Playgroup Australia submission to the Senate Committee on Autism. August 2020.
Executive Summary
Playgroup Australia is the peak body for the playgroup movement in Australia, and our vision is creating a village through play. Of relevance to this enquiry, Playgroup Australia delivers PlayConnect supported playgroup for families of children with Autism Spectrum Disorders (ASD), developmental delays or behavioural concerns.
With the national rollout of the National Disability Insurance Scheme (NDIS), the program was marked for transition to the NDIS in 2019, which would have resulted in the cessation of the program. However, In recognition of the very clear need for supports like PlayConnect alongside NDIS, ILC and ECEI the program has been granted two 12-month extensions (concluding mid-2021) to determine the most appropriate ongoing funding stream for the program. Playgroup Australia has, and continues to engage with funding bodies and relevant stakeholders to explore future funding options for the program moving forward.
Playgroup Australia asks the Senate Select Committee:
- Recognise the important role that the PlayConnect Program plays for children with ASD characteristics, their siblings and families
- Call for the Australian Government to provide funding certainty and growth for the program into the future as per the following recommendations.
Consistent with our most recent budget submission,1 Playgroup Australia make the following recommendations:
- The Government continue funding PlayConnect for this program at $6.8m over four years.
- The Government extend the funding of PlayConnect to allow for the delivery of 55 additional playgroups for families with children with ASD, developmental delays or behavioural concerns, in identified areas of need at $6.7m over four years.
Introduction
Playgroup Australia is pleased to provide this submission to the Senate Select Committee on Autism to support the committee’s inquiry into services, supports and life outcomes for autistic people in Australia. We are the peak body for the playgroup movement in Australia, and our vision is creating a village through play.
1 https://playgroupaustralia.org.au/resource/playgroup-australia-pre-budget-submission-2020/
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Playgroup Australia and the State and Territory Playgroup Organisations support over 8000 playgroups for children from birth to five years old. Around 170,000 families participate in the playgroups reaching almost 80% of all Australian postcodes2. This makes playgroup one of Australia’s largest social movements.
Playgroup has been a fundamental building block of Australian society for generations. Over 45 years of supporting community playgroups has showed us that playgroup helps build stronger, more resilient communities and families, and builds the capacity of parents to support child and family wellbeing in the vital early years period. Playgroups connect children and parents to the communities around them, providing them with a space to meet others and be supported by their peers, and to connect with community services. These local connections support child development, parent-to-parent support, volunteerism, and community cohesion.
The anecdotal evidence of the benefits of playgroups is well supported within the research literature and in the feedback from families. This evidence shows playgroup participation:
- Increases children’s readiness for school (Gregory et al 2016); 3
- Improves parental outcomes, including parents in disadvantaged families (Hancock et al 2016);4
- Builds community capacity and increased levels of community trust (McShane et al 2016)5; and
- Results in children performing better on all Australian Early Development Census (AEDC) measurements including physical, social, emotional, language communication and cognitive development (Sincovich et al 2019).6
Further, the evidence suggests these benefits are gained at a relatively low cost. An Independent Cost Benefit analysis of community playgroups (2019) found a return of $3.60 for every dollar invested7. This represents an excellent investment return.
The Longitudinal Study of Australian Children (LSAC)8 estimates that 40% of Australian children aged under five attend a playgroup at some stage prior to starting school. The role of Playgroup Australia is to ensure playgroups are available and accessible to every Australian family, including those from vulnerable backgrounds and those living with disability.
Within this remit we support the delivery of a variety of playgroup types. This ranges from universally accessible community playgroups, run entirely by volunteer parents and making up most of our playgroups, to targeted playgroups supported by professional staff that assist children and families with developmental difficulties and disabilty, or those experiencing extreme disadvantaged or vulnerability.
Introduction to PlayConnect
Of particular relevance to this enquiry, Playgroup Australia delivers PlayConnect supported playgroup for families of children with Autism Spectrum Disorders (ASD), developmental delays or behavioural concerns. PlayConnect groups are currently delivered in 42 sites across all states and territories in both metropolitan and regional areas. Annually, these groups are attended by over 400 families, including parents, children with ASD, developmental delays or behavioural concerns, siblings, and other carers.
