Operational Guideline – Planning and
Assessment – Supports in the Plan –
Supports for Early Childhood
Legislation
1.
Read ss.3, 4, 21 and 34 of the National Disability Insurance Scheme Act 2013 (NDIS Act) and the
National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Supports for
Participants Rules).
General principles
2.
People with disability should have their privacy and dignity respected.
See s.4(10) of the NDIS Act
3.
The role of families, carers and other significant persons in the lives of people with disability is to be
acknowledged and respected.
See s.4(12) of the NDIS Act
4.
Positive personal and social development of people with disability, including children and young
people, is to be promoted.
See s.4(16) of the NDIS Act
5.
Reasonable and necessary supports for people with disability should:
a.
Support people with disability to pursue their goals and maximise their independence, and
b.
Support people with disability to live independently and to be included in the community as
fully participating citizens, and
c.
Develop and support the capacity of people with disability to undertake activities that enable
them to participate in the community and in employment.
See s.4(11) of the NDIS Act
6.
The preparation, review and replacement of a participant’s plan should so far as reasonably
practical be individualised; directed by the participant; where relevant consider family, carers and
significant others; consider availability of informal support, access to mainstream and community
supports; and build individual capacity to increase participation and inclusion in community with the
aim of achieving individual aspirations.
See s.31 of the NDIS Act
7.
Plans should maximise choice and independence of the participant and facilitate tailored and
flexible responses to individual goals and needs.
See s.31 of the NDIS Act
Operational Guideline – Planning and Assessment – Supports in the Plan – Supports for Early
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8.
The statement of participant supports specifies the general supports (if any) and the reasonable
and necessary supports (if any) that will be funded. In deciding whether to approve a statement the
delegate must:
a.
Have regard to the legislation and rules, participant statement, relevant assessments, and
b.
Be satisfied that all clauses of s.34 of the NDIS Act on reasonable and necessary are met
including that the support is most appropriately funded by the NDIS and offers value for
money, and
c.
Have regard to the principle that a participant should manage their plan to the extent they wish
and the operation and effectiveness of any previous plans of the participant.
See ss.33, 34 and 35 of the NDIS Act
Early intervention supports for early childhood
9.
Early childhood interventions can be provided where reasonable and necessary for children under
6 years of age. They aim to optimise learning, development and social participation of the child by
facilitating the achievement of the normal developmental milestones of early childhood, with
particular regard to the functional domains of self-care, language, cognition and motor
development.
10. This requires a focus on the child within the context of their family, supporting them to articulate
their values, priorities and aspirations and recognising that all families, with the necessary supports
and resources, can enhance their children’s learning and development.
See Workgroup on Principles and Practices in Natural Environments,
OSEP TA Community of Practice: Part C Settings. (2008, February).
11. Supports discussed in this Operational Guideline include early intervention supports for children as
early investment in achieving functional outcomes for children and minimising long term
dependence and support costs.
Reasonable and necessary supports
12. Before specifying any general support, or reasonable and necessary support, in a participant’s plan
the delegate has to:
a.
Be satisfied that all the criteria set out in s.34(1) of the NDIS Act are met in respect of each
funded support before it is included in a participant’s plan
b.
Ensure the support:
i.
Will not cause harm to the participant or pose risk to others,
ii.
Is due to the effect of the disability on the participant and does not duplicate supports
available from other systems,
iii.
Does not relate to day to day living costs (e.g. rent, groceries, utility fees) unless directly
attributable to the impact of the disability on the participant, and
iv.
Is not illegal or consist of income replacement
See Operational Guideline – Planning and Assessment – Supports in the Plan
See rs.5.1, 5.2 and 5.3 of the Supports for Participants Rules
c.
Consider the additional guidance for delegates set out in this operational guideline in relation
to early childhood supports.
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13. This Operational Guideline lists the matters that delegates are to consider under s.34(1)of the
NDIS Act. Delegates should note that the matters to be considered may need to be considered in
relation to more than one paragraph of s.34(1).
