outcomes focused monitoring system should be in place.
• Sector leadership: NDS is ready to support governments in design and implementation, leveraging its national reach and provider engagement.

These themes are further explored in the detailed responses to the terms of reference clauses.

4.0 Responses to the Terms of Reference

a) Evidence-based resources to help parents identify and support children with mild to moderate developmental delay

National Disability Services (NDS) strongly supports the development and implementation of evidence-based resources that empower families to identify and respond to developmental concerns early. Information should be clear and accessible to assist families to navigate and make informed choices across the disability ecosystem.

The current system often delays access to support by requiring formal diagnosis or age-based eligibility, which can disadvantage children with mild to moderate developmental delay. NDS advocates for functional, not diagnostic, access — where support is based on a child’s developmental needs and context, not on clinical labels or thresholds. Early identification must be embedded across universal platforms and tools should enable proactive screening and timely referral, particularly when paired with family-centred, strengths-based approaches that build parental capacity and confidence. Diagnosis of conditions can take many months/years and the importance of functional support as early as possible in a child’s life cannot be overstated. As such foundational supports for children should be focused on the largest cohort of children with development concerns to ensure early access to supports.

Evidence shows that supports are most effective when delivered in natural environments—where children live, play and learn—rather than in clinical settings. Programs should equip families with practical strategies to support their child’s development and promote emotional wellbeing, while also fostering peer connection and reducing isolation. NDS members have told us that routine-based assessments and interventions are best done in the home environment.

Importantly, foundational supports must be inclusive and culturally responsive. NDS recommendations are discussed further under the relevant terms of reference.

Family centred strengths-based approaches are essential to equip parents with strategies and emotional support. Health literacy can be low in some families and so support should meet families where they are and work with them to assist them to navigate and negotiate services. Our members identify the importance of sibling support, and peer and parent lead programs.

Recommendations:

• Navigation and information: Access to clear accessible information and navigation tools that families understand. Assists families to make informed choices on supports and therapeutic interventions.
• Natural settings for support: Services should be embedded in everyday environments—home, playgroups, early learning centres — rather than clinic-based models.
• Early identification evidence-based tools: Use of evidence-based tools to support early identification.
• Functional (not diagnostic) access: Access to supports should be based on functional need rather than diagnosis or age, to avoid delays and inequities.
• Family capacity building: Family-centred, strengths-based approaches that equip parents with strategies and emotional support.

b) Effectiveness of current and previous programs across mainstream settings

The access to and effectiveness of early childhood intervention programs in mainstream settings has been mixed. Current jurisdictional gaps between NDIS and state services, result in delays, confusion, gaps and inequity. Lack of an agreed framework or strategy across Federal and states and territories has resulted in gaps in service delivery.

NDS supports the development of a nationally consistent foundational supports system, jointly commissioned by federal and state governments. Current funding arrangements are siloed, fragmented and insufficient. The withdrawal of what now is being called foundational type supports (previously tier 2 supports) by states and territories following the introduction of the NDIS has left a vacuum in service provision, resulting in families turning to the NDIS even for mild developmental concerns. Thriving Kids must be adequately funded to fill this gap and ensure that foundational supports are universally available, inclusive, and sustainable.

At the time of writing there is no agreement across Commonwealth, States and Territories on the design and delivery of foundational supports for children. This represents a risk particularly when considering a target implementation date of July 2026. NDS calls for a national Foundational Supports Strategy agreed by Commonwealth, and states and Territories to align the design of the new system, as recommended by the NDIS Review.

Whilst clarity of cohorts is necessary for the NDIS and foundational supports for children it is also critical that new silos aren’t created and that there is a seamless system of supports across the full continuum of mainstream/foundational supports for children and NDIS. There must be no gap between these service systems as this risks some children and families failing to receive the supports that they need.

Funding needs to be targeted and flexible, and consistent with evidence-based guidelines including the Best Practice Framework. Coordinated and collaborative planning and delivery is needed across federal, state, and departmental (e.g. social services and child protection or safety, health, disability and education) levels of government to clarify responsibilities and align funding streams.

