STANDING COMMITTEE ON HEALTH, AGED CARE AND DISABILITY
MDAAS SUBMISSION RESPONSE TO THE INQUIRY INTO THE THRIVING KIDS INITIATIVE
NOVEMBER 2025
ACKNOWLEDGEMENT OF COUNTRY
We respectfully acknowledge the traditional custodians of the land on which we live, work, and meet. We pay our respects to Elders past, present, and emerging.
We recognise their enduring connection to their land, waters, and skies and honour their rich cultural heritage and knowledge systems.
We commit to listening, learning, and standing in solidarity with Aboriginal and Torres Strait Islander peoples, walking alongside them in the ongoing journey towards justice and reconciliation.
Contact for this submission:
Dr Sera Yilmaz
redacted
MULTICULTURAL DISABILITY ADVOCACY AUSTRALIA
www.mdaa.org.au
About MDAA
Multicultural Disability Advocacy Australia (MDAA) is the peak body in NSW for all people with disability (PWD) and their families and carers, with a particular focus on those from multicultural backgrounds.
Our purpose is “to permanently anchor inclusion and nurture strength in diversity.”
Our mission is to “explore inclusive pathways and exchange informed ideas that honour and embrace the unique experiences shaped by diversity.”
MDAA works within a culturally safe framework to ensure equitable service provision for diverse consumers. We provide support in the form of Individual Advocacy, with the aim to build the capacity of multicultural people with disability, and ensure that the rights of individuals are promoted, protected, and secured.
MDAA’s other services include Systemic Advocacy, NDIS Appeals and Reviews, Education Advocacy and ongoing projects including the Aged Care Volunteer Visitor Scheme (ACVVS).
About this Submission
MDAA welcomes the opportunity to provide a submission to the House of Representatives Standing Committee on Health, Aged Care and Disability for the Inquiry into the Thriving Kids Initiative.
This submission draws on MDAA’s extensive experience advocating for children and families from multicultural backgrounds, as well as First Nations communities, especially in the areas of disability, early childhood development, and education.
The Thriving Kids Initiative presents a significant opportunity to establish a nationally consistent system of essential supports for children under eight with developmental delays and disabilities, outside the NDIS. MDAA’s submission focuses on promoting cultural safety, equity, and intersectional approaches, as well as evidence-informed strategies to enhance accessibility, reduce barriers, and ensure meaningful engagement of families in early support services.
Cultural Safety and Equity in the Thriving Kids Initiative
It is MDAA’s view that to ensure effective and equitable delivery of the Thriving Kids Initiative, it is important to consider equity and intersectional issues for children who identify as Aboriginal and Torres Strait Islander (First Nations) and those from multicultural backgrounds. These children often experience multiple, intersecting barriers, including cultural differences, language challenges, disability, geographic isolation, and socioeconomic disadvantage. Achieving equity requires more than just recognising diverse groups: it necessitates service systems that actively ensure cultural safety, eliminate discrimination, engage meaningfully with families, and adapt delivery to the lived realities of intersecting identities (Australian Institute of Health and Welfare [AIHW], 2023). [1]
MDAA recognises the need for meaningful and consistent co-design strategies with First Nations and multicultural people and their communities. Co-design is important as it ensures services are culturally safe and to increase and sustain engagement of vulnerable groups. Through our MDAA Learning [2] training program, MDAA provides specialised training to organisations on cultural safety, cultural humility, and inclusive practice with multicultural and First Nations communities. Cultural safety, in this context, involves creating environments where people feel respected, understood, and free from the risk of cultural disempowerment (Royal Australian College of General Practitioners [RACGP], n.d.). [3]
MDAA also emphasises the importance of providing information in multiple languages and ensuring the correct and appropriate use of interpreters. This includes encouraging the establishment of culturally specific services and embedding industry training that responds to the diversity of cultural experiences through a person-centred, culturally humble framework. Services must be supported to develop the knowledge and skills needed to engage effectively with multicultural and First Nations communities. Working with organisations such as MDAA, which specialise in this training, is an effective and efficient way to increase practice knowledge and capacity. We make it clear in this submission based on our outreach experiences in regional communities, that the rollout of the Thriving Kids initiative in regional and rural Australia requires particular attention. A high proportion of First Nations communities reside in these areas, where historical under-engagement and limited-service availability are well documented. Families are often forced to travel significant distances or incur substantial costs to access support, placing them at a disadvantage.
