Submission to the Inquiry into Thriving Kids

Submitted by: Members of the Child Development Sub-Network (Queensland Health employees)

Date: 3/10/25

Contact: Dr Joanne Thomson and Susan Pagel, Co-chairs, Child Development Sub-network via redacted

Executive Summary

Introduction

This submission represents the collective practice knowledge of Queensland Health clinicians working in child development services across the state, as part of the Child Development Sub-Network (CDSN). Our sole vested interest is in improving the health, wellbeing, and developmental outcomes for children and families. There is no financial gain associated with this submission.

The CDSN operates as an independent, clinician-led platform under the Queensland Child and Youth Clinical Network (QCYCN). It provides a space for health professionals to share learnings and best practice care to guide improvements in child development within community settings. Importantly, the CDSN is chaired and staffed by Queensland Health employees in non-funded roles, ensuring that its leadership is grounded in frontline service delivery and free from external financial influence.

Frontline service delivery for child development services in Queensland aligns with the evidence-based model of care outlined in 2 Act Now for kids2morrow: 2021 to 2030. This model is built on six key principles:

Life course perspective and approach
Early intervention
Evidence-informed practice
Family-centred practice
Equity-based service planning and provision
Inter-professional and transdisciplinary care

These principles are underpinned by Bronfenbrenner’s ecological model of development, which recognises that children thrive through complementary interactions across multiple environments—home, school, and community—and through robust individual characteristics, both internal and relational.

This model of care challenges the prevailing focus on screening and siloed service delivery across the health and disability continuum. Instead, it promotes integrated, holistic, and equitable approaches to care.

This submission highlights key programs and initiatives across Queensland that reflect the principles above, with emphasis on the following approaches:

1. Transdiagnostic Assessment approaches

Children presenting to health services are often assigned a single primary diagnosis, a pattern that also emerges during initial identification and screening. Transdiagnostic assessment protocols offer a more holistic approach by evaluating symptoms, functional abilities, and social factors shared across neurodevelopmental conditions. These protocols encourage the use of tools that assess developmental domains within the child’s broader context—including family dynamics and community influences—leading to more personalised and effective support strategies.

2. Place-Based Initiatives

Place-based models are designed to meet the distinct needs of local communities, especially those facing disadvantage or service gaps. These initiatives prioritise co-design with families and community stakeholders, fostering culturally safe, locally informed solutions. By integrating health, education, and social services, place-based approaches create wraparound supports that are responsive to community context and promote equitable access to care.

3. Life Course Perspective

While many current initiatives focus on the first 2000 days of life, child development clinicians hold a unique position within the public health continuum—supporting children and families from the antenatal period through adolescence, including those with disability. Recognising and investing in this life course perspective is essential. It requires awareness of key developmental transitions, evolving support needs, and differences in functioning across childhood, adolescence, and into adulthood. This approach ensures continuity of care and supports long-term wellbeing.

Key messages

Early identification and accessible parental support tools are vital to improving developmental outcomes. Embedding these tools within systems that consider the child’s family and community context ensures responsiveness to diverse cultural and familial needs.
Numerous initiatives across Queensland support the screening and care of children with developmental concerns. The most effective approaches are place-based and recognise families as the primary context for a child’s development—empowering them to build capacity and support their child’s growth.
Targeted investment in workforce capability is essential to deliver equitable, high-quality child development services—particularly in addressing gaps in training, assessment tools, and support for behavioural challenges.
Equitable, integrated care for children with developmental concerns—especially those from First Nations and CALD backgrounds—requires place-based, cross-sector collaboration and system-level reforms that reduce fragmentation and prioritise those most disadvantaged.

Conclusion

A thriving child is supported not only through health interventions, but through a holistic approach to wellbeing that includes families, communities, and environments. Policies and programs must recognise children within their ecological context, with active collaboration across sectors to strengthen family capacity and community supports.

