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

Introduction

ANZACATA is the peak professional body representing creative arts therapists across Australia, New Zealand, and Asia. Our members are highly trained allied health professionals who use art, drama and dance and movement to support individuals experiencing mental health challenges, developmental delays, trauma, and disability. Arts Therapy is grounded in evidence-based, trauma-informed, and neuro-affirming practices. It is particularly effective for children with verbal communication concerns, including those with autism, developmental delay, and trauma histories (Cohen-Yatziv and Regev, 2019; D’Amico and Lalonde 2017; Eaton 2007; Hackett et al. 2020; King and Parada, 2021, King 2021).

Importantly, Arts Therapy has demonstrated positive outcomes for children with learning disabilities, supporting their social, emotional, and academic development (Martínez-Vérez et al. 2024). Arts Therapy is linked to improvements in attention, memory, and problem-solving abilities, as well as sensory regulation. Other benefits include improvements in motor skills and sensory balance, body control and endurance, (Vogel et al. 2024; King and Parada, 2021), which are often areas of difficulty for children with ASD and/or developmental delays. For example, working with clay can strengthen hand muscles, while large-scale painting can help build gross motor coordination. Arts Therapists adapt techniques using modified tools and adaptive equipment to accommodate physical disabilities (López-Escribano & Orío-Aparicio 2024).

We welcome the opportunity to contribute to the Thriving Kids Inquiry and commend the government’s focus on supports for children with mild to moderate developmental concerns.

Overall comments

• ANZACATA supports the concept of embedding additional supports for children with mild to moderate delay and/or autism into mainstream settings; however, the success of this approach depends on the capacity of these settings to genuinely accommodate the needs of children and families. As noted in our response to the Terms of Reference below, current approaches to supporting children within these settings have limitations. There is a risk that Thriving Kids could replicate or exacerbate these issues, leading to greater inequalities in access and outcomes for children.
• Funding and oversight for mainstream settings—such as child and maternal health, early childhood education, primary care, and schools—come from multiple tiers of government: local, state, and Commonwealth. Significant variations already exist in programs and funding redacted: s22 redacted redacted redacted

across states, creating a risk that the effectiveness and equity of Thriving Kids will differ between jurisdictions. The Commonwealth must establish strong guidelines and program requirements including requiring a suitably qualified workforce of allied health professionals to ensure national consistency, supported by robust monitoring and evaluation.

• Changes to disability services must be carefully coordinated to prevent children and families from losing vital care during the transition. There is considerable uncertainty about how Thriving Kids will interact with the disability sector and what this means for children currently accessing services under the NDIS—services they cannot access elsewhere. Many children receiving Arts Therapy through the NDIS have turned to this modality after talk therapies failed to meet their needs. Our members report that parents are concerned about losing access to Arts Therapy if their children are removed from the NDIS and placed under Thriving Kids. We strongly believe that no child should be removed from the NDIS until appropriate alternative supports are fully available under Thriving Kids.
• Allied health professionals, including Arts Therapists, should be a central component of the Thriving Kids program. These professions bring the skills and flexibility needed to work across the mainstream settings where Thriving Kids will operate—from identifying and assessing children with additional needs to delivering both general and targeted supports for children and families. To achieve this, existing barriers that prevent allied health professionals from working to their full scope of practice in these settings must be addressed. This includes limitations within primary care, early education, and schools.

Response to Terms of Reference

1. Examine evidence-based information and resources that could assist parents identify if their child has mild to moderate development delay and support parents to provide support to these children.

Allied health professionals, including Arts Therapists, are well positioned to provide evidence-based information and develop resources that help parents identify developmental delays. This may be through parent groups in community settings, early childhood services, or mainstream education environments. Arts Therapists, as part of the allied health team, can play a unique role by using creative, strengths-based approaches to engage both children and families in the process of early identification and support.

Allied health practitioners working with children with autism and/or developmental delays often focus on building parental capacity to support their child’s development. For example, Art Therapy offers an accessible and non-threatening way for parents to understand their child’s needs and learn strategies to foster communication, emotional regulation, and social skills through creative modalities such as visual arts, role play and dance/movement. This individualised approach allows practitioners to tailor interventions to the child’s developmental profile and the family’s capacity, ensuring that support is both practical and meaningful.

In addition, information and resources for parents must be linked to concrete supports for children and families, so that parents and caregivers have clear pathways to services within

mainstream settings, including targeted supports where necessary. This includees creative therapeutic options, such as Arts Therapy.

2. Examine the effectiveness of current (and previous) programs and initiatives that identify children with developmental delay, autism or both, with mild to moderate support needs and support them and their families. This should focus on community and mainstream engagement, and include child and maternal health, primary care, allied health playgroups, early childhood education and care and schools.

ANZACATA is concerned that current programs and initiatives aimed at identifying and supporting children within mainstream settings are often fragmented, inconsistent, and fail to recognise the vital role that allied health services—such as Arts Therapy—can play.

