Friday, 3 October 2025

Committee Secretary
PO Box 6021
Parliament House
Canberra ACT 2600

To: The House Standing Committee on Health, Aged Care and Disability

RE: Inquiry into the Thriving Kids Initiative

On behalf of the Australasian ADHD Professionals Association (AADPA), I would like to thank the Committee for the opportunity to make a submission to this inquiry.

AADPA is a national not-for-profit association representing healthcare professionals in Australia and New Zealand involved in the assessment, diagnosis, and support of ADHD. We are the second largest ADHD professional organisation in the world. Our membership is broad and includes researchers and academics, psychiatrists, paediatricians, psychologists, general practitioners, nurses and many other allied health professionals, and ADHD Coaches. Many of our members also have lived experience.

In the attached submission we have broken down our detailed responses to the Terms of Reference with recommendations at the end of each section.

We look forward to collaborating with the Inquiry as needed and hope to work with other stakeholders to develop solutions and pathways that address the needs of individuals with ADHD and create a brighter future for our communities. All AADPA’s work is geared to make a meaningful difference to people living with ADHD through accurate assessment and diagnosis and evidence-based treatment and supports.

Yours sincerely

Professor David Coghill

President, Australasian ADHD Professionals Association (AADPA)

Financial Markets Foundation Chair of Developmental Mental Health

Departments of Paediatrics and Psychiatry

University of Melbourne

E: redacted

Submission to the Thriving Kids Inquiry

From the Australasian ADHD Professionals Association (AADPA)

Date: October 3, 2025

Executive Summary

The Australasian ADHD Professionals Association (AADPA) welcomes the opportunity to contribute to the Thriving Kids inquiry. As the peak body representing interdisciplinary healthcare professionals involved in ADHD assessment, diagnosis, and support across Australasia, AADPA brings extensive expertise in neurodevelopmental conditions that frequently present with mild to moderate developmental delays in early childhood.

ADHD is the most common neurodevelopmental disorder in Australian children, affecting approximately 4-5% of children. Early identification and intervention are critical, yet current systems fail to adequately identify and support many children with ADHD during the crucial early years. Not every developmental challenge is ADHD, but failing to recognise ADHD when present leads to misdiagnosis, delayed intervention, and poorer outcomes.

This submission draws on AADPA’s Australian Evidence-Based Clinical Practice Guideline for ADHD (2022), research by AADPA members, and our collective expertise. We recommend embedding ADHD expertise in Thriving Kids design and implementation, developing evidence-based resources, training the workforce, ensuring culturally appropriate assessment, creating coordinated pathways, and addressing critical workforce gaps.

About AADPA

AADPA is a national not-for-profit association representing healthcare professionals in Australia and New Zealand involved in the assessment, diagnosis, and support of ADHD. Our membership includes researchers, psychiatrists, paediatricians, psychologists, GPs, nurses, allied health professionals, ADHD coaches, and people with lived experience.

Since 2019, AADPA has led national collaborative projects, including the Australian Evidence-Based Clinical Practice Guideline for ADHD (2022, NHMRC-endorsed), Consumer Companion Guide (2023), The Social and Economic Costs of ADHD study (Deloitte Access Economics, 2019), demonstrating over $20 billion annual impact, and state-based workforce development initiatives.

Response to Terms of Reference

1. Evidence-Based Information and Resources to Assist Parents

The Challenge

Parents lack accessible, evidence-based resources to distinguish when concerns indicate neurodevelopmental conditions like ADHD versus typical developmental variation.

Not every child with learning difficulties or attention problems has ADHD, but failing to recognise ADHD when present leads to misdiagnosis and delayed intervention.

Research by AADPA members (Bisset et al., 2023, Journal of Child Psychology and Psychiatry) found families report difficulty accessing accurate information about ADHD, confusion about diagnostic processes, limited knowledge about evidence-based interventions beyond medication, and insufficient guidance on supporting their child’s development.

