The Secretary Standing Committee on Health, Aged Care and Disability Inquiry into the Thriving Kids Initiative
Via email: Health.Reps@aph.gov.au
Standing Committee on Health, Aged Care and Disability’s Inquiry into the Thriving Kids Initiative, Submission from Children’s Healthcare Australasia
Summary
Children’s Healthcare Australasia (CHA), representing 95 paediatric health services nationally, supports the Australian Government’s efforts to improve early childhood development systems. With Australia ranking 35th out of 38 OECD countries for child wellbeing, and 12.5% of children starting school developmentally vulnerable—the highest rate since 2009—significant reform is urgently required.
CHA acknowledges the importance of rethinking the role of the NDIS in supporting children with mild to moderate developmental delay and autism. While the NDIS has delivered critical supports for many, its design has unintentionally created barriers to access for families unable to secure a formal diagnosis, and increased pressure from parents for a diagnosis to access support. This support can often result in the provision of high-cost therapy packages with limited evidence of benefit. This imbalance risks diverting finite resources away from the families with the greatest needs. Long waitlists for public paediatric services—ranging from 10 months to 3.5 years—reflect a system under pressure, where access to support is based on diagnosis rather than need.
CHA advocates for a shift toward a function and needs-based assessment model for children with mild to moderate developmental challenges enabling timely, proportionate, evidence-based and cost-effective interventions. Community-based Child and Family Hubs—both physical and virtual—staffed by multidisciplinary teams (including medical, allied health, psychology, social work with strong connections with education and other government sectors), can deliver early supports, while public Child Development Clinics focus on complex cases. This model allows children to receive the right support at the right time without unnecessary delays.
A key priority is addressing inequity, given groups are disproportionately affected in the Australian Early Development Census data. Families with socio-economic advantage more easily navigate the current system and access services, while Aboriginal, Torres Strait Islander, refugee, and culturally and linguistically diverse (CALD) communities face systemic barriers. Families affected by neurodiversity also face unique challenges when accessing services. All services must be trauma-aware and culturally safe, co-designed with the communities they serve. These services need to be accessible and free, as delivered by public health services to ensure a safety net for all children. Tools such as ASQ-TRAK and the emerging work of The Tracking Cube from Griffith University provide promising culturally appropriate approaches, among others.
Workforce shortages, particularly in public paediatric and allied health must be addressed through a coordinated national workforce strategy, expanding training, incentives, and sustainable employment pathways. Public health service providers are the greatest providers of health workforce training in
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Australia, and will continue to require workforce to deliver such training opportunities. Digital infrastructure is also essential—supporting shared information systems, outcome tracking, and service integration across the health, education and community service sectors. Existing health platforms can be developed to do this.
CHA recommends the Thriving Kids initiative adopt a “no wrong door” approach, with a single national entry point (e.g. portal or hotline), supported by local care navigators that communicates with existing health platforms. Integration across health, education, and social services is critical, ensuring seamless transitions and continuity of care.
Drawing on successful domestic and international models, CHA sees an opportunity for transformative reform. With a consistent national framework and local flexibility, Thriving Kids can reduce wait times, improve access, and ensure all children, regardless of background, have the opportunity to thrive. It will be critical to ensure the public health sector remains the spine of such reform with a universal screen and respond function building on existing child health nursing services to ensure seamless transition through generalised and more targeted supports.
Table of Contents
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Re: Children’s Healthcare Australasia Submission - Inquiry into the Thriving Kids Initiative
About Children’s Healthcare Australasia
Children’s Healthcare Australasia (CHA) is a national non-profit organisation with membership comprising 95 paediatric services across Australia, including all specialist Children’s Hospitals and a majority of general hospitals providing care to children and families. CHA’s membership includes national representation of Child Development Services from a variety of metropolitan and regional areas.
The problem as we see it
CHA welcomes the interest of federal and state governments in identifying and co-designing systems of care and support to better ensure that all children thrive. It is concerning that Australia is currently ranked 35 out of 38 OECD countries for child wellbeingi, especially given our mature democracy and wealth per capita. It is also concerning that there is significant and growing need among Austraia’s children and families for supports to enable young children to thrive. The 2024 Australian Early Development Census (AEDC) shows 12.5% of children start school developmentally vulnerable in two or more key development domains—the highest rate since the Census commenced in 2009ii. Investing in the health and wellbeing of our children is not only the right thing to do, it is economically prudent, as children grow into adults who drive productivity in our economy.
