Thriving Kids (Part 1): What It Could Mean for Families and Children

There’s been a lot of discussion about the proposed Thriving Kids reforms and what they might mean for children with developmental differences, disabilities, and their families.

Change can be positive. Reform can improve access and equity. But when systems shift — especially in early childhood and disability — the ripple effects can be significant.

This change has been on my mind and is something I can’t stop thinking about — for our clients and families, and also for myself as a small business owner. So I thought I would write about it across two blog posts: one outlining my thoughts and worries for the families we know and love, and one from a small business perspective.

While I know these blog posts could become controversial, they outline some of the questions and concerns that still remain for me as a therapist and a supporter of the families we serve. So, let’s unpack some of the potential impacts.

Provider Choice: Will Families Still Have It?

One of the strengths of the current NDIS model is that families can choose providers who align with their values — whether that’s neuro-affirming practice, trauma-informed care, relationship-based therapy, or highly specialised intervention practices.

With Thriving Kids, it remains unclear whether families will be able to stay with their existing providers, or be forced to change providers, or if they will be able to choose their provider if they are newly diagnosed or have never accessed therapy before.

My concern is that if Thriving Kids introduces tighter eligibility thresholds, panel allocation models, or regionalised service delivery, families may have reduced ability to choose not only their preferred therapist and service provider, but a therapist with the specific expertise to meet the needs of their child (e.g., PDA-informed, sensory integration trained, trauma-informed, neuro-affirming).

To me, this raises red flags. At Enable Me, we do our best to match each child with the therapist who best fits them and their family’s needs. We believe that continuity, trust, and attunement are foundational for regulation and skill development. In larger service providers, however, this doesn’t always tend to be the priority; instead, referrals may go to the next available therapist, whether they have the skills or the temperament to suit your child.

Access to Occupational Therapy in Schools

Currently, we see many of your children in schools. However, from what is known about Thriving Kids, access to occupational therapy support within school environments may become even harder than it is today through NDIS channels (which believe me is getting harder by the year).

If Thriving Kids shifts responsibility for school-based therapy back to education systems, several things may happen. For instance, therapy may become consultative only, meaning that we would support the teacher to support the child, rather than being able to directly provide therapy in the school environment. 

The flow on effect is that we could no longer complete classroom observations, collaborate with teachers, implement environmental adjustments (including sensory and regulation supports) that are individualised to both the child and the setting, or provide support with participation at recess or lunchtimes.

And while consultative models can work well in some cases - especially when teachers have capacity, training, and time -  they rely heavily on school resources, priorities, and staff availability, which can vary a lot from school to school.

If access narrows, families may need to rely more heavily on clinic-based therapy — which doesn’t always translate as effectively to the classroom environment. Additionally, waitlists are also likely to increase, as there are only so many sessions children can attend before and after school.

School-based OT isn’t just about handwriting. It’s about belonging, participation, regulation, transitions, friendships, and confidence — and the Government need to recognise this, and the skills required to enhance this for some of our neurodivergent kiddos that our teachers haven’t been trained for.

What If a Child Has “Only” One Diagnosis — Like Autism?

This is probably my biggest concern.

If eligibility is tiered based on complexity or multiple diagnoses, children with a single diagnosis (e.g., autism) may be categorised as “lower level” — even when their functional impact is significant. But we know that diagnosis count does not equal impact. We also DON'T yet know how the Government plans to define either "mild to moderate autism or developmental delay" or "low-moderate support needs".

For example, an autistic child diagnosed with level 1 support needs may present with high sensory sensitivity, emotional regulation challenges, school can’t, and social vulnerability, and still require intensive occupational therapy support at home and school — even without additional diagnostic labels. This is because functional capacity fluctuates in neurodivergent individuals depending on the demands placed on them, their health, sensory load, cognitive capacity to ‘mask’, variable executive function, energy levels, and social and emotional load.   

If funding models shift toward high-complexity prioritisation, families may need to demonstrate greater impairment or risk to access services. This can unintentionally create pressure to “prove severity.” It is already challenging enough in the NDIS world, and it is not a space families should have to occupy under a new, supposedly more family-friendly scheme.

Increased Gatekeeping and Administrative Burden

The NDIS has already turned many excellent occupational therapists away from this area of practice due to the increasing administrative burden placed on us (funding periods, anyone?)

