STANDING COMMITTEE ON HEALTH, AGED CARE AND DISABIITY
Submission by Koorana Child and Family Services Ltd

3 October 2025

Contact Details

For more information, please contact:

Morgan A. Fitzpatrick
Chief Executive Officer
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About Koorana

Koorana Child & Family Services Ltd (Koorana) is a not-for-profit that has been operating since 1976 in the Sydney region.

Today, we work across South Western Sydney, South East Sydney, Inner West, and the Sutherland Shire. Koorana delivers a range of supports to All Children, of All Abilities, to help them to achieve All of life’s Possibilities. These include early childhood intervention and therapeutic supports, inclusive early childhood education services, supported playgroups and other community programs to families of young children.

We support over 2000 children a year across over 100 post codes.

We are deeply committed to inclusion of all children of all abilities, and supporting parents on their parenting journey.

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Introduction

Koorana welcomes the announcement of the Thriving Kids Initiative and sees its potential to fill gaps in services for a range of cohorts of children and families in the community including:

• Children with developmental concerns or delay with mild to moderate needs;
• Children with developmental differences, e.g., ADHD;
• Children exiting the NDIS who still have developmental support needs;
• Children not eligible for NDIS due to visa status;
• Families receiving NDIS but not getting all the support they need – e.g., parent peer support, sibling support.

We see Thriving Kids as a huge opportunity to move away from a diagnosis-dependent model to a model which focuses on support needs. This destigmatises developmental support needs and removes barriers to access. Further, it is a huge opportunity to reduce the wait time and unnecessary steps for families in their journey to access supports.

However, with this opportunity, it is also critical to make sure families transitioning from NDIS to Thriving Kids do not lose supports which are critical for the child and family to thrive. Designing the system to meet these children and families’ needs is critical.

Koorana has supported a range of activities which consider the design needs for foundational supports for children under the age of 9 over recent years. We invite the Committee to review the following publications which address these points:

• Early Childhood Intervention Best Practice Network – July 2024 – Foundational Supports and the Disability Ecosystem for Children with Developmental Concerns, Delays, Differences and Disabilities – Principles, Best Practices and Solutions
• Child and Family Supports Alliance NSW (CaFSA NSW) – May 2024 – Principles for Developing a NSW Foundational Supports System for Children with Developmental Differences, Delays, or Disability and their Families

We also support the following Inquiry submissions:

• Australian Child and Family Supports Alliance (ACaFSA)
• Early Childhood Intervention Best Practice Network

In addition to these submissions, we wish to submit our own response which we hope will provide helpful solutions for consideration under the Thriving Kids Initiative.

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We see critical elements of any Thriving Kids Initiative to be access to:

1. Best Practice Early Childhood Intervention;
2. Parental Support – including peer support, information and resources, trainings and advocacy support;
3. Capacity building for the community/services – including early childhood educational settings and schools.

We appreciate the opportunity to highlight examples of these programs as part of this Inquiry.

Response to Inquiry Terms of Reference

Koorana has responded to the Inquiry Terms of Reference individually for ease of the Committee. We have responded to those Terms of Reference that are most relevant to our work or that have not been fully address in other submissions and publications noted above.

Terms of Reference

• 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.
• 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.

Koorana operates several unique programs which help with the identification of developmental concerns, differences, delays or disabilities, and support both parents and other caregivers/professionals in a child’s life.

Foundations of Growth Program

Koorana has delivered the Foundations for Growth program since 2022, and is currently in the 4th year of operation. This program is funded by The Smith Family with Communities for Children funding from the Commonwealth Department of Social Services.

Funding is provided as block funding to support five primary schools each year.

Funding is used at three levels:

1. Individual developmental screening and support:
   • At the start of our engagement, we meet with the school to identify children which may need developmental support to access the curriculum. This is also an opportunity for the schools to identify their concerns and areas they wish to receive more support with, which allows us to identify the most suitable allied health discipline. For example, a speech pathologist for a school with

more concerns around the language and communication of their students or an occupational therapist for a school with more concerns around sensory processing, emotional regulation and fine motor skills.