[1] Australian Institute of Health and Welfare. (2023). Cultural safety in health care for Indigenous Australians: Monitoring framework. https://www.aihw.gov.au/reports/indigenous-australians/cultural-safety-health-care-framework/contents/background-material\ [2] https://www.mdaa.org.au/mdaa-learning\ [3] Royal Australian College of General Practitioners. (n.d.). Cultural safety framework. https://www.racgp.org.au/cultural-and-health-training-framework/framework/cultural-safety
The lack of transport in these areas is also of concern. Linking services to early childhood settings, schools, and community hubs is important to streamline service delivery and improved accessibility.
Recommendations
- Embed Cultural Safety Training
Fund and require cultural safety, humility, and equity training for all staff, delivered in partnership with organisations like MDAA, to better support First Nations and multicultural children. - Improve Regional Access
Prioritise linking services to community hubs, schools, and early childhood settings in regional/rural areas, including culturally specific supports and interpreters, to reduce barriers for families.
Delayed Diagnosis & the Need for Early ‘Softer’ Intervention
Children from multicultural backgrounds frequently receive a diagnosis of disability or developmental delay later than their peers. This delay is often driven by a combination of factors, including language barriers, low health-literacy among parents/carers, unfamiliarity with local systems of early childhood development and diagnostic services, cultural stigma and cultural understandings of disability that may differ from mainstream western models. For example, research in Australia has found that multicultural status is significantly associated with a later age diagnosis and can predict increased severity of developmental symptoms (Hussain et al., 2023). [4]
When diagnosis is delayed, children miss out on the critical ‘early years window’ of neuro-plasticity (birth to early school age) when the greatest gains from intervention can be achieved. MDAA proposes that early intervention needs to start not just at school entry but ideally in the early years of childhood, and must adopt a gentler, culturally responsive, community-embedded approach. Such ‘soft’ interventions might include family-centred supports, parent mentoring, culturally familiar service delivery, and community-linkages, which engage families before high-stakes schooling begins. Results from Chile’s Second National Quality of Life Survey (2005) [5] indicated that approximately 30% of children under five years old did not meet expected developmental milestones, with the highest rates of delay observed among those in the lowest income quintile.
[4] Hussain, A., John, J. R., Dissanayake, C., Frost, G., Girdler, S., Karlov, L., Masi, A., Alach, T., & Eapen, V. (2023). Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia. BMC Pediatrics, 23, 415.
[5] Milman, H. M., Castillo, C. A., Sansotta, A. T., Delpiano, P. V., & Murray, J. (2018). Scaling up an early childhood development programme through a national multisectoral approach to social protection: Lessons from Chile Crece Contigo. BMJ, 363, k4513. https://doi.org/10.1136/bmj.k4513
Considering these findings, and in response to growing international evidence linking early childhood development to long-term social and economic outcomes, President Michelle Bachelet, a trained paediatrician and Chile’s first female head of state, identified child development as a central policy priority upon taking office in 2006. The paper indicated that much less is known in terms of how to translate this knowledge into effective large-scale programs that should include cross collaboration among various sectors including an all of government approach.
It has been reported recently that Turkiye has implemented a Family-Based National Early Intervention Programme targeting children aged 0-8 years who are at risk of developmental delays or disabilities (UNICEF Turkiye, 2025) [6]. The programme is led by the Turkish Ministry of Family and Social Services in coordination with the Ministries of Education and Health, highlighting a strong multi-ministerial approach to early intervention. It focuses on early identification, providing family-centred supports, and delivering services through early childhood development centres as part of community outreach. This model demonstrates an emphasis on early age intervention, integration of services across sectors, and community- and family-based delivery in mainstream settings.
