Recently, the Australian Parliament made substantial changes to how the NDIS works. One of the changes, section 10 of the revised NDIS Act, required that the NDIS develop lists of:
- NDIS supports, and
- not NDIS supports.
The NDIS created these lists: they are available from the NDIS webpage
Government promised the disability sector that it would consult the disability sector about these lists. The NDIA showed its DRCO Forum members its draft lists. Most forum members said critical supports were missing from the draft list of NDIS supports, and the ‘not NDIS supports’ draft list included items that are (or should be) NDIS supports. But that was the end of the “consultation”; the NDIA wrote its own lists regardless.
Early intervention is a key item for young NDIS participants. It is a particular concern for young autistic NDIS participants.
The NDIS supports list (MS Word or PDF) says:
Early intervention supports for early childhood
Supports that are evidence-based early childhood intervention supports for children 0-9 years (including children aged 0-6 with developmental delay) and their families to achieve better long-term outcomes for the child.
This includes:
- therapy provided by allied health professionals including speech pathologists and occupational therapists
- a key worker for a child’s family.
Systemic advocates, clinicians and researchers for autism repeatedly advise the NDIA that people on the autism spectrum, including children, need varied supports that depend on individual need. Clearly, the early intervention supports for early childhood on the NDIS supports list are not “varied supports”.
Notably, the early intervention supports in the NDIS supports list are universal, they do not vary depending on a participant’s disability type. The NDIA supports list does not recognise any need for varied early intervention supports for children with different disability types. This is not consistent with advice the NDIA commissioned - see https://a4.org.au/node/1191 (MS Word or PDF version of the report from NDIS website, 2016) and Autism CRC’s Evidence review into Early interventions for children with autism. In particular, the autism sector in Australia has asked governments to recognise autism as a diverse spectrum of distinct disability types.
Using the Freedom of Information (FoI) process, I requested the evidence that the NDIA used as its basis for these particular items on its list of NDIS supports. The result showed that there is zero evidence that:
- generic speech therapy is effective for young autistic NDIS participants - see https://www.righttoknow.org.au/request/evidence_supporting_speech_patho (actual response is here) - it says
Searches conducted
The NDIA’s Technical Advice & Practice Improvement Branch, Service Guidance Division, Evidence and Practice Division and Policy Division conducted searches and did not locate any documents relevant to the scope of your request.
- generic occupational therapy is effective for young autistic NDIS participants - see https://www.righttoknow.org.au/request/evidence_supporting_occupational (actual response is here)
- the NDIA’s preferred key worker model is effective for young autistic NDIS participants - see https://www.righttoknow.org.au/request/evidence_for_early_childhood_int (actual response here).
These FoI decisions show that NDIA has zero evidence that the NDIS supports in its Section 10 list of supports for early intervention are effective for autistic children. This means that the NDIA has zero evidence showing the listed early intervention supports for early childhood satisfy section 34(1) of the NDIS Act in relation to autistic children. The NDIS cannot justify stating these supports in an autistic NDIS participant’s NDIS Statement of Participant Supports (NDIS Plan) instead of providing an NDIS plan that allows the participant to choose evidence-based early interventions such as those described in the UNC evidence-based practice for autism report.
One problem is that having a single list for all disability types and circumstances simply does not work.
The NDIS website now says “From 3 October 2024, participants will only be able to use their NDIS funds for items listed as NDIS supports”. The section on early intervention from the list quoted above only lists speech and occupational therapies; no other allied health therapies are listed. And NDIS officials do not allow participants flexibility. This outcome may not be what the authors of the NDIS supports list intended but it is how the list is interpreted.
The Minister told the parliament that the recent changes that they made to the NDIS legislation would increase flexibility in participant plans but NDIS officials use the changes to limit or minimise plan flexibility. Many NDIS plans lack the flexibility they require to meet the needs of children with disability. This is what our politicians rushed into voting for.
The list of exclusions (MS Word or PDF), things that are not NDIS supports, says:
Related to early childhood development
- Early childhood supports or therapies to support the general child development needs of a child.
- Childcare fees (including any fees associated with specialist or segregated childcare service models), long day care, family day care and informal care arrangements. This includes the costs associated with the reasonable adjustment that childcare services are required to make to accommodate a child with developmental delay or disability.
- Teaching aids or supports related to educational attainment.
The first item in this list even appears to contradict the NDIS early intervention supports for early childhood above. With this exclusion list, it is hard to see what early intervention (if any) the NDIS intends to provide for autistic children who are NDIS participants.
Without effective early intervention for the increasing numbers of children diagnosed with autism spectrum disorder, the NDIS cannot be economically sustainable. Autistic children become autistic adults. Future growth in the number of autistic adults and their higher support costs resulting from the NDIS having denied them essential early intervention will have enormous economic and social impacts on the nation … irrespective of whether the NDIS survives.
The government’s promise to consult the disability sector over the recent changes to NDIS legislation and operations has been broken. Trust in government and the NDIS is lost. And the NDIS is not what government promised people with disability and Australian taxpayers.
Note: I have come across a few speech therapists who provide more effective therapy for autistic children; either because they provide evidence-based practice (based on published research for autistic children) or because they learned their methods from astute observation, experience and maybe instinct a repertoire of effective techniques.