• With parent consent, classroom observations are undertaken and children screened for developmental concerns and learning support needs.
• Following observations, a formal assessment is conducted on children identified and flagged during the screening process to establish a clear picture of support needs, as well asl, goals for therapeutic support and capacity building.
• A debrief is then provided with the classroom teachers and parents with recommendations on:
  • Classroom accommodations and strategies;
  • Strategies for parents to consider at home.
• Where possible, both individual and group therapeutic support is provided to these students with ongoing follow up of both classroom teachers and parents to build skill and confidence to meet the child’s needs.
• Our Foundations for Growth team also work within a Key Worker model to allow for transdisciplinary support, especially as the needs of each school tend to evolve as the program progresses and consultation with another discipline may be beneficial or required.
• At the end of the program both teachers and families are provided with a written report detailing assessment findings, intervention goals and recommendations for any further assessment or intervention that may be beneficial for that child. This allows for the child’s educational team to provide follow up and support as necessary to families once the program has finished.

2. School capacity building:
   • In addition to support around individual children’s needs, we work with the school to understand where they require further support.
   • This may be areas where they have trends (e.g., a large volume of Kindergarten children with speech delays) or where they have identified they need for more professional development.
   • Support is provided in two ways:
     • Consultation around the environment, routines, or other adjustments which could be made across the school to be more accommodating of diverse needs.
     • Targeted professional development for their educational team. This involves school staff identifying a specific topic or gap in knowledge and our allied health team providing hands on workshops to develop their skills and confidence in this area.

3. Parent capacity building:
   • In addition to support around individual children’s needs, we work with the school to understand where parents may benefit.
   • We offer group trainings to parents within the school to provide further information, support and resources which may meet their needs.
   • Parents of the children identified as needing therapeutic supports receive capacity building from our therapist, which involves: i. a discussion about the assessment findings and concerns the parent may have; ii. a demonstration of strategies that can be implemented to support their child, support with making referrals to appropriate agencies; iii. and a written report covering the assessment, intervention and recommendations.

Typically, we deliver the program for one year at each school; however, some schools opt in for additional years as they continue with their journey of building inclusive practices.

We find this combination of both school-level capacity building and individual support/accommodation/strategies effective to support schools with becoming more responsive and inclusive to diverse needs, as well as, ensuring individual children’s needs are met so that they can fully participate in the educational program.

Outcomes have been significant; the 2024-25-year saw:

• Over 400 children screened for developmental concerns
• 135 teachers taking part in workshops and capacity building sessions
• 123 parents taking part in workshops and capacity building sessions
• 100 children receiving assessment, targeted intervention support and reports
• 97 children receiving referrals to paediatricians and external agencies

98.9% of children reported satisfaction with the service upon completion, with 97.3% showing clinical improvement on reassessment. 94.5% of teachers and parents reported an improved capacity to understand the children’s needs and support them to achieve their social, functional and educational goals.

Feedback included:

• Principal: “It was amazing to have a responsive team of allied health professionals to assist our Learning Support Team in making appropriate adjustments and accommodations for our students. It was a great opportunity to develop our skills in supporting students within our school.”
• Principal: “Having allied health professionals embedded in our school has changed how we support students. It’s been a game-changer.”

• Parent: “Thank you [Koorana therapist] for seeing [child]. You have no idea how much I appreciate the effort you’re putting into getting her on track. All information on activities I can do with her at home are much appreciated!”
• Parent: “Before this, I didn’t know where to start. Now I feel like I understand my child better and know how to help.”

Relevance to the Thriving Kids Initiative

Relevance to the Thriving Kids Initiative

A challenge within the current NDIS market is the volume of individual therapeutic providers delivering supports in schools. This presents challenges for schools with regard to:

1. The logistics and administration of managing multiple therapists each day;
2. Disruption to the classroom environment and learning of other students;
3. Conflicting advice and strategies recommended;
4. Lack of integration at a school-wide level of strategies to create an inclusive environment holistically.

This also creates challenges for families to know how to identify which providers deliver a quality, evidence-based service.

Lastly, for the system, it leads to duplication of costs (e.g., the cost of travel is duplicated due to the volume of therapists all travelling to the same location).

We believe models like our Foundations-for-Growth Model are a critical way forward. As have been recommended in other publications of our alliances and networks, we recommend that funding both under Thriving Kids and NDIS move to engage a limited number of providers in each geography to reduce market size, complexity and duplication.

Under this model, a limited panel of therapeutic/early childhood intervention providers would be approved to operate in each geography. To be approved, they would need to provide evidence of their service delivery alignment to the National Best Practice Framework for Early Childhood Intervention.

These providers would deliver two types of services:

1. School level capacity building: Each school and early learning centre would be assigned a lead provider that would work systemically with them on upskilling their educational team, providing resources for parents, and considering school-wide initiatives to improve accessibility and inclusion. This would be block funded.

2. Individual therapeutic support and capacity building: Families would be able to use their Thriving Kids or NDIS funding to engage any of the approved providers on the local panel to deliver individual therapeutic support and capacity building of their child’s educators/family/other professionals.