The proposed Thriving Kids Initiative intends to identify developmental concerns earlier and reduce the frequency of late diagnoses, resulting in improve outcomes for children. However, its current design raises some concerns. The 8-year age limit for accessing supports is particularly inadequate for children from multicultural communities, who often experience delayed access to assessment pathways due to intersectional barriers, negative cultural views of disability, and lack of culturally safe services.
This creates an unintended inequity whereby children who are diagnosed earlier can receive significantly more support than those diagnosed later.
In addition, the existing framework, even though it is in its early days, does not clearly define how ‘mild to moderate’ developmental delay will be determined, which risks inconsistent or exclusionary decision-making. With no clarity or nationally consistent criteria for determining what constitutes ‘mild to moderate’ developmental delay or autism, there is a significant risk of inconsistent interpretation between practitioners, jurisdictions, and service systems that could result in children being incorrectly categorised, excluded from appropriate supports, or pushed toward NDIS’ pathways unnecessarily. Establishing transparent, evidence-based criteria developed with clinical experts, disability communities, and multicultural stakeholders is important to ensure fair and accurate decision-making.
[6] UNICEF Türkiye. (2025, October 31). Family-based national early intervention programme launched to support children at risk of developmental delays. https://www.unicef.org/turkiye/en/press-releases/family-based-national-early-intervention-programme-launched-support-children-risk
Considering these case studies, by intervening earlier and more sensitively and considering partnerships and a joint approach among various stakeholders, the risk of children from multicultural communities falling behind (academically, socially or developmentally) is reduced, and schools, families and communities are better prepared. Grassroots organisations like MDAA can play a bridging role, ensuring children receive timely supports and advocacy, and that families are informed, supported and understood.
Funding Place-Based Initiatives
To create meaningful and sustainable outcomes for children and families, it is important that funding under the Thriving Kids initiative supports place-based approaches. This means directing funding to organisations that are already embedded within local communities, have established relationships, and understand the specific cultural and social dynamics of the area (Burgemeister et al., 2021). [7]
MDAA has seen the first-hand benefits in this model and, outside its offices in Sydney, maintains a regular presence in regional and rural locations such as Wagga Wagga, Griffith, Wollongong, and Bega. MDAA ensures that the same staff members return to these areas to build familiarity, consistency, and trust with local families and service networks. This approach has proven effective in improving access to advocacy, information, and supports for multicultural families and children with disability, especially those who may otherwise fall through service gaps (Walters et al., 2023). [8]
Investing in existing organisations with an established presence in these communities ensures that funding is used efficiently, builds on current infrastructure, and avoids duplication of services. Most importantly, it strengthens relationships of trust that are critical to engaging multicultural families and ensuring equitable outcomes for children.
Recommendations
- Fund Local Organisations with Established Community Connections
Prioritise funding to organisations that already operate in regional and rural areas, have a trusted presence, and understand the local context and needs of families. - Promote Collaboration Across Place-Based Services
Encourage partnerships between local advocacy organisations, schools, and health or family services to deliver coordinated, culturally responsive supports for children and families.
[7] Burgemeister, F. C., Crawford, S. B., Hackworth, N. J., Hokke, S., Nicholson, J. M. (2021) “Place-based approaches to improve health and development outcomes in young children: A scoping review.” PLoS ONE, 16(12): e0261643.
[8] Walters, E., Findlay, G., Curtis-Tyler, K., & Harden, A. (2023). Embedding community development approaches in local systems to address health inequalities: A scoping review. Community Development Journal, 58(4), 699-718. https://doi.org/10.1093/cdj/bsad026.
