Hi! I’m David. Hope your week has started well!
Today, I’m looking at some of the real world challenges we’ll all have to work through with the roll-out of Thriving Kids:
Thriving Kids is just a plan unless it immediately degenerates into hard work*
Thriving Kids has ambitious and laudable aims. But, to work, state governments must translate the model into actions within local communities that help improve outcomes for children with autism and/or developmental delay. State governments face three key challenges:
Knowledge: Governments don’t - and can’t - know enough about every community’s real conditions, needs, and informal networks to design services that give every child in the state access to the same level of service.
Incentives: The new system should reward measurable improvements in child outcomes. But, too often, governments and their bureaucracies measure inputs (like the number of programs delivered), rather than whether they actually helped children. (We’ve looked at this before in the context of existing programs intended to help children in mainstream settings.)
Trade-offs: States must make hard choices about which services they fund, and how they deliver them. Not everyone will be happy, including some families of children accustomed to NDIS supports.
These risks are well-known features of social programs delivered by governments. They are not specific to Thriving Kids.
But they allow us to make predictions about some of the main real world challenges state governments face as they look to roll out Thriving Kids.
Predictable front-line risks
Increased bureaucracy:
tensions between health, disability and education bureaucracies over who will control which aspects of programs;
duplication, with overlapping systems and complicated interfaces between systems.
Increased complexity of navigation for families: Another layer of complexity for families to navigate.
Ongoing tensions between local knowledge vs. central design:
accounting for differences between inner city suburbs, regional centres, rural and remote communities;
uneven local capacity to deliver services, e.g. in regional and rural communities;
challenges engaging with multilingual and culturally diverse populations and Aboriginal and Torres Strait Islander families in culturally safe ways.
Misallocation of services: some children who need help losing access, and others getting access to supports they may not need or benefit from.
Workforce/role confusion:
workforce dislocation, including challenges with recruitment, training and supervision in public and private roles;
teachers and early childhood educators expected to take on therapeutic work; and
allied health care workers expected to perform education roles.
Commissioned provider conflicts of interest and/or misaligned incentives. Providers:
being incentivised to measure activities, not results; and
when challenged on outcomes, blaming “external factors” to justify continued funding. (This is an example of the “Shirky principle”, which states that organisations will try to preserve the problem to which they are the solution.)
Ideally, governments should be alive to these risks. They should design their new systems to eliminate (or at least mitigate) them.
Time will tell.
Case study: New South Wales’s Foundational Supports
In February 2026, the NSW Legislative Council Select Committee on Foundational and Disability Supports Available for Children and Young People in NSW released their first report. The report looks at the supports available for children and young people with developmental delay or disability in NSW, and the challenges families have accessing them.
The Select Committee made 14 findings and 17 recommendations, identifying several challenges and potential policy recommendations that might influence the NSW Government as it implements Thriving Kids. It provides a good snapshot of some of the “on the ground” issues highlighted above.
Key existing challenges
Cost of living pressures for families.
Location lottery: disparities in the availability, quality and cost of services in different places in NSW - especially rural and remote areas.
Poor integration between health, education and disability services, including disconnected referral pathways and uncertainty about eligibility and available supports.
Long waiting lists for many services.
Lack of services for Aboriginal and Torres Strait Islanders or LBOTE/CALD
Over-reliance on diagnosis to access some services.
Limited community-based services equipped to support the number of children affected.
Difficulties for families trying to navigate systems, especially for children who have health and/or disability and/or educational needs, and for families with low health literacy.
Mixed community perceptions of service providers.
Workforce shortages, including NSW losing workers to other states and private practices, high rates of worker stress and burnout, limited career paths and low pay.
Unstable funding models - short term project grants and commissioning leading to fragmented services and limited system-wide data.
Limited stakeholder involvement in the design of services (young people, families, allied health, educators).
Key recommendations
Clear system mapping, including eligibility boundaries, service scope definitions, and interface points with NDIS, health and disability sectors.
A focus on early intervention/prevention, and parent and carer capacity building.
Statewide-integrated foundational supports co-location navigation model with shared referral protocols across health, education and community services.
Funding models to include “multi-year, flexible block funding arrangements, outcome-based accountability, and co-investment mechanisms to enable long-term planning, workforce stability, and continuity of care”.
Community “place-based solutions” like relational contracting based on the needs and strengths of each community, with shared accountability among service providers, families and community stakeholders.
Services embedded in homes, playgroups, early learning, neighbourhood centres, family support centres, and school settings, including co-commissioned allied health supports and integrated planning between education, health and disability systems.
Rural and remote access guarantees (outreach, telehealth, mobile allied health teams, travel subsidies, workplace incentives and regionally-tailored commissioning).
Co-design of services with affected stakeholders, including families, local communities, and allied health providers.
Transition pathways for children turning 9 and older.
Bottom line
States have their work cut out to achieve Thriving Kids’ ambitious goals. So do allied health professionals who work with children with autism and/or developmental delay.
It’s time to switch our attention to on-the-ground realities and specifics for the local communities we serve. When service gaps inevitably arise, we should try to fill them with evidence-based, safe services that suit children with developmental delay and autism and their families.
* Paraphrasing Peter Drucker
Question for you!
What (if anything) are you hearing right now about the Thriving Kids (or Foundational Supports) roll out in your neck of the woods? Reply to this email and let me know! I read every reply.
Free, useful things!
Resource
Learning opportunity
Useful read
SLP (and/or dad) joke
That’s it for this week.
See you next Monday!
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Have a great week - David.
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