Goals and aspirations
14. Where a child is under 6 years of age it is likely that goals and aspirations will be broadly described
and focussed on the development of the child rather than specific goals. Where goals are
described specifically (e.g. school readiness) it will be appropriate for supports to relate to both the
broad and specific goals identified in the plan.
See s.34(1)(a) of the NDIS Act and
Operational Guideline – Planning and Assessment – Supports in the Plan
Supports that will not be funded or provided by the
NDIS
15. The Supports for Participants Rules provide that a support will not be funded by the NDIS if it:
a.
Is likely to cause harm to the participant or pose a risk to others, or
b.
Is not related to the participant’s disability, or
c.
Duplicates other supports delivered under alternative funding through the NDIS or other
systems, or
d.
Relates to day-to-day living costs
16. In relation to early intervention supports, delegates need to specifically consider whether a support
is likely to cause harm to the participant by virtue of creating a dependent or harmful relationship
between the participant and or their family and the support, to the extent that the independence and
participation of the child is diminished.
17. In relation to early intervention supports, delegates need to specifically consider whether a support
relates to a participant’s disability rather than being the kind of support required for early childhood
development for a child without disability. For example, it would generally not be appropriate for the
NDIS to fund children’s toys because all children need toys and play items to learn and develop.
However, where relevant to progressing the goals for the participant, if there was a specialised or
modified toy required due to the participant’s disability, such as a special seat to enable them to use
a tricycle, the NDIS may fund the additional expense associated with the toy, over and above the
cost of a normal toy.
See s.34(2) of the NDIS Act and Part 5 of the Supports for Participants Rules and
Operational Guideline – Planning and Assessment – Supports in the Plan
Supports most appropriately funded by the NDIS
18. The NDIS Act requires that a delegate must be satisfied that a support is most appropriately funded
or provided through the NDIS and not more appropriately funded or provided through the NDIS and
not more appropriately funded or provided through other service systems:
a.
As part of a universal service obligation, or
b.
In accordance with reasonably adjustments required under disability discrimination law.
See s.34(1)(f) of the NDIS Act
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19. In relation to early childhood supports, the NDIS will be responsible for:
a.
Individualised supports, specific to a child’s disability (or developmental delay), which are
additional to the needs of children of a similar age and beyond the reasonable adjustment
requirements of early childhood development service systems.
b.
Early interventions for children with disability (or developmental delay) which are:
i.
Specifically targeted at enhancing a child’s functioning to undertake activities of daily
living, but not supports which are specifically for the purpose of accessing a universal
service such as school readiness programs that prepare a child for education, and
ii.
Likely to reduce the child’s future support needs, which would otherwise require support
from the NDIS in later years, including through a combination and sequence of supports.
See rs.7.8 and 7.9 of the Support for Participants Rules
20. The NDIS will not be responsible for:
a.
Early childhood education and personal care supports which are usually required by children
of a similar age including inclusion supports that enable children to participate in early
childhood education and care settings, or
b.
Supports, which are clinical in nature provided in the health system, including acute,
ambulatory or continuing care, or
c.
New-born follow-up provided in the health system, including child and maternal health
services.
See r.7.10 of the Supports for Participants Rules
21. The below table provides guidance on whether a support is more appropriately funded or provided
through the NDIS or by other parties. Other parties can include other government agencies,
independent organisations funded by government to provide services or individuals and families.
22. Delegates are to exercise judgement in determining when the NDIS should fund costs listed in Part
B of the following table taking into account the requirements in s.34 of the NDIS Act. In particular,
where the decision is that another system should be including the participant in mainstream
activities, the NDIA Local Area Coordinator role can work with participants and their families to
maximise access to mainstream and community systems.
A. NDIS is generally more appropriate to fund the following supports:
1.
2.
Assistance with daily personal activities - specific to a participant’s disability (or developmental
delay) which are additional to the care requirements expected of a child without disability, if
funded in an early childhood education and care setting and:
a.
Where the participant has exceptional needs beyond the inclusion support offered by the
early childhood system, and
b.
Would otherwise prevent the participant from accessing early child education services
such as assistance with feeding and managing airways or ventilation.