A new system, such as Thriving Kids, from my understanding of the final report ,  is going to mean new assessment processes, centralised triaging, standardised outcome measures, and more documentation.

It may also result in less clinical autonomy for therapists, more pressure toward measurable short-term outcomes (which are not always achievable given the nature of some goals we work on), and reduced capacity for preventative or relationship-based work.

This worries me. When systems emphasise measurable outputs and uniformity, subtle but critical areas — regulation, self-concept, trauma recovery, identity development — can become harder to prioritise because they cannot be easily “fixed” within a set timeframe.

Children are diverse. Families are diverse. Neurodivergence is diverse. Standardisation can help some children — but it can also disadvantage those who don’t fit neat categories - like most of the kiddos being targeted for Thriving Kids.

I also worry that for you and your family, this will likely mean more forms, more reassessments if NDIS deem you no longer meet their criteria, longer waits, and less flexibility.

Early Intervention vs “Wait Until It’s Severe”

One risk in the Thriving Kids reform is inadvertently raising the bar for support. From what I have read, it appears that unless a child is showing significant functional impairment, access to allied health may be limited. 

Parenting education courses are likely to become the first line of intervention. While I agree that parental education is important, early intervention may reduce as a result.

This is the opposite of best practice and what we know from decades of developmental research that states that early, preventative, relationship-based support is far more effective (and cost-effective) than crisis-driven intervention later.

Anecdotally, most of the parents we see in our clinic are already well educated about their child, their diagnosis, and their needs — but they often don’t have the capacity to complete another education course. They are burnt out and struggling day to day due to their child’s needs and lack of practical support — and that is under a system that is supposedly better funded and equipped than what Thriving Kids may be.

If children are categorised as “not complex enough,” families may end up needing to seek private therapy — further increasing inequity in already vulnerable households.

Emotional Impact on Families

Beyond the logistics already mentioned, major reform such as Thriving Kids creates uncertainty. When systems change, anxiety rises, and we can see this already.

Families of children with disabilities already navigate so much every day. There is advocacy fatigue. There is financial pressure due to reduced work capacity or needing time off to attend appointments. There are school negotiations to ensure a child’s needs are met. And there is the emotional toll of being a full-time carer.

If you are fearing the loss of supports, feeling pressure to secure reports quickly, or concerned about “falling through the cracks,” please know you are not alone. The majority of parents I have spoken to about Thriving Kids feel the same, and we are always here to listen.

It is time for the Government to provide clearer communication and outline what transitional safeguards they will implement to prevent harm, now we are 6 months away from implementation.

What We Don’t Yet Know & What You Can Do In The Mean Time

One of the biggest frustrations for me is that many crucial details remain unclear, and to be quite frank, I don’t think the final report answered much at all. 

For example, some of the millions of questions I have include:

• How eligibility thresholds will be defined?

• Whether existing supports will be grandfathered?

• How transitions will occur?

• Will therapy caps apply and will be go back to block funding?

• How will services be commissioned, and will there still be a role for small family businesses who have the existing expertise, connections and experience in supporting families in their local areas?

• What formal role will schools hold?

• Who will upskill the teaching workforce to identify neurodivergence?  And how will teachers fit even basic individualised therapy strategies into an already overcrowded curriculum if allied health are taken away?

So what can you do in the mean time during all of this uncertainty? 

• Stay informed through trusted sources (we will share what we know, when we know it)

• Keep documentation of your child’s current functional needs and supports

• Maintain open communication with your providers

• Focus on your child’s strengths and current supports

While there is a lot we don’t yet know, one thing we can usually be certain of is that large system reform is slow. Services are not disappearing overnight.

My Final Thoughts

Change in disability systems like Thriving Kids must centre on the child. It should not be about budgets or metrics.

It should be guided by the best available evidence — which tells us that children thrive when they have consistent relationships, individualised support, access to therapy in the environments that matter most, and health professionals who see the whole child.

Whatever Thriving Kids becomes, the hope is that it protects what families value most: trust, choice, expertise, and humanity.

Because thriving isn’t just about access. It’s about finding a place like Enable Me Occupational Therapy where you belong.

Til Part 2,

Katie