developmental delay Australia

Why Children With Developmental Delays Wait Too Long

By Home Visit Network

27 August 2026

16 min read

For a parent who first notices their child is not hitting milestones on time, every month matters. A two-year-old who is not yet speaking, a four-year-old who struggles to hold a pencil, a school-aged child who cannot follow multi-step instructions: these are not small concerns that resolve on their own. Early intervention works precisely because the developing brain is most receptive to therapeutic input in the first years of life. Yet across Australia, children with developmental delays are routinely waiting six months, twelve months, or longer before they receive the assessment and therapy they need.

The scale is significant and moving in the wrong direction. The 2024 Australian Early Development Census, which assessed more than 288,000 children in their first year of school, found 23.5 per cent were developmentally vulnerable on one or more domains, up from 22.0 per cent in 2021.^[1] The proportion of children on track across all five domains fell to 52.9 per cent, and the largest single increase in vulnerability was in emotional maturity.^[1] Roughly one in four children is arriving at school already behind.

The waits are measurable too. A study of a child developmental assessment service in South Western Sydney, covering 2,354 patients, found a median wait of 302.5 days for assessment, with only 70 per cent seen within twelve months.^[2] Children with global developmental delay were disproportionately from the most disadvantaged areas, and they waited longer than others.^[2] That is the inequity in a single finding: the children with the greatest need and the fewest resources wait the longest.

This is not a new problem, but it is a worsening one, and it is about to change shape substantially. The intersection of workforce shortages, complex funding pathways, major NDIS reform, limited community-based services, and a primary care system under its own considerable pressure has produced a system where the families who most need timely help are the ones most likely to fall through the gaps.

The Biggest Change Coming: Thriving Kids

Any family navigating developmental delay in Australia right now needs to know about Thriving Kids, because it fundamentally changes where support for this cohort comes from.

Thriving Kids is the first phase of Foundational Supports, a new system of services sitting outside the NDIS. Governments have jointly committed $4 billion over five years, with the Commonwealth contributing $2 billion and states and territories matching it.^[3] It is designed for children aged 8 and under with developmental delay and/or autism with low to moderate support needs, and their families.^[4]

The key details for families:

Rollout begins 1 October 2026, with full implementation by 1 January 2028.^[4]
No diagnosis is required to access support through Thriving Kids.^[3] This is significant given how much delay is currently caused by waiting for diagnostic assessment.
Supports include general supports (peer support programs, supported playgroups) and targeted supports including allied health therapies delivered by qualified clinicians, individually or in small play-based groups.^[5]
Services will mostly be delivered where children live, learn and play, including at home and in community settings.^[3]
Children with permanent and significant disability, including those with high support needs, continue to be supported through the NDIS.^[4]
NDIS access arrangements for children are expected to change from 1 January 2028, requiring amendments to the NDIS Act.^[4]

The intent is earlier identification and easier local access, addressing precisely the bottleneck this article describes. The legitimate concern, raised by advocates and families, is that detail on exactly what will be funded, how eligibility will be assessed and how transitions will work is still being finalised between the Commonwealth and the states. Families currently receiving NDIS early intervention should seek clarity from their planner about what the transition means for their child, rather than assuming continuity or assuming loss.

Why the NDIS Pathway Is Not Working Fast Enough

For many families, the NDIS has been the gateway to early intervention therapy: speech pathology, occupational therapy, physiotherapy, psychology and behaviour support. The Early Childhood Approach, designed for children under nine following an extension of the age limit on 1 July 2025 (previously under seven), is meant to streamline access. In practice, families report that the process from first concern to approved funding plan often takes many months, particularly when initial applications are incomplete, when supporting evidence from specialists is difficult to obtain quickly, or when families do not have the literacy or support to navigate a complex bureaucratic process.

Paediatricians are often the first specialist a family needs to see, and public system wait times can stretch beyond twelve months in many parts of Australia, including suburban areas that do not think of themselves as underserved. Without a diagnostic report or developmental assessment, NDIS applications are harder to progress. The result is a delay stacked on top of a delay.

The most recent data confirms the scale of the problem. Parliamentary Estimates figures from March 2026 show the median wait for a Child Development Service paediatrician in Western Australia reached 23.9 months, up from 18.7 months in October 2025 and 16.4 months in 2022. Children in the same system were also waiting over 11 months for a clinical psychologist and over 8 months for an occupational therapist. While WA data is the most granular publicly available, the pattern of worsening waits is consistent with what clinicians and families report across other jurisdictions.