The benefit to this approach is that:

• It limits the volume of providers engaging with the school – reducing administrative burdens and inconsistency of advice;
• It keeps several options available for families so that they aren’t limited in their choices;
• School-level capacity building is delivered in a meaningful and customised manner;
• Families can also use those same therapists at home, which enables consistency in strategies between environments and reduces the cost of extra handover/collaboration;
• By having the panel across a geography, you increase the opportunity for consistency of therapeutic team from early learning settings to school to improve transitions;
• Cost to the scheme reduces by removing the duplication of travel charges but such a large volume of providers.

Koorana’s Integrative Practice Model

A second program model that Koorana delivers is our Integrative Practice Model in our community preschools.

Koorana operates inclusive community preschools which target children experiencing vulnerabilities including low socioeconomic status, culturally and linguistically diverse children, children who are First Nations background and children with additional needs and/or disabilities.

We have two preschools currently operating in Lakemba and Roselands, with an additional preschool opening in Bass Hill in January 2026.

For each preschool, Koorana reserves 25% of its daily places for children with additional needs and/or disabilities. We receive funding from the NSW Department of Education to support us to add additional staff which increase the adult-to-child ratio to make this inclusion level safe and provide high quality learning environments for all children in attendance.

Over the last six years, Koorana has developed a unique model for delivering support in this preschool environment that enables significant numbers of children of all abilities to learn and grow together.

Our Integrative Practice Model integrates elements from an evidence-based model called ‘The Pyramid Model’ which has international recognition with the Early Years Learning Framework and the Best Practice Guidelines for Early Childhood Intervention.

At a baseline, the preschool is designed to be inclusive of children from diverse needs. Visual communication tools, Key Word signing, sensory tools, environmental design, clear routines, relationships and communication are all designed to be inclusive to all children.

Then, on top of this, we embed a therapeutic team on a regular basis at our centres. They spend the day at the centre and integrate supports at the time / point of the day that a child will most benefit. For instance, a child may need support a mealtimes – this allows that support to be spread at those times throughout the day. Or if a child needs support to engage in group activities, the therapist can integrate in those supports at those times. In a traditional approach, therapists may come to a centre just for an hour, and then may not be able to provide support when a child is most ready to engage/or most needs that support.

In addition to the flexibility of this rostering model, the therapists can also then work with the educational team at the time that best suits them as well. This allows the educational team to be fully briefed and involved so that they can integrate those strategies into the normal routine or supports for the child. And, even into the educational program. Further, by staying for the day, the therapists can then have direct opportunity to speak to the parents and offer that engagement directly as well. This upskills the parents to translate those strategies at home, to increase consistency, and also allows for two-way feedback on how things are going in other environments.

Our therapeutic team also endeavours, where families agree, to work with them in the home environment to support the child’s development in different settings. This increases parental confidence and skill, gives further context to the therapeutic team on the child’s needs/circumstance, and enables consistency in strategies. These sessions can be delivered on days the child does not attend the preschool, in school holidays, or in a way that best suits the child and family.

The model demonstrates strong cost-effectiveness with an average of 1–3 NDIS hours per fortnight per child, significant developmental gains are achieved. This makes the model highly scalable within existing budgets and workforce constraints.

This model provides incredible support to educational teams and parents, and has demonstrated very positive outcomes in practice for children.

Below is a graphic which helps to demonstrate the activities undertaken by each member of the team-around-the child, and jointly delivered, as well as the underlying foundations that inform the model.

The model is supported by strong outcomes and evidence. See below some outcomes from children in 2024-2025.

2024 School Transition Pathways for Children with HLSN

• 50% enrolled in mainstream schools, mainstream classrooms
• 30% enrolled in mainstream schools, supported classrooms
• 20% enrolled in schools for specific purposes
• 95% of placements aligned with family goals

2024–2025 Client Survey Results for Children with HLSN

Child Progress Towards Goals (% of families agreeing their child made progress)	Improvement in Child’s Development (% of families noticing improvement)	Parent Confidence in Supporting Child (% of families feeling more confident)
March 2024: 66%	March 2024: 75%	March 2024: 76%
October 2024: 79%	October 2024: 84%	October 2024: 87%
April 2025: 78%	April 2025: 83%	April 2025: 87%

Stakeholder Feedback

A parent shared: “For the first time, I feel like my child’s preschool and therapy are working together, and I know how to help at home. It makes a big difference for our family.”

An educator noted: “Having therapists with us all day means we can learn by doing - we feel much more confident supporting children with complex needs.”

