NDIS

Small NDIS allied health providers: keep moving, and don’t give up

David Kinnane · 28 November 2025 · Leave a Comment

State of play:

As at the end of November 2025, NDIS reforms include lots of parts, uncertainty, and complexity.

Unknown unknowns:

Small allied health providers must plan for 2026. But how can we make decisions about strategy, services, marketing, recruitment, training, compliance, resources, and finances with so many balls up in the air?

Chessboard fallacy:

More than 250 years ago, Adam Smith warned us not to look at policy reforms as a game in which governments rearrange people like chess pieces. We make better decisions if we accept that every person and organisation affected by NDIS reforms has their own goals, incentives and biases (including us).

Not about us, or “us versus them”:

It sometimes feels like small providers have been targeted for elimination. But the stakes are much higher for participants. And we shouldn’t assume governments, regulators, the media, large providers or others are acting with malice. We all want better value services and outcomes for people with disability. We all want the NDIS to survive.

So what do we expect in 2026, and why?

1. Increased NDIS allied health funding pressures as:

participants lose scheme access through eligibility reassessments;
children with ‘mild and moderate autism or developmental delay’ are diverted to Thriving Kids (see below);
the early intervention pathway is abolished for most kids;
new plans are approved with tighter funding controls;
I-CAN support needs assessments roll out for participants aged 16 and over (perhaps with algorithmically-determined funding);
the permanent definition of “NDIS supports” is released and implemented;
the NDIS Evidence Advisory Committee’s Capacity Building and Therapies Subcommittee scrutinises the cost-effectiveness and quality of evidence for different therapies (including dosages);
recommendations emerge from the therapy pilot (commencing in January 2026) to “better understand costs and characteristics of quality service delivery”. (Controversially, this was commissioned through a closed, non-competitive tender that locked out small providers); and
additional/differential pricing limits are imposed for different types of therapy, and travel (e.g., the new price limits for music and arts therapists from 24 November 2025).

2. Continued government and media narratives about “dodgy providers” and “unregistered cowboys”

Politicians conflate “unregistered providers” with bad actors and fraudsters to maintain public and taxpayer support for urgent reforms.
Large registered providers – with very real profitability challenges – continue to run the “unregistered = dodgy cowboy” line because it helps them lobby for special pricing arrangements, mandatory registration of all providers, and taxpayer bailouts. They know these changes would drive more small allied health providers out of the sector and reduce competition – and participant choice.
Allied health professionals are regulated. Duplicative rules increase costs and distract from service delivery, which is why we endorse the NDIS Provider and Worker Registration Taskforce 2024 recommendation to “deem registration” of allied health providers based on existing allied health regulations plus worker checks.

3. More small providers will exit the sector, but others will adapt and keep going

On 24 November 2025, the NDIA said that, as the market matures, some providers will decide to stop delivering all or some sorts of NDIS supports.
In June 2025, the Independent Pricing Committee predicted much the same thing, recognising that pricing limits make it difficult for small allied health clinics with staff to remain viable (see links).
We are not powerless pawns. Lots of small providers are advocating for “reforms to the reforms”, making submissions to consultations, meeting with MPs, working with peak bodies, unionising, and/or supporting disability advocates and affected participant groups.
No one is going to bail out insolvent small allied health providers – and nor should they. Over the last 18 months, many providers have worked hard to reduce their dependence on NDIS funding. Unavoidably, this has reduced access to therapy for participants in some areas.

4. Families will be underwhelmed by Thriving Kids programs and outcomes

Thriving Kids, not yet agreed, looks like a return to block-funded programs, general strategy-sharing, parent training, and (possibly) short interventions, perhaps in groups.
Evidence-based early intervention programs, like Inklings, show promise. Outcome data for school programs are much less compelling (see links).
We don’t know who will deliver Thriving Kids programs ‘on the ground’, although we expect large registered providers (with subcontractors), and/or state government employed workers.