Recommendations

1. Develop Tiered Parent Education Resources:

   • Tier 1 (Universal): Developmental milestones including attention, self-regulation, and social-emotional development
   • Tier 2 (Targeted): Information for parents of children showing potential concerns, including when to seek assessment
   • Tier 3 (Condition-specific): Resources for parents of children diagnosed with ADHD or other neurodevelopmental conditions

2. Create ADHD-Specific Parent Resources That:

   • Explain ADHD presentations across ages 0-5 years
   • Distinguish ADHD from age-appropriate high activity
   • Highlight differences in presentations between genders
   • Outline evidence-based parent training programmes
   • Provide practical strategies for supporting self-regulation and attention
   • Clarify assessment pathways

3. Ensure Resources Are:

   • Co-designed with parents with lived experience
   • Culturally adapted for First Nations and CALD communities
   • Available in multiple formats and languages
   • Evidence-based and regularly updated
   • Free and accessible through multiple touchpoints

4. Integrate Evidence-Based Psychoeducation: The AADPA Guideline emphasises high-quality psychoeducation as a cornerstone of ADHD support. Thriving Kids should pilot evidence-based psychoeducation models, evaluate what information delivered how and when best supports families, and build the evidence base for parent education programmes.

2. Effectiveness of Current Programmes and Initiatives

Current Gaps

Existing early childhood health checks focus on physical growth, motor development, speech, vision, hearing, and immunisation, but inadequately capture early ADHD indicators. Research shows 2 in 5 children in NSW start school without reaching all developmental milestones, and approximately 1 in 7 children in Australia have a neurodevelopmental disorder, with ADHD being the most common (7.2% prevalence in children aged 0-14).

Key problems:

• Workforce training gaps: Limited training in recognising ADHD presentations in young children
• Screening tool limitations: Current tools lack both sensitivity and specificity for ADHD-related concerns (persistent inattention, extreme difficulty waiting, excessive motor activity impairing learning, emotional dysregulation)
• Pathway fragmentation: Long wait times (often exceeding 2 years) for public paediatric assessment and significant out-of-pocket costs in the private system
• Siloed approaches: Fail to capture high co-occurrence with other neurodevelopmental and mental health conditions

Evidence from School-Based Models

The Djing.gii Gudjaagalali (Children Stars) School Clinic in rural NSW demonstrates the effectiveness of integrated care:

• 79% of students had learning difficulties
• 77% had behavioural concerns
• 73% had emotional concerns
• ADHD was diagnosed or requiring management in 40% of cases
• Critically, 71% of ADHD cases had unmet needs prior to clinic review

This model demonstrates the interconnection between health, development, and learning; high rates of unmet need in the community; the value of integrated, accessible assessment pathways; and the importance of multidisciplinary approaches. The median 45-day wait compared to 2+ years for usual care, with high utilisation and low non-attendance, shows that co-location reduces barriers and GPs can effectively manage ADHD with appropriate support.

Recommendations

1. Enhance Developmental Surveillance:

   • Integrate ADHD-informed screening into existing health check frameworks
   • Train all professionals conducting developmental checks in recognising early ADHD indicators
   • Use accurate, validated, and age-appropriate screening tools

2. Adopt Integrated, Stepped-Care Models:

   • Universal: All children receive developmentally-informed monitoring
   • Targeted: Children with identified concerns receive enhanced assessment and brief interventions
   • Specialist: Children with complex concerns access multidisciplinary assessment

3. Strengthen Community-Based Programmes:

   • Invest in early childhood programmes building attention, self-regulation, and social skills
   • Pilot parent training programmes for families of preschoolers showing ADHD indicators
   • Evaluate effectiveness using child outcomes, parent confidence, and service utilisation metrics

4. Create Clear Referral Pathways:

   • Establish coordinated entry points for assessment
   • Define which professionals can assess and manage ADHD at different complexity levels
   • Ensure timely access (target: assessment within 3 months of identification)

5. Implement Collaborative Care Models:

Foster collaboration between child health nurses, GPs, paediatricians, psychologists, and allied health professionals; as well as early education and schools, drawing on AADPA’s experience developing shared-care frameworks.