For service delivery to be effective for children and their families the system needs quality providers. Quality providers have key systems and processes that ensure high quality and effective service delivery including:

• Governance arrangements including continuous quality improvement, co-design policy and practices, strong governance frameworks and a ‘speak up culture’
• Services and supports are grounded in good governance, supervision and accountability. There is evidence-informed, and outcomes focused with a person centred human rights approach.
• Providers prioritise client safety and wellbeing, choice and quality of life. There are accessible feedback and complaints systems. Providers also have good processes in place to identify and scaffold children and families who may at be at risk. This includes robust processes to work with child protection and child safety systems.
• Quality providers invest in their workforce through training and supervision, and workforce development. They collaborate effectively to build the capacity of mainstream service systems such early childhood education and care and allied health professionals.

The commissioning approach should be designed to select quality providers to deliver foundational supports. Quality providers have a range of historic and current capabilities in existing or previously funded programs with proven outcomes. This expertise lends itself well to the ability to scale up service models, workforce and relationships to deliver new services. The best outcome is achieved when longer contracts are provided to enable high quality, sustainable and effective service delivery by quality providers.

Families in regional and remote communities experience compounded disadvantage due to a lack of allied health professionals, limited access to specialist services, and higher out-of-pocket costs. Allied health workforce shortages are particularly acute with recruitment and retention of skilled staff remaining a persistent challenge. Alternative commissioning approaches for regional settings provide an opportunity to address these barriers. Mapping services across each jurisdiction provides additional information to inform the commissioning approach and ensure equity of access.

Integrated models have demonstrated greater effectiveness by linking health, education, and disability services at the local level. In relation to foundational supports, the key worker model or lead practitioner are important elements to guide and inform families in their decision making.

Improvement in early childhood intervention supports in schools is consistently raised through reviews and NDS member feedback as a key priority to address for foundational supports for children to be effective. The NDIS individualised approach to funding supports has resulted in numerous therapists seeking access to children during school hours creating administrative challenges for schools. Fees have been implemented and a lack of coordination and knowledge in the school system creates further barriers. Effective service delivery in schools is a critical factor for successful design and implementation of foundational supports for children.

Access to timely and affordable diagnostic services remains a significant barrier for many families, particularly those in regional and remote areas. Long wait times for paediatric assessments—sometimes up to 18 months—delay access to early supports and can result in children missing critical developmental windows. The financial burden of private assessments is substantial, and families often face out-of-pocket costs only to be deemed ineligible for the NDIS. These challenges are compounded for families experiencing social disadvantage and those from culturally and linguistically diverse (CALD) and First Nations backgrounds, who may encounter additional barriers such as lack of culturally safe diagnostic pathways and trusted local providers.

The Thriving Kids initiative announcement included new Medicare items for developmental assessments and allied health services, which are intended to reduce financial barriers and improve access to early diagnosis. These items will support general practitioners, pediatricians, and allied health professionals to identify developmental concerns earlier and refer families to appropriate supports. Further clarity is required regarding the design of these Medicare items, including referral pathways, service costs, and provider responsibilities. Implementation must align with the Best Practice Framework —avoiding the medicalisation of developmental support and ensuring services are delivered in natural settings that promote inclusion and family-centred care.

Services must be available equitably across regions and delivered in culturally safe ways. Without targeted investment in workforce and infrastructure, particularly in rural and remote areas, these reforms risk reinforcing existing inequities.

NDS recommends investment in community-based diagnostic services, including partnerships with Aboriginal Community Controlled Organisations and multicultural health services, to ensure assessments are accessible, culturally safe, and responsive to family needs. Trusted staff and community organisations play a vital role in supporting families through the diagnostic process and linking them to appropriate supports.

Recommendations:

• Address jurisdictional gaps between NDIS and state services: Current jurisdictional gaps between NDIS and state services, result in delays, confusion, gaps and inequity. Coordinated and collaborative planning and delivery is needed across federal, state, and departmental levels of government to clarify responsibilities and align funding streams.
• Flexible, targeted funding aligned with best practice: Funding needs to be targeted and flexible and consistent with evidence-based guidelines including the Best Practice Framework.
• Commissioning quality providers with strong governance and workforce development: Commissioning should select for quality providers. Quality providers have demonstrated appropriate governance, service and support, quality and safeguarding and workforce development in place to deliver high quality supports.
• Map service availability, especially in regional areas: Mapping services across each state/territory to ensure equity of access with a specific focus on regional and remote communities and informing the commissioning approach. It also builds a picture of the current supports that are working well in a community and where there are gaps. Members have noted that there is a need for a new approach, but that it is important not to disregard long standing, effective and well utilised existing programs that have gained trust and built social capital. Commissioning approaches should include alternative commissioning particularly for regional and remote settings. It is critical that services are free or very affordable. There are

opportunities to scale existing community programs that are already delivering effective supports.