2 Playgroup Australia (2019). Annual Report 2018-19. 3 Gregory, T, Sincovich, A, Harman-Smith, Y & Brinkman, S (2017). The reach of Playgroups across Australia and their benefits for children’s development: A comparison of 2012 and 2015 AEDC data. Telethon Kids Institute, South Australia. 4 Hancock, K, Cunningham, N, Lawrence, D, Zarb, D, & Zubrick, R (2015). Playgroup participation and social support outcomes for mothers of young children: A longitudinal cohort study. PLoS ONE, 10(7). 5 McShane, I, Cook, K, Sinclair, S, Keam, G & Fry, J (2016). Relationships Matter: The Social and Economic Benefits of Community Playgroups. A research report prepared for Playgroup Australia. Melbourne RMIT University. 6 Sincovich, A., Harman-Smith, Y., & Brinkman, S. (2019). The reach of playgroups and their benefit for children across Australia: A comparison of 2012, 2015, and 2018 AEDC data. Telethon Kids Institute, South Australia 7 Daly, A., Barrett, G. & Williams, R (2019). Cost Benefit Analysis of Community Playgroup, Playgroup Australia, Canberra 8 Hancock, K, Cunningham, N, Lawrence, D, Zarb, D, & Zubrick, R (2015). Playgroup participation and social support outcomes for mothers of young children: A longitudinal cohort study. PLoS ONE, 10(7).
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PlayConnect playgroups provide responsive, individual support to whole families. The program provides:
- Developmentally appropriate play and peer engagement opportunities. Sessions are purposefully planned to provide both children and caregivers with the opportunity to learn together through play in a safe, supportive environment that recognises and caters for individual. Activities within PlayConnect sessions are chosen to minimise these challenges or are modified to suit the developmental and social needs of children attending.
- Peer support for parents, other carers and siblings. PlayConnect playgroups provide a forum for parents, siblings and other caregivers to foster supportive social relationships with others who share similar experiences. These networks provide an emotional and practical support for families across the challenging and often emotional journey of parenting a child with disability. In the case of parents, this peer support often extends to include informal mentoring, with more experienced parents within a group providing support and mentorship to newer members to build parenting confidence and capacity.
- Community outcomes through the provision of information, community linkages and referrals. The PlayConnect program supports both formal and informal learning tailored to address these specific needs of parents, caregivers and families. PlayConnect facilitators work informally with families to identify their information and referral needs, and with community stakeholders to understand the local service and support landscape. Where possible, families are connected with services within the local community to meet their needs.
The PlayConnect program model is flexible to allow facilitators to respond to the needs of families and children and targeted opportunities for capacity building. While typical disability support services under the NDIS focus on the individual, PlayConnect extends this reach to encompass broader family networks. This is in line with the Principles outlined in Principles for High Quality Playgroups: Examples from research and Practice9.
The program caters for children from infancy to school-age and their extended families. It is targeted at:
- Children without an NDIS plan, and their families, including those waiting for NDIS assessment, those deemed ineligible for funding, or those otherwise outside of the NDIS system and
- Families with NDIS funding, providing social and community support, capacity building, and peer-group learning and support for children, carers and siblings. These outcomes are not typically funded within NDIS early intervention plans, which tend to focus on individual therapy, and as such cannot be purchased by families with NDIS funding.
In 2019 the program provided services to 414 children with ASD, developmental delays or behavioural concerns, supported over 400 families and in excess of 120 siblings nationally. This included 135 Culturally and Linguistically Diverse and 33 Indigenous families.
Fifty four percent (54% or 233) of children within the target group had a confirmed ASD diagnosis. The remaining 46% (191) children were either undertaking assessment or have been found to not meet diagnostic criteria.
Thirty seven percent (37% or 152 children) of participants had an NDIS plan. The remaining 63% (262 children) were without NDIS funding support, either deemed ineligible or awaiting assessment.
9 Commonwealth of Australia (Commerford, C., Y Hunter, C). (2017). Principles for high quality playgroups: Examples from research and practice. Melbourne, Australian Institute of Family Studies. Available online (29/07/2019) at: https://aifs.gov.au/cfca/publications/principles-high-quality-playgroups
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The PlayConnect program has been funded since 2008, initially under the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and later the Department of Social Services (DSS). During this time the program has supported thousands of families with children with ASD, developmental delays and behavioural concerns.
Families typically begin attending when their child is approximately 18 months old, prior to entering into any formal diagnostic process, and continue to participate for approximately two years before transitioning into formal education. There is no cost to families to attend.
PlayConnect during the Pandemic
In line with national Covid-19 measures all PlayConnect playgroups suspended face-to-face delivery at the commencement of Term 2 2020. Through these unprecedented times program staff have adapted typical models of service delivery to ensure families within the PlayConnect network remained supported.