3. Equity and Intersectional Issues: First Nations and CALD Communities

First Nations Children

There is little evidence about ADHD prevalence in First Nations children, though incidence of neurodevelopmental conditions and developmental delays is higher than in non-Indigenous populations. Significant barriers persist including:

Cultural and practical barriers: Reluctance to engage with mainstream services due to past negative experiences and lack of cultural safety; limited access in remote/rural areas; cost of assessments and travel; transportation difficulties; language barriers; lack of awareness; stigma and discrimination; differing cultural understandings of child development and behaviour.

AADPA has shown that a common assessment tool used in neurodevelopment, including with First Nations peoples, the Strengths and Difficulties Questionnaire, performs poorly in Indigenous peoples, suggesting the need for the development of culturally appropriate screening and assessment tools for Indigenous peoples

Critical need: Mental health, including neurodevelopmental conditions, interconnects with spiritual, environmental, cultural, political, social, emotional, and physical health domains in First Nations communities.

We need more information to effectively deliver culturally appropriate care. Clinicians need support to understand how to frame neurodevelopmental conditions and articulate treatment (clinical and cultural), building on existing strengths, beliefs, and practices.

CALD Communities

CALD families face language barriers limiting communication with providers; cultural differences in understanding neurodevelopmental conditions; fear of judgement or child protection involvement; limited awareness of Australian systems; stigma associated with disability diagnosis; and varied educational expectations and behavioural norms.

Recommendations

1. First Nations-Specific Strategies:

   • Co-design all resources and pathways with First Nations communities, health services, and educators with valid psychometric tools
   • Fund Aboriginal Community Controlled Health Organisations to deliver Thriving Kids assessments using culturally safe, holistic frameworks
   • Train First Nations health workers in developmental surveillance and ADHD recognition
   • Commission research into ADHD prevalence, presentation, and culturally appropriate assessment and intervention approaches
   • Develop co-designed culturally appropriate assessment tools for neurodevelopment
   • Integrate cultural supports (Elders, cultural liaison officers) into assessment and intervention pathways
   • Deliver services in community, reducing barriers of distance and unfamiliarity

2. CALD Community Strategies:

   • Translate resources into priority community languages
   • Use multilingual health workers and interpreters in all assessments
   • Provide culturally specific psychoeducation addressing cultural beliefs about ADHD
   • Partner with multicultural health services and community organisations

• Train mainstream providers in cultural competence and working with interpreters
• Address stigma through community education campaigns

3. Cross-Cutting Equity Measures:

   • Ensure all Thriving Kids services are free at point of care
   • Deliver services in accessible locations (schools, childcare centres, community health centres)
   • Provide transport support where needed
   • Proactive outreach—bring services to communities
   • Monitor equity by tracking uptake and outcomes by Aboriginal status, language, socioeconomic status, and geography
   • Fund targeted programmes to close equity gaps

4. Workforce Support and Training Required

Critical Workforce Gaps

Health systems across the country face critical shortages in nursing, mental health services, paediatrics, child psychiatry, psychology, and rural/remote areas. The 2020 Henry Review found 50-70% of public paediatrician caseloads involve ADHD, overwhelming services designed for broader paediatric care. Current university curricula provide minimal ADHD training for most health professionals.

Recent inquiries, including the 2020 NSW Henry Review and 2023 Federal Senate Inquiry into ADHD, concluded it is unrealistic to think there will ever be enough secondary care medical practitioners (paediatricians, psychiatrists) to adequately manage demand for ADHD assessment and ongoing management.

Thriving Kids must embrace workforce flexibility, enabling GPs, nurses, and allied health professionals to contribute to assessment and support.

