Submission:
Retaining Physiotherapy and Exercise Physiology as Essential Early Intervention Services within Thriving Kids
Submitted by: Ocean Kids Health
Contacts:
- Katie Cleary — Director & Senior Paediatric Physiotherapist
- Desiree Frigenti — Director & Senior Paediatric Physiotherapist
- Ben Hall — Director & Senior Exercise Physiologist
- Phone: (03) 7009 3652
- Email: hello@oceankidshealth.com.au
- Submission Type: Private Practice — For Public Use
- Date: 26 September 2025
Ocean Kids Health strongly urges the National Disability Insurance Scheme (NDIS) to retain Physiotherapy and Exercise Physiology as core services within the Thriving Kids early intervention initiative. Children with autism spectrum disorder (ASD) and developmental delays often face significant barriers to movement, participation, and inclusion.
Physiotherapists and Exercise Physiologists are highly trained movement experts who empower children to achieve the motor milestones and confidence necessary for learning, play, and independence. Research demonstrates that Physiotherapy and exercise-based interventions play a critical role in improving motor skills, physical activity levels, and quality of life for children with ASD and developmental conditions (Zhao et al., 2021).
These services are not optional — they are essential, evidence-based, life-changing interventions that reduce long-term costs to the NDIS and the broader healthcare system.
“To move is to thrive — and every child deserves that chance.”
1. Physiotherapy: A Lifeline for Children with Motor Delays
Children aged 0–5 with developmental challenges frequently present with:
- Delayed rolling, crawling, and walking
- Hypotonia (low muscle tone)
- Poor balance and coordination
- Poor strength
- Sensory-motor integration difficulties
- Limited participation in active play
- Reduced confidence
Paediatric physiotherapists are experts in:
- Early motor milestone development
- Postural control and core strength
- Gait training and mobility
- Equipment prescription and neuromuscular management
- Coordination and gross motor skill development
Without timely physiotherapy, children risk falling further behind, leading to greater dependency, social isolation, and increased long-term support needs (Reynolds et al., 2015; Sanz-Cervera et al., 2019).
“You cannot thrive if you cannot move. Physiotherapists give children that chance.”
2. Physiotherapy and Occupational Therapy: Complementary, Not Interchangeable
Occupational therapists primarily support fine motor skills, sensory processing, and self-care tasks. Physiotherapists uniquely address:
- Gross motor coordination
- Gait, strength, balance, and posture
- Musculoskeletal and neurological impairments
- Orthopaedic and complex movement planning
These disciplines are complementary. A child with global developmental delay requires both, not substitution of one for the other (Novak et al., 2013).
3. Early Gait Training: A Critical Window of Opportunity
Walking is a foundational milestone for independence, play, and social engagement. For many children with ASD or developmental delay, physiotherapy provides:
- Core strengthening
- Postural alignment
- Treadmill-based training
- Orthotics and adaptive aids
- Sensory-motor integration
Research shows treadmill training significantly improves gait and postural control (Wang et al., 2020), while early interventions prevent complications such as toe-walking, hip dislocations, scoliosis, and contractures (Miller et al., 2020).
“When a child learns to walk, they don’t just move — they explore, engage, and connect.”
4. Exercise Physiology: Enabling Participation and Inclusion
Children with autism are less likely to engage in sports and play due to:
- Motor coordination difficulties
- Low physical confidence
- Sensory sensitivities
- Behavioural barriers
Exercise physiologists are trained in:
- Movement science and biomechanics
- Behavioural support strategies
- Strength and conditioning
- Adapted physical activity for disability
Exercise Physiologists enable children to build physical literacy, improve gross motor skills, and gain confidence to join community-based activities. Evidence shows structured physical activity improves motor skills, emotional regulation, and participation (Sowa & Meulenbroek, 2012; Healy et al., 2018).
“Every child deserves to swim, run, and ride with friends. Exercise physiology helps make that happen.”
5. Case Studies: Real Lives, Real Impact
Case Study 1: “Leo” Walks Against the Odds
- 2-year-old with global developmental delay, unable to sit by 18 months.
- Received physiotherapy: core strengthening, treadmill gait training, play-based therapy, and family coaching.
- Outcomes: walking independently at 30 months, kindy participation by age 3, avoided mobility aids, estimated NDIS savings: $70,000 over 5 years.
Case Study 2: “Eli” Learns to Swim
- 4-year-old autistic child with motor delays and anxiety around water.
- Received exercise physiology: individualised aquatic therapy, sensory-modified exposure, structured routines, and parent coaching.
- Outcomes: swimming independently after 12 weeks, transitioned to mainstream swimming lessons, improved confidence and community inclusion.