Disability-specific family support, which are required as a direct result of a participant’s
functional impairment, including for parents with disability (e.g. post-diagnosis information,
linkages, referrals and support coordination)
B. Depending on their purpose the following supports can be more appropriately funded by either NDIS
or other parties:
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1.
2.
3.
4.
Behaviour and therapeutic supports
a.
NDIS: to increase a child’s level of functioning, or ameliorate a future degradation in
functioning,
b.
Other parties: where these interventions are clinical or the purpose is to treat a medical
condition (see rs. 7.4 and 7.5 of the Supports for Participants Rules).
Aids and equipment
a.
NDIS: portable aids and equipment which are required by a participant for the purpose of
improving functioning (e.g. hearing aids, wheelchairs, personal communications
devices), but not requiring medical or surgical procedures
b.
Other parties: aids and equipment, which are:
i.
A reasonable requirement to enable access to a facility (e.g. Ramps, lifts, hearing
loops, or other capital works), or
ii.
Required for an educational outcome (e.g. Modified computer hardware, education
software, braille textbooks), or
iii.
Fixed or non-transportable in early childhood education and care facilities that
enable a student access to education (e.g. Hoists).
Assistance with transport
a.
NDIS: specialist transport to and from the early childhood education and care facility
required as a result of a participant’s disability (where no other transport option is
available and not substituting for parental responsibility),
b.
Other parties:
i.
Where transport is required for activities that are part of an early childhood
education or care program (e.g. excursions), or
ii.
Reasonable adjustments for transport providers (e.g. reasonable adjustments to
busses).
Specialist support and training
a.
NDIS: for early childhood and care staff in activities related to the specific personal
support needs of an individual participant, including training on specific behaviour
management plans,
b.
Other parties: for early childhood education and care staff to provide care and support
and/or engage all children, including those with disability.
C. Other support systems are generally more appropriate to fund the following supports:
1.
Clinical and diagnostic services – including specific screening for development delay
a.
Maternal and child health – responsible for supports which are clinical and medical
services, including acute, ambulatory, continuing care and new-born follow up,
b.
Subacute care services that are delivered under the management of a clinician,
c.
Post-acute care – including clinical supports that are delivered to a participant in their
home following an acute episode or premature birth (including nursing care and medical
supplies),
d. Palliative care.
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2.
Early childhood and children’s services attendance – fees associated with early childhood
education and child care, play groups, including disability-specific early childhood education
and care services.
3.
Inclusion supports – to enable children with disability to access early childhood education and
care, (including those funded through the Australian Government’s Inclusion and Professional
Support Program) and requirements to make reasonable adjustments under the:
a.
Disability Discrimination Act 1992,
b.
Disability (Access to Premises Buildings) Standards 2010, and
c.
Disability Standards for Accessible Public Transport 2002.
Social and economic participation
23. Delegates should apply this element of reasonable and necessary supports in a way that is
sensitive to the age of the child. In some instances it will be appropriate for delegates to consider
future social and economic participation in the context of the child’s developmental goals.
See s.34(1)(b) of the NDIS Act
Value for money
24. Delegates must consider value for money both in the context of the relative expense of different
supports available to achieve the same goal and also whether the investment in supports would be
value for money over time. For example, where an early investment is likely to reduce the child’s
future support needs from the scheme, a delegate may judge that a more expensive support would
be value for money as an early investment (even where that value may be realised over the period
of several plans).
See s.34(1)(c) of the NDIS Act
Effective and beneficial
25. In considering current good practice, the delegate would generally consider that a therapeutic
support for early childhood is likely to be effective and beneficial where the support is:
a.
Linked to mainstream programs of support (such as the health and education systems) and
involves specialist providers actively engaging with and building the capacity of those linked
mainstream programs to facilitate the child and family’s inclusion and participation,
b.
Coordinated by a Key Worker using a trans-disciplinary approach where there are multiple
interventions delivered across a range of different environments,
c.
“Routines based” which facilitates meaningful daily activities in a child’s natural environment,
d.
Focussed on enabling a family to support their child’s development and learning,
See s.34(1)(d) of the NDIS Act
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Taking into account reasonable expectations of
families
26. The community has general expectations about the supports that would be provided by family or
primary care givers to a child including those under 6 years of age. The NDIS can fund supports
that are needed as a direct result of the child’s disability but will not displace the ordinary role of
parents, families and carers.