Part of the driver for the Thriving Kids reform is NDIS cost growth: new participants, many of them children with mild to moderate autism, pushed annual scheme growth toward 11 per cent, and the government has set a target of slowing that to around 5 to 6 per cent while refocusing the NDIS on long-term significant disability. Whether that produces better outcomes for children or simply moves them to a less-funded system is the question families and clinicians are watching closely.

The Workforce Shortage Behind the Waitlist

Even when families secure funding, they then face the second queue: getting onto a therapist’s books. Speech pathologists in particular are in critically short supply relative to demand. Occupational therapists working in paediatrics report caseloads at or beyond sustainable limits. In regional and rural areas, the shortage is acute enough that some families drive two or three hours for a single therapy session.

The therapists on our network report that the paediatric caseload is among the most emotionally and professionally demanding they work with, and many experienced practitioners are actively limiting new paediatric intakes simply to maintain quality of care for existing clients. This is not indifference. It is a workforce that has not grown in proportion to demand.

Training pipelines for speech pathologists and occupational therapists are not producing graduates at a rate matching demand created by the NDIS, an ageing population, and growing awareness of developmental conditions. Notably, state governments have flagged workforce capability readiness as a specific component of Thriving Kids implementation,^[3] which is an acknowledgement that a new funding system without more clinicians will not fix the queue.

Some state responses are already underway. In December 2025 the NSW Government funded 32 additional paediatric allied health professionals, including speech pathologists, occupational therapists and physiotherapists, across 15 local health districts specifically to reduce early intervention wait times. That is a meaningful but modest response relative to the scale of unmet demand.

Primary Care: Stretched Before the Referral Is Made

Before any funding pathway begins, the primary care encounter is often where a parent’s concern is either validated or dismissed. GPs are the first point of contact for most families, and the pressure on general practice is significant. The federal government committed $7.9 billion to expand bulk billing, with a target of nine in ten GP services bulk billed by 2030.^[6] From 1 November 2025, bulk-billing incentives were extended to all Medicare-eligible patients, not just children under 16 and concession card holders, with a new voluntary Bulk Billing Practice Incentive Program paying practices an additional 12.5 per cent loading if they bulk bill every patient.^[6] Affordability matters for families already managing the financial stress of raising a child with additional needs.

From 1 July 2025, the GP Chronic Condition Management Plan (GPCCMP) replaced the former GP Management Plan and Team Care Arrangement. The GPCCMP uses a standard referral letter rather than a structured form, provides up to five allied health sessions per year with an 18-month referral validity, and carries a rebate of around $61.80 per session. For children whose needs do not meet the NDIS access threshold but who would benefit from allied health input, this pathway is an important option, and the simplified administration is a genuine improvement.

However, five sessions per year is a modest allocation for a child with significant developmental delay who may need weekly or fortnightly therapy. The GPCCMP is a bridge, not a solution.

Since 1 November 2025, Medicare telehealth rebates require either an in-person GP visit within the previous 12 months or MyMedicare enrolment. For families using telehealth to access GP consultations, maintaining a relationship with a regular practice matters more than ever.

The Gap Between Diagnosis and Funded Therapy

One of the most consistently frustrating experiences for families is diagnostic limbo: a child has clearly identified needs, but the formal assessment required to access funding is itself expensive and hard to access. Developmental paediatricians, psychologists and speech pathologists all charge for comprehensive assessments. Medicare rebates exist but do not cover the full cost of many assessment processes. Private out-of-pocket costs for a comprehensive developmental assessment can run into the hundreds or thousands of dollars before a family has received a single minute of therapy.

This creates an inequity that follows developmental trajectories, and the Sydney data bears it out: children with global developmental delay from the lowest socioeconomic areas waited longest for assessment.^[2] Families with financial resources, private health insurance, and the capacity to manage complex referral processes move through faster. Families without those advantages wait longer, and their children lose developmental time they cannot recover.

This is one reason the no-diagnosis-required design of Thriving Kids is potentially significant.^[3] If support can be accessed on functional need rather than a purchased diagnosis, one of the most inequitable bottlenecks in the current system is removed.

Mobile and In-Home Therapy: Reducing Barriers Without Solving Them

Mobile and in-home allied health services have a specific and practical role. For children with developmental delays, the clinical case for therapy in the home or in a natural environment, including childcare or school settings, is well established. Children generalise skills more effectively when they learn them in the environment where they will use them. A speech pathologist working with a child in their own kitchen, using their own toys and daily routines, is doing something qualitatively different from clinic-based therapy. Notably, Thriving Kids is explicitly designed around delivering supports where children live, learn and play,^[3] which aligns policy with what the evidence has long supported.