Commit to Minimal Out-of-Pocket Costs to Ensure Equity in Access
A major barrier for many multicultural families and those from low socio-economic backgrounds is the out-of-pocket cost of accessing supports, therapies, and programs for children. Even when services exist locally, the costs of transport, co-payments, or participation fees often make these programs inaccessible (Howie, Bull, & Callander, 2022). [9]
At this stage, the Thriving Kids initiative does not provide clarity on who is responsible for these out-of-pocket costs, which creates uncertainty and anxiety for families and may limit equitable access. Without clearly defined funding arrangements, families may be unfairly burdened or miss out on programs entirely.
To ensure equity of access, it is important that funding models specify who pays for what and include measures to reduce financial barriers, such as subsidising participation fees, providing travel allowances for regional families, or embedding the cost of interpreters and cultural liaison workers directly into program funding. True equity means that every child, regardless of postcode, socio-economic status, or cultural background, can participate without financial stress.
Recommendations
- Clarify Funding Responsibilities
Explicitly define who covers costs for participation, transport, interpreters, and other necessary supports to remove uncertainty and ensure families are not financially disadvantaged. - Embed Equity-Based Subsidies
Include subsidies or fee-waivers for families from low-income, multicultural, or disability backgrounds to eliminate cost-related barriers and promote inclusive participation.
The effectiveness of School-Based Community Hubs and Advocacy Partnerships
School-based community hubs, especially those located in or alongside schools, have the potential to serve as a bridge between children, families, community services and the education system. For example, the National Community Hubs Program (in partnership with the Scanlon Foundation) situates hubs in primary schools so that families can connect directly with the school, local services (health, settlement, early learning) and each other (Scanlon Foundation, n.d.). [10]
[9] Howie, P., Bull, C., & Callander, E.J. (2022). Inequities in vulnerable children’s access to health services in Australia. BMJ Global Health, 7(3), e007961. https://doi.org/10.1136/bmjgh-2021-007961\ [10] Scanlon Foundation. (n.d.). Community Hubs. https://www.scanlonfoundation.org.au/community-hubs/
In this way, hubs increase effective communication: they allow schools to engage more meaningfully with families, allow families to feel a sense of belonging and to access supports, and enable community organisations to operate in a familiar location. This is especially important in multicultural and disability contexts where trust, cultural familiarity and coordinated responses matter.
For organisations like MDAA, education advocacy funding enables us to act as a conduit between the school and the child/family. MDAA’s role can include liaising with the schools to ensure the child’s disability and learning support needs are understood; supporting the family in navigating education systems; and helping the school to embed inclusive practices and access external supports. By working alongside a hub model, MDAA can leverage the school’s established location and community connections, avoiding duplication, reducing access barriers for families, and accelerating the school’s capacity to respond to diverse needs.
When community hubs are properly funded and supported, the school, the advocacy organisation and the family form a strong tri-partite partnership: the school provides educational infrastructure and teaching expertise; the advocacy organisation brings specialised knowledge (disability, multicultural, advocacy); and the hub location provides the physical and social connection. This leads to more timely identification of needs, smoother transitions into school, better engagement of families and ultimately improved outcomes for children with disabilities from multicultural backgrounds.
A report from the Scanlon Foundation Research Institute (Scanlon Foundation, n.d.) [11] noted that “the bonds created through Community Hubs, between individuals, the local community and support services and institutions, strengthen families’ sense of place and belonging in their neighbourhood and ultimately contribute to Australia’s social cohesion.”
Similar international support for a strategy can be seen in Italy where early childhood hubs, known as Poli per l’Infanzia, make up part of the country’s Integrated System for children aged 0-6 (Italy, 2017, Art.3). [12]. These hubs bring together a range of services, including nurseries, preschools, parenting programs, and community supports, in a single, family-centred setting. They aim to promote continuity of education, inclusive access, and early intervention, particularly for children from vulnerable or diverse backgrounds. The hubs also provide a community focal point for families, offering workshops, support services, and culturally responsive programs, demonstrating a practical model of multi-service, community-based early childhood support.