AADPA’s Workforce Development Experience

AADPA is currently involved in several workforce development initiatives demonstrating that GPs and nurses can deliver high-quality ADHD care when properly trained:

• Western Australia: Partnering with RACGP and WA Health to deliver the WA ADHD GP Training Programme, training 65 specialist GPs in assessment, diagnosis, and prescribing by mid-2026
• New South Wales: Collaborating with NSW Health to develop e-learning modules for clinicians, enabling shared-care trials in regional areas
• South Australia: In negotiations regarding similar GP workforce development and expanded prescribing rights

Recommendations

1. Mandate ADHD Training in Professional Education:

   • Undergraduate: Include neurodevelopmental conditions in medical, nursing, psychology, education, and allied health curricula
   • Postgraduate: Require ADHD competencies for GP training, child health nursing, paediatrics, psychiatry
   • Continuing professional development: Provide accessible, free training for current workforce

2. Develop Role-Specific Training Pathways:

   • Early childhood educators: Brief training in developmental monitoring and referral
   • Child health nurses: Extended training in neurodevelopmental assessment and parent support
   • GPs: Comprehensive training in ADHD diagnosis and management
   • Allied health: Discipline-specific ADHD training

3. Create Accessible Training Resources:

   • Online modules accessible statewide
   • Face-to-face workshops for skill development
   • Communities of practice for ongoing learning and peer support
   • Clinical mentoring and supervision for complex cases

4. Support Multidisciplinary Team Development:

   • Fund positions for ADHD specialist nurses
   • Develop career pathways for allied health professionals in neurodevelopmental services
   • Create protected time for team meetings and case coordination

5. Domestic and International Policy Experience and Best Practice

Key International Models

United Kingdom - Dundee ADHD Clinical Care Pathway (DACCP): Developed by AADPA President Professor David Coghill, this highly influential model has nurse practitioners and GPs providing front-end clinical care with structured assessment pathways, measurement-based care, and shared care between primary and specialist services, achieving dramatic improvements in clinical outcomes. Now adopted worldwide and forming the basis for NSW clinical pathways.

Other models: Canada uses GP-led diagnosis with specialist consultation for complex cases and school-based support services. Scandinavia emphasises multidisciplinary assessment, free parent training programmes through community services, and mandated school-based supports.

Australian School-Based Integrated Care

The Djing.gii Gudjaagalali (Children Stars) School Clinic in rural NSW demonstrates high unmet need (71% of ADHD cases, 86% of autism cases), accessibility (median 45-day wait vs. 2+ years usual care), high acceptability, and that co-location reduces barriers whilst GPs can effectively manage ADHD with appropriate support.

Urban models in Sydney (Kalgal Burnbona, Ngaramadhi Space) show similar improved outcomes through multisector collaboration.

Recommendations

1. Adopt Evidence-Based Clinical Pathways: Use the AADPA Clinical Practice Guideline for ADHD as the foundation for ADHD identification and support within Thriving Kids, ensuring consistency with national best practice.

2. Pilot Integrated Service Hubs: Building on school-based models, pilot Thriving Kids hubs co-located with early childhood education that provide multidisciplinary assessment, deliver evidence-based interventions, link to specialist services when needed, and evaluate outcomes rigorously.

3. Implement Measurement-Based Care:

   • Establish a minimum dataset for all Thriving Kids participants
   • Use validated outcome measures
   • Create data infrastructure to support continuous improvement

4. Learn from International Experience Whilst Adapting Locally: Adapt models to Australian context (funding structures, geography, cultural diversity) and partner with research institutions for evaluation.

6. Mechanisms for Seamless Transitions Through Mainstream Systems

Current Transition Challenges

Children with ADHD experience multiple problematic transitions: early childhood to school (concerns not communicated); between health providers (no clear handover); across sectors (siloed services); geographic moves (loss of continuity); and age-based service exits. Families report fragmented care, repeatedly explaining their child’s history, long wait times, inconsistent advice, and falling through gaps.