(Zhu et al., 2020; Wang et al., 2020).
6. Risks of Excluding Physiotherapy and Exercise Physiology
If excluded from Thriving Kids, the risks include:
- Delayed walking and milestone achievement
- Preventable orthopaedic complications (e.g., scoliosis, hip dislocation)
- Increased falls, hospitalisation, and injuries
- Greater reliance on equipment and personal care
- Mental health impacts due to inactivity and exclusion
- Increased lifetime care costs to the NDIS (Woods et al., 2018)
“Removing these services does not save money — it shifts costs from prevention to crisis.”
7. Long-Term Role of Exercise Physiology
Beyond early childhood, Exercise Physiologists:
- Support transition into sport and recreation
- Promote lifelong physical literacy
- Prevent obesity and chronic conditions
- Maintain social engagement and mental health
Shields et al. (2013) demonstrated that early structured exercise interventions result in lasting benefits, including improved participation and reduced risk of obesity and cardiovascular disease.
8. Ocean Kids Health: A Proven Model
Ocean Kids Health is a Victorian-based, private provider, specialising in:
- Paediatric physiotherapy
- Exercise physiology
- Multidisciplinary, family-centred care
Our evidence-based approach leads to:
- Faster developmental progress
- Greater school readiness
- Reduced lifetime support needs
- Improved participation
- Reduced NDIS costs over the lifetime
We encourage the NDIS to involve frontline providers like Ocean Kids Health in co-design of early intervention policies.
9. Recommendations
To ensure children with developmental delays and autism thrive, we recommend the NDIS:
- Retain Physiotherapy and Exercise Physiology as core early intervention services.
- Maintain referral pathways to Physiotherapists for gross motor delays.
- Recognise the distinct and essential role of Exercise Physiology.
- Support multidisciplinary collaboration, not substitution.
- Ensure equitable access to qualified providers across regions.
- Involve experienced providers in shaping best-practice service models.
10. Conclusion
Physiotherapy and Exercise Physiology are essential early interventions that help children achieve critical milestones, prevent secondary complications, and promote independence. Removing these services would create immediate harm and long-term costs.
By retaining them within Thriving Kids, the NDIS invests in:
- Inclusion, independence, and empowerment of children
- Evidence-based, preventative care
- Cost savings for the disability and healthcare system
“Thriving begins with moving. Moving begins with physiotherapy and exercise physiology.”
References
Healy, S., Nacario, A., Braithwaite, R. E., & Hopper, C. (2018). The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Autism Research, 11(6), 818–833.
Miller, A., et al. (2020). Early physiotherapy interventions for children with motor impairments: Preventing musculoskeletal complications. Developmental Medicine & Child Neurology, 62(3), 310–318.
Novak, I., et al. (2013). A systematic review of interventions for children with cerebral palsy: State of the evidence. Developmental Medicine & Child Neurology, 55(10), 885–910.
Reynolds, J. E., Bendixen, R. M., Lawrence, S. L., Lane, S. J., & Coker, P. (2015). A systematic review of early motor interventions for children with autism spectrum disorder. Journal of Pediatric Rehabilitation Medicine, 8(2), 99–112.
Sanz-Cervera, P., Pastor-Cerezuela, G., Gonzalez-Sala, F., & Tarraga-Minguez, R. (2019). Early intervention in motor development for children with autism spectrum disorder. International Journal of Environmental Research and Public Health, 16(23), 4735.
Shields, N., Synnot, A. J., & Barr, M. (2013). Perceived barriers and facilitators to physical activity for children with disability: A systematic review. Research in Developmental Disabilities, 34(4), 1277–1294.
Sowa, M., & Meulenbroek, R. (2012). Effects of physical exercise on autism spectrum disorders: A meta-analysis. Research in Autism Spectrum Disorders, 6(1), 46–57.
Wang, T., Chen, C., & Li, Y. (2020). Effects of treadmill training on motor development in young children with developmental delay: A systematic review. Disability and Rehabilitation, 42(17), 2492–2504.
Woods, C. B., Hannon, J. C., & Murtagh, E. (2018). Physical activity, motor competence, and health-related outcomes in children with developmental disabilities. Research in Developmental Disabilities, 81, 85–96.
Zhu, J., Sun, J., & Wu, S. (2020). Individualized physical activity interventions for children with autism spectrum disorder: Effects on participation and anxiety. Journal of Autism and Developmental Disorders, 50(5), 1871–1884.
Zhao, M., Chen, S., Wu, Z., & Sun, S. (2021). The effects of physical activity interventions on motor skills and cognitive development in children with autism spectrum disorder: A meta-analysis. Journal of Autism and Developmental Disorders, 51(5), 1370–1386.