Sarah MacInnes' heart breaks having to watch children wait years to get the help they need.
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But with a growing demand for paediatric care and a lack of university graduates to go around, that's the reality she lives in.
Mrs MacInnes is a co-director at Orange's Seed Paediatric Services which specialises in therapeutic intervention for neurodiverse children between the ages of zero and 12.
During an average week, the clinic's seven occupational therapists will service roughly 120 families in total.
The "distressing" part isn't the number they help, it's the number they can't.
Seed has roughly 130 families on a waiting list two years long and they aren't the only ones.
The average wait time for children with significant development challenges is six years in Tamworth, three years in Wagga Wagga and two-and-a-half for Orange.
Most of the children Seed services have difficulty regulating their emotions which can result in "meltdowns and behavioural outbursts".
Without early intervention, the ripple effect this can have on parents, siblings, teachers and themselves can be "huge".
"It has a very real impact. The longer a child's nervous system is working the way it is, the more that becomes ingrained and impacts on their wellbeing," Mrs MacInnes said.
"It really is at crisis point."
What are the issues?
For Seed - which also operates sites in Dubbo and Bowral - recruiting to regional areas has been a challenge.
Mrs MacInnes believed the problem wasn't solely down to a lack of graduating occupational therapists, of which she estimated just 25 per cent turned to paediatrics.
It was also about figuring out ways to entice those graduates to regional centres, rather than metropolitan areas.
"Orange is certainly a fabulous place to live. It's a really rich food and wine area, there's wonderful education options for children and families and a dynamic community they can be a part of," Mrs MacInnes said.
"It's about how do you entice OTs to get out to regional areas and experience it."
Getting recent graduates out to places like Orange is only half the battle though.
If those employees aren't supported properly, Mrs MacInnes said they could look for other employment opportunities or to leave the industry altogether.
"It's about having organisations being willing to support new graduates and ensuring their wellbeing is looked after in terms of not seeing huge caseloads straight out of university, to avoid that burnout," she added.
"Ultimately it impacts our children and families because unfortunately they are the ones sitting on the waitlist."
What can be done?
Mrs MacInnes believes a scarcity of services, although not ideal, encourages innovation.
At Seed they have been looking for ways to service the waitlist with initiatives such as group programs.
To help support the industry as a whole though, Mrs MacInnes said businesses and universities need to build stronger relationships and consider getting students into the workforce before they have graduated.
"In organisations with really strong clinical support, that could be a really good solution to an extent," she said.
"Ultimately we need to be getting those graduates through the doors."
To help create a long-term solution, children's health charity Royal Far West is seeking funding for a three-year pilot to expand their developmental assessment and treatment service based in Manly with two new rural based paediatric assessment clinics in Wagga and Dubbo.
More than 60 per cent of the families they support come from the Murrumbidgee and western NSW regions.