Opportunity: Scaling the Digital Blue Book (and similar models) & the Child Development Registry (University of Sydney)

Whilst NSW centric these the digital Child Personal Health Records (varies in each state) provides infrastructure for capturing developmental surveillance data longitudinally, enabling

access by authorised providers, flagging children requiring assessment, tracking intervention uptake and outcomes, and supporting transitions with complete developmental history.

The Child Development Registry (Brain and Mind Clinic - USYD) has been collecting data in NSW, Victoria and Queensland. It was developed specifically to chart neurodevelopmental conditions.

Recommendations

1. Expand GP Role in ADHD Assessment, Diagnosis and Management: With GPs increasingly taking on ADHD assessment, diagnosis and treatment:

   • Provide comprehensive training and support in developmental surveillance and ADHD assessment
   • Enable GPs to coordinate referrals and synthesise specialist input
   • Support GPs to maintain long-term oversight across transitions
   • Fund adequate time for comprehensive ADHD assessments (approximately 3 hours)
   • Create clear protocols for GP-led ADHD care within collaborative frameworks

2. Create Dedicated Care Coordination for Complex Cases: The AADPA Clinical Practice Guideline for ADHD recommends every person with ADHD should have someone to coordinate their care. Fund care coordinators (nurses, allied health, or social workers) to navigate services, communicate between providers, support families, ensure treatment plan implementation, and facilitate transitions.

3. Develop Transition Pathways:

   • Preschool to School: Standardised transition summary including developmental history
   • Child Health Nurse to GP: Formal handover at age 5, including Thriving Kids results
   • Specialist to GP: Shared-care arrangements with clear roles
   • Primary to High School: Updated assessment and support planning
   • Child to Adult Services: Transition planning beginning at age 16

4. Align Funding and Service Models: Enable the same providers to work across age ranges, fund coordinated packages of care (not isolated episodes), and incentivise collaboration and information sharing.

5. Use Technology Strategically: Enhance digital Blue Book (and its variants) or the Child Development Registry with clinical decision support, enable secure messaging between providers, provide families with portal access to their child’s records (My Health Record), and use telehealth to maintain continuity when families relocate.

6. School-Based Platform for Continuity: Leverage education settings as a stable platform: conduct Thriving Kids assessments in childcare/preschool settings, use results to inform school transition planning, maintain engagement through school-based health services, and facilitate connections to external services.

Note: The NSW Parliamentary Inquiry into improving access to early childhood health and development checks (to which AADPA submitted in February 2024) was paused and did not report. In part this submission builds on that earlier work.

Critical Issues and Concerns

1. ADHD Should NOT Be Overlooked

As the most common neurodevelopmental condition, ADHD must be embedded in Thriving Kids from the outset. ADHD frequently co-exists with other neurodevelopmental conditions, just as autism, and these more complex presentations are associated with poorer everyday functioning. Overlooking ADHD risks creating new service gaps for tens of thousands of children directly affected by these reforms.

2. Not Every Learning Difficulty Is ADHD—But ADHD Is Often Missed

Not every developmental delay or challenge is ADHD. Difficulties with maths, reading, or social cues do not necessarily mean a child has ADHD. Equally, failing to recognise ADHD when present leads to misdiagnosis, delayed treatment, and poorer outcomes. Understanding the difference is critical.

3. The Link to NDIS Transition

ADHD is not the primary driver of NDIS growth, but it is a major co-occurring condition amongst children transitioning from the NDIS. It is a highly treatable condition and therefore if identified early we have an opportunity to reduce lifelong burden.

Addressing ADHD through Thriving Kids will reduce system pressure, improve health and education outcomes, and deliver substantial cost savings to governments. 4. Avoid Screening Without Diagnostic Capacity Children with ADHD should be supported through health and education systems, not disability services, except where functional impairment is severe.