5. New allied health service gaps will emerge

Public disability, health and education systems in many states are under stress.
Funding systems are built on the false premise that people’s disability, health and education needs are unrelated:
- If you have a disability or have worked for a person with disability or delay – an autistic toddler, a dyslexic teenager, a young adult with cerebral palsy, an older adult with Parkinson’s disease, for example – you know this is untrue.
- Health, education and disability systems and budgets are interdependent, which explains, in part, why governments have handcuffed Thriving Kids to the 5-year public hospital deal negotiations.
- State governments, like NSW, continue to consult on “Foundational Supports” (talking about the same cohort of kids as Thriving Kids). Thriving Kids may look very different state-to-state, region-to-region.
Overall demand for allied health services remains high. But the allied health workforce is limited, especially in rural and remote settings.
Many allied health providers work across multiple systems and will split their resources based on client demand, professional interests and skills, and system incentives. In states like NSW, health and education bureaucracies don’t always get along, and working between systems is inefficient, with access and other real world logistical challenges.
A large chunk of the allied health workforce with disability experience is employed in the private sector because of the way the NDIS used to work. As the model changes, the workforce and employers will adapt. But this will take time, and new service gaps will emerge.

6. Provider legal and compliance risks and costs will increase

Legal and compliance risks for providers, owners and managers have steadily increased over the last two years.
If enacted, the new NDIS reform bill (released on 26 November 2025) will further increase risks for all providers (not just the “fraudsters and cowboys”).
Expect insurance premiums to rise, too.

7. A flight to quality?

Regardless of funding models and business pressures, we can’t cut corners if we want to succeed:

Clients deserve excellent services: including safe, timely, evidence-based, client-centred, convenient, and high quality services.
Our staff deserve respect: Professionals want to learn, to belong, to create, to grow, and for their work to have an impact. They need to be trained and supervised properly. They need the right resources to deliver great services that produce real outcomes for clients.

Bottom line:

Small allied health providers that deliver quality services to participants while supporting teams should feel proud of their hard work this year and take heart. As 2026 approaches, we should back ourselves to compete on quality and outcomes with large providers, and to provide participants with real choice and control.

Go deeper:

The Chessboard Fallacy

Thriving Kids Advisory Group Communique – November 2025 | Australian Government Department of Health, Disability and Ageing

Foundational Supports for Children | NSW Communities and Justice

Not-for-profit disability services are closing due to untenably low price caps, NDIS architect warns

NDIS providers’ losses double, more taxpayer bailouts likely (paywalled)

New tool to deliver simpler pathway to disability supports | NDIS

NDIS Evidence Advisory Committee | Australian Government Department of Health, Disability and Ageing

Quality supports program tender | NDIS

Updated NDIS Pricing Arrangements and Price Limits 2025-26

Professionals Australia NDIS Allied Health Union

Allied health providers and pricing controls: independent providers that employ, train, and supervise staff are caught in the middle, and might not survive (and the NDIA knows it)

NDIS Supports rules | engage.dss.gov.au

Independent Pricing Committee | NDIS

Small allied health NDIS providers: should we all be registered?

Thriving Kids: will ‘targeted supports’ deliver what children and families need?

Thriving Kids in Schools: Will it Work?

Thriving Kids: will ‘targeted supports’ deliver what children and families need?

David Kinnane · 20 November 2025 · Leave a Comment

State of play:

On 7 November 2025, the Thriving Kids Advisory Group held the second of what will be three meetings to advise the Government on the design of Thriving Kids.

Zoom in:

Among other things, the group is considering targeted support models, including:

“what opportunities are provided to expand universal, [Medicare] health and development check, and community and Allied Health services”; and
the need for supports that “respond to complexity of children’s developmental and social needs, and the well-being of parents and families”.

Zoom out:

For thousands of children with “mild and moderate” autism and developmental delay, Thriving Kids is intended to replace NDIS-funded, individualised supports.

