Submission 312 — Outcomes Therapy — Inquiry into the Thriving Kids initiative

Email: info@outcomestherapy.com.au
PO Box 1403
North lakes, QLD 4509
www.outcomestherapy.com.au\ Phone: 0466 994 500
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Submission to the Inquiry into the Thriving Kids Initiative

Background to author:

I am an Autistic, ADHD Mum to three multiply neurodivergent children, carer for my intellectually disabled Older Brother who has 24/7 support needs, and the life partner of my multiply neurodivergent husband. I am also an experienced Occupational Therapist (18 years), company director, Allied Health clinical and professional supervisor, neurodiversity affirming consultant, and employer of neurodivergent occupational therapists.

I am making this submission under multiple stakeholder guises:

• a concerned parent/carer,
• participant representative,
• employer,
• clinical and professional supervisor and
• worker within the current NDIS scheme.

Executive Summary I am writing to contribute to the Inquiry into the Thriving Kids Initiative from multiple perspectives as outlined above. I live and work inside the NDIS every day. I witness the extraordinary potential of children and families when appropriate supports are available—and I also see the harm, debt, and instability caused by poor policy design, inaccessible systems, and eroded choice and control.

The Thriving Kids Initiative presents an opportunity to embed best practice and avoid repeating historical mistakes in disability support. However, recent proposals raise serious concerns about equity, evidence, and outcomes for children and families.

This submission combines lived experience with over 18 years of professional practice in occupational therapy, clinical supervision, and allied health business management. I outline how the proposed Thriving Kids Initiative must be shaped to avoid repeating historical failures and to instead embed neuroaffirming, trauma-informed, evidence-based, and family-centred approaches.

Key positions:

1. Severity labels (“mild,” “moderate”) are outdated, harmful, and risk excluding children from support.
2. Early identification and intervention must prioritise timely, multidisciplinary, and discipline-specific input, not a one-size-fits-all Keyworker model.
3. Parent and family wellbeing are inseparable from child outcomes and must be core to program design.
4. Equity and intersectionality demand urgent attention for First Nations families, culturally and linguistically diverse (CALD) families, and those in regional/remote areas.
5. Workforce support and retention are essential, with a need to invest in experienced clinicians and neuroaffirming, trauma-informed training.
6. System transitions must be seamless, coordinated, and consistent across early childhood, health, education, and NDIS systems.

If designed well, Thriving Kids could be a nation-leading initiative that genuinely helps children thrive. If designed poorly, it risks retraumatising families, undermining workforce stability, and escalating long-term costs.

1. Identifying Children with Developmental Delay and Autism

Early identification is critical, but current systems are failing families. According to the Australian Institute of Health and Welfare, wait times for public developmental assessments can exceed 12 months in some regions, with families in rural and remote areas waiting even longer.

Then there’s the “Jumping on the bandwagon” rhetoric that the media and others are peddling, which increases the risk of missed diagnoses. Additionally, too often, families are dismissed by GPs and Child Health nurses with statements such as “He’s just a boy” or “She’s shy”. Many are referred for “parenting programs” instead of appropriate developmental assessment. These delays cause families to miss the optimal early intervention window.

Evidence shows that simplistic severity categories (“mild,” “moderate,” “severe”) are outdated and harmful, and the government needs to cease using such discriminatory language. A child’s capacity fluctuates with environment, sensory demands, trauma history, and support. Families are excluded from services when their child is deemed “not disabled enough,” yet these same children often burn out later and require far more intensive (and costly) support as adolescents or adults.

Recommendations:

• Replace severity labels with a needs- and context-based approach that considers family wellbeing, sensory and relational profiles, and environmental fit.
• Allow families to source evidence-based and needs-driven assessments from Allied health professionals, not community partners using a not-fit-for-purpose tool incorrectly, as has been the case for the current NDIS, and as is concerning families of younger children since the announcement of the Government this week regarding the ICAN assessments for the over-16’s NDIS Cohort – another not-fit-for-purpose across disabilities assessment.

2. Effectiveness of Current and Previous Programs

From my 18 years as an Occupational Therapist, and seeing it play out in the care of my brother and own children historically, I know that one-size-fits-all programs do not work. The old block-funded models of days past left many children seeing only one therapist a few times a year. Reverting to such models risks wasting the early years and worsening lifelong outcomes.

Community programs, even with the best of intentions, often traumatise children by demanding compliance with rigid social or behavioural norms. For autistic and neurodivergent children, being forced to mask or “be resilient” does not build capacity—it causes anxiety, dysregulation, and long-term harm. This is the basis of much community outrage regarding Minister Butler’s use of the “Inklings’ Program’ as a talking point during his press-conference speech.

International research (e.g., Zwaigenbaum et al., 2015) demonstrates that neuroaffirming, relationship-based interventions lead to better long-term outcomes for autistic children compared to compliance-based approaches.

Models such as DIR Floortime, Circle of Security, and trauma-informed care provide evidence-based, relationship-focused alternatives that truly promote development. These are currently being provided in the current individualised-support model of the NDIS. They may be able to be leveraged for the next iteration of NDIS early Intervention supports, but we must heed caution to never revisit the dark-ages of centre-based and dictated supports for families.

Recommendations:

• Fund multidisciplinary, neuroaffirming, family-centred supports that draw on evidence-based developmental science rather than compliance-based interventions.
• Continue to fund individual-level interventions, intensively where required.
• Develop neurodiversity-affirming group programs and parental education modules to side alongside these individualised interventions.