[11] Scanlon Foundation. (n.d.). Community Hubs. https://www.scanlonfoundation.org.au/community-hubs/\ [12] Italy. Decreto Legislativo 13 aprile 2017, n. 65. Istituzione del sistema integrato di educazione e di istruzione dalla nascita sino a sei anni, a norma dell’articolo 1, commi 180 e 181, lettera e), della legge 13 luglio 2015, n. 107. Gazzetta Ufficiale, 16 May 2017 (Suppl. Ord. n. 23). https://www.normattiva.it/uri-res/N2Ls?urn%3Anir%3Astato%3Adecreto.legislativo%3A2017%3B065.
Recommendations
- Fund Integrated School-Hub Partnerships
Allocate specific funding streams for advocacy organisations to partner with school-based community hubs. This ensures the advocacy organisation can be embedded in the hub environment, collaborate with school leadership and provide ongoing support to families and schools. - Embed Hub-Based Capacity for Disability & CALD Supports in Budget Allocations
Ensure that hub funding explicitly covers disability-inclusive education support, cultural liaison services and family advocacy. Schools and hubs should have access to specialised advocacy partners so that children with disabilities, particularly from multicultural backgrounds, are supported early and appropriately.
The Need for Independent Oversight in School Appeals Processes
Through its education advocacy work, MDAA has observed that most school-based complaints or appeals processes are handled entirely internally, with decisions managed within the school or school system. While schools often have internal administrative procedures, there is generally no accessible, independent, external oversight available to families or students who wish to challenge decisions, particularly those relating to disability supports, inclusive education, or equity of access.
This lack of external review creates several issues. First, it can limit transparency and accountability, as schools are effectively reviewing their own decisions. Second, it places families in a vulnerable position, particularly those from multicultural backgrounds, who may be less familiar with internal administrative processes or lack confidence navigating school bureaucracy. Third, internal processes may not consistently apply inclusive or culturally safe approaches, which can disadvantage children with additional needs.
As highlighted in MDAA’s submission to the Foundational Supports Inquiry, “schools must first be equipped with the tools and information required to carry out their duty of care. Most of a child’s life is spent in schooling, making schools a main point of contact for families and carers.” [13]
Investment in the education system, including teachers and school staff, is crucial to the lasting success of the Thriving Kids Initiative. Without appropriate knowledge of disability, inclusive pedagogy, cultural safety, and child behaviour, children risk being left behind.
[13] Multicultural Disability Advocacy Association. (2025, April 23). Submission - Inquiry into foundational and disability supports available for children and young people in New South Wales. redacted
Embedding cultural safety training and equity-focused professional development within schools and allied services is essential to ensure that children from multicultural and First Nations backgrounds are supported effectively and inclusively.
External oversight is important to ensure that appeals are handled fairly, objectively, and in line with legal and educational standards. Independent review mechanisms, whether through state education departments, ombudsman services, or designated advocacy bodies, provide families with confidence that concerns will be addressed transparently. They also incentivise schools to uphold best practices in disability support, equity, and inclusive education.
Recommendation
The Thriving Kids Initiative should consider the establishment or strengthening of independent appeal pathways, particularly for issues relating to disability, learning adjustments, and equity, to complement existing internal processes. This would provide families with recourse that is accessible, impartial, and culturally safe, ultimately improving accountability and outcomes for children.
General Practitioner Education, Evidence-Based Reporting, and Funding Support
GPs play a critical role in identifying, monitoring, and supporting children with disabilities or developmental concerns, particularly in early intervention contexts. Through MDAA’s work in education advocacy, it has become clear that high-quality, evidence-based report writing by GPs is important to ensure children can access the supports and adjustments they require in schools and community services. Accurate reports provide the foundation for educational planning, eligibility for therapies, and access to funding or disability supports, which are key components of the Thriving Kids Initiative. [14]
GPs often face challenges in producing comprehensive reports that meet the needs of education and disability systems. Barriers include time constraints, lack of training in education-focused documentation, and limited understanding of intersectional and culturally safe approaches. Ensuring that GP reports include clear evidence, measurable recommendations, and culturally safe language is important for equitable access to services, particularly for children from multicultural and First Nations backgrounds.