AADPA’s Clinical Practice Guideline for ADHD does not support universal ADHD screening in populations where diagnostic and intervention services are unavailable. Identifying children without the capacity to assess and support them causes harm: families become anxious without access to help, children are labelled without intervention, services become overwhelmed, and trust in the system erodes.

Thriving Kids must build diagnostic and intervention capacity before (or concurrent with) enhanced identification efforts.

5. Early Childhood Education Centres and Schools Are Essential for Capturing Missed Children

Developmental checks alone are not sufficient to detect every child with ADHD. Inevitably, some children will fall through the cracks and their ADHD will become apparent at a later stage in the

classroom. Schools are therefore a vital resource for capturing children who are missed during early routine health checks, and it is essential that schools are engaged in the discussion about their role in supporting children with ADHD.

6. Gender Differences in ADHD Presentation

There is evidence that ADHD presents differently in girls than in boys and diagnostic criteria do not adequately consider this. Thriving Kids must ensure that assessment approaches capture the full spectrum of ADHD presentations.

Conclusion

Thriving Kids represents a once-in-a-generation opportunity to transform early childhood developmental support in Australia. For this initiative to succeed, ADHD expertise must be embedded from the outset.

AADPA stands ready to work with government, health services, education sectors, and communities to ensure that Thriving Kids delivers:

• Accurate identification of children with ADHD and other neurodevelopmental conditions
• Evidence-based interventions that improve outcomes for children and families
• Equitable access to services for all children, (inc. First Nations and CALD communities)
• A skilled workforce capable of delivering high-quality developmental support
• Seamless transitions through health, education, and community systems
• Sustainable models that reduce pressure on specialist services whilst maintaining quality

We welcome the opportunity to contribute our expertise to this important initiative.

Australasian ADHD Professionals Association
Web: www.aadpa.com.au\ Email: admin@aadpa.com.au
ABN: 85 616 076 049

This submission was prepared by:

AADPA with input from individuals with lived experience and AADPA members across disciplines.

References

AADPA Resources and Guidelines

Australian ADHD Professionals Association (AADPA). (2023). Australian Evidence-Based Clinical Practice Guideline for ADHD: Consumer Companion Guide. Melbourne, Australia: AADPA. Available at: https://adhdguideline.aadpa.com.au/consumer-companion/

AADPA - Deloitte Access Economics. (2019). The social and economic costs of ADHD in Australia. Melbourne, Australia: Deloitte. https://www.deloitte.com/au/en/services/economics/perspectives/social-economic-costs-adhd-Australia.html

Key ADHD Research and Evidence

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Asherson, P., Buitelaar, J., Faraone, S. V., & Rohde, L. A. (2016). Adult attention-deficit hyperactivity disorder: Key conceptual issues [Review Article]. The Lancet Psychiatry, 3(6), 568-578. https://doi.org/10.1016/S2215-0366(16)30032-3

Bisset, M., Brown, L. E., Bhide, S., Patel, P., Zendarski, N., Coghill, D., Payne, L., Bellgrove, M. A., Middeldorp, C. M., & Sciberras, E. (2023). Practitioner review: It’s time to bridge the gap – understanding the unmet needs of consumers with attention-deficit/hyperactivity disorder – a systematic review and recommendations. Journal of Child Psychology and Psychiatry, 64(6), 848-858. https://doi.org/10.1111/jcpp.13752

Bruno, C., Havard, A., Gillies, M. B., Coghill, D., Brett, J., Guastella, A. J., Pearson, S.-A., & Zoega, H. (2023). Patterns of attention deficit hyperactivity disorder medicine use in the era of new non-stimulant medicines: A population-based study among Australian children and adults (2013-2020). The Australian and New Zealand Journal of Psychiatry, 57(5), 675-685. https://doi.org/10.1177/00048674221114782

Coghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., Daley, D., Danckaerts, M., Dittmann, R. W., & Doepfner, M. (2021). The management of ADHD in children and adolescents: Bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). European Child & Adolescent Psychiatry, 1-25.

