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Thriving Kids Programs Part 1: Inklings

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In his National Press Club Address 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’ll take a brief look at them. 

We’ll start with a program called Inklings.

Context:

Over time, Thriving Kids is intended to replace the NDIS early intervention pathway for children with mild and moderate autism and developmental delay. It’s meant to be funded 50:50 by the Federal Government and the States. (As of now, Thriving Kids has yet to be agreed with the States.) 

Overview:

Inklings is a very early parenting support program for children aged 6 months+ and in the first 2 years of life who are showing behavioural signs of possible autism.* 

History:

Inklings was adapted from a program called iBasis-VIPP, which was itself adapted from a Dutch program called Video Interaction to Promote Positive Parenting (VIPP). 

Who ‘owns’ it?

The Kids Research Institute Australia and the University of Manchester co-own the intellectual property in the iBASIS manual (2023). 

Goals:

Inklings supports (amongst other things):

  • social interaction and communication development for babies with early developmental delays; and
  • parents’ communication with their baby.

What does it involve?

  • It takes 5 months.
  • A trained therapist delivers Inklings directly to parents and their infant. 
  • It’s delivered in family homes.
  • It’s 10-12 therapy sessions long:
    • The first two sessions focus on baby behaviour.
    • The 3rd and 4th sessions, look at parent behaviour. 
    • The 5th and 6th sessions focus on more complex chains of social interactions.
    • The program is rounded out with 5 or so ‘booster’ sessions to consolidate learning.

Core features:

  • Child-led, helping parents learn to follow their baby’s natural interests. 
  • A focus on social interactions and communication between the baby and the parents.
  • In each session, parent-baby interactions are videoed and reviewed, with therapist feedback, including on positive examples of sensitive interactions.
  • Therapist observations, supporting parents’ self-reflection, and focusing on behavioural changes.
  • 15 minutes of daily home practice interacting with their infant in natural situations (e.g. play, mealtimes) using newly-learned skills. 

Evidence:

Inklings has been shown to be effective by two randomised controlled trials involving more than 150 babies (see below). At the age of 3 years, children who received the treatment as 9-month+ aged babies showed a statistically significant reduction in the severity of their autistic behaviours, and were less likely to meet the diagnostic criteria for an autism diagnosis.

Controversy:

Some autistic adults have concerns about some aspects of the treatment and point out that autism cannot be prevented or cured. In recent years, Inklings researchers have actively consulted with autistic adults to understand different perspectives on acceptable supports for babies and toddlers (see below), and to embrace neuroaffirming language (e.g. in the 2023 iBasis manual and other program materials). 

Bottom line:

Inklings is an evidence-based, very early family support program for children from age 6 months in their first 2 years of life who are showing early signs of autism. Compared to some other autism therapies, it’s a relatively ‘low dose’ and low cost program, making it appealing for governments looking to fund a program to help families at scale.

Further reading:

*Important note: When looking for very early signs of possible autism, researchers and health professionals look at multiple behaviours, including spontaneous eye contact, so-called “protodeclarative pointing” (where the child points to an object or event to direct another person’s attention to it), social gestures, imitation, and response to name. A lack of one or more of these behaviours does not of itself mean a child is autistic. If you are concerned about your child, speak with a health professional.

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

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“Thriving Kids”, announced by Minister Mark Butler on 20 August 2025, is the snappy new name for Foundational Supports for children.

But is it more than that?

We don’t have a lot of details right now. But it sounds different from the original proposal for Targeted Foundational supports (discussed in 2024), and a lot more like what the Grattan Institute recommended (back in June 2025 – see below):

  • The Federal Government to take leadership of the new national system (to avoid eight different State systems).
  • Limiting NDIS access for children to only those children with significant and permanent disability (i.e. children who are likely to need lifelong support).
  • Funded programs, like Inklings, MHiPS and Positive Partnerships for children with mild and moderate developmental delay or autism to be delivered in mainstream settings, like community health centres, supported playgroups, and schools. 
  • Increased scrutiny over consistent pricing and value for money of allied health and other services across disability, health and aged-care sectors.