27. For example it is a reasonable expectation that parents and family members spend time with their
children in developing their skills and capacity. NDIS funding support is appropriate where the
child’s needs are not reasonable for a parent with a child of that age.
28. Early childhood interventions should focus on supporting families and care givers in providing
optimal learning experiences in the course of their everyday lives.
29. Families are valued members of the early childhood intervention team and involved in all aspects of
intervention. It is important that supports that are funded in the participant’s plan are family centred,
that the participant’s family is able to manage the demands on their time associated with the
supports, and that the overall effect of the early intervention supports is to reduce stress on the
family whilst achieving outcomes for the participant.
See s.34(1)(e) of the NDIS Act and Operational Guideline – Planning and Assessment – Supports in the Plan
Expectations as to levels of support
30. Therapeutic supports for children under the age of six should be based on the needs of the child
and generally would fall into one of three categories:
a.
Level 1 - low needs - $6000 to $8000 per annum,
b.
Level 2 - medium needs - $8001 - $12000 per annum, or
c.
Level 3 - high needs - $12001 - $16000 per annum.
31. Level 1 (low needs) is generally appropriate for a child with a developmental delay, or mild
disability, who is developing slower than their peers. This child and their family may require regular
primary service provider/key worker support and some support to access mainstream services
(such as transition from preschool to school), family life and community activities. There may also
be some consultation/visits required from additional therapists from disciplines other than the key
workers’. Prescription of, and tuition in the use of, disability related equipment, tools and resources
to facilitate development and/or communication may also be required. The latter does not include
toys and play equipment which are normally provided to children.
32. Level 2 (medium needs) is generally appropriate for a child with a disability or developmental delay
who either has moderate single and/or multiple areas of need/concern that require specific
intervention, or behavioural concerns or some family complexities that may require referral to other
agencies. This child and their family would require regular primary service provider/key worker
support and targeted support to access mainstream services (such as school transition), family life
and community activities. Families/carers will require help to access relevant information to help
them support their child’s development. There may also be occasional visits required from
additional therapists from disciplines other than the key workers’. Equipment, tools and resources
to facilitate development, positive behaviour support and/or communication also is likely to be
required. Liaison with other specialist agencies or providers may be required.
33. Level 3 (high needs) is generally appropriate for a child with a disability and/or severe
developmental delay, multiple disabilities, severe behavioural difficulties, rapid deterioration and/or
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complex health/medical needs who has severe and/or multiple needs that require specific
intervention. There may also be high levels of family distress and complexity such as maternal
depression, drug or alcohol abuse, or other issues that require liaison with and/or referral to other
agencies.
34. This child (high needs) and their family would require regular and intensive primary service
provider/key worker support and concentrated support to access mainstream services (such as
ECEC and school transition), family life and community activities. Families/carers may also require
intensive family support to help them to meet their child’s needs and support their development.
Visits may be required for additional therapies from disciplines other than the key workers’ regularly
or in an intensive episodic way. Equipment, tools and resources to facilitate development and/or
communication will be required. Safety issues may also need to be addressed. Cross agency
collaboration may also be required (including with child protection, adult disability services, etc) as
may liaison with other specialist agencies or providers.
35. In some limited circumstances it may be appropriate for higher levels of support to be provided. In
considering whether a higher level of support is needed the delegate should consider:
a.
Previous outcomes achieved with lower levels of therapeutic support,
b.
Impact of disability on multiple body systems,
c.
Intensity of support needed to enable a child to transition successfully into mainstream
childcare or school, and
d.
Multiple hospitalisations and medical interventions which require more intensive therapy to
allow carers and teachers to assist the child in re-assimilation into mainstream activities.
36. It is expected that NDIS will fund necessary and reasonable early childhood interventions that are
intensive where the intervention is able to deliver significant improvements within a period of
approximately 6 months. Up to 4 periods of early intervention may be funded. Funding further
periods of early childhood supports is not precluded where that funding will further reduce the
impact of the child’s disability.
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