While the nature of the support depended on the needs of families within each group, all program facilitators made at least weekly contact with each family within their group across the PlayConnect network. Contact ranged from one-to-one engagements, to interactive group contact largely focusing on parents and carers, to the delivery of online activities for whole families. These engagements occurred across a range of platforms including phone calls, text messages, email and a variety of social media platforms and online meeting platforms (including closed Facebook groups, Messenger groups, WhatsApp groups, Zoom and Skype).
In addition, many facilitators prepared weekly newsletters, play activities and information resources and distributed these amongst their group. Others planned and provided online content, including weekly music and play sessions (Tasmania and Australian Capital Territory), and online PlayConnect sessions with craft and play activities (Queensland and sites in Victoria). Others still produced at home activity and resource kits and hand delivered these to families (sites in New South Wales, South Australia and the Northern Territory).
As we begin to return to face-to-face service delivery program facilitators continue to engage with families and respond to individual needs to responsively support this transition.
Program Evaluation
Evaluations of the program have consistently highlighted the value of PlayConnect, at both program and participant levels. A program evaluation undertaken by Australian Research Alliance for Children and Youth (ARACY) 10 this year concluded that program fills an important service gap for families, and articulated several key findings:
- PlayConnect is highly valued by participants with participating families express consistently high levels of satisfaction with the program.
- PlayConnect successfully provides participants with:
- information and referrals; increased parenting confidence
- increased behaviour management capacity which results in increased engagement in community
- engages children in appropriate play opportunities
- the opportunity for peer engagement with other families
- the opportunity for their child to play and interact with other children and
- a safe and non-judgemental community space.
10 Australian Research Alliance for Children and Youth (ARACY) (2020). PlayConnect Evaluation. Available online (3/8/2020) at https://playgroupaustralia.org.au/resource/playconnect-evaluation.
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- Unlike NDIS-funded therapeutic interventions, which tend to be delivered in a one-to-one model, PlayConnect encourages social interaction and peer-to-peer engagement for both the children attending and their families providing a whole family model of support.
- PlayConnect provides these benefits despite tight funding and resources, and the program could be made more effective with additional support11.
Annual participant surveys and internal program reviews also consistently reflect the value of the program and the positive impacts for the families attending. Parents and caregivers report the program:
- Provides vital opportunities for peer engagement and support for whole families (parents and carers, children and siblings)
- Significantly improves the capacity and confidence of families to support their children with ASD and ASD-like characteristics. Specifically, this includes managing challenging and socially inappropriate behaviour, using ASD appropriate aids and tools, and accessing relevant support services within local communities
- Increases parental knowledge and understanding of ASD as well as supports within the local community.
These findings are echoed in the comments of participating parents, with feedback including:
“Feeling you have a place where people understand, and your children feel accepted and appreciated for them. Having other parents to talk to about the day to day aspects of caring for the children, feeling others understand and feeling heard”
“I have felt relaxed and made some great friendships here. Having other parents to hear their experiences and advice has been so valuable.”
“It’s been a huge support for our family, something both boys really look forward to each week (and not stressful for me). It’s great being able to get some support.”
“The groups are an amazing idea to bring the community together. As a parent I felt like no one around me knew what I was going through when my son was diagnosed and now I have somewhere in my community with understanding people has made a world of difference to us!”
“PlayConnect has been a life saver for our son, his siblings and myself at the most difficult, frightening and challenging time of our lives. The support, assistance and care from all staff and other parents has guided us through a daunting time to happy outcomes and a brighter future. Our son and his siblings are in a safe space where they have become more connected and happier as well as developing new skills, making connections and developing their interests. PlayConnect has provided my family with a community of support, a wealth of knowledge, and a place to call home.”
Similarly, an evaluation undertaken by La Trobe University in 201412 determined:
- PlayConnect was an effective program that consistently delivered the program goals and objectives “to provide play-based opportunities for parents and their young children with ASD to learn and socialise, and for parents to learn about their children’s needs, create informal social support networks, and engage in their communities“.
11 Australian Research Alliance for Children and Youth (ARACY) (2020). PlayConnect Evaluation. Available online (3/8/2020) at https://playgroupaustralia.org.au/resource/playconnect-evaluation.
12 Unpublished internal document (2014). Available upon request.
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- The program was accessible, with low barriers to accessibility, with particular mention made of: no participation cost; no requirement for a formal referral; no diagnostic requirement; inclusion of extended families; and flexible and responsive service delivery. Further, the program successfully reached those experiencing the highest levels of socio-economic disadvantage, and those considered the most vulnerable and at risk.
