Australasian Society for Developmental Paediatrics (ASDP)
30 September 2025
Dr Mike Freelander
Chair, House Standing Committee on Health, Aged Care and Disability
Re: Inquiry into the Thriving Kids Initiative
Dear Dr Freelander,
The Australasian Society for Developmental Paediatrics (ASDP), represents over 900 doctors, mostly paediatricians, with expertise in neurodevelopment and child health We welcome the opportunity to contribute to the Inquiry into the Thriving Kids Initiative.
We commend the Government’s commitment to earlier identification and support of developmental concerns and to creating a national support system for children aged 0–8 with mild to moderate developmental delay and autism. This is a vital reform moment. Families tell us that the current system is fragmented, inequitable, and overly reliant on the NDIS—leaving many children unseen until problems are entrenched.
Children’s neurodevelopment can’t wait. The first years of life are a period of unparalleled brain plasticity, when timely support changes lifelong trajectories (Boyce, 2021). Yet too many children face exclusion from services based on rigid diagnostic requirements, inequitable access, or exclusion from education and community life. We believe that Thriving Kids must be about finding a sustainable ground where supports are early, targeted, and flexible, and reset the system around children, families and their communities.
ABN: 30 828719 189
PO Box 470, Roseville NSW 2069, Australia
admin@asdp.au | asdp.au
Child Development in Australia
- Almost one quarter of Australian children are developmentally vulnerable in one or more developmental domains; 12.5% have delays in two or more domains. (AEDC, 2024)
- In 2024, 23.6% children (up from 18% 2009) were identified by teachers for further assessment due to medical, physical, behavioural, emotional, or cognitive concerns.; (Centre for Community Child Health, 2011)
- Genetic differences are a key driver of developmental disorders, but environmental adversity magnifies risks, while supportive environments foster resilience. (Boyce, 2021).
- There are critical periods in a child’s development, where children’s brains are most sensitive to the effects of experience. (Boyce, 2021)
- Children living in regional, rural and remote areas, First Nations children as well as children from migrant and refugee backgrounds, are at even greater risk of developmental vulnerability. (Woolfenden, 2021)
- Children experiencing developmental difficulties also experience higher rates of physical and mental ill health, and childhood health trajectories have lifelong impacts. (Butler, 2022)
Principles for Thriving Kids
- Care determined by objectively assessed functional need, and children’s developmental strengths and goals, not diagnosis. Care delivered through a stepped, personalised, transdiagnostic approach that addresses developmental, mental and physical health and their antecedent risks together. (Wakschlag, 2019, Patel, 2023).
- Family-centred, relationship based and strengths-based care. Families are the primary partners in care. Invest in parent coaching, peer models, group models, and lived experience expertise. (Autism CRC, 2021)
- Care integration across systems — Vertical (stepped care) and horizontal (across health, education, disability, social care) integration (Wolfe, 2016; Lord, 2022).
- Care that links and supports children, families and communities. Community and family supports which engage community strengths and target harmful social environments to promote and support healthy physical, mental health and developmental trajectories for children. (Patel, 2023; Boyce, 2021)
- Inclusive services— Services must embrace diversity, including neurodiversity and value the lived experience of children and families. Services must be culturally safe, inclusive, and accessible to rural/remote and culturally and linguistically diverse families. (Fitzpatrick, 2024)
- Evidence-based, outcomes focused and accountable. Systems must ensure national guardrails to ensure evidence-based approaches to assessment, supports and policy. Supports must measure functional longitudinal outcomes for children. (Lord, 2022)
ASDP Recommendations to the Committee
1) Understand the needs of children
- Understand the strengths and support needs of each child, and their environment- an ecological approach. Use this understanding to tailor supports which map onto their strengths, support needs and goals- aim for “goodness of fit” rather than “one size fits all”. (Fitzpatrick, 2024)
- Understand that a child’s support needs are determined by their goals, strengths and challenges rather than their diagnosis.
- Foster understanding of neurodiversity, and tailor children’s communities, environments and care systems to embrace diversity and value the lived experience of children and families.
- Integrate understanding of physical health (including nutrition, exercise and sleep, vision and hearing), development, learning and mental health. ( Butler, 2022) Integrate the support of emotional and mental health needs of children with developmental supports.
2) Invest in Integrated Systems
- Invest in universal platforms which reach all children and give all children the basics needed to thrive. This system-wide uplift shifts the population of children towards improved health and development to deliver maximal gain. (Wolfe, 2016) (ARACY, 2010)
- Integrate systems and platforms of care and ensure that adequate consultation occurs across all relevant sectors including health, disability, education, communities and early learning. (Wolfe, 2016)
- Integrate systems of care within sectors. Invest in primary and secondary health care, and health promotion, and link this with tertiary service and expertise.