If this is right, the new system may mean:

  • the end of the early intervention NDIS pathway and individualised supports for most children who would otherwise qualify for the NDIS under current rules; and 
  • the creation of new (block-funded?) programmed services to be delivered in mainstream settings, like early community childcare settings and schools.

There was also talk of creating a new Medicare bulk-billed item for GPs to check 3-year-olds for developmental issues, and providing access to new Medicare allied health items.

Of course, we’re yet to hear from the States, who will be paying for half of it. (Some States like NSW have been working and consulting on the earlier Foundational Supports proposal.)

This new system is due to start rolling out from 1 July 2026, with major NDIS access changes flagged for sometime in 2027.

We await more details! 

But, in the meantime, there is already a lot for us all to work through as we think about choice and control and service delivery models for children with developmental delay or disability and their families. 

Related reading:

In deep water: paediatric allied health NDIS providers should read the Grattan Report

Targeted Foundational Supports consultations: an “idea salad” with more questions than answers for allied health providers?

Speech from Minister Butler, National Press Club – 20 August 2025

‘NDIS Supports’ definition: who’s confused?

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On 30 July 2025, the Government published its report on the August 2024 ‘Consultation on Draft Lists of NDIS Supports’.

The report is very late.

The report and its timing may confuse some participants and providers.

Here is a quick recap:

The Government published its draft “in” and “out” lists to define NDIS Supports on 4 August 2024 – almost a year ago.

The consultation period was very short: 4-to-25 August 2024.

Participants, providers, advocates and others found the time to respond to the consultation: the Government received more than 7,000 responses and submissions.

The Government imposed its transitional rules for NDIS Supports on everyone on 3 October 2024 – almost 10 months ago.

Until 30 July 2025:

  • it was unclear whether the Government had listened to anyone who responded or made submissions;
  • some participants and providers thought that:
    • they had wasted their time responding to the consultation paper; and/or
    • the Government had ignored their submissions; and/or
    • there was no real consultation about the NDIS support lists – the Government had already ‘made up its mind’ when it published the lists.

As predicted by many people who responded to the consultation, the “in” and “out” lists have been difficult to apply in practice.

The report shows that the Government knew about many of the problems with the lists, including:

  • the application of black-and-white inclusion and exclusion rules to “grey areas” at the intersection between disability-related supports and mainstream health care and mental health care (e.g., pp 13, 29-32);
  • the practical effects of excluding particular supports for a person with disability when there are well-known, significant gaps in early childhood, health, education, aged-care and other mainstream supports and systems for people with disabilities (e.g., pp 10, 13, 33-35);
  • the practical challenges of establishing whether an individual’s specific need in a given case may relate to their disability, healthcare, educational attainment, or employment (e.g., pp 10, 33-34);
  • the meaning and scope of ‘evidence-based’ therapeutic supports (e.g., pp 17-18); and
  • confusion about how the rules apply to the funding of various specialist and standard products and equipment, and different assistive technologies, and communication devices and information equipment (e.g., pp 11, 20, 25).

On 16 June 2025, the Government launched another consultation on the definition of NDIS Supports – this time to replace the transitional rules with a “final definition”.

This second consultation closed on 27 July 2025.

We look forward to reading the next consultation report.

Hopefully, this time the Government will give participants, providers and other stakeholders an opportunity to see and comment on the proposed new definition well before the new definition comes into effect.

Sector on edge: the NDIA knows it needs better processes to reduce NDIS reform anxiety and to rebuild trust with participants and providers

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“Implementation [of reforms] does not stop with how our service delivery staff put that in a plan. Providers also have to know the consequences, know what to do, know what participants will come to them and ask about, and be able to support them” – NDIA staff member* 

Big picture:

The NDIS reforms of 3 October 2024 were not well-implemented or communicated to participants or providers. A new report reveals NDIA management knows about some of the things that went wrong internally. But will they learn from their mistakes, and listen to participants and providers?