• Strengthen integration across health, education, disability and child protection: Collaboration and integration must be strengthened across NDIS, education, health (child and maternal, primary care, community health, allied health) and child protection to ensure effective foundational supports. Pathways should offer multi-disciplinary supports with flexible models.
• Improve service delivery in schools: Access, fees and lack of coordination hinder early intervention in schools together with a lack of dialogue within education sector. Service delivery in schools is a critical success factor.

c) Equity and intersectionality, especially First Nations and CALD children

Persistent inequities in access to early childhood intervention remain a significant concern, particularly for First Nations and culturally and linguistically diverse (CALD) children. Data consistently shows that CALD families have had low access rates to early intervention supports since 2009, and First Nations children continue to face barriers related to cultural safety, trust, and service availability. These inequities are further compounded by factors such as visa status, geographic location, and socioeconomic disadvantage.

NDS recommends investment in culturally safe, community-based, and place-based models that are co-designed with First Nations and CALD families. Trusted organisations—such as Aboriginal Community Controlled Organisations and multicultural service providers—play a critical role in engaging families, building trust, and delivering supports in ways that are responsive to local needs and cultural contexts. Place-based approaches, tailored to the unique strengths and challenges of each community, are essential for achieving equity in access and outcomes.

To address persistent gaps Thriving Kids must prioritise the development and funding of culturally safe services, ensure that foundational supports are universally accessible regardless of visa status, and embed intersectionality as a core principle in program design and evaluation.

Families from First Nations and CALD backgrounds face persistent barriers to accessing early supports, including lack of culturally safe services and trusted referral pathways. NDS recommends investment in community-based, place-based models that are co-designed with families and delivered by trusted local organisations.

The Thriving Kids announcement included new Medicare items to support early development assessments and allied health services. It is to be noted that consideration should be given to potential barriers such as gap fees and lack of access for some visa holders. Medicare items must be designed in line with best practice for early childhood intervention.

Recommendations:

• Invest in culturally safe diagnostic and support services: Need for trusted staff and community organisations to support First Nations and culturally and linguistically diverse (CALD) families.
• Implement place-based models tailored to community needs: Tailored approaches for specific communities are recommended.
• Address visa-related service exclusions: CALD families may be excluded from some services due to visa status. Options and impact should be considered.

d) Workforce support and training

A skilled, sustainable, culturally competent workforce is essential to provide multi-disciplinary services for the success of the Thriving Kids initiative. However, current workforce pressures across early childhood education and allied health sectors threaten the quality and accessibility of foundational supports. Workforce shortages, particularly in regional and remote areas, are exacerbated by low remuneration, limited career progression, and high reliance on trainees. Competition across the care and support sector for these roles is intense. These issues impact service delivery, increase staff turnover, and reduce the time available for supervision, mentoring, and professional development. As a system designed to support families it is important that social work is considered as part of the allied health workforce.

A targeted workforce strategy would enable the effectiveness of foundational supports for children by identifying and addressing gaps. Strategies could include alternative commissioning approaches in rural and regional settings, recognition of the importance of supervision and non-contact time and renumeration. Ongoing workforce development including training in cultural safety, trauma-informed care and reflective practice are essential. Consideration should be given to the value of peer workforce in foundational supports.

An important opportunity is identified for professional development to teachers and early childhood educators to build capacity and confidence. This in turn will support and bolster the capability of the workforce delivering supports. Early childhood educators provide play-based support for 0-5 years and are well placed to play an important role in functional assessments for development concerns. There is also the opportunity to capacity build play based interventions across the allied health workforce.