Coghill, D., & Hodgkins, P. (2016). Health-related quality of life of children with attention-deficit/hyperactivity disorder versus children with diabetes and healthy controls. European Child & Adolescent Psychiatry, 25(3), 261-271.

Coghill, D., & Seth, S. (2015). Effective management of attention-deficit/hyperactivity disorder (ADHD) through structured re-assessment: The Dundee ADHD Clinical Care Pathway. Child

and Adolescent Psychiatry and Mental Health, 9(1), 52. https://doi.org/10.1186/s13034-015-0083-2

Dodds, M., Dona, S. W. A., Gold, L., Coghill, D., & Le, H. N. (2024). Economic burden and service utilization of children with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Value in Health, 27(2), 247-264.

DuPaul, G. J., Evans, S. W., Mautone, J. A., Owens, J. S., & Power, T. J. (2020). Future directions for psychosocial interventions for children and adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 49(1), 134-145.

Enns, J. E., Randall, J. R., Smith, M., Chateau, د., Taylor, C., Brownell, M., Bolton, J. M., Burland, E., Katz, A., Katz, L. Y., & Nickel, N. C. (2017). A multimodal intervention for children with ADHD reduces inequity in health and education outcomes. The Canadian Journal of Psychiatry, 62(6), 403-412. https://doi.org/10.1177/0706743717692301

Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K.-P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059-1088. https://doi.org/10.1016/j.euroneuro.2018.08.001

French, B., Sayal, K., & Daley, D. (2019). Barriers and facilitators to understanding of ADHD in primary care: A mixed-method systematic review. European Child & Adolescent Psychiatry, 28(8), 1037-1064. https://doi.org/10.1007/s00787-018-1256-3

Knott, R., Mellahn, O. J., Tiego, J., Kallady, K., Brown, L. E., Coghill, D., Williams, K., Bellgrove, M. A., & Johnson, B. P. (2024). Age at diagnosis and diagnostic delay across attention-deficit hyperactivity and autism spectrums. Australian & New Zealand Journal of Psychiatry, 58(2), 142-151. https://doi.org/10.1177/00048674231206997

McKenna, K., Wanni Arachchige Dona, S., Lisa, G., Angela, D., & Le, H. N. D. (2023). Barriers and enablers of service access and utilization for children and adolescents with attention deficit hyperactivity disorder: A systematic review. Journal of Attention Disorders, accepted 18/10/2023.

Sciberras, E., Streatfeild, J., Ceccato, T., Pezzullo, L., Scott, J. G., Middeldorp, C. M., Hutchins, P., Paterson, R., Bellgrove, M. A., & Coghill, D. (2022). Social and economic costs of attention-deficit/hyperactivity disorder across the lifespan. Journal of Attention Disorders, 26(1), 72-87. https://doi.org/10.1177/1087054720961828

Sevastidis, A., Wanni Arachchige Dona, S., Gold, L., Sciberras, E., Coghill, D., & Le, H. N. D. (2023). Social gradient in use of health services and health-related quality of life of children with attention-deficit/hyperactivity disorder: A systematic review. JCPP Advances, e12170.

Wanni Arachchige Dona, S., Badloe, N., Sciberras, E., Gold, L., Coghill, D., & Le, H. N. (2023). The impact of childhood attention-deficit/hyperactivity disorder (ADHD) on children’s health-related quality of life: A systematic review and meta-analysis. Journal of Attention Disorders, 27(6), 598-611.

Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., … Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20(1), 404. https://doi.org/10.1186/s12888-020-02707-9

School-Based Integrated Care Models

Arenson, M., Hudson, P. J., Lee, N., & Lai, B. (2019). The Evidence on School-Based Health Centers: A Review. Global Pediatric Health, 6, 2333794x19828745.

Green, N., O’Connor, P., Forrester, B., Williams, I., & Sanci, L. (2021). Doctors in Secondary Schools: A multi-sectoral approach to youth responsive primary health care. International Journal of Integrated Care, 21.