Report: 

On 23 June 2025, the NDIA’s Policy, Evidence and Practice Leadership Division published a report with its “early observations” on the NDIA’s initial implementation of NDIS Act amendments that took effect on 3 October 2024, including:

  • section 10 and its accompanying transitional rules defining NDIS Supports (containing the “in list” and “out list”); and
  • section 33 (funding amounts, periods and components).

Context:

The “in and out” lists were finalised on 2 October 2024 and implemented on 3 October 2024 (p 8) after what can be described (charitably) as a very limited consultation period. Many stakeholders were dissatisfied with the consultation timeframes (p14). After the reforms went live, NDIA staff, participant, planner, and provider confusion ensued over interpretation of the lists.

Cases in point:

For example, some participants and providers were confused about:

  • whether funding for food and transport (both on the “out list”) were permissible in relation to short-term accommodation (p13);
  • whether the use of tablets (on the “out list”) embedded in assistive communication devices (on the “in list”) were okay (p24);
  • what, exactly, was meant by the term ‘evidence-based therapeutic support’ (p24); and
  • whether therapy types that were not on the in or out lists were okay (e.g. for chiropractic therapies) (p25). 

What went wrong:

Among other things, the report authors observed that:

  • the amendments generated participant uncertainty and anxiety (p6);
  • months of planning proved inadequate, and initial implementation of the changes was more challenging than expected (p26);
  • NDIA staff weren’t ready or adequately trained to answer some specific stakeholder questions with confidence (pp6-7, 25), including gaps in knowledge and skills needed to apply the changes to “nuanced circumstances” (i.e. beyond generic answers) (pp20, 27). To quote an NDIA staff member: “We had to do our first participant information session on the changes on the afternoon of 3 October and we were still trying to understand the changes ourselves” (p27); 
  • the NDIA had to publish around 50 clarifications (p7) and felt some of their clarifications and corrections were drowned out by social media commentary (p13);
  • problem resolution was stymied by inadequately coordinated internal communications across the NDIA (p7); 
  • some NDIA staff were unaware when previous guidance and FAQs had been superseded (p 25); and
  • some plan managers and providers responded by taking a “risk averse” approach to the “out list”, and erred “on the side of caution” (p8), which may not have been anticipated by the NDIA.

Lessons learned?

The report authors make some sensible suggestions for future reforms, mainly focused on improving internal processes. But stakeholders weren’t overlooked, with recommendations that included:

  • recognising that the pace of change may not be sustainable, given its potential impacts on stakeholders, participants and the disability community and “for ensuring continued collaboration and quality outcomes” (p31);
  • involving participants and sector stakeholders in the planning process to identify potential issues (p32);
  • more emphasis on participant communication and engagement before changes take effect (p31);
  • the importance of prepared resources and clear communication in place before reforms take effect (p31); and
  • the need to consider “unintended consequences” (secondary effects) of flurries of clarifications from the NDIA post-reforms, e.g. on participant and other stakeholder anxiety levels (p31).

Why this matters now: 

  • Since the October 2024 reforms, stakeholder relationships have been further strained by the 2025-2026 NDIS Pricing Arrangements and Price Limits that take effect on 1 July 2025. 
  • Section 33-empowered changes to funding periods are now being implemented, including 1, 3 and 12 month periods, affecting participants (and providers who must design systems to comply with changes). 
  • The next major round of reforms are upon us, including:

Bottom line:

The NDIA knows it needs to maintain strong relationships with the disability community because they are “essential for the ongoing success of the reform program” (p31). It also knows that providers have to understand the rules before we can build systems to comply with them and to support the participants we serve (p28). Good internal processes and clear communication from the NDIA will play a big part in determining the outcomes of the next tranche of reforms and  public confidence in the scheme. 