Friction Points:

The stakes are high. Many children need targeted help but will no longer be able to access it under the NDIS. Even with improved universal information services, targeted supports will be crucial for many autistic children and children with developmental delay.
Timelines are tight. The Government requires the group to finalise its advice on the design of Thriving Kids “in early December 2025”.
The states are pushing back:
- Media reports on 20 November 2025 suggest negotiations between Federal and state governments on funding are not going well.
- In parallel, some states (like NSW) are consulting on “foundational supports”, which may or may not be completely consistent with Thriving Kids.

The goal:

The advisory group wants Thriving Kids targeted supports to be “inclusive, strengths-based, neuro-affirming…trauma informed and effective in identifying children who may benefit from additional support”.
Identifying kids who need additional support is of course important. But, naturally, many families want to know what specific supports will be provided to their child.

Use what we know:

Lots of work has already been done to outline what’s needed to improve outcomes for young autistic people.
In December 2022, AutismCRC published a National Guideline for supporting the learning, participation and wellbeing of autistic children and their families (Guideline). The Guideline:
- was developed by a group that included autistic people, families, researchers, and health professionals; and
- includes 84 consensus-based, evidence-informed recommendations that explain how to work with autistic children and their families in ways that are “safe, effective, and desirable”.
While the Guideline’s scope is limited to helping autistic children, many of its recommendations apply to children with developmental delay.

Reality check:

The Guideline gives us a framework to evaluate any proposed targeted supports for children.

What we’re watching*:

In line with the Guideline, Thriving Kids targeted supports should be:

Child and family-centred (1);
individualised for each child and family (2);
ethical (7);
evidence-based (10);
delivered only with the informed consent of parents (12);
delivered by people who:
- are properly qualified and supervised, and engaged in continuous professional development (13); or
- (if not regulated health professionals) have:
  - the appropriate knowledge, skills, experience, training and regulation; and
  - adequate supervision and support from the professional who has overall responsibility for the delivery of supports (51);
timely and accessible (16);
focused on family-led goals, with support from practitioners and other relevant people (22);
meet the child’s sensory needs across activities, interactions, and settings (28);
delivered in setting(s), formats, and dosages likely to lead to the most meaningful and sustained increase in the child’s learning, participation and wellbeing (53, 54 and 56);
designed to:
- allow children and families to give feedback and make complaints(78); and
- require providers to inform the child and family about any potential or actual conflicts of interest in providing supports or making referrals(79).

Bottom line:

There’s an awful lot we don’t know about Thriving Kids; and its funding is uncertain. But, whatever happens, we all want better outcomes for autistic children and children with developmental delay.

The Guideline distills years of research and multiple perspectives into specific recommendations to achieve better outcomes. It should be used to help finalise the design of targeted supports under Thriving Kids – and to evaluate whether they are likely to help the kids who need them.

Go deeper:

Thriving Kids Advisory Group Communique – November 2025

Fiscal Fisticuffs Turn into Health Funding Brawl (The Australian, 20 November 2025)

Supporting Autistic Children Guideline – AustismCRC

Thriving Kids in Schools: Will it Work?

Thriving Kids Programs Part 1: Inklings

Thriving Kids Programs Part 2: Mental Health in Primary Schools (MHiPS)

Thriving Kids Programs Part 3: Positive Partnerships

Breaking news: “Thriving Kids” – more than just a new name for Foundational Supports for children?

*References to numbers are to Guideline recommendations.

Thriving Kids in Schools: Will it Work?

David Kinnane · 11 November 2025 · Leave a Comment

At its core, Thriving Kids is an ambitious plan by the Federal Government to:

divert children with mild and moderate autism and developmental delay from the NDIS early intervention pathway; and
replace NDIS-funded individualised allied health therapies for these children with block-funded programs delivered in ‘natural environments’, like schools.