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3. Equity and Intersectionality

The barriers are even greater for First Nations and culturally and linguistically diverse families. Many already experience systemic discrimination, geographic isolation, and language barriers in healthcare. In my practice, I see families unable to access diagnostic or therapeutic services because they live in regional areas or cannot afford private assessments when public waitlists are multiple years long.

Intersectionality must be embedded in all aspects of program design. Children and families may face compounded barriers due to disability, gender, socioeconomic status, LGBTQIA+ identity, or refugee background. Targeted outreach, flexible funding, and trauma-informed practice are essential to ensure no child is left behind.

These compounded barriers reinforce inequities, leaving many children without timely or appropriate support during critical developmental windows. Addressing this requires tailored, culturally safe approaches that actively engage families and communities, reduce logistical and financial obstacles, and prioritise outreach to those who are traditionally underserved. By embedding these principles into service design and delivery, we can move towards a more equitable system that genuinely meets the diverse needs of all children and families.

Recommendation:

• Invest in culturally safe, community-led services, train interpreters in developmental and neurodiversity language, and ensure outreach to regional and remote communities.
• To operationalise recommendations such as transition coordination, the government could pilot funded roles within community health or independent advocacy organisations, ensuring coordinators are not tied to any single service provider.
• Culturally safe outreach could include partnerships with First Nations health services and CALD community leaders, with interpreters trained in neurodiversity-affirming language.
• Telehealth and mobile assessment teams can help bridge access gaps in remote areas.
• Digital solutions, such as secure online care coordination platforms and telehealth services, can improve continuity and access—especially for families in regional and remote areas. Investment in digital literacy and infrastructure is needed to ensure equitable benefit from these innovations.

4. Workforce Support and Training

The success of Thriving Kids depends on the workforce. Many skilled clinicians are leaving the private practice and disability sectors due to underfunding, unsustainable workloads, and inflexible models. Workforce attrition in allied health has increased by over 20% in the past five years, contributing to service gaps. These clinicians aren’t going to move towards bigger organisations who have historically been top heavy with greater administrative burden, and little left to fund experienced staff on the ground.

Without experienced therapists, the workforce will be dominated by underqualified staff, which is unsafe for children and families. It is therefore essential to implement strategies that not only retain skilled clinicians, but also foster the development of a knowledgeable, stable workforce capable of delivering high-quality, neuroaffirming, and culturally responsive care. By ensuring fair remuneration, professional growth opportunities, and flexible working arrangements, we can build a workforce that is empowered and equipped to meet the complex needs of all children and families, regardless of their background or location. This approach will help address existing disparities, facilitate timely access to services, and underpin the broader aim of delivering equitable, family-centred support across the system.

Recommendation:

• Retain experienced clinicians with fair remuneration, professional supervision, and flexible work conditions.
• Upskill professionals in neuroaffirming, trauma-informed, and attachment-aware practice.
• Provide accessible training to GPs and child health nurses to reduce diagnostic delays.

5. Domestic and International Policy Lessons

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To benefit from the lessons learned internationally, Australia must look beyond traditional models and invest in approaches that are collaborative, adaptable, and centred on the needs and strengths of both children and their families.

Drawing on policy successes from overseas, it is clear that sustainable outcomes are achieved when early intervention services actively partner with families, prioritise culturally responsive practices, and embed continuous feedback from lived experience experts into service design and delivery. It is required and expected that these services:

• Are Family-centred, not program-driven.
• Include Parents support, as parent wellbeing directly predicts child wellbeing
• Are centred on children being provided with environments of belonging rather than pressured into “inclusion” or “resilience.”

By embracing these principles, Thriving Kids can avoid replicating outdated models and ensure that Australian children and families receive the holistic, effective support they deserve, setting the stage for truly seamless transitions across all relevant systems

6. Seamless Transitions Across Systems

Children with developmental delay and disability should move seamlessly between early childhood education, schools, health, and community systems. At present, transitions are fractured, with families re-telling their story at every stage and carrying paperwork between disconnected systems.

To address these challenges, it is essential to establish coordinated pathways that ensure information flows securely and efficiently, sparing families the burden of repeatedly narrating their experiences and managing complex documentation. By implementing integrated systems and dedicated transition supports, children and their families can experience continuity of care and education, fostering a sense of stability and belonging throughout each developmental milestone. This approach not only reduces administrative stress but also enables professionals across early childhood, school, health, and community sectors to work collaboratively, ultimately enhancing outcomes for all involved.

Recommendation:

• Create funded “transition coordination” roles, independent of schools, to guide families through key life stages.
• Align Thriving Kids with the Early Years Learning Framework, Disability Standards for Education, and NDIS pathways.
• Ensure continuity of supports into adolescence to prevent crises.
• Establishing a lived experience advisory panel—including parents, young people, and clinicians—would ensure ongoing consultation.
• Annual reviews of the Thriving Kids Initiative would be imperative, with public reporting on key metrics (e.g., family satisfaction, wait times, service access by region and demographic). These measures would support transparency and continuous improvement.

Final Comments and Recommendations: Thriving Kids has the potential to make a transformative impact—but only if it avoids outdated approaches and listens to the lived expertise of disabled people, families, and clinicians. What children need is not labels, compliance, or resilience. They need safe, relationship-based, neurodiversity affirming environments where they and their families truly belong.

I urge the Committee to:

• Not release further information without significant consultation with the people these changes will directly effect.
• Protect family choice and control;
• Fund discipline-specific allied health alongside Keyworker models;
• Embed parent and family capacity-building;
• Remove severity categories;

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• Retain and upskill the workforce; and
• Build a system that creates belonging, not exclusion.

Australia cannot afford to repeat the mistakes of the past. Our children deserve more than survival—they deserve to thrive.

redacted

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