CHA welcome the federal Government’s interest in rethinking the role of the NDIS in supporting children and families with mild to moderate developmental delays and needs. Despite the good intentions behind the NDIS, there have been some unintended consequences for children with mild to moderate developmental issues. One of these has been that many of the support services that once existed for families migrated into the NDIS economy, which in turn prompted families to become anxious about gaining a diagnosis from a paediatrician so as to access supports for their child. Waiting lists for public General Paediatric clinics reflect this, with CHA Child Development Services members reporting a current range of 536 to 1691 waitlisted families across varying levels of services. Services report families and children currently needing to wait between 10 months and 3.5 years after referral by a GP to be seen by a specialist paediatrician (depending on the various factors such as triage category etc). It is important to acknowledge, however, that this is only one of a number of complex reasons as to why public Child Development Services are experiencing unprecedented demand. The complexity of patient presentations is increasing, and pressures on families within society are mounting.
Children with emerging developmental needs could be provided with more timely and proportionate support through expanding community-based Child and Family Hubs (physical and virtual) with multidisciplinary workforce, including paediatric medical and Allied Health professionals with expertise in child development and social workers to support families to better support their children. Evidence also exists that access to legal aid and other aspects of community services enhances outcomes for families. Public Child Development clinics could then focus on assessing and supporting families whose child has more complex clinical needs.
In his speech of 20 August 2025 announcing Thriving Kids, Minister Butler refenced overservicing of some children with developmental needs in the current NDIS, describing examples of individual
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participants receiving more then 70 therapy sessions in a year. Without measures of patient outcomes it is difficult to assess the efficacy of this investment but if this is the case, this level of intensity is inequitable given how many children do not access the NDIS despite having legitimate needs for support with developmental delays or issues. By constrast, Public Child Development Services typically see patients 2-3 times for specialist appointments, with referral back to community based supports where appropriate and available. Within still-existing public community based supports (which have significantly diminished across the country with the rollout of NDIS), children are typically offered brief packages of targeted allied health / peer support intervention (education or therapy) between 3-6 appointments). The notion that Child Development Services are overservicing children is too simplistic given the complexity paediatricians and other allied health professionals carry on a day-to-day basis. Therefore, we recommend exercising caution with the assumption that generalised supports will be the entire solution to the waitlist pressure – a combination of adequate resourcing and addressing of inefficiencies within health is also required to reduce wait times. Redesign of service funding and pathways to make it possible for families to receive appropriate and timely support and interventions outside the NDIS but complementary to public health service provision is welcome.
CHA supports the proposed shift from a diagnosis-based system regulating access to care and support for early childhood development, toward one underpinned by needs-based, functional assessment. This already occurs where universal child health nursing screening occurs and could be developed outwards with unifying platforms into a greater “identify and respond” model of care. This change would allow scarce healthcare and disability resources to be more effectively targeted to the children and families who need them most. Where a child has a low level of developmental delay, is able to attend education, has parents who feel capable to care for them, and is able to communicate and participate, a lower-cost, brief but timely intervention (for example, from a speech therapist) may be all that is required to optimise development. Importantly, these interventions should be focused on teaching carers and educators how to embed therapy strategies into everyday interactions and environments alongside universal screening services, maximising impact while minimising cost. Conversely another child with low level of developmental delay, but living within the holistic family environment of complex needs - such as parental mental health or financial hardship should be supported to access appropriate community and family support services, rather than rely on extensive NDIS therapy plans. Hospital-based Child Development Clinics can then be reserved for children with more complex physiological, neurodevelopmental, or behavioural needs.
We welcome interest in finding solutions to address challenges for children and families seeking to access timely and appropriate child development assessments and supports to ensure their child has the best opportunity to thrive. With 1 in 8 children in need of some form of developmental support prior to school age, the current landscape of services is ill-equipped to optimise children’s wellbeing as they enter school.