In Minister Mark Butler’s words, Thriving Kids represents the Federal Government’s vision for a “better system” for children with mild and moderate delay or autism that features a:

“robust system of supports to help them thrive”; and
“more rigorous evidence base for the supports being funded by taxpayers”.

Good intentions…

Bold social policy visions with noble names like Thriving Kids are hard to criticise without sounding like you’re attacking the objectives. (Who doesn’t want kids to thrive?)

We all:

want a better system for children with autism and developmental delay; and
know that publicly funded disability services must be economically sustainable.

But policy goals are not outcomes.

We want high quality services for children

In their recent Quality Support for Children booklet, the NDIA and NDIS Quality and Safeguards Commission reminded us that all providers must ensure services to children with disability or delay:

represent best practice;
focus on positive outcomes for children and their families; and
improve their quality of life.

We should hold Thriving Kids to the same standards.

Two questions arise:

Is the Thriving Kids approach backed by evidence that programs will deliver improved outcomes for students with mild and moderate autism or developmental delays?
Is the Government’s vision of bringing federal, state and local government, philanthropic organisations, and community services “under one roof”, “coordinated by schools” likely to work consistently across Australia?

Question 1: Do block-funded school programs improve student outcomes?

In the Thriving Kids announcement, Minister Butler name-checked programs like Mental Health in Primary Schools (MHiPS) and Positive Partnerships as examples of existing programs that might be scaled up nationally and block-funded to support school-aged children with mild and moderate autism or developmental delay.

Over the last couple of months, we’ve looked at the resources and evidence for MHiPS and Positive Partnerships. You can read our summaries via the links below.

Across these programs, we’re concerned – both by what we found, and by what we didn’t find:

Limited independent evidence – We didn’t locate any high quality independent studies with controls for expectation and other biases. (If you know of any, please send them to us.) We don’t know if or how the programs work, or whether they achieve their stated purpose.
No data on improved student outcomes – The peer-reviewed studies we did find reported third-party perceptions and outcomes, e.g. teacher and parent views. We didn’t locate studies demonstrating improved outcomes for students.
No evidence of student feedback – We didn’t find anything substantive about what students think of the programs, or whether the programs have been adjusted to take into account preferences, criticisms, or other feedback.

Question 2: Real-world implementation issues: predictable problems for programs

In chapter 2 of his still-controversial 1995 book, The Vision of the Anointed: Self-Congratulation as a Basis for Social Policy, economist Thomas Sowell outlined what he saw as a four-stage pattern of social policy failure:

Stage	Pattern
1. The Crisis	The Government labels the current system as in “crisis”.
2. The Solution	The Government proposes a new policy to end the crisis, claiming it will achieve beneficial result “X”. Any criticism that it won’t achieve X and will lead, instead, to negative result “Y “are dismissed as absurd, simplistic or dishonest.
3. The Results	The Government implements the policy. It does not achieve X, but results in Y.
4. The Response	Policy critics are dismissed for ignoring the “complexities” involved, as “many factors affect the outcome”. Critics are asked to prove that the detrimental effects (Y) were caused solely by the policy, but the Government isn’t asked to prove that the policy itself (X) improved outcomes.

To date, the Thriving Kids narrative appears to fit Stages 1 and 2 of Sowell’s pattern.

Are we headed for policy failure?

With funding yet to be agreed with states, it’s far too early to tell whether Thriving Kids will happen as announced and, if so, whether it will fit stages 3 and 4 of Sowell’s pattern.