[14] Multicultural Disability Advocacy Association of NSW. (2025, April). Submission to the Inquiry into foundational and disability supports available for children and young people in New South Wales [Paper]. redacted
Recommendations
- Fund GP Training in Evidence-Based Reporting
Provide targeted funding for GPs to undertake training in education- and disability-focused report writing, including culturally safe practices for multicultural and First Nations children. - Support Culturally Safe and Inclusive Reports
Ensure GP reports include culturally responsive language and consider intersectional needs to improve equitable access to school and therapy supports. - Allocate Time and Resources for Comprehensive Documentation
Fund GPs to dedicate sufficient time for preparing high-quality, actionable reports, strengthening early intervention outcomes under the Thriving Kids Initiative.
Culturally Responsive Rollout and Community Engagement
To ensure the Thriving Kids Initiative is rolled out effectively, it is important that implementation strategies are culturally safe and inclusive, especially for First Nations and multicultural communities. Many families from these backgrounds may be unfamiliar with formal disability terminology, complex funding structures, or technology-based platforms, which can create confusion or anxiety about accessing supports.
Embedding information sessions within local community hubs, schools, advocacy organisations like MDAA and early childhood settings will provide opportunities for families to engage directly, ask questions, and understand the benefits of the initiative in plain, culturally appropriate language. It is equally important that advocacy organisations are adequately trained to explain the initiative clearly, highlight its practical advantages, and provide guidance in multiple languages. This approach ensures families are informed, reassured, and empowered to access supports for their children, promoting equitable participation and reducing barriers to engagement or anxiety about misconceptions relating to the initiative.
Additional Comments (Thriving Kids Advisory Group related)
MDAA welcomes the establishment of the Advisory Group and its role in shaping national service models, identifying service gaps, and providing advice across the Commonwealth and states. We note the Group’s commitment to considering findings from the NDIS Review, the Parliamentary Inquiry into Thriving Kids, and national consultations on foundational supports. We recommend that insights and evidence relating to multicultural communities be explicitly incorporated throughout all phases of the Group’s work.
While the Terms of Reference refer to “diverse expertise” and consultations with Disability Representative Organisations (DROs), MDAA observes there is no explicit reference to multicultural representation.
We recommend that the Advisory Group ensure inclusion of multicultural disability expertise, both within membership and through “deep dive” engagement processes, to reflect the diversity of children and families across Australia.
The Group’s scope includes identifying gaps in the service system. MDAA recommends that these gaps be examined through an intersectional lens, particularly considering barriers faced by multicultural families such as language challenges, limited culturally appropriate services, and inadequate access to interpreters.
Finally, regarding communication and engagement strategies, MDAA recommends that national approaches be culturally safe from the outset. This should include the provision of translated materials and the use of inclusive outreach methods to ensure all families can access and understand information about services.
Closing Remarks
MDAA appreciates the opportunity to provide input to the Inquiry into the Thriving Kids Initiative. We strongly support the initiative’s goal of delivering nationally consistent, early supports for children under eight with developmental delays and disabilities, outside the NDIS.
As outlined throughout this submission, ensuring cultural safety, equity, and intersectional responsiveness is key to the success of the program, particularly for children from First Nations and multicultural backgrounds. Place-based approaches, early and gentle interventions, school-based hubs, independent oversight, and GP education are all critical mechanisms to ensure children and families are supported effectively.
MDAA encourages the Committee to embed these principles into the design, implementation, and evaluation of the initiative. As grassroots not-for-profit organisation, we are ready to collaborate, share expertise, and provide culturally informed guidance to ensure that Thriving Kids delivers equitable, accessible, and meaningful outcomes for all children and families across Australia.