While public Child Development services are but one player in this landscape they are nevertheless an important key player. All current public Child Development Services across Australia are oversubscribed with significant waiting times for children to be seen. Our members witness first-hand the inequities of the current system, where some families can access extensive disproportionate supports, whilst others with equal or greater need wait years for assessment and intervention. It is essential that health, particularly those working with the community and child development space, remain key players in the NDIS foundational support reforms, alongside education, disability and community service sectors. Our members are keen to collaborate in the redesign process and to play
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their part in delivering better targeted, more timely and more equitable supports to children with developmental concerns. We are keen to ensure that the unintended consequences of reform do not occur, with increased silos between general and targeted supports or further resource constraint to public health services.
Recommended principles to underpin the design of Thriving Kids
As the Thriving Kids initiative is being designed, we urge the Committee, and Governments at national and jurisdiction levels to:
- Focus on a strengths-based approach that prioritises helping families and communities to provide safe and supportive developmental opportunities for their children – this should ideally commence as early as pregnancy care, when vulnerabilities in parents’ lives can be identified and supported to enable them to help their child to thrive. Services and pathways should be co-designed with communities that need them the most, such as Aboriginal and Torres Strait Islander communities, refugee and culturally and linguistically diverse communities.
- Maintain a clear-sighted commitment to equity and proportionate universalism - we know that the children and families that most need support to thrive are often least able to access relevant services and supports. The NDIS has rewarded families with the capacity to advocate for services for their child but has had limited capacity to identify and respond to the needs of children living in disadvantaged families. There is a need for cross-sectoral partnerships and collaboration among health, education, housing, social services to ensure children and their families have the physical environment and social supports needed to support healthy development. Services need to remain accessible and culturally appropriate in this reform.
- Prioritise timely recognition and intervention – it’s all well and good to improve screening for developmental vulnerability, but we need to have the right ecosystem of services for children and their families and timely access to supports if we are to make any difference to the 1 in 8 children that are currently developmentally vulnerable at school age. Post identification, fmilies are often waiting years for assessments, for therapies and for supports, and can move from one wait list to another. Meanwhile the evidencebased window for early intervention that makes a meaningful difference passes and disadvantage is ‘baked in’ to the child’s journey through school.
- Build on existing services and supports - Focus on improving access, integration, and clear pathways rather than on inventing yet another siloed service. Navigating care and supports for children with developmental delays or challenges is already difficult for most families. Thriving Kids needs to provide an ’Any Door is the Right Door’ approach that has clear pathways for engaging with children and families and coordinating their access to the services and supports that are most relevant to their specific needs, no matter where they begin their journey (Maternal Child Health Nurse visit, GP visit, enrolling in Early Learning, etc). Seamless transition between services where indicated is critical. Child and Family Hubs provide an opportunity for this co-location to occur.
- Develop ways to ensure visibility of outcomes to all players – including families, funders, and service providers. With different IT systems and measures, service providers (hospital and community, public and private), there is a lack of visibility about how well we are collectively doing in supporting children to overcome or learn to live with developmental challenges. Such data are vital to enable both families and service providers to learn what works best and optimise access to proven models/pathways. We need to ensure that any intervention - whether it is community lead support programs or intensive clinical therapy - is effective.
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Measurement and evaluation with national standards is essential to ensure activity is evidence-based.
- Ensure interventions are effective and proportionate – after concerns are identified through screening, the response must be matched to the child’s actual needs and context. This means providing evidence-based supports of proven benefit, with an emphasis on interventions that build the skills and capacity of families, carers, and educators to embed strategies in everyday interactions. This avoids over-servicing, ensures cost-effectiveness, and maximises developmental outcomes for children.
CHA has for many years convened a network of Child Development Services, whose members are subject matter experts in the diagnosis and management of a range of developmental issues in young children, including Autism and its associated comorbidities and complexities. We have consulted with our Child Development Services network on the Committee’s terms of reference and offer the following information and recommendations for the Committee’s consideration for its inquiry into the Thriving Kids Initiative.
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.
Parents have a key role to play in identifying and supporting their child’s developmental needs and vulnerabilities. We support the intention flagged by the Minister to ensure Thriving Kids focuses on supporting parents to identify and respond to developmental concerns/issues. This needs to include education and support for parents to understand child development, strengthen their skills for supporting their child’s developmental needs, help parents to navigate care services/supports, and build local community connections and wrap around supports for families with mental health or other issues impacting on their capacity to support their child to thrive. The recently released National Framework for Best Practice Early Childhood Interventioniii provides useful guidance on how this ecosystem of supports could be structured.