Recommendations:

• Address allied health shortages, especially in regional areas: training and retention are major issues. Incentives and alternative commissioning should be considered. The Thriving Kids workforce should be considered in other cross-governmental initiatives and strategies such as the Allied Health Professional Roadmap.
• Enhance paediatric content in university courses: University courses lack paediatric content.
• Provide professional development for educators: Opportunity to provide professional development to teachers and early childhood educators to build capacity and confidence.
• Develop a national workforce strategy including peer workforce models: To ensure sufficient supply of trained workers to deliver foundational supports for children.

e) Domestic and international best practice

Consistent review findings are that best practice in early childhood intervention (ECI) is underpinned by a structured framework of principles, practices, and strategies co-designed with families, practitioners, and communities. The vision is that all young children with developmental concerns, delay or disability and their families thrive in their early years, with ECI services promoting the capabilities of parents, carers, service providers, and communities to provide children with the experiences and opportunities they need to participate meaningfully in home, community, and early learning settings.

Key principles include cultural safety (especially for Aboriginal and Torres Strait Islander children and families), respect for diversity, rights-based and family-centred approaches, authentic relationships, inclusion in natural settings, and strengths-based, outcomes-focused practice.

Key worker implementation and community capacity building have already been mentioned as key elements to the success of foundational supports for children. Digital inclusion is increasingly becoming a barrier to access either through lack of access to the hardware functionality or lack of knowledge in using the systems. Investment in digital inclusion is essential especially in regional and remote Australia.

The NDIS Review recommended that governments develop a Foundational Supports Statement of Intent and a national strategy to guide investment, implementation, and accountability as a first step. This should include clear funding mechanisms, commissioning pathways, and outcome measures. The Review also called for a national foundational supports strategy that is aligned to relevant national frameworks and that includes nationally consistent mechanisms for monitoring outcomes and collecting data are needed to ensure quality, equity, and continuous improvement.

A Foundational Supports Statement of Intent and a national strategy are needed to guide investment, implementation, and accountability. This should include clear funding mechanisms, commissioning pathways, and outcome measures. Identifying how Thriving Kids and recent information, linkages and capacity grants (ILC), which included a focus on

families, fit within this strategy will increase coordination and help address the system fragmentation currently being experienced by children and their families.

Innovation must be embedded in the design and delivery of foundational supports. NDS recommends investment in community capacity-building, peer-led programs, and inclusive service models that reflect the diversity of families and communities. A national outcomes framework and public reporting mechanisms should be established to monitor effectiveness and drive continuous improvement.

Recommendations:

• Implement Key Worker model for integrated care: Embedding support into children’s daily environments, offering families consistent, integrated care across therapy, education, and community settings is best practice and should be designed into foundational supports for children.
• Build community capacity through education and campaigns: Build capacity of families, early childhood educators and communities. Campaigns and resources to equip with practical skills and education to identify behaviours that may signal a need for early childhood intervention support.
• Invest in digital and non-digital advisory services: Investment in both digital and non-digital advisory services is essential, especially in rural areas to ensure information and advice is available to all families.
• Align with national frameworks: Thriving Kids should align with the Best Practice Framework, Australia’s Disability Strategy, Early Years Strategy, Safe and Supported: The National Framework for Protecting Australia’s Children 2021-2031, and the National Agreement on Closing the Gap.
• Develop a national Foundational Supports Strategy: NDS calls for a Foundational Supports Strategy agreed across all governments to guide investment, implementation and ongoing reporting.
• Establish national outcomes framework and public reporting: National and state/territory outcome measures and public reporting to track effectiveness should be implemented.

f) Seamless transitions through mainstream systems

Seamless transitions across health, education, disability, and community systems are essential to ensure children and families experience continuity of support as their needs evolve. However, current systems are fragmented, with multiple entry points, inconsistent eligibility criteria, and limited coordination between services. These challenges are particularly acute during key transition periods—such as the move from early childhood settings to school, or from and between NDIS and mainstream service systems (and in future foundational supports). These challenges are compounded for families from regional, CALD, and First Nations communities and for marginalised families. Our members have described the experience of a seamless system as clear, consistent, accessible and timely communication and minimal to no disruptions to services or loss of services.

The NDIS Review recommends a “no wrong door” approach, where families can access information, assessment, and support from any entry point, and are guided through the system by trusted professionals. Children with development concerns create anxiety and concerns for families. These aspects are exacerbated in rural communities and can bring stigma and shame. Inclusive entry points and no wrong door and crucial to providing help to children and their families. Supported playgroups are highlighted by members as a ‘soft entry’ point.