Child and maternal health services are frequently the first point of contact for children showing signs of developmental delay and/or autism. Yet, the availability and quality of these services vary significantly across jurisdictions, and many lack the capacity to provide the comprehensive support that children and families need, particularly in under-served locations such as regional and remote areas.

Primary care settings are also critical for early identification. However, families often struggle to navigate referral pathways—especially for children with mild to moderate needs, who may not meet strict eligibility criteria for specialist services. Additionally, there are limitations to Medicare, including the exclusion of various allied health professions, including Arts Therapy, despite their capacity to provide meaningful support to these cohorts (see more on Medicare below).

Allied health professionals, such as Arts Therapists, are well-positioned to deliver targeted early interventions, such as play-based and group therapies in community settings. Despite this, they remain underutilised, and funding is typically limited to children with high needs—leaving a significant gap for those with mild to moderate challenges. Arts Therapy, in particular, is under-recognised in formal funding structures, despite growing evidence of its effectiveness.

Early Childhood Education and Care services and schools offer valuable opportunities to identify and support children with developmental challenges. However, access to specialist support within mainstream settings is variable and educators often lack the training and resources needed to adequately support these children. Within schools, Arts Therapists are already supporting children through initiatives such as Victoria’s Schools Mental Health Menu. However, there is significant variability between states and territories: some have well-established allied health teams within mainstream education, while others have minimal provision. Even where teams exist, demand frequently exceeds capacity. In many cases, the inclusion of allied health professionals depends on the discretion of individual school management.

Further, accessing additional funding and services for children with additional needs is currently complex and inconsistent. Schools typically cannot provide diagnoses and must rely on families to seek external assessments—creating barriers for those lacking financial resources or knowledge of the system. Funding models for additional school-based supports

vary across jurisdictions. Integration funding is not automatically granted based on diagnosis and often requires extensive documentation and advocacy from both schools and families.

Overall, these systems tend to offer a narrow range of services and fail to incorporate the full spectrum of evidence-based approaches. Even within multidisciplinary teams, the breadth of allied health services—such as Arts Therapy—is frequently overlooked.

Medicare

Medicare funds allied health services through programs like Better Access, Chronic Disease Management, and disability-specific initiatives, covering a range of professionals such as psychologists, speech pathologists, and physiotherapists. However, Arts Therapy is not included on this list of Medicare-funded allied health professions, meaning families cannot currently access rebates for Arts therapy services under these programs.

And while these Medicare funded programs recognise the importance of allied health in delivering holistic care, they face significant challenges that limit their effectiveness as a model for delivering services under Thriving Kids. Primary care services/PHNs typically draw on a narrow range of clinical professions (e.g., psychology, occupational therapy, speech pathology) and do not fully utilise the breadth of allied health professions, including Arts Therapy. Equally, while some children may only need therapy from one allied health professional, many benefit from a collaborative approach, which is difficult under existing Medicare arrangements, which currently offer limited support for coordinated, team-based care. Low rebates and a lack of bulk billing incentives or funding for travel also limit the capacity of opportunities for multidisciplinary, holistic care. If Thriving Kids is to be delivered in part through Medicare and primary health services, changes to the model, including expanded dedicated Medicare items will be needed. This includes adding Arts Therapy to the list of allied health professions eligible for Medicare funding.

3. Identify equity and intersectional issues, in particular, children who identify as First Nations and culturally and linguistically diverse.

The Thriving Kids initiative, while designed to integrate with existing health, education, and social services, carries a significant risk of perpetuating existing inequities. Systemic discrimination, lack of cultural safety, and barriers to access within these systems could be replicated for First Nations families, culturally and linguistically diverse (CALD) communities, and socioeconomically disadvantaged groups. These challenges are compounded by geographic inequities: regional and remote areas remain under-served and face critical workforce shortages, including in allied health professions.

Meeting demand within mainstream services will require proactive measures to remove barriers to care. This includes funding for travel to regional locations, leveraging technology for service delivery, and developing locally tailored programs that reflect the unique needs of different communities.

Arts Therapy offers an inherently inclusive and adaptable approach, making it particularly effective for First Nations children, CALD communities, and children with intersectional identities. Art Therapists are trained in culturally safe, non-verbal, and strengths-based methods that honour each child’s unique way of expressing themselves. We strongly

recommend that the Committee explicitly include Arts Therapy in its consideration of culturally responsive supports.

4. Identify gaps in workforce support and training required to deliver Thriving Kids.

There is a growing workforce of qualified allied health professionals, including Arts Therapists in Australia, yet they remain underutilised due to lack of recognition within mainstream health and education systems. ANZACATA-accredited therapists hold postgraduate qualifications and adhere to a professional code of ethics. However, without formal recognition as allied health professionals in all jurisdictions, their integration into mainstream supports remains limited. We urge the Committee to:

• Recognise Arts Therapists as part of the allied health workforce.
• Include Arts Therapy in workforce development strategies for Thriving Kids.