Support
It is essential that families have access to comprehensive evidence-based education, tools and resources, accommodating parents with a lower health literacy, as well as timely access to expertise from relevant health professionals (GPs, paediatricians, and/or Allied Health professionals) when developmental vulnerability is flagged or suspected. CHA’s members agree that the “child health book”, the baby’s official personal health record, should be available electronically with easily accessible resource links for parents and carers. The Raising Children Networkiv provides a ‘go to’ resource for families that CHA members currently recommend to parents but are not aware of other parent facing apps or tools. This non-profit network should be supported to continue to provide, and to expand its services.
How to reliably identify developmental delay
Australia currently lacks a consistent national framework for screening young children for developmental delay. Thriving Kids should address this, but also a carefully considered definition of what constitutes mild to moderate delay in this context. Universal child health and developmental screening is essential to support parents to learn about developmental milestones and assess the
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progress of their child. For meaningful visibility of child development each child needs to be screened more than once. It is important to consider the fact that developmental surveillance is not just one point in time, rather an ongoing process of monitoring a child’s growth and development over time through repeated observations, discussions with parents or carers, and the used of validated tools. This aims to identify developmental challenges early, track progress, and guide timely referral to assessment or intervention if needed.
GP health checks, Maternal and child health visits, and immunisations at 18 months and 4 years of age all offer opportunities to undertake screening/surveillance. Enrolment in Early Learning Centres or Kindergarten/school also provides a useful time to screen for developmental delays/challenges.
There would be value in having a national parent focused Thriving Kids App where parents could be prompted to fill out a questionnaire (options for text, text-speech, CALD options with explanations for terms/questions, etc), with results being forwarded to a Thriving Kids Coordinator to link them in with relevant local services depending on the results. Examples of this exist both from the UKv and NZ.
Tools for identifying developmental delay
There are a range of digital screening tools currently in use by health professionals across Australia. They do not all need to be the same tool, but they do need to be evidence based. Examples include
- the Ages and Stages Questionnaire (and ASQ-TRAK, ASQ-SE) Home - Ages and Stages – the ASQ SE is well regarded and valuable in identifying those families that need the most support
- Children’s Health Queensland red flags Red Flags Early Identification Guide (Birth to 5 years) brochure
- Royal Children’s Hospital’s Parents Evaluation of Developmental Status. Parents’ Evaluation of Developmental Status - Revised (PEDS-R) - Centre for Community Child Health
Advantages:
- These tools are already well used so clinicians are familiar and trained in them.
- They each have reasonable sensitivity and specificity at predicting severe, moderate and mild developmental delay.
Limitations:
- They are designed for use by health professionals not parents, although PEDS is designed to be filled out by parents but interpreted by a professional- this could move to an app based automatic scoring system with prompts (e.g chatbot type assistance)
- There is a lack of translation into different languages, and lack of co-design to ensure their cultural safety, although this has occurred with associated tools such as the SDQ, which is utilised in the B4 School Check in NZ.
- GPs also have restricted access to some of these tools.
- Some states are still using paper-based versions of these tools which limits the efficiency of sharing the resulting data with relevant care providers to whom the family may be referred.
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2. Examine the effectiveness of current (and previous) programs and initiatives that identify children with development 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.
We strongly support the importance of engaging all key players in this space, including community and mainstream services, such as child and maternal health, primary care, Allied Health, playgroups, early childhood education and care, schools, NGO’s and also Child Developmental Services. Reflecting on the current effectiveness of these services, over many years, there has been a dismantling of resources and supports from these core community services, exacerbated further by the diversion into NDIS funded pathways. This has created fragmentation, duplication and inequity in services. For Thriving Kids to succeed, its framework must actively support cross-sectoral collaboration, minimise duplication and provide families with a ‘no wrong door’ approach, and ensure clear pathways for escalation to the most appropriate service for community and specialist interventions and supports. Child Development Services delivered by public hospitals are only one part of this ecosystem, but they remain a critical player.
Our members welcome the proposed focus on building a supportive network of services around families of children with developmental vulnerabilities, and emphasise the importance of recognising psychosocial factors such as parental mental health, family violence, food insecurity, and inadequate housing. For some children, however, biological, genetic, or physiological determinants drive developmental needs and require specialised healthcare responses.