Home Visit Network was built by a mobile therapist who understood that access to care should not depend on a family’s ability to transport a child to a clinic, manage a waiting room with a dysregulated child, or take significant time off work for every appointment. In our experience working with mobile practitioners, the practical barriers to clinic attendance, particularly for families managing complex behaviour, sensory sensitivities, or multiple children, are real and significant. Removing those barriers improves attendance and engagement, which improves outcomes. Families can find qualified mobile practitioners by conducting a postcode search on the platform.

Mobile therapy does not solve workforce shortages or funding waitlists. But it addresses secondary barriers that prevent families from accessing therapy even when they have managed to secure it. Flexible scheduling, reduced travel, and the ability to embed therapy into daily routines are not luxury features. For many families, they are the difference between consistent therapy and therapy that lapses.

What Families Can Do Now

While systemic reform works its way through implementation, there are practical steps families should know about.

Do not wait for a definitive diagnosis to start. A referral under the GPCCMP for speech pathology or occupational therapy can begin while a fuller assessment is underway. Five sessions is not enough, but it is better than nothing, and a therapist can begin building a picture of a child’s needs that supports further applications.

Know that the NDIS Early Childhood Approach does not require a diagnosis for children under seven. Functional evidence, showing what a child cannot do that other children their age can, is the relevant basis for access. Families told they need a diagnosis before applying should seek independent advice.

Ask about Thriving Kids in your state. Rollout begins 1 October 2026 and is being delivered differently in each jurisdiction, with services commissioned locally.^[5] If your child is 8 or under with low to moderate support needs, this is likely to become your primary pathway, and understanding the local timeline matters.

Consider mobile therapists to shorten the gap. In-home practitioners can often offer greater scheduling flexibility than clinics, which can reduce the wait between funding approval and first appointment. Families who use our platform tell us that finding a practitioner who comes to them has meaningfully shortened that gap.

Frequently Asked Questions

Why do children with developmental delays wait so long for therapy in Australia?

The main reasons are funding application complexity and processing time, a shortage of paediatric allied health professionals relative to demand, the cost and scarcity of diagnostic assessments, and limited community-based services, particularly outside major cities. One Sydney study found a median wait of over 300 days for a developmental assessment alone. Each delay compounds the others.

What is Thriving Kids and does it affect my child?

Thriving Kids is a new $4 billion national program sitting outside the NDIS, for children aged 8 and under with developmental delay and/or autism with low to moderate support needs. Rollout begins 1 October 2026 with full implementation by 1 January 2028. No diagnosis is required to access it, and supports include allied health therapies delivered where children live, learn and play. Children with permanent and significant disability continue to be supported by the NDIS.

Does my child need a formal diagnosis to access early intervention?

Not necessarily. Under the NDIS Early Childhood Approach, children under nine can access supports based on functional evidence of developmental delay rather than a confirmed diagnosis (the age limit was extended from seven to nine on 1 July 2025). Thriving Kids has also been designed so that no diagnosis is required. Families should not wait for a diagnosis before seeking support.

Can a GP refer my child to a speech pathologist or occupational therapist through Medicare?

Yes. Under the GP Chronic Condition Management Plan (GPCCMP), which replaced the former GP Management Plan and Team Care Arrangement from 1 July 2025, GPs can refer children for up to five allied health sessions per year, with an 18-month referral validity and a rebate of around $61.80 per session. This is a useful option while other funding is being sought, though limited for children with significant needs.

What is the difference between NDIS-funded therapy and Medicare-funded therapy?

NDIS funding, where approved, provides an individualised budget for therapy that is not capped at five sessions per year. Medicare supports through the GPCCMP provide up to five sessions annually with a rebate of around $61.80 per session, with gap fees possible. For children with ongoing, complex developmental needs, NDIS funding has generally been the more appropriate pathway, though from late 2026 many children with low to moderate needs will be supported through Thriving Kids instead.

Are there in-home therapy options for children with developmental delays?

Yes. Many speech pathologists, occupational therapists and other allied health professionals offer mobile services, visiting children at home, at childcare or at school. In-home therapy can be particularly effective because it embeds therapeutic strategies into the child’s natural daily environment, and it is the delivery model Thriving Kids is explicitly built around.

References

About the Author

The Home Visit Network Team connects Australians with qualified mobile healthcare professionals who provide services in the comfort of your home.