The Disability Royal Commission calls for robust governance, data sharing, and accountability mechanisms to ensure transitions are planned, monitored, and responsive to the needs of children and families.

Consistent recommendations reinforce the importance of integrated models across service streams and specifically in education. Key workers and navigation type services are critical elements that reduce duplication, minimise service gaps, and ensure children do not fall through the cracks. They also reduce the experience of families having multiple therapists or providers delivering supports. Foundational supports for children should include development and scaling of integrated, ecosystem-based models—such as the Key Worker approach—that link health, education, and disability services at the local

level. Best practice highlights that these services are effective when embedded in natural environments and co-designed with families and local communities.

NDS supports the development of a nationally consistent framework for transitions, with clear roles and responsibilities across sectors. This includes early planning, multidisciplinary collaboration, and culturally safe practices that reflect the diverse needs of families. Outcomes monitoring and public reporting are a key component of a best practice strategy.

Recommendations:

• Embed navigation support across sectors: Navigation support should be built into the design and across sectors e.g. education, providing advice and information on services including localised knowledge, and support families, navigate and make informed choices.
• Ensure multiple entry points and ’no wrong door’ access: Supports should be accessible through regular touchpoints such as hospitals during birth, parent groups, maternal health, schools, and community settings.
• Co-design an integrated ecosystem across health, education and disability: a co-designed, well-connected system across health, education, child protection and disability across states and territories.
• Track user experience and outcomes: The experience of children and families, and the outcomes of support should be incorporated into the national outcomes framework and publicly reported.

5.0 Conclusion

The design and implementation of foundational supports for children in Australia provides a once in a lifetime opportunity to strengthen the Australian disability ecosystem. The commitment of the Federal Government to establishing foundational supports for children by July 2026 provides a needed direction and momentum to improve opportunities and support for children across Australia.

The timeline is challenging and ambitious. Working together to design and implement solutions is the task now. NDS and our members stand ready to contribute and support this important work.

Contact

Michael Perusco

CEO National Disability Services

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[NDS website](NDS website)

Friday 3 October 2025

Key References

Department of Health, Disability and Ageing Thriving Kids Factsheet [Thriving Kids — Fact sheet | Australian Government Department of Health, Disability and Ageing](Thriving Kids — Fact sheet | Australian Government Department of Health, Disability and Ageing)

Early Childhood Intervention Best Practice Network ‘Foundational Supports and the Disability Ecosystem for Children with developmental concerns, delays, differences and disabilities. (July 2024) [2024.07-ECIBP-Network-Foundational-Supports-and-the-Disability-Ecosystem DIGITAL.pdf](2024.07-ECIBP-Network-Foundational-Supports-and-the-Disability-Ecosystem DIGITAL.pdf)

Independent Review of the place of Art and Music Therapy within Australia’s National Disability Insurance Scheme. Stephen Duckett AM (April 2025) [Independent review into art and music supports | NDIS](Independent review into art and music supports | NDIS)

National Best Practice Framework for Early Childhood Intervention Published by Australian Government Department of Health, Disability and Ageing (29 September 2025) [National Best Practice Framework for Early Childhood Intervention | Australian Government Department of Health, Disability and Ageing](National Best Practice Framework for Early Childhood Intervention | Australian Government Department of Health, Disability and Ageing)

NDIS Review — Final report (2023) [Working together to deliver the NDIS | NDIS Review](Working together to deliver the NDIS | NDIS Review)

NDIS Review Factsheet 5: Children and Families Anew connected system of support and new early intervention NDIS pathway | NDIS Review

NDS Early Childhood intervention forum — summary report NDS (August 2025) (unpublished)

NDS Top 10 priorities for NDIS reform (August 2023) [NDS_Top_ten_reform_priorities_for_NDIS_Reform_2023. pdf](NDS_Top_ten_reform_priorities_for_NDIS_Reform_2023. pdf)

Speech from Minister Butler, National Press Club 20 August 2025 [Speech from Minister Butler, National Press Club — 20 August 2025 | Health, Disability and Ageing Ministers | Australian Government Department of Health, Disability and Ageing](Speech from Minister Butler, National Press Club — 20 August 2025 | Health, Disability and Ageing Ministers | Australian Government Department of Health, Disability and Ageing)