- The program was highly valued by families and participants were highly satisfied with the quality of the program. Parents particularly valued: the family support offered within the program; opportunities for interaction with other children with ASD; and the accessibility of groups.
The Future of PlayConnect
PlayConnect and the NDIS
With the national rollout of the National Disability Insurance Scheme (NDIS), PlayConnect was initially marked for transition to the NDIS in 2019, which would have resulted in the cessation of the program. This would have significant created areas of unmet need for families with young children with ASD, developmental needs or behavioural concerns nationally.
The NDIS Early Childhood Early Intervention approach aims to “assist families understand the potential role of the NDIS and to guide them to other appropriate supports and to offer independent advice on providers of support most suited to their needs”13. Within this remit, The NDIA appointed Early Childhood Partners focus, appropriately, on eligibility and planning for children that meet the NDIS criteria.
This is the fundamental distinction between the services provided by the ECEI partners and the PlayConnect program. The ECEI partners and the NDIS more broadly provide an undoubtedly important service, however they fail to act as a replacement in meeting the needs of PlayConnect participants in several ways:
- They lack the capacity to provide long term, sustained support to families.
- Are unable to cater for the needs of whole families, focusing instead on the individual child’s NDIS eligibility and assessment processes.
- Cannot support children who are determined to be ineligible for funding under the NDIS other than through short term advice or referral.
- Early intervention plans primarily fund therapy provision and cannot be used to cover the cost of playgroup, or to replace the parent support elements of PlayConnect.
As evident in the most recent program evaluation the supports provided by the PlayConnect program cannot be replaced by the NDIS. PlayConnect is a complementary support that meets an important service gap for families both within and outside of the NDIS framework.
To explore this a little further, in 2019, 63% of program participants were without an NDIS plan, with current data suggesting a similar representation. These children were awaiting NDIS review, have been found not to meet the requirement for an NDIS plan, or are otherwise outside the NDIS systems. For these families, PlayConnect acted as an important source of support and connection that would otherwise be unavailable.
Furthermore, for the 37% of participants with an NDIS plan PlayConnect provides a supported peer and play engagement opportunity for children with ASD, developmental delays or behavioural concerns and their families. PlayConnect builds the capacity and confidence of both children and carers, which in turn allows them to maximise the benefit of their NDIS funding packages. Additionally, in locations where there are significant waiting lists for families to access therapists, PlayConnect provides accessible early
13 NDIS. ECEI Partners in the community. Available online (13/08/2019) at: www.ndis.gov.au/understanding/what-ndis/whos-rolling-out-ndis/ecei-partners-community
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intervention to bridge the gap and support families until appropriate therapy becomes available. These supports are not typically covered by NDIS plans.
PlayConnect does not fit within the Information, Linkages and Capacity Building (ILC) component of the NDIS, as this funding stream focuses on delivering outcomes through targeted short-term grants processes. There is a very clear need for supports like PlayConnect alongside ILC, ECEI and the NDIS. In recognition of this existing need Playgroup Australia has, and continues to engage with funding bodies and relevant stakeholders to explore future funding options for the program moving forward. The program has been granted two 12-month extensions (concluding mid-2021) to determine the most appropriate ongoing funding stream for the program. Recognising the particular funding and procurement issues around the program, Playgroup Australia looks forward to working with the NDIA and Department of Social Services to resolve future funding and sustain this vital family support program.
Funding PlayConnect
The program is currently funded at c$1.48 million per annum (including GST and SACs). This provides for the delivery of 42 groups nationally, three groups more than required under the existing funding agreement. However, consistent with the recommendation of the ARACY program evaluation (2020) we are seeking an increase of program funding to a total annual investment of c$1.657 million per annum (including GST and SACs).
Based on the 42 PlayConnect groups delivered around the country, this equates to $39,452 per group each year, including national and state administration costs. Over the course of 40 PlayConnect sessions annually, this equates to $986 for each PlayConnect session, and based on an average group size of 10 children, a cost of $99 per child per two-hour session, or $45 per hour.