As Thriving Kids is designed, CHA urges policymakers to ensure timely access for children with significant developmental concerns to assessment and intervention through dedicated Child Development Services, while also enabling these services to share expertise, data, and insights more efficiently with community-based providers across health, early education, and schools. We do not need a new system, rather a bolstered spine with greater transectoral partnership and working.
Physical and electronic integration between Thriving Kids and Child Development Services is essential if the model is to succeed. The Child and Family Hub model provides a strong foundation for this integration, combining hospital and community-based services with an e-Hub to facilitate access for rural and remote families. Such a model would ensure families can connect with the right supports—whether locally or virtually—without unnecessary delays or duplication.
If Thriving Kids becomes an NDIS alternative but fails to integrate with Child Development Services—as has occurred with the NDIS—crippling waitlists will persist and families will be no better off. Families need a seamless, integrated ecosystem of services that adapts to their child’s changing needs over time; they do not need another silo under a different name.
No provider within public Child Development Services is comfortable with families waiting months or years for assessments that determine access to evidence-based supports. While rationing is unavoidable, this national redesign presents a vital opportunity to evaluate what must be preserved, what can be retired, and what new investments are needed to improve equity and efficiency. CHA
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members are at the forefront of innovation in this area but need implementation funding for equitable evidence-based contemporary models of care to be realised.
Finally, fragmented information-sharing between providers remains a major barrier. Families repeatedly tell us they are tired of retelling their story. A national digital platform that allows authorised providers across health, education, and community services to share information with families’ consent would significantly improve both efficiency and the effectiveness of targeted interventions.
3. Identify equity and intersectional issues, in particular, children who identify as First Nations and culturally and linguistically diverse.
CHA members have reported that the more educated and socio-economically advantaged families who request or seek supports generally gain access to the NDIS. These families have often subsequently received an oversupply of services. The NDIS is therefore underservicing families less able to advocate for their child with developmental delays or concerns.
To improve outcomes for more vulnerable or disadvantaged families it will be important to provide trauma-aware, culturally safe, services. The distrust that many First Nations families have for healthcare services is understandable given that as many as 1 in 10 Aboriginal babies are still being removed at or soon after birth in our maternity hospitals. At the very least, all services that come within the Thriving Kids initiative, whether Child and Family Hubs, Early Childhood Education Centres, or Child Development Services, need to be trained and required to provide culturally safe screening and/or support services. It is essential that efforts to improve access to child development care and supports for Aboriginal and Torres Strait Islander children and families are developed in partnership with, and led by, Aboriginal controlled organisations. There are many examples from the wider health and social sectors of where failure to do this authentically have resulted in poor or ineffective services that do not address the needs of children and families. The ASQ-TRAK, hosted by the University of Melbourne, is a developmental screening tool for observing and monitoring the developmental progress of Aboriginal and Torres Strait Islander children aged 2 months to 5.5 years old. As a co-designed, strengths-based tool its core mission is to improve timely and equitable access to child development support. Another positive example is the maternal and child health indigenous service - Waijungbah Jarjums, “for mob by mob” at Gold Coast Health.
CHA would expect that the development of the Thriving Kids Initiative will include co-design with First Nations people, refugee families, and with Culturally and Linguistically Diverse communities, including the development of translatable parent-report tools and questionnaires.
In addition, equity and diversity considerations must also include neuro-affirming practice. A significant proportion of children accessing Thriving Kids will have neurodevelopmental conditions, and many will be raised by parents who themselves are neurodivergent or have learning needs. Services must therefore be designed in ways that are affirming of neurodivergent identity, accessible to families with varied communication and cognitive needs, and capable of supporting intergenerational patterns of neurodivergence. This requires not only clinical expertise but also adaptations in how information is presented, how families are engaged, and how interventions are embedded into everyday environments. Without these adjustments, families risk being excluded or misunderstood, compounding the inequities the initiative is intended to address.
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4. Identify gaps in workforce support and training required to deliver Thriving Kids.
