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Significant Changes For Autism Spectrum 0-12 Years

With proposed fund rationing for early supports on the table, Vanessa covers the knowns and unknowns from the Interventions for Children on the Autism Spectrum consultation paper. Feedback deadline is May 14.

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Updated 15 Apr 202415 Apr 2021

Just before Easter, the NDIA released the ‘Interventions for Children on the Autism Spectrum’ consultation paper. The proposed changes are significant for children under the age of 13, and they need to be considered in the context of the government’s broader legislative and cost-cutting agenda for the NDIS. Most importantly, the consultation paper reveals details about the future of support for children on the autism spectrum, including price caps.

In many ways, this write-up appears to be more of an expectation-setting exercise, rather than a genuine attempt at consultation. Many of the questions asked of the public fundamentally miss the mark, and there is no inquiry into whether these funding tiers will enable effective early intervention support. Still, the paper makes essential reading for all families of children with autism.

 

Price caps

The consultation paper proposes four levels of funding, signalling a rationing of early childhood intervention supports for the first time.

The paper outlines four levels of capacity building funding for children with autism:

Alarmingly, the NDIA has already determined that most participants will receive the ‘middle of the range, and only a small amount of participants [are] expected to receive the top range.’ Such statements are problematic, as a key principle of the NDIS is that each child is assessed and funded according to their needs. The paper states that ‘the NDIA is currently required to determine funded support by considering each individual support and whether it meets the reasonable and necessary criteria under section 34 of the NDIS Act and Rules.’ The word ‘currently’ is important because we now know from leaked draft legislation documents, that the government is considering reworking reasonable and necessary.

Essentially, with these proposed changes, children will be assessed and placed into one of the four levels of funding for their capacity building support. Coupled with potential rewrites of the legislation, parents and caregivers could be left with limited legal avenues to challenge.

Parents and caregivers who do not agree with the amount of funding allocated will have to make do with the budget-allocated additional support or self-fund to meet their children’s needs. We know that some targeted programs and support for children exceed the top range of level 4. In defence of these levels, the NDIA has claimed that people who live in higher socioeconomic areas receive higher budgets on average and that this is an effort to reduce that inequity. But will these changes actually deliver greater equity? Probably not. Families who have greater resources have the ability to provide more self-funded therapy for their children, but many families do not have this option.

 

Qualified staff

The paper highlights the importance of appropriately qualified (both in formal qualifications and experience) staff that should deliver early childhood interventions, and we couldn’t agree more. What is less clear for families and caregivers is the qualifications and experience of the early childhood partners, particularly as they have been charged with delivering short-term early intervention support for children up to the age of 9 and for children who do not meet the criteria for an individualised funded plan. The paper includes some suggested questions for parents to ask providers. Many of these would be relevant for parents to ask the early childhood partners, for example,

  1. What does the intervention include? How much time will be involved?
  2. How long have you been delivering the intervention? What is your expertise in this area?
  3. What improvements have you seen in children you’ve been working with?
  4. How will you follow up on the progress of my child? How will you update us on progress? How will our reflections on progress be included?
  5. How much will we (family and carers) be involved in learning and practicing the interventions?
  6. Will you provide us with training or guidance?

In general, part of the issue with this list of questions is that parents and caregivers may not be able to properly assess the answers providers give them. A question is only one half of the puzzle.


Conclusion

What are the implications of getting it wrong? There is no disputing the research that the early diagnosis of autism spectrum disorders and early intervention support have significant positive effects on children’s development, leading to increased social and economic participation. As the 2011 Productivity Commission Report stated ,‘Where the NDIA is satisfied that there is good evidence that a particular intervention is safe and leads to beneficial outcomes for people with a disability and has assessed the intervention to be likely to be cost-effective, the NDIA should allocate funding to it.’

It may be better for the NDIA to instead identify the types of evidenced programs and early child intervention support they are willing to fund, particularly considering effectiveness, value of investment for the scheme and, most importantly, positive outcomes for children and their families. The failure to provide evidence-based early intervention support at just levels of funds is short-sighted and will result in higher future costs of running the scheme.

Submissions are due on 14th May. The deadline was originally 30th April, but I guess they figured out that releasing a paper for families with young children over Easter and during the school holidays wasn’t the best option.

 

You can read the paper here: https://www.ndis.gov.au/community/have-your-say/interventions-children-autism-spectrum

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