Proposed Annual Program Funding
| Proposed Annual Program Funding | $1,657,000 |
|---|---|
| Annual cost per group (42 groups) | $39,452 |
| Weekly running cost (40 weekly sessions) | $986 |
| Hourly cost per family per week (av. 10 children per group) | $45 |
While the NDIS Pricing Guide evolves regularly this represents a significantly lower cost support model than individual or group therapeutic capacity building supports available within NDIS plans. While PlayConnect facilitators are not typically allied-health clinicians, they are trained ASD providers, supported by an extensive suite of program of resources, play activities and ASD supports to provide developmentally appropriate activities during playgroup. This ensures, that while they may not have specific allied health qualifications, PlayConnect is delivered by staff that are trained to provide high quality group facilitation and support to families.
Continuation and Expansion of PlayConnect
PlayConnect is a highly cost-effective program within the disability service sector, and a very low-cost program for Government. The program uniquely bridges the gap between behaviours of concern, diagnosis and service delivery. Without the supports provided by the program the 400 plus families that attend PlayConnect groups annually will be without critical support, with the potential of increased education and support costs leading into school transition.
Furthermore, Playgroup Australia has identified strong and increasing demand for these specialised playgroups to increase service available to families who otherwise sit on the margins of mainstream disability and support services. Our research has identified a total of 55 additional sites, more than half in regional locations, where there is both demand and capacity for additional PlayConnect services.
Our recommendation is for the continued funding of the PlayConnect program as a four-year program allowing for the ongoing delivery of existing groups and the expansion of the program to allow for the establishment of new sites in the areas of identified need. This would result in 97 PlayConnect groups running across all jurisdictions, from cities to remote locations by 2023-2414.
In addition, we recognise the capacity of the PlayConnect program to be adapted to support families with young children with disabilities other than ASD, and further recognise that supports of this nature are not widely available for these families. We welcome the opportunity to explore future initiatives to provide support to these vulnerable families.
Recommendations
Playgroup Australia recommends the Senate Select Committee:
- Recognise the important role that the PlayConnect Program plays for children with ASD characteristics, their siblings and families
- Call for the Australian Government to provide funding certainty and growth for the program into the future as per the following recommendations.
Consistent with our most recent budget submission,15 Playgroup Australia make the following recommendations:
- The Government continue funding PlayConnect for this program at $6.8m over four years.
- The Government extend the funding of PlayConnect to allow for the delivery of 55 additional playgroups for families with children with ASD, developmental delays or behavioural concerns, in identified areas of need at $6.7m over four years.
Attachment A provides a breakdown of budgets for these proposals.
Contacts
Fiona May
CEO
Playgroup Australia
Nicole Kee
PlayConnect Program Manager
Playgroup Australia
14 While Playgroup Australia has identified available and appropriate locations, we would confirm locations and sequencing of the rollout in partnership with the Department of Social Services (DSS) and work closely with DSS to ensure evaluation of the sites each year, taking into account demographic shifts that may affect both demand and capacity, particularly in remote and very remote areas. 15 https://playgroupaustralia.org.au/resource/playgroup-australia-pre-budget-submission-2020/
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Attachment A. Breakdown of budget proposals.
Sustain the PlayConnect Program
Budget to sustain the delivery of existing PlayConnect group.
| Budget year | No. of groups operating | Cost, including CPI increase ($000)16 |
|---|---|---|
| Year 1 | 42 | $ 1,657 |
| Year 2 | 42 | $ 1,690 |
| Year 3 | 42 | $ 1,724 |
| Year 4 | 42 | $ 1,759 |
| 42 | $ 6,830 |
PlayConnect Scaled Growth
Budget to support the scaled growth of the PlayConnect program to include 55 new delivery sites nationally17.
| Budget year | No. new groups | Cost, including CPI increase ($000) |
|---|---|---|
| Year 1 | 11 | $ 664 |
| Year 2 | 27 | $ 1,471 |
| Year 3 | 43 | $ 2,098 |
| Year 4 | 55 | $ 2,513 |
| 55 | $ 6,746 |
Total Proposed PlayConnect Budget
Cumulative proposed budget for the continued delivery of existing sites and the scaled growth of new sites.
| Budget year | Total groups | Cost, including CPI increase ($000) |
|---|---|---|
| Year 1 | 53 | $2,321 |
| Year 2 | 69 | $3,161 |
| Year 3 | 85 | $3,822 |
| Year 4 | 97 | $4,272 |
| 97 | $13,576 |
16 These amounts build the ERO decision into the base amounts after 2021. 17 Please note, the cost per group within the Scaled Growth budget is higher than that for existing groups. This reflects the costs of establishing new groups in regional and remote locations. Currently, it costs approximately $39,000 (on average) to operate a group, but this rises for remote groups due to increased staff travel time. It would be expected that future years would operate at reduced cost without these establishment costs.
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