Access to vital public paediatricians, Allied Health workforce, including speech therapists, occupational therapists and physiotherapists with expertise in child development is critical, and one of the rate-limiting factors affecting the capacity of Child Development Services to effectively support families. The creation of the NDIS attracted much of the Allied Health workforce out of public child development services into community and private practices, with families only being able to access their care if confirmed as eligible for NDIS support. This transition was neither necessary or beneficial. Child Development Services are underfunded nationally impacting their effectiveness, and Thriving Kids must not become the “either-or” funding option for Commonwealth or State governments as occurred with NDIS. This will be devastating for children with more complex needs. The Allied Health workforce will shift from public health services into NGOs, inadvertently dismantling opportunities to enhance multidisciplinary care, isolating paediatricians, and most importantly, disrupting the training pipeline. Many jurisdictions have learnt that the best employer of health staff is health, and well-meaning reform can result in inadvertent creation of silos, shifts of workforce and fundamentally a reduced service to the children the reform is trying to support. Public health services do not close books, do not take away key services when funding runs out, so are the only vehicle for ensuring accessible service to children long-term.
In rethinking the role of NDIS in supporting children with developmental issues, consideration needs to be given to the financial and system supports needed to ensure Allied Health providers become more accessible to children and families with need for timely, and often limited, interventions that can make substantial differences to a child’s development. Many children with mild to moderate developmental issues can benefit from timely interventions by a relevant Allied Health professional and may have no ongoing need for support after the therapy concludes. Others may benefit from an initial assessment by an Allied Health therapist, and then delivery of the intervention by carers, educators and other community workers. Yet we have to have the right professionals in the right places to receive referrals, whether from Child Development paediatricians, GPs, or even school or ELC-based professionals, and to provide care when and where families need them. This will require some dedicated attention and planning.
CHA would recommend that a specific workforce strategy be developed to grow the number and capacity of Allied Health professionals with expertise in child development. Such a workforce strategy should consider the location (e.g. hospital/community, public/private, metropolitan/rural) and skillsets of current Allied Health workforce, identify gaps in relevant disciplines, and propose ways to grow these workforces. This strategy should address training pathways to ensure that work readiness is achieved prior to working in child development roles.
Child & Family Hubs could provide one part of the solution to growing the Allied Health workforce if they provide local secure employment, administrative supports, and opportunities to facilitate the training and development of new Allied Health Professionals interested in child development. We also need incentives for Allied Health professionals to work alongside paediatricians in public child development clinics. While not every child needs multidisciplinary assessment, those that do can benefit enormously from being able to access such care at the one place. Paediatricians are also much more efficient and effective in caring for these children and their families within multidisciplinary teams.
If Thriving Kids becomes a program delivered through jurisdictional Departments of Community Services, there will still be a critical need for close collaboration with Health to ensure Allied Health
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workforces are supported with accreditation, supervision, CPD requirements, and clear career progression pathways. A non-health employer of health staff is not without complexity and does not often succeed with high attrition of staff (e.g. education, regional sports trusts). Part of accreditation requirements in health specialties is an established collegial supervisory network which cannot be created overnight. Any government department willing to employ health staff needs to be willing to be a provider of clinical placements, supervision and training of future workforce. There is also a pressing need to uplift access to training opportunities for Allied Health professionals involved in child development. Current barriers to training include time constraints, high costs (only medical staff receive CPD funding supports in most institutions), and staffing pressures. There is also a need for more high-quality training opportunities, particularly around skills in engaging with families experiencing disadvantage and low levels of trust of healthcare services, trauma-aware care, and how to ensure care is culturally safe, particularly for Aboriginal and Torres Strait Islander children and families.
5. Draw on domestic and international policy experience and best practice.
CHA is aware of research in this space by leading child health research institutions such as the Murdoch Children’s Research Institute’s Centre for Community Child Health in Melbourne and The Kids Institute in Perth. Our members would recommend the Committee consider their recommendations.
CHA members support the newly developed National Best Practice Framework for Early Childhood Intervention referenced earlier and is also aware of the positive evaluations being undertaken of programs such as Child and Family Hubs in several jurisdictions. These Hubs are community based, multidisciplinary, and provide easy access for local families to a range of relevant supports from health, mental health, early childhood, and social services. We understand evidence currently pending publication by the Centre for Community Child Health confirms these Hubs are facilitating earlier identification of developmental vulnerabilities, improved parent confidence and skills in supporting their child, and improved engagement in support services leading to better outcomes.
The UK Sure Start Programvi, an early intervention program supporting children under four, is modelled on the same concept and has reportedly improved children’s access to education, improved health outcomes, learning outcomes and reduced involvement in juvenile justice. Canada’s Early Years Centres are similar to this.