Queensland requires a coordinated, equitable, and evidence-informed system to support children with developmental concerns and their families. Investment in workforce capability, cross-sector integration, and place-based, intersectional approaches are essential to realise the Thriving Kids vision and deliver lasting benefits for children, families, and the broader health system.

We acknowledge that this submission has not undergone full consultation across the CDSN due to time constraints. However, we welcome ongoing engagement and future opportunities to support key ideas with further evidence and collaborative input.

Evidence-Based Resources for Parents

Early identification and parental support are critical to improving developmental outcomes. Evidence indicates that there are high economic returns on early intervention. Early intervention is not limited to the first 2000 days and may occur at any time across the life course, as soon as possible following the identification of a developmental concern.

Identification of developmental concerns may often occur through the primary health care system (ie. GPs, Child Health nurses) but it may also be supported through other generalist service providers, including educators, who may support and direct families to access further care options.

Several tools and resources are available to assist parents. Some of these are which are accessible beyond primary health care are listed below:

Parents’ Evaluation of Developmental Status (PEDS): A validated screening tool that empowers parents to report concerns and helps professionals identify developmental delays early. Utilised by child health nurses in Queensland as part of the screening toolkit. Also utilised in various initiatives with childcare centres to support developmental screening.
ASDetect: A free mobile app developed by La Trobe University that uses evidence-based criteria to help parents identify early signs of autism in children aged 11 to 30 months. Currently used in Darling Downs HHS to support parental understanding and triaging at intake to child developmental services.
Early Intervention Red Flags Document: A simple guide for educators and GPs to identify developmental warning signs. Utilised across Australia and New Zealand, it provides a simple tool for parents to identify concerns and engage with a professional to seek further support.

These tools are accessible and user-friendly, helping bridge the gap between parental concern and professional assessment.

However, with any tool, some of the following considerations should occur:

Navigation: Ensuring information is easily accessible about how to access the next stage in care (e.g. screening/assessment). Investment in system changes to support navigation and access is critical to ensure children and families access to the care they need.
Evidence Based Information: Access to evidence-based information on where families can start to support the best outcomes for their child after identification.
Ecological frameworks: Consideration of the broader ecological system around a child. Identification of developmental concerns is only one part of a child’s presentation. Understanding family systems, environment context, cultural and parenting factors are important to respond and support a child to grow healthier and stronger.

Key Message: Early identification and accessible parental support tools are vital to improving developmental outcomes. Embedding these tools within systems that consider the child’s family and community context ensures responsiveness to diverse cultural and familial needs.

Effectiveness of Current and Previous Program

Effective programs must be grounded in the principles outlined earlier and informed by an ecological model of development. Programs that embrace this holistic view are better positioned to deliver meaningful and sustainable outcomes.

The following two tables provide a summary of:

Known screening approaches currently used across Queensland.
Programs and initiatives that children and families are actively engaging with.

Please note that some of these programs may not be represented in the current literature. Further information can be provided upon request.

Screening of Children with Developmental Concerns

Setting/Context	Screening Approach / Tool
Screening programs in Day Cares / Child Cares	Thriving and on Track (CHQ - HHS) Healthy Kindy Kids Pilot (Townsville HHS) The Early Development Intervention Engagement - EDIE (Gold Coast HHS)
Screening of children who have had an adverse medical event as an infant	Utilisation of The Social Attention and Communication Surveillance (SACS) tool by health workers (Torres Straits HHS) Long Term Care Pathway Congenital Health Disease (CHQ – CHDLife) Growth and Development clinics to support screening and follow up (embedded in pathways across HHSs)
Community developmental response (Ie GP, Health worker, Child Health)	Tracking Cube – a culturally responsive approach to screening, diagnosing and monitoring neurodevelopment that helps identify disorders (Ie GP, Health worker, Child Health) such as FASD, ADHD, Autism in primary healthcare.
Frameworks to support assessment within an ecological model	The Nest Wellbeing Framework – ARACH F-Words for Child Development – Can Child Social and Emotional Wellbeing Framework (SEWB)

Community-based programs and initiatives often play a key role in identifying children at risk of developmental delay or autism. Allied health-led programs using evidence-based assessment tools can diagnose developmental delays and determine severity. However, autism diagnosis and severity assessment require a medical or health-led approach. No single pathway suits all families, and diagnostic processes should inform individualised packages of support across health, education, and social care.