Jones, D., Barton, D. J., Dyson, R., Macbeth, P., Lyle, D., Sunny, P., Thomas, A., & Sharma, I. (2019). A community engaged primary healthcare strategy to address rural school student inequities: a descriptive paper. Primary Health Care Research & Development, 20(e26), 1-6.

Mendoza Diaz, A., Lazaro, A., Burman, C., Best, J., Goldthorp, K., & Eapen, V. (2021). School-based integrated healthcare model: How Our Mia Mia is improving health and education outcomes for children and young people. Australian Journal of Primary Health, 27, 71-75.

Miller C, Rungan S, Schmidt D, Smithers-Sheedy H, Ebbett W, Evans E, Hu N, Khan JR, Sanci L, Lingam R. 2025. Djing.gii Gudjaagalali (Children Stars) School Clinic; a novel primary care led Rural School Based Integrated model of care [manuscript submitted for publication, BMC Primary Care]., PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-6963481/v1]

Miller C, Smithers-Sheedy H, Hu N, Schmidt D, Christie A, Morris T, Sanci L, Lingam R. Reducing Health Inequity for Children and Young People in Rural Australia: Are Digital Interventions a Panacea? A Rural Generalist’s Commentary. Australian Journal of Rural Health. 2025;33:e70015.

Rungan, S., Miller, C., Daley, D., Barton, D., Ebbett, W., Mikhail, S., et al. (2025). Bridging the divide: the growing role of school-based integrated care in regional Australia. BMJ Paediatrics Open, 9(1), e003245.

Rungan, S., Goldfeld, S., Liu, H-M., Woolfenden, S., Smith-Merry, J., & Eastwood, J. (2023). Ngaramadhi Space: An Integrated, Multisector Model of Care for Students Experiencing Problematic Externalising Behaviour. International Journal of Integrated Care, 23(19), 1-16.

Rungan, S., Liu, H., Smith-Merry, J., & Eastwood, J. (2024). Kalgal Burnbona: An Integrated Model of Care Between the Health and Education Sector. International Journal of Integrated Care, 24(14), 1-14.

Rungan, S., Mikhail, S. A., Smith-Merry, J., Liu, H. M., & Eastwood, J. (2023). Retrospective audit of a school-based integrated health-care model in a specialised school for children with externalising behaviour. Journal of Paediatrics and Child Health, Nov 14, jpc.16515.

Rungan, S., Smith-Merry, J., Liu, H. M., Drinkwater, A., & Eastwood, J. (2024). School-Based Integrated Care Within Sydney Local Health District: A Qualitative Study About Partnerships Between the Education and Health Sectors. International Journal of Integrated Care, 24(2), 13.

World Health Organization and the United Nations Educational, Scientific and Cultural Organization. (2021). Making every school a health-promoting school: implementation guidance. Geneva: World Health Organization.

First Nations and Equity

National Indigenous Australians Agency. (2024). Commonwealth closing the gap 2023 annual report and 2024 implementation plan. Canberra: Australian Government. Retrieved from https://www.niaa.gov.au/resource-centre/indigenous-affairs/commonwealth-closing-gap-2023-annual-report-and-2024-implementation-plan

Policy and Service Delivery

NSW Health. (2020). Review of health services for children, young people and families within the NSW Health system (‘Henry Review’). Sydney: NSW Government. Retrieved from https://www.health.nsw.gov.au/kidsfamilies/paediatric/Pages/henry-review.aspx

Sayal, K., Mills, J., White, K., Merrell, C., & Tymms, P. (2015). Predictors of and barriers to service use for children at risk of ADHD: Longitudinal study. European Child & Adolescent Psychiatry, 24, 545-552.

Wolfe, I., Satherley, R. M., Scotney, E., Newham, J., & Lingam, R. (2020). Integrated Care Models and Child Health: A Meta-analysis. Pediatrics, 145(1).