The Thriving Kids Program design must also ensure that high-quality allied health professional services—such as Arts Therapy—are not replaced by less qualified or lower-skilled staff. For example, while allied health assistants (AHAs) play an important role in supporting the delivery of allied health services in mainstream settings, they do not have the skills or qualifications of fully trained allied health professionals. In efforts to reduce costs, there is a risk that providers will substitute and/or reduce access to professional services, reducing the efficacy of programs.

This risk is particularly acute for self-regulating professions such as Arts Therapy. Currently, there is nothing preventing an AHA—or any other person—from representing themselves as a professional. This makes it difficult for the public to know whether they are receiving treatment from a Masters-trained clinician or a VET-trained assistant.

The Duckett Review of Art and Music Therapy on the NDIS recommended that Art Therapy under the NDIS be delivered exclusively by Masters-trained professional members of ANZACATA. Professor Duckett highlighted the distinction between evidence-based Art Therapy delivered by qualified professionals and art classes offered for leisure. We strongly believe that services delivered under the Thriving Kids program should uphold the same standard to ensure that evidence-based interventions are provided by appropriately qualified staff. Therefore, we recommend that the government specify that these services be delivered exclusively by accredited members of recognised allied health peak bodies. In the case of Arts Therapy, the body recognised by the NDIS for this regulation is ANZACATA.

5. Draw on domestic and international policy experience and best practice.

ANZACATA acknowledges the significant work invested in developing the new Best Practice Framework for Early Childhood Intervention, which will play a vital role in supporting the goals of Thriving Kids. We particularly welcome the Framework’s emphasis on collaboration. Arts Therapists, alongside other allied health professionals, are primed to work in collaborative, interdisciplinary teams.

For this approach to succeed within Thriving Kids, two key enablers are essential:

a) Clear guidelines to ensure services are delivered by qualified professionals—such as Arts Therapists—working to their full scope of practice; and b) Adequate funding and structural support to enable genuine collaboration across professions.

6. Identify mechanisms that would allow a seamless transition through mainstream systems for all children with mild to moderate support needs.

Arts Therapists are well positioned to support children through key transitions—into school, between services, and across developmental stages. Their work often bridges the gap between health, education, and community, providing continuity of care that is relational, creative, and child-centred. We recommend that Arts Therapy be embedded in multidisciplinary teams across early childhood education, primary schools, and community hubs as part of a seamless foundational support system.

References

Cohen-Yatziv, L., & Regev, D. (2019). The Effectiveness and Contribution of Art Therapy Work with Children in 2018—What Progress Has Been Made So Far? A Systematic Review. International Journal of Art Therapy, 24, 100-112. https://doi.org/10.1080/17454832.2019.1574845

D’Amico, M., & Lalonde, C. (2017). The Effectiveness of Art Therapy for Teaching Social Skills to Children With Autism Spectrum Disorder. Art Therapy, 34(4), 176–182. https://doi.org/10.1080/07421656.2017.1384678

Eaton L.G., Doherty K.L., Widrick, R. (2007). A review of research and methods used to establish art therapy as an effective treatment method for traumatized children, The Arts in Psychotherapy,34, (3)256-262, https://doi.org/10.1016/j.aip.2007.03.001.

Hackett, S. S., Zubala, A., Aafjes-van Doorn, K., Chadwick, T., Harrison, T. L., Bourne, J., Freeston, M., Jahoda, A., Taylor, J. L., Ariti, C., McNamara, R., Pennington, L., McColl, E., & Kaner, E. (2020). A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care. Pilot and Feasibility Studies, 6(1), 180. https://doi.org/10.1186/s40814-020-00703-0

King, J.L (2021) (ed) Art Therapy, Trauma, and Neuroscience: Theoretical and Practical Perspectives Routledge Mental Health Series.

King, J. L., & Parada, F. J. (2021). Using mobile brain/body imaging to advance research in arts, health, and related therapeutics. European Journal of Neuroscience, 54(12), 8364–8380. https://doi.org/10.1111/ejn.15313

López-Escribano, C., & Orío-Aparicio, C. (2024). Creative arts therapy for autistic children: A systematic review. The Arts in Psychotherapy, 91, 102224. https://doi.org/10.1016/j.aip.2024.102224

Martínez-Vérez, Victoria, Paula Gil-Ruíz, and Sara Domínguez-Lloria. (2024) Interventions through art therapy and music therapy in autism spectrum disorder, ADHD, language disorders, and learning disabilities in pediatric-aged children: A systematic review. Children 11.6 (2024): 706.

Vogel, S. W., Mullins, K. L., & Kumar, S. (2024). Art therapy for children and adolescents with autism: A systematic review. International Journal of Art Therapy, 1–10. https://doi.org/10.1080/17454832.2024.2343373