Programs Supporting Children with Developmental Concerns

Service Offering	Description	Statewide Examples
Parent Coaching & Capacity Building	Coaching families to embed developmental strategies into daily routines through evidence-based programs	Hanen, HIPPY, Envisage (link), Autism Queensland Workshops
Short-Term Targeted Interventions	Time-limited, goal-oriented support across developmental domains, involving parents/caregivers	Delivered through many child development services
Tele-Practice & Hybrid Delivery	Online coaching, therapeutic supports, and group sessions	Delivered through many child development services
Inclusion Support	Partnering with mainstream services to support inclusion and upskill providers	Inclusion Support Program TOTS
Peer Support & Family Networks	Facilitated groups for carers to share experiences and strategies	PlayConnect, Playgroups, Mission Australia, Carer Gateway
Transition Support	Planning for developmental and social transitions, including early education milestones and NDIS	Integrated into CDS and early childhood services

Note: PlayConnect+ Playgroups are valuable for social engagement but currently underutilised. Attendance may improve with the inclusion of therapists.

Key message: Numerous initiatives across Queensland support the screening and care of children with developmental concerns. The most effective approaches are place-based and recognise families as the primary context for a child’s development—empowering them to build capacity and support their child’s growth.

Workforce Support and Training Gaps

Delivering consistent, high-quality child development services across Queensland requires sustained investment in workforce development. As demand for early intervention and transdisciplinary care grows, so does the need for a skilled and supported workforce—particularly in regional and remote areas where recruitment and retention remain challenging.

Queensland’s geographic and demographic diversity calls for flexible, locally informed workforce strategies. Place-based, evidence-informed solutions must be backed by targeted incentives, clear career pathways, and strong support structures. Leveraging community knowledge and service networks is essential to delivering equitable care close to home.

To guide this effort, the Queensland Child and Youth Clinical Network’s Child Development Subnetwork developed the Child Development Clinical Capabilities Framework (2023), outlining the skills and attributes needed to deliver contemporary, family-centred, trauma-informed, and culturally sensitive care.

This initiative aligns with broader strategic directions, including HealthQ32, the Allied Health Workforce Strategy (2019–2029), and the Allied Health Workforce Plan (2022–2026), all of which emphasise equity and the importance of a capable, connected workforce.

Although strategic visions and frameworks exist to support workforce development, there remains a significant gap in their consistent implementation and practical application. This exists both within child development services and across the community, health and disability continuum. Key themes are captured in the table below.

Capability Gaps
Clinical Capabilities in Child Development	While the Child Development Clinical Capabilities Framework exists, dedicated training programs to support its implementation are currently lacking. Investment in workforce development is needed to build capability and embed the framework into practice.
Assessment Tools for children 6-12 years	Many child development services focus primarily on children under six, resulting in a significant gap in the assessment and understanding of children aged six and above.
Assessment Tool – Functional /Transdiagnostic	Although evidence supports the use of functional and transdiagnostic approaches, there is a lack of accessible, evidence-based tools to identify, screen, and assess children across developmental domains.

Capability Gaps
Adolescent and young adult care	Adolescents require distinct engagement and assessment approaches to support their developmental journey. However, many child development services do not cater to this age group, and there is limited understanding and application of adolescent-specific models where services do exist. models for child developmental services that do see this age group.
Supporting children with behavioural challenges	There is a widespread shortage of specialist workforce capability to support children and young people presenting with behaviours of concern across the health and education continuum.
Supporting children with ADHD (non-pharmaceutical)	Dedicated training and resources for non-pharmaceutical interventions for children and young people with ADHD are limited, impacting the ability to offer holistic and tailored support

Key Message: Targeted investment in workforce capability is essential to deliver equitable, high-quality child development services—particularly in addressing gaps in training, assessment tools, and support for behavioural challenges.