But – so we can check in later – let’s make some predictions about foreseeable problems with block-funded national programs for children with mild and moderate autism and developmental delays delivered in schools:

Accountability issues – No one organisation will bear single responsibility for program outcomes (successes or failures). No single organisation will be accountable to students or families for improved student outcomes. Instead, responsibility will be split, e.g., between federal and state governments, program-designers/researchers, lead providers, the school leadership team, teachers, subcontractors and the workers actually delivering the programs in schools.
Delivery-model limitations – Some children will be missed, including children who are home-schooled, and children who do not or cannot regularly attend school for any reason.
Uneven implementation – Block grants are likely to result in regional variation in the availability and quality of services. (This is a valid criticism of the current system, too.)
Increased complexity in schools – Real-world “on-the-ground” issues will affect program fidelity and delivery, e.g. degree of leadership and teacher support, capacity and training, competing curriculum and extracurricular demands, student socioeconomic, cultural and language differences, existing behavioural and other supports, state education and health and disability policies, and all the many other things that affect school operations, day-to-day. Education, health and disability sector politics are also likely to affect delivery differently in different states.
Indirect supports may not improve individual student outcomes – Programs that provide evidence-based strategies and information to teachers and families (like Positive Partnerships) are of course useful. But, many autistic children and children with developmental delay need tailored therapy, delivered directly.
Loss of expertise and targeted supports – Some programs, like MHiPS, require educators to spot children who need individualised therapy and to refer them to allied health providers. But this presupposes such services exist. The independent pricing review report acknowledged that ongoing NDIS reforms and price settings may push some allied health providers and clinicians out of the sector, limiting access to well-trained, properly supervised, and experienced clinicians (see links below for more detail).
Increased bureaucracy will reduce funding for front-line supports – Block-funded programs delivered in schools may involve a mix of providers and systems, private and public sector organisations, large and small. Funds may flow through multiple layers of bureaucracy, with red tape and risk aversion practices eating into funds intended for students.
Checks on competition and innovation – Locking in specific programs at scale may stymie research and innovation. Shirky’s principle says that organisations will try to preserve the problems to which they are the solution. Organisations may resist better solutions that would eliminate the need for ‘their’ program. Providers may be incentivised to create dependencies that ensure continued need for their programs. They may be disincentivised to invest in quality improvements, especially if tenders are awarded to closed panels and/or to the lowest bidder.

Bottom line

“Taxpayers deserve to know that the big investment made in the NDIS is paying for supports that are actually going to make a difference.” – Minister Butler.

This is equally true for Thriving Kids.

We hope that Thriving Kids defies Sowell’s pattern and succeeds. But, before we scale up, block-fund and deliver programs through schools nationally, we should – at the very least – demand high-quality evidence that they improve student outcomes and provide value for money for taxpayers, compared with other options.

Go deeper:

Unless otherwise stated, all comments attributed to Minister Butler are to his Speech to the National Press Club on 20 August 2025

Thriving Kids Programs Part 2: Mental Health in Primary Schools (MHiPS)

Thriving Kids Programs Part 3: Positive Partnerships

The Vision of the Anointed: Self-Congratulation as a Basis for Social Policy by Thomas Sowell

For more on Thomas Sowell’s work applied to education policy, we recommend this recent article by David Didau

Quality support for children | NDIS

Allied health providers and pricing controls: independent providers that employ, train, and supervise staff are caught in the middle, and might not survive (and the NDIA knows it)

Thriving Kids Programs Part 3: Positive Partnerships

David Kinnane · 5 November 2025 · Leave a Comment

In his National Press Club Announcement of 20 August 2025, Minister Mark Butler name-checked some programs that might be scaled up and block-funded under Thriving Kids. In this series, we’re taking a brief look at them.

This time, we’re looking at Positive Partnerships.

Context:

Thriving Kids is intended to replace the NDIS early intervention pathway – and individualised NDIS therapy supports – for children with mild and moderate autism and developmental delay. As of now, the states have yet to agree funding, timing and other details for Thriving Kids with the Federal Government.

Overview:

Positive Partnerships (PP) is a national project to support autistic school students.

History:

PP was launched in 2008, as part of the Helping Children with Autism Initiative, and has been expanded through a number of phases.

Who “owns” it:

PP is funded by the Australian Government Department of Education and is now delivered by Aspect (Autism Spectrum Australia).

Goals:

PP supports (amongst other things) families, educators and communities to “strengthen positive outcomes for autistic young people”.