Relevance to the Thriving Kids Initiative

As with our Foundations for Growth program, we believe that this model is well-suited to the Thriving Kids Initiative. In many ways, it is an expansion of the model we have proposed in the last section and could funded and delivered under the same ‘panel of providers per geography’ approach.

A key learning from this model which would be helpful to integrate is the rostering of therapeutic resources across a full day rather than just an hour (noting, with a limited number of providers entering a school, this is very possible to achieve by a provider).

Koorana’s Key Worker Model and Best Practice Early Childhood Intervention

Koorana delivers its early childhood intervention services in alignment to the National Best Practice Framework for Early Childhood Intervention.

Several key components of these best practice are:

1. A focus on parent and caregiver capacity building – this means we focus on building the confidence and skill of the parent or other caregivers (e.g., educators) in a child’s life to support their development. This is seen as more important than ‘direct intervention’ with a child as the efficacy of the outcomes comes from it being implemented day-to-day outside of the session.
2. A focus on delivering support in the everyday environments where the child lives, learns and plays – this means we deliver our services primarily in schools, homes, or where children are participating in other community activities. This allows us to better understand their support needs in those settings and tailor strategies and interventions most effectively. It is difficult to effectively advise without this context, and also difficult to effectively upskill caregivers if therapies are not delivered in these environments.
3. Transdisciplinary practice – this means our therapists work together to support each other’s goals and strategies. Occupational Therapists might be helping to support a child’s regulation so that they can engage in Speech Therapy. Or, a Speech Therapist could be supporting toilet training delivered by an Occupational Therapist. The strategies delivered by one discipline are to support the common goals of the child. They meet regularly as a Team-around-the-Child to discuss how they can work together to support the child and family.
4. Key Worker model – as an expansion on the last point, a Key Worker is typically appointed to be the lead support for a family. A Key Worker will work with the family as the primary point of contact and this can reduce burden on seeing all disciplines all of the time. For instance, a family may see all required disciplines to start, set some goals and discuss strategies. Then, the Key Worker might work with the family to implement and trouble shoot those strategies. When new input is needed, they can reach back out to the other disciplines and engage their specialist input.

Key Workers can be from any discipline (e.g., Occupational Therapy, Speech Therapy, Psychology, Physiotherapy) but are often Early Childhood Specialist Teachers who have broad knowledge across early childhood development and learning strategies. They are able to integrate input and support the child’s development and parental capacity building holistically.

The Key Worker Model is well-evidenced and demonstrates excellent outcomes in practice.

Relevance to the Thriving Kids Initiative

The Key Worker Model is ideal for children with lower to moderate support needs. The Key Worker is able to holistically consider a child and family’s needs and provide broad developmental advice, strategies and direction for supporting a child’s development.

They are able to then call on specialist advice from other disciplines as required to support the child’s needs and work as a team-around-the-child with other professionals.

The Key Worker reduces the frequency all specialist allied health professionals need to be seen – which is less overwhelming for families, reduces cost to the system, and reduces workforce pressures and shortages.

In addition to the above, we strongly advocate for any early childhood intervention delivered under Thriving Kids to be aligned to the Best Practice Framework (to be released) which includes a focus on parental and caregiver capacity building and support in everyday environments.

Supported Playgroups

Koorana’s first services were supported playgroups and we continue to operate these today across several locations each day in South Western Sydney.

Our playgroups are delivered by trained early childhood specialists – typically early childhood educators or Teachers and Family Workers. All families are welcome, but we particularly target areas where families may be experiencing disadvantage or vulnerability.

Our playgroup programs are designed to align to the Early Years’ Learning Framework and a curriculum is in place for each school term to enable a quality early childhood education opportunity for all children.

This model supports parents in a range of ways:

• It provides the opportunity to connect with other parents in their local community and creating a sense of belonging in the community. Parents whose mental health is thriving are better able to support their children.
• Parents learn practical play and learning strategies during sessions that they can take away and use in other environments, at home, in the park, etc. This extends children’s learning and development well beyond playgroup time, while also strengthening the parent–child bond and increasing parents’ confidence as their child’s first teacher.
• It provides the opportunity to speak to an early childhood specialist to discuss their child’s development and get ideas, solutions and strategies. Further, from this we can help recommend next steps, make referrals, or provide information. This removes barriers for all families, and for those

experiencing vulnerability or isolation, it ensures they are not left to navigate complex systems alone and their children receive timely support.