Equity and Intersectional Issues

Children with developmental concerns who identify as First Nations or come from culturally and linguistically diverse (CALD) backgrounds often face compounded barriers to accessing timely and appropriate support. These barriers include systemic inequities, cultural disconnects, geographic isolation, and fragmented service delivery. The Queensland Department of Health’s Disability Service Plan 2025–2028 acknowledges that people with disability may have intersecting identities—including intellectual and psychosocial disability, First Nations heritage, and multicultural backgrounds—which can result in poorer health and wellbeing outcomes due to increased barriers to care.

“Vulnerable children are more likely to live in disadvantaged neighbourhoods and face physical, social, service, socio-economic, and governance challenges that limit access to the infrastructure and services they need. Despite increased support needs, these children often receive less. The solution lies in designing supportive, networked, and place-based early intervention services that wrap around children and families—integrating child and family services, early childhood education, and broader social supports to ensure every child gets a fair start in life”. (Geatches, L., & Preston, 2023, p14).

To achieve short- and long-term improvements in health and wellbeing, services must prioritise those most disadvantaged. This imperative is supported by the World Health Organisation and enshrined in the Queensland Human Rights Act 2019, which affirms the right to equitable access to care. A visible, statewide network of providers—spanning metropolitan, regional, and rural locations—is essential. The intersectionality of these providers creates a safety net for children and families at risk, ensuring no child is left behind.

Integration with Mainstream Services

Despite the existence of evidence-based early intervention supports, integration across mainstream services—such as education, health, and child safety—remains challenging. Differing mandates, funding models, and eligibility criteria often lead to siloed delivery and poor coordination.

To address these challenges, Queensland must align goals across sectors, build shared frameworks, and foster cross-sector partnerships. Integrated care requires coordinated and collaborative efforts from all providers, regardless of sectorial, organisational, or geographic boundaries. This approach ensures that children with developmental delay and disability receive cohesive, timely, and effective supports throughout early childhood.

Several initiatives already demonstrate the potential of integrated, place-based, and equity-focused approaches:


Intake to child development services	Utilisation of a “No wrong door” intake pathways to ensure that all referrals have a pathway of care. This may include access to child health or community partners. Examples in Townsville HHS, Gold Coast HHS, CHQ HHS and West Moreton HHS
Thriving Kids Partnership	Lockyer Valley Together (West Moreton Health HHS)


Place Based initiatives	Logan Together (Metro South HHS), Gladstone Region Engaging in Action Together

Future Mechanisms for Seamless Transitions

To support children with mild to moderate developmental needs through mainstream systems, Queensland must adopt integrated, person-centred approaches that reduce fragmentation and promote continuity of care. Key mechanisms that could be implemented in the future to reduce fragmentation by eliminating key barriers may include:

Consent: A single consent process that covers all state-funded services would reduce administrative burden and facilitate smoother transitions between sectors.
Language: Investment in initiatives that provide a shared language across service providers will improve service collaboration. Concepts such as Brain Builders by Aracy that are implemented in the initiative Lockyer Together provide a shared language for cross sector providers to discuss children, care and developmental health.
Integrated Information Systems: Tools such as My Health Record could be utilised more effectively if a care plan module was developed that support recommendations across service sections. Investment in a Digital Red Book can support shared access to developmental data across health, education, and social care.
Funding. Cross-Service Funding structures that financially support joint case discussions and shared service delivery can break down silos and improve coordination. This is critical to allow primary care practitioners, private clinicians and public health services to integrate care for children and their families.
Scope: Embedding responsibilities for care coordination into job description for every service provider ensures accountability and promotes a “no wrong door” approach.

Key message: Equitable, integrated care for children with developmental concerns—especially those from First Nations and CALD backgrounds—requires place-based, cross-sector collaboration and system-level reforms that reduce fragmentation and prioritise those most disadvantaged.

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