What does it do?

PP delivers free professional learning and other resources to parents, carers and school staff, including teachers.
It does this through its website resources, workshops, webinars and online modules.

Resource examples:

Information sheets and tools, e.g. about reacting to diagnosis, supporting self-care and independence, communication, and dealing with transitions.
1-2 day parent and carer workshops about autism, how it affects children at home and school, ways to strengthen home-school-community partnerships, advocacy, sensory processing, and behaviour management.
Whole -school and individual professional learning for teachers, e.g. about teaching strategies, curriculum adjustments, student mental health, strengthening social relationships, and dealing with change.
Combined parent/carer/teacher workshops.
Online modules and webinars about autism-related topics

Cost to date:

The Government has invested more than $100 million into PP.

Influence:

PP reports that, between 2015 and 2021:

30,000 educators across more than 1,860 schools, and more than 8,600 parents and carers, have accessed the workshops or online learning resources; and
705,000 people have used the website.

Does it work?

PP appears to be helpful for parents, carers and teachers:

A 2011 conference paper/case study concluded that PP resources increase parent/carer and teacher knowledge and confidence in meeting the needs of autistic students.
A 2022 study of nine parents of autistic students and nine teachers found that the parent-teacher workshops strengthened parent-teacher partnerships through an improved understanding of autistic students’ needs.

Yes, but:

The purpose of PP is to improve outcomes for autistic students:

The studies we found focus on indirect measures (parent /carer and teacher perceptions). We haven’t found an independent, peer-reviewed study that includes direct measures of student outcomes. (If you know of one, please let us know!)
The published studies have small sample sizes and lack controls. For example, researchers did not control for expectation bias: if someone expects a resource or treatment to be effective, they tend to focus more on positive outcomes and discount negative ones, which can distort research findings that rely on parent and teacher interviews or reports.
Improving educational outcomes for students with communication challenges requires much more than information-sharing and training. For example:
- teachers and other staff need time, resources, and support from leaders to implement tools, strategies and practices in busy classrooms; and
- different students can have very different support needs at different stages, sometimes requiring individualised supports that go far beyond general teaching and communication strategies.

Bottom line:

PP includes lots of useful, free resources for parents, carers, and teachers of autistic students. It would be great to see peer-reviewed research measuring student outcomes directly. For Thriving Kids, it would also be useful to see if any of the resources could be used or adapted to support other students, e.g. students with language or learning disorders, ADHD, and/or developmental delays.

The Key Worker Model for young children with developmental delay or disability: does it actually improve child outcomes?

David Kinnane · 28 October 2025 · Leave a Comment

Almost always, children with developmental delays or disabilities need the support of more than one health professional.

Health and education professionals should always work as a team with the family to support the child.

This requires a lot of communication and teamwork.

If no one coordinates services, you end up with different professionals working on different goals without reference to each other, potentially creating service gaps and duplication.

A “siloed” approach is challenging for families, and inefficient for everyone.

In Australia, the key worker model is viewed as a best practice approach:

for early childhood intervention services (ECIS); and
under the Early Childhood Early Intervention Framework of the National Disability Insurance Scheme (NDIS).

The multimillion dollar question

Does the key worker model deliver better outcomes for children with developmental delays or disabilities?

Spoiler alert: The evidence (so far) is less convincing than expected!

But, first, we’ll outline an example of a Key Worker model used currently in Australia.

