Thriving Kids early intervention reforms

Thriving Kids is designed for children aged zero to eight with developmental delay and/or autism who have low to moderate support needs. 

It establishes a distinct tier of support outside the NDIS, targeting children who benefit from early, evidence-based intervention but do not meet thresholds for permanent and significant disability. 

In doing so, it delineates more clearly between children requiring foundational supports and those requiring individualised, scheme-based funding. 

The Thriving Kids reforms shift the system away from diagnosisled access and towards earlier, needs-based care. 

Removing the requirement for a formal diagnosis report is a practical change. 

It reduces delay, removes cost and simplifies entry for families who have been navigating a process that too often prioritises eligibility over care. The policy logic is clear. 

Delayed access drives worse outcomes and higher downstream costs. 

Early intervention changes trajectories, particularly in childhood, where development is rapid and the consequences of inaction accumulate quickly. 

This reform also sits within a broader recalibration of the NDIS. 

The move towards strengthening foundational supports is intended to reduce reliance on individualised packages and redirect children to earlier, community-based care. Thriving Kids is a key part of that shift. 

However, the risk is structural. 

If foundational supports are not clearly defined, consistently funded and clinically anchored, the system fragments. 

Access becomes uneven, demand escalates elsewhere and the pressure returns to the NDIS and hospital system at higher cost and complexity. Physiotherapy is central to avoiding that outcome. 

It provides early assessment, targeted intervention and continuity of care across developmental delay, disability and chronic conditions. 

It is also one of the few disciplines able to operate across prevention, early intervention and more complex care, making it critical to system flow. 

Yet access to physiotherapy remains uneven. 

It is too often contingent on NDIS entry or out-of-pocket capacity rather than embedded as part of universal early supports. 

That gap is what Thriving Kids must address. 

The case for physiotherapy is practical. 

Early assessment, intervention and family support improve outcomes and reduce escalation into higher-cost care. 

The question is not whether physiotherapy is needed but whether the system is designed to use it. 

Delivery will matter more than design intent. 

Embedding physiotherapy in multidisciplinary, community-based models is not an optional inclusion – it is what makes early intervention functional. 

This requires more than referral pathways. It requires funding that supports sustained care, not episodic contact, and workforce settings that enable physiotherapists to operate at the top of scope. 

The APA Policy and Government Relations team is shaping a national campaign to support this next phase of reform. 

The focus is on ensuring that physiotherapy is designed into foundational supports, strengthening direct access and aligning funding with early intervention objectives rather than late-stage demand. 

A dedicated policy advisory group has been established to bring together policy, clinical and system expertise. 

It provides a structured mechanism to test positions, identify risks and align messaging across jurisdictions. 

Engagement with governments is already underway, with targeted outreach to ministers, shadow ministers and departmental leads responsible for implementation in each state and territory. 

Implementation is not uniform.

Jurisdictions are progressing at different speeds, with policy design, consultation and commissioning processes at varying stages.

With services expected to come online from late 2026 and full implementation planned by 2028, there is a limited window to influence design decisions before they are locked in. 

Early discussions have focused on embedding physiotherapy within foundational support models and ensuring it is reflected in commissioning and service design. 

This work is being progressed through both national and jurisdiction-specific channels, supported by member expertise and ongoing consultation, to ensure physiotherapy is consistently represented as implementation decisions are made. 

This is reinforced through clear policy positions being put to governments. 

At a national level, the APA is seeking recognition of physiotherapy as a core Thriving Kids profession across identification, assessment and intervention, alongside Medicare items that enable direct access as part of child development pathways. 

There is also a strong case for physiotherapy representation on implementation and commissioning bodies, so clinical expertise informs system design from the outset. 

At a state and territory level, the focus turns to delivery. Inclusive commissioning will be critical – particularly models that enable participation by private physiotherapy providers and make full use of existing workforce capacity. 

Procurement design, outreach, telehealth and service delivery across early childhood settings, schools and community hubs will all shape whether access improves in practice. 

The objective must be to ensure that the existing paediatric physiotherapy workforce is fully utilised to deliver early, evidencebased care. 

A significant proportion of that workforce sits in private practice, alongside services delivered in community and public settings. 

Commissioning models that default to a narrow provider base, particularly not-for-profit-only approaches, risk sidelining existing capacity. 

If that occurs, workforce participation will contract over time, access will become more constrained and geographic inequities will widen. 

The reform will not reduce demand; it will redistribute it into a smaller, less flexible delivery system. Inclusive commissioning frameworks are therefore critical to maintaining workforce capacity, sustaining access and delivering on the intent of Thriving Kids.

Thriving Kids removes a barrier at the front end. 

The task now is to ensure that the system behind it is configured to respond.