S9E04 - Unpacking Thriving Kids NSW

A major shift in early childhood supports

The long-anticipated Thriving Kids rollout is beginning to take shape in New South Wales, offering the clearest indication yet of how early childhood supports may operate from October 2026.

Children already on the NDIS are not expected to be removed immediately. However, children aged eight and under who may previously have entered the NDIS under mild to moderate autism categories are expected to be redirected into Thriving Kids instead.

This marks a significant shift for OTs, families and private providers.

While the program includes many evidence-based early intervention ideas, it is also arriving alongside tighter NDIS eligibility. For many clinicians, the concern is not the existence of Thriving Kids itself, but what families may lose access to in the process.

What the Thriving Kids model includes

The current draft specifications outline a system focused on short-term, early intervention supports for children, families and carers.

Proposed services include supported playgroups, parenting programs, peer support and allied health intervention delivered individually or in groups. There is also a strong focus on family navigation and coordination.

Importantly, the model appears focused on functional support rather than diagnosis.

General supports and early intervention

The general supports stream includes playgroups, parenting programs, peer support and referral services.

The draft also includes allied health “in-reach” within these programs, allowing clinicians to observe children in play-based settings, provide developmental guidance and support referrals into targeted services.

For many OTs, this resembles community outreach models already operating within some health services.

Targeted allied health supports

The targeted support stream includes time-limited, goal-focused allied health intervention.

Services may be delivered individually, in groups or through multidisciplinary collaboration across clinics, homes and community settings.

Although exact limits have not yet been released, the wording strongly suggests therapy caps around intensity and duration.

Group intervention also appears likely to play a larger role. While groups can work well for some children, clinicians are concerned they may become the primary pathway for children who require more individualised support.

Why providers are concerned

One of the biggest challenges for providers is the proposed commissioning structure.

The New South Wales expression of interest documentation strongly prioritises not-for-profit organisations as preferred providers. This has created widespread concern across private practice, particularly for regional and rural clinicians who are already filling workforce gaps.

However, the draft specifications also reference a pre-qualified allied health panel that may allow private practitioners, sole traders and small businesses to deliver fee-for-service supports where service gaps exist.

This pathway appears especially relevant in thin-market and regional locations where NGOs or public services may not have enough workforce capacity.

The practical reality in regional areas

For many regional communities, private practitioners are already the only available providers.

Long waitlists, recruitment difficulties and workforce shortages remain significant issues. As a result, practices operating in these locations may have stronger opportunities to demonstrate why private allied health involvement remains essential.

The expression of interest process allows providers to outline:

• Existing early childhood experience
• Regional or multicultural service delivery
• Telehealth and in-person capacity
• Partnership arrangements
• Workforce capability and organisational structure

There is also a strong emphasis on collaboration between providers, including partnerships with Aboriginal community-controlled organisations and allied health services.

For some smaller practices, consortium-style partnerships may become an important pathway moving forward.

The return of capped intervention models

Many clinicians recognise similarities between Thriving Kids and pre-NDIS systems where intervention was often short-term and group-based.

The concern is not necessarily that group programs exist, but whether children who need ongoing support will still have access to consistent therapy.

Families of children with ADHD, anxiety and developmental concerns have already struggled to access support under the current system. Many providers worry more children may now fall into those same gaps.

At the same time, parts of the model are genuinely promising.

The focus on peer support, family navigation, early touchpoints and community-based intervention aligns strongly with best-practice early childhood approaches. If these services were being introduced alongside existing NDIS access, many clinicians would likely welcome the program enthusiastically.

Questions around assistive technology and coordination

The draft specifications also include low-cost assistive technology funding for communication, mobility, sensory regulation and daily functioning.

However, clinicians have raised concerns about how equipment provision will work in practice.

Mobility and sensory supports rarely succeed through equipment alone. Effective implementation usually requires assessment, training and follow-up support. There is still little detail about funding caps, approved product pathways or how therapy input will integrate alongside equipment provision.

The program also introduces a family support coordination role designed to help families navigate services and systems.

Rather than a traditional NDIS key worker model, this role appears more focused on care coordination and oversight. For families navigating multiple systems, this could become an important source of continuity.

Preparing your practice for what comes next

Despite ongoing uncertainty, one message is becoming increasingly clear.

Private practices will need to think strategically about diversification.

Many providers are already exploring private fee-paying pathways, school-based supports, community partnerships and collaborative service models. Others are considering consortium arrangements to strengthen future tender opportunities.

There is still substantial uncertainty around pricing, therapy caps and implementation. However, waiting for complete clarity may leave practices unprepared.

For OTs, this is likely to be a period of recalibration rather than business as usual.

Key takeaways for OTs

• Thriving Kids is expected to begin in New South Wales from October 2026.
• Children already on the NDIS are not expected to lose access immediately, but new children may enter Thriving Kids instead.
• The model appears focused on short-term, goal-based and group-oriented intervention.
• Current documentation strongly favours NGO-led delivery.
• Regional and rural providers may still play a significant role where workforce shortages exist.
• Collaboration and partnership models are likely to become increasingly important.
• Practices should begin considering diversification strategies now.
• Significant uncertainty remains around funding, therapy caps and implementation.

Links

Communities and Justice: Thriving Kids
https://dcj.nsw.gov.au/community-inclusion/disability-and-inclusion/thriving-kids.html

OT Unplugged - Brisbane Friends of the Podcast Event - 20 May 2026: https://www.trybooking.com/events/landing/1576072

Balmoral Burn Fundraiser Event - Support Sarah here: https://raceroster.com/events/2026/109219/humpty-dumpty-balmoral-burn/pledge/participant/46083634