Key Workers and the NDIS early childhood approach (current system)*

In Australia, if a family has concerns about their young child’s development or disability, they usually have a chat with the child’s GP, child health nurse, or early childhood educator.
If, after those discussions, the family remains concerned, they can contact the NDIS or an “early childhood partner” – often large organisations funded by the NDIS to deliver early childhood support to families in particular areas.
If the child has a developmental delay or disability, early childhood partners can support families to apply for NDIS funding.
Under current pricing arrangements, NDIS Plans can include Key Worker funding (under Capacity Building supports) for early childhood supports to assist a child (younger than 9) with developmental delay or disability and their family or carers in home, community, and early childhood education settings, to work towards increased functional independence and social participation.
The Key Worker – usually an allied health professional (e.g. a speech pathologist, occupational therapist, physiotherapist) or early childhood educator – is appointed and funded both as the main service provider and as the main point of contact for the family and the team.
In theory, families can nominate a Key Worker of their choice. In practice, Key Workers often work for the early childhood partner.
Based on the child’s needs, a transdisciplinary team is assembled to support the child (e.g. a team might include a speech pathologist, occupational therapist, physiotherapist, and one or more educators). In theory, families can choose their own therapists. In practice, team therapists often also work for the early childhood partner.
Coordinated by the Key Worker, and in partnership with the family, the team delivers services to the family and/or the child – usually in natural environments, like homes and preschools, using family-centred practices.

Examples of Real World Challenges

Lots of factors affect how well the model works in practice, including:
- each child’s support needs;
- each family’s circumstances, needs, priorities, and language and cultural backgrounds;
- where the family lives, and whether early childhood partners and experienced key workers and therapists are available (a significant challenge in some rural and remote areas);
- the workplace cultures, policies, and capacities of the organisation(s) involved (including how they manage potential conflicts of interest);
- each key worker’s experience, training, and skills to coordinate and deliver supports;
- each team member’s experience, supervision, discipline-specific and transdisciplinary training, access to resources, and overall work loads;
- specifics of the place(s) in which the services are delivered (e.g. including access arrangements); and
- funding models, regulatory settings and announced reforms – including incentives to support high quality transdisciplinary care.
Under this model, it’s unclear how many families have real choice and control over the individual professionals who work with them to support their child.

Crucial Research Gaps

A recent systematic review found significant limitations in the research base underpinning the key worker model for children with developmental delay or disability (see link below).

Just six studies qualified for inclusion in the review (including two Australian studies).
There is no single definition or description of exactly what is meant by “family-centred practices”.
It’s difficult to identify “active ingredients” of the model that lead to positive outcomes for children.
Based on the review findings, the key worker model appears to:
- be significantly correlated with better family outcomes (like family satisfaction, and quality of life); BUT
- have no significant relationship with improved child developmental outcomes! This is potentially a big problem.

Bottom line

In light of the review’s findings, and the current speed and direction of NDIS and Thriving Kids reforms, we need urgent research – including experimental group comparison studies – to ensure key worker models actually improve developmental and functional outcomes for children with delays or disabilities.

NDIS

State of play:

Unknown unknowns:

Chessboard fallacy:

Not about us, or “us versus them”:

So what do we expect in 2026, and why?

1. Increased NDIS allied health funding pressures as:

2. Continued government and media narratives about “dodgy providers” and “unregistered cowboys”

3. More small providers will exit the sector, but others will adapt and keep going

4. Families will be underwhelmed by Thriving Kids programs and outcomes

5. New allied health service gaps will emerge

6. Provider legal and compliance risks and costs will increase

7. A flight to quality?

Bottom line:

Go deeper:

State of play:

Zoom in:

Zoom out:

Friction Points:

The goal:

Use what we know:

Reality check:

What we’re watching*:

Bottom line:

Go deeper:

Good intentions…

We want high quality services for children

Two questions arise:

Question 1: Do block-funded school programs improve student outcomes?

Question 2: Real-world implementation issues: predictable problems for programs

Are we headed for policy failure?

Bottom line

Go deeper:

Context:

Overview:

History:

Who “owns” it:

Goals:

What does it do?

Resource examples:

Cost to date:

Influence:

Does it work?

Yes, but:

Bottom line:

Further reading:

The multimillion dollar question

Key Workers and the NDIS early childhood approach (current system)*

Examples of Real World Challenges

Crucial Research Gaps

Bottom line

Further reading