- Integrate systems across time so that systems are geared towards healthy and thriving trajectories and long-term outcomes for children. (Wolfe, 2016)
- Support stepped care models with universal support and proportionate targeting. (Lord, 2022)
- Consider integration of Thriving Kids with the goals and implementation of the National Children’s Mental Health and Wellbeing Strategy, including Head 2 Health Kids, as research shows that mental and developmental difficulties share common antecedents and therapeutic requirements. (National Mental Health Commission, 2021)
- Ensure accountability, evaluation, and measurement of outcomes. (Lord, 2022)
3) Invest in Children’s Environments and Communities
- Invest in place-based, local approaches empower communities and services to design responses that reflect the needs of children and families. Centre for Community Child Health (2011)
- Fund and scale local hubs and health platforms with navigation, co-location and integration across health, education and social care. (Jamison, 2017)
- Foster children’s needs and provide therapy in regular childhood settings and with other children. This promotes development of community links, group and social learning, and inclusivity, as well as sustainability.
- Target interventions which address the social determinants of health, and target social gradients in communities.
- Value the diversity of communities, their strengths and needs.
4) Invest in Parents and families
- Ensure parents have universal, inclusive, and responsive supports to understand child development, strengthen parenting skills, navigate services, and build social and community connections.
- Providing multiple offerings such as evidence-based advice and information, digital navigation supports, playgroups, structured family programs, and peer support networks, ensures parents can access a range of supports that meet their needs.
- Services must be equipped to provide these offerings and respond to parent concerns with timely, evidence-based, family-centred approaches that deliver safe, seamless, and inclusive support. (Centre For Community Child Health, 2025)
5) Invest in an integrated workforce of childhood professionals
- Ensure sustainable funding, workforce development, and evaluation.
- Enable cross sector curricular development, research, training and engagement towards thriving children, families and communities. Consider programs such as the Common Approach to teach a consistent approach to the basics supporting healthy childhood development (ARACY, 2010)
- Develop increased skill flexibility and transdisciplinary skills in child development and mental health. (Lord, 2022)
Conclusion
The Thriving Kids Initiative is a once-in-a-generation opportunity. It must be bold enough to shift from fragmented, diagnosis-driven, inequitable care to an integrated, family-centred, evidence-based system that nurtures every child’s potential through the development of strong families and communities.
The ASDP would be pleased to provide further evidence and expertise and to work with the Committee to ensure Thriving Kids achieves its vision.
Warm regards,
redacted
Dr Katie Heathershaw
President, Australasian Society for Developmental Paediatrics
redacted
Dr Louise Bulter
Vice President, Australasian Society for Developmental Paediatrics
E: admin@asdp.au | W: www.asdp.au
References
AEDC (2024). Australian Early Development Census, National Report.
Australian Research Alliance for Children and Youth (ARACY) (2010) The Common Approach® Taskforce recommendation report (2010) The Common Approach® to Assessment, Referral and Support: Working together to prevent child abuse and neglect — final report
Boyce WT, Levitt P, Martinez FD, et al. Genes, Environments, and Time: The Biology of Adversity and Resilience. Pediatrics. 2021;147(2): e20201651)
Butler L, Harris A, Rapaic T, Heussler H, Bor W. Specialist care of children with complex needs: Insights from comparison of child development and child mental health clinics. J Paediatr Child Health. 2022 Nov;58(11):2058-2067. doi: 10.1111/jpc.16161. Epub 2022 Sep 7. PMID: 36070197.
Carey, G., Malbon, E., Olney, S., & Reeders, D. (2021). The personalisation paradox: a critical review of personalisation in the NDIS. Australian Journal of Public Administration.
Centre for Community Child Health (2011) Policy Brief - Place-based approaches to supporting children and families. Issue 23. https://www.rch.org.au/uploadedFiles/Main/Content/ccch/PolicyBrief23-place-basedapproachesfinalweb2.pdf
Fitzpatrick, A., Baque, E., Caithness, T., Dargue, N., Evans, K., Girdler, S., Groves, L., Hinze, E., Lewis, T., Llambias, A., Ng, Z. Y., Sulek, R., Varcin, K., Waddington, H., Wicks, R. & Trembath, D. (2024). National Framework for assessing children’s functional strengths and support needs in Australia. Autism CRC
Hertzman, C. (2010). Tackling inequality: get them while they’re young. BMJ, 340, 346-348.
Jamison DT, Gelband H, Horton S, et al., editors. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 27.
Lord, C., Charman, T., Havdahl, A., et al. (2022). The Lancet Commission on the future of care and clinical research in autism. The Lancet, 399(10321), 271-334.
National Mental Health Commission. National Children’s Mental Health and Wellbeing Strategy. 2021, National Mental Health Commission.
Patel, V. (2023). Transforming mental health systems globally: principles and policy recommendations. The Lancet, 401(10390).
Shonkoff, J. P., Boyce, W. T., Levitt, P., et al. (2021). Leveraging the biology of adversity and resilience to transform paediatric practice. Pediatrics, 147(2), e20193845.
Wakschlag, L. S., Roberts, M. Y., Flynn, R. M., et al. (2019). Future directions for early childhood prevention of mental disorders. J Clin Child Adolesc Psychol, 48(3), 539-554.
Wolfe, I., Macfarlane, A., Donkin, A., Marmot, M., & Viner, R. (2016). Integrated care: a solution for improving children’s health? Arch Dis Child, 101(11), 992-997.
Woolfenden, S., et al. (2015). Inequities in child health: the impact of social disadvantage on child developmental outcomes. BMJ Open, 6(9), e012144.
Autism CRC (2021). Strengths and Supports Framework.