6. Identify mechanisms that would allow a seamless transition through mainstream systems for all children with mild to moderate support needs.
When addressing this question of identifying mechanisms for seamless transitions it is important for clear differentiation between mild and moderate support needs. Mild and moderate support needs vary enormously, and the therapies, interventions and support strategies cannot sensibly be categorised together. It is also unclear if the Thriving Kids Initiative is for children with “mild-moderate developmental delay, and autism” or “mild-moderate development delay and mild-moderate autism”, thus our previous comment regarding definitions. The supports required for these differing levels of challenge and consequential mechanisms for transition have immense variation. CHA members request clarification around the cohort of patients to be included in the Thriving Kids Initiative, and acknowledgement that a on-size-fits-all approach is unlikely to be effective.
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CHA members envisage that Thriving Kids has the potential to make a transformative impact on the health and wellbeing of young children in Australia. Thriving Kids has the potential to enable:
- a universal system of care (no child misses out),
- within a nationally consistent framework (evidence-based care & supports),
- built on robust cross sectoral partnerships (health, education, housing, social services wrapping around vulnerable families)
- using compatible data and communication systems (everyone knows what’s happening and what’s next),
- but with flexibility for local adaptations in the ecosystem of services (tailoring what’s on offer to the needs of local communities)
- an ongoing evaluation and reporting function for child development services
We believe such a model could reallocate existing resources in a more targeted and connected model that would be invaluable to both families and service providers. Such an approach, which the Centre for Community Child Health describes as ‘Local solutions with national guardrails’ could optimise efficiency, reduce waitlists and improve equity of outcomes.
Such a system would require, among other things, a patient/family-held digital data sharing system across health, education and the disability sectors. Using secure, family controlled digital platforms to assist effective multidisciplinary teams working at their top of scope would promote intersectoral partnerships rather than further entrench current siloed ways of working.
Thriving Kids supports could be embedded nationally in the services families are already engaged in, such as the Maternal & Child Health nurse/worker, their GP or their Early Learning Centre. Child and Family Hubs offer a potential practical way to coordinate cross sectoral services and tailor care to meet local needs.
CHA supports the concept of a national single-entry portal (website or 1800 call number) with local triage by a Child and Family Hub that could provide more vulnerable families with a clinical navigator or care coordinator. The rationale for the NDIA to have replaced care coordinators with “navigators” remains unclear and from the point of view of Child Development Services trying to assist families to access support. Our members support the return of a “support coordinator type role” to assist the streamlining of supports for a family as they journey the system, simplifying the framework for families to move through with consistent, accessible support.
Members noted the potential benefit of a pilot scheme and evaluation, prior to implementation across Australia, and the power of co-designing pathways with and for different communities of children and families with lived experience. It is also recognised that for such a system to be effective, there would be a need for strong collaboration not only between health, education and social services in each jurisdiction, but also between federal and state governments.
The voices of families with lived experience of navigating the current complex array of services that affect child development should also be included in the development of the Thriving Kids initiative. Listening to and learning from those families who have navigated the system should be a priority when defining a seamless transition to improve support and outcomes. Formalised patient and family reported experience and outcome measures should be integral to evaluation of Thriving Kids, and used to shape the ongoing development of this initiative once it is in place.
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Thank you for the opportunity to make a submission on this important initiative. For further information please contact:
Dr Barb Vernon Chief Executive Officer Children’s Healthcare Australasia
E: redacted
T: redacted
References
i Organisation for Economic Co-operation and Development. (2022). Child Wellbeing Dashboard. Paris: OECD Publishing.
Retrieved from https://www.oecd.org/els/family/child-well-being/data/dashboard/
ii Commonwealth of Australia (2025). Australian Early Development Census National Report 2024. ISSN 2206-284X (Online). Department of Education, Canberra.
iii See National Best Practice Framework for Early Childhood Intervention | Australian Government Department of Health, Disability and Ageing
iv Raising Children: The Australian Parenting Website see Raising Children Network https://raisingchildren.net.au
v See Early Years - Home https://earlyyearshelp.greatermanchester.org.uk/
vi See description of this Program on the Australian Institute of Family Studies website: The UK Sure Start Program | Australian Institute of Family Studies