Go deeper:

Full report (very difficult to search for, and find, on the NDIA website):

NDIA (Policy, Evidence and Practice Leadership Division), The Introduction of defined NDIS supports, funding amounts, funding periods and funding components – Early observations on implementation, Version 1.0 – June 2025.

Consultation on NDIS Supports rules

NDIS Evidence Advisory Committee

*quote, from p28 of the report.

Divided we fall: provider vs. provider, and the unbundling of allied health provider NDIS therapy services 

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The big picture:

The 2024-2025 Annual Pricing Review, released by the NDIA on 11 June 2025, is full of bad news for allied health providers and the participants we serve. Most commentary so far has focused – quite rightly – on the most imminent price limit cuts for physiotherapists, dietitians, and podiatrists, as well the tough pricing limits for allied health provider travel. But there’s a lot more in the review to think about.    

The bigger picture:

The NDIA has abandoned the idea of a flat hourly NDIS price limit for allied health therapies, deeming it “no longer necessary to facilitate market expansion” (p12). It has signalled it will move toward:

  • a differentiated pricing approach (pp13, 88); and
  • an unbundling of some allied health services to provide greater transparency and oversight of allied health therapy services/activities (pp82-84).  

Market context:

In the six months to December 2024: 

  • more than 55,000 allied health providers provided NDIS services to almost 413,000 participants;
  • total allied health therapy payments reached $2.4 billion; and
  • five types of therapies accounted for more than 75% of therapy payments: occupational therapy, early childhood, behaviour support, speech pathology, and physiotherapy (pp51-54). 

Dual market structure:

There is a growing schism in the market for NDIS allied health therapy services:

  • Registered: About 10% of providers are registered, and make up about 62% of total payments. (The top 10 registered providers have a total market share of around 10.5% – p57-58.) Registered providers tend to operate at scale. 
  • Unregistered: About 90% of therapy providers are unregistered and make up about 38% of total NDIS payments. Unregistered providers tend to be small businesses, with “flexible business models and lower administrative overheads” (p56).  

Why it matters:

The NDIA recognises that differences in provider scale, cost structure and administrative capacity will influence providers’ responses to price limits (p61). In various parts of the review, the NDIA appears to:

  • contrast “small-scale, low overhead unregistered providers” with “a small number of larger registered providers with greater infrastructure and clinical governance capabilities” (p 11);
  • suggest that the diversity of business models across the sector “highlights emerging challenges with the alignment between current price limits and they way therapy supports are being delivered in practice” (p13);  
  • opine the registered providers “represent a relatively stable base” (p63); and
  • conclude that its ongoing therapy review pricing should consider factors like “practitioner qualifications, workforce availability, service settings, regulatory obligations  and the nature of participant outcomes achieved” (p88).

Unbundling therapy services:

NDIS therapy supports currently include direct face-to-face time as well as indirect participant-related planning, clinical communication, documentation, resource creation and travel (p82-83). The NDIA thinks this “bundling” makes it difficult to determine whether providers are being efficient. It recommends: 

  • “unbundling” provider travel for therapy supports (with effect) from 1 July 2025 (p83); 
  • exploring whether to impose new price limits and other guidance on report-writing arrangements (p84); and
  • closer scrutiny on session lengths and visibility of what is delivered in each session (p.86). (This appears to underpin the recommendations about presenting therapy support price limits in 10-minute increments (p16)). 

What we’re watching:

  • Future pricing limit reforms: In addition to different pricing limits for different kinds of therapies, we may end up with different pricing limits for different provider types (e.g. registered, unregistered), support complexity and delivery settings (p87).  
  • Further ‘unbundling’ of therapy support services: The NDIA may seek more granular oversight of therapy supports to increase its visibility over different components of our services (p 86).
  • Interaction with other reforms: Further pricing limit reforms are likely to be affected by mandatory registration proposals (and vice versa), including the still-open question of whether AHPRA registration and professional self-regulation of allied health professionals will satisfy NDIS registration requirements (in whole or in part). 

Read more:

2024-2025 Annual Pricing Review

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