• Staff are able to observe children’s development over time, supporting parents to monitor progress and intervene early if concerns arise. This ongoing trusted relationship benefits every family, while for vulnerable families it provides reassurance and confidence they may not otherwise have in understanding their child’s development.
• Supported playgroups integrate with other services like child and family health nurses and other community providers. This empowers all parents with knowledge and access and is especially valuable for families who may feel less confident in approaching professionals outside of a trusted setting.
• A quality early childhood education curriculum is delivered, including engaging incursions are delivered to expand access to this outside of formal early childhood education settings. As such, supported playgroups extend the reach of early intervention by capturing children who may not otherwise be engaged in early education until later years.
• Through ongoing engagement, a child’s development can be observed and the parents guided as needed. This ongoing trusted relationship benefits every family, while for vulnerable families it provides reassurance and confidence they may not otherwise have in understanding their child’s development.
• As our model offers support to all children, children learn and grow together, as do their parents, regardless of a child’s needs. This helps reduce stigma and builds a sense of belonging within their community.

Outcomes are also very strong for this program.

2024-2025 Client Survey Results

Child Progress Towards Goals (% of families agreeing their child made progress)	Improvement in Child’s Development (% of families noticing improvement)	Parent Confidence in Supporting Child (% of families feeling more confident)
March 2024: 78%	March 2024: 66%	March 2024: 76%
October 2024: 100%	October 2024: 98%	October 2024: 97%
April 2025: 78%	April 2025: 78%	April 2025: 81%

Stakeholder Feedback

Parent Feedback: “What I really appreciate about the service from Koorana is the supportive and welcoming environment they provide for both parents and children. The staff is always friendly, and they create a safe space where my children can explore and develop their skills through various activities. I also love the range of activities offered, which help in their physical, social, and cognitive development. Additionally, the playgroup allows my kids to interact with other children, which has been great for building their social skills. The service is well-organized, and I feel confident that my children are benefiting from the experience.”

Parent Feedback: “Sending [Child’s Name] in Koorana is the best thing we did for his improvement. We very satisfied on their service. Their educators are very kind, and experienced. [Child’s Name] had separation anxiety, but their educator’s handle him very calmly, as a parent now we feel very safe to send him at Koorana.”

Relevance to the Thriving Kids Initiative

Koorana’s supported playgroups provide a range of supports for families in early childhood. As such, we feel the supported playgroup model is important in the Thriving Kids Initiative. Not all families will attend early learning, or may not until the preschool years. This model catches children earlier in their development to help identify and support developmental concerns earlier.

Further, it helps to build a support network for parents early.

And from a system perspective, the model reduces long-term demand on specialist and intensive services by addressing developmental and wellbeing concerns earlier.

We strong advocates for its benefits for many families, and also acknowledge that it does not suit all families including working families, families with their own challenges with socialising, and many families need much more intensive support.

We recommend that any playgroup model funded under Thriving Kids be funded to enable professionalisation of the workforce and curriculum so that the benefits of this important model can be fully realised.

Terms of Reference

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

Koorana supports a culturally diverse client group and has done so for nearly 50 years.

It is critical in our experience to ensure that services are provided in the local community by local-trusted providers where trust and comfort exist.

We also have seen that it is critical to deliver services in everyday-settings families are already accessing. There can be stigma and isolation attached to having a child with additional needs, or identifying as needing support, therefore a barrier is created in asking families to attend a ‘institution’ to receive this support. By going where families already are, this can be more comfortable to support access.

In addition, we find in our communities that visa status is a barrier to supports. Firstly, as it prevents access to Medicare or NDIS, but also because of fears that permanent visas will not be approved if their child has additional needs. Ensuring supports will not impact visa, and eligibility is universal is critical to accessibility of the Thriving Kids Initiative for CALD communities.

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

We believe that the implementation of the Key Worker Model would be an effective strategy to support a child and family through mainstream systems.

As a Key Worker is familiar with the goals and strategies of all members of the team-around-the child, they can help direct families as to where they can receive additional support or may benefit from services.

For instance, a child presenting with a speech delay. A Key Worker can support the family to access a hearing test through their local MP, recommend they book in with an ENT for review, while simultaneously supporting the family on sounds they can work on, visuals they might implement and to learn Key Word signing. This helps direct families

and gives them practical strategies to support their child’s development at the same time.

Over time as needs change and evolve, they can continue to support the family to integrate in and access key supports through mainstream services as required.

We refer to the Early Childhood Intervention Best Practice Network’s submission for further detail.

Conclusion

We thank the Committee for their time in considering ours and other submissions. And, we welcome the opportunity to discuss the services discussed in more detail, as appropriate and helpful to the Committee.