Submission No 4

SUPPORTED DECISION-MAKING IN NSW

Organisation: Autism Spectrum Australia

Date Received: 4 March 2026

Level 5, Tower B, The Zenith, 821 Pacific Highway
Chatswood NSW 2067
1800 277 328
redacted
www.aspect.org.au\ ABN 12 000 637 267

WRITTEN SUBMISSION

Autism Spectrum Australia (Aspect) welcomes the opportunity to provide written feedback to the 2026 Parliament of NSW on the Inquiry into supported decision-making for adults with disability and older people in NSW.

About Aspect: Australia’s Autism Experts

Aspect is one of Australia’s leading national autism service providers and knowledge leaders. With nearly 60 years of experience, we partner with autistic people of all ages to co-design and deliver supports that are individualised, goal-driven, and evidence-based.

We provide a broad, lifespan approach to support people on the autism spectrum, their families, and their communities, helping them achieve their goals where they learn, live, and play.

Education: We run one of the world’s most extensive autism-specific educational programs, including 10 schools and 113 satellite classes (Kindergarten to Year 12).

Individual & Community Support: We offer a wide range of services for children, adolescents, and adults, including diagnostic assessments, therapies (Speech Pathology, Occupational Therapy, Psychology, etc.), positive behaviour support, individualised early childhood support, group and community-based services and transition support.

Knowledge Leadership: Our Aspect Research Centre for Autism Practice (ARCAP) ensures all our services are guided by the latest research and best practices.

Workplace & Community Partnerships: We help organisations become truly inclusive by providing environmental assessments, staff training, and sensory space design.

Our highly skilled NDIS delivery team of around 300 staff – including clinical psychologists, allied health professionals, specialist teachers, and support workers – are dedicated experts in the field of autism. Crucially, we employ many autistic and neurodivergent staff who bring invaluable lived experience and expertise to our teams.

We are funded through a mix of NDIS, state/federal initiatives, philanthropic support, and fee-for-service offerings, allowing us to develop innovative service models across most states and territories.

Aspect has responded to the below relevant terms of reference

a) the lived experience of people seeking to access appropriate support to make decisions for themselves

Aspect highlights the following points from the lived experience of autistic adults:

Communication Differences: The lack of tailored, accessible information (for example, easy read, visual aids) is a major barrier. There is a need for supporters and professionals to understand and accommodate diverse communication styles and preferences, including non-verbal communication, processing time, and literal interpretation.

Sensory and Environmental Needs: Autistic individuals may experience sensory overload in formal settings (for example, tribunal, doctor’s office), which can diminish a person’s ability to participate effectively in decision-making in that context.

Lack of Trust and Understanding: Autistic individuals have experiences of having their capacity and competence doubted, their preferences dismissed, or being pressured into decisions by family, carers, or professionals who do not truly understand autism-specific needs or the concept of supported decision-making.

Need for Consistency and Predictability: The importance of consistent supporters and clear, structured processes to reduce anxiety and enhance their ability to make informed choices.

It is critical to note that these factors may impact in the moment decision making and are not a reflection of decision-making capacity generally. Often supports are not provided to ensure that decision making is made accessible.

Based on the feedback from the Aspect Think Tank, the lived experience of autistic individuals seeking decision-making support is often characterized by a struggle against paternalism and a systemic lack of “the right to fail.”

The following themes emerged from this feedback group:

1. The “Cotton Wool” Effect

Many individuals report a lifetime of being over-protected, described metaphorically as being “wrapped in cotton wool.” While often motivated by a well-intentioned duty of care, this experience frequently leads to:

Reduced Agency: A feeling that one’s capacity is permanently underestimated.

Emotional Toll: Participants noted that this over-protection

felt really bad,“ leading to frustration and a sense of infantilization.

2. The Double Standard of Failure

A central component of this lived experience is the inequity in how “poor” decisions are treated.

For non-disabled people: A bad choice is viewed as a personal mistake or a learning opportunity.

For autistic people: A bad choice is often weaponized as evidence of incapacity, leading to the potential removal of future decision-making rights.

The Result: This creates a high-pressure environment where individuals feel they must be “perfect” to maintain their autonomy, whereas true support should allow for the dignity of risk.

b) barriers to implementing models for supported decision-making across legal, financial, health, education, employment and care systems in NSW

Aspect identifies significant systemic and cultural barriers for supported decision-making:

Legal/Financial Capacity Assessments: Legal frameworks often default to a

deficit“ model of capacity, leading quickly to substitute decision-making (guardianship/financial management) rather than exploring all options for support. There is a lack of training for legal and financial professionals on the principles and practice of supported decision making. Often engagement with those with more profound disability seems tokenistic rather than supporting the individual to engage in a way that is meaningful for them.

Restrictive Practices Consent Practices: Consent and decision making for the use of restrictive practices is complex. Substitute decision making is often relied upon when the person may withdraw their consent for the use of the practice.

Health/Care Risk Aversion: Health and care providers often adopt overly cautious, risk-averse approaches, defaulting to substitute decision-makers to protect themselves, thereby overriding the person’s will and preferences. This is likely linked to training and skills deficits within the industry in understanding decision making rights and completing capacity assessments. There is likely confusion for service providers where there is a Plan Nominee and their role for consent in service provision.

Education/Employment Lack of Tailored Adjustments: While rights exist, practical

reasonable adjustments

(for example, communication supports, environmental adaptations, or sensory supports) needed to support decision-making in these settings are often not understood or implemented.

Cultural Barrier: A persistent cultural barrier exists where professionals and the public struggle to genuinely believe that Autistic people or people with cognitive disabilities have the right to make their own decisions. Additionally, a cultural shift is required to ensure that the benchmark for decision-making capacity is not whether the decision is agreed to by other stakeholders.

c) the distinct experiences of and challenges faced by Aboriginal people and people from culturally and linguistically diverse backgrounds

Aspect advocates for reforms that explicitly address intersectional disadvantage:

Aboriginal People: The response would stress the need for culturally safe and responsive SDM, recognising the importance of family, community, and kin relationships in decision-making. Challenges include systemic distrust of government agencies and a lack of Aboriginal-led, autism-informed support services.

Culturally and Linguistically Diverse (CALD) Backgrounds: Challenges include the limited availability of decision-making resources in languages other than English, cultural variations in decision-making and family roles, and the need for support workers and interpreters who are not only bilingual but also understand the Autistic experience.

d) the role and functions of the Ageing and Disability Commission (ADC) in relation to supported decision-making

Aspect sees ADC as having a crucial, but potentially under-leveraged, role:

Education and Promotion: The ADC is well-placed to lead state wide information and education campaigns to build the skills of autistic adults, supporters, and the general community on the principles and practice of supported decision making.

Aspect recommends that there is education for individuals, families and supporter around decisions making rights and supporting decision making before people reach adulthood.

Systemic Advocacy: ADC should use its power to inquire into and report on systemic issues of abuse, neglect, and exploitation that include the denial of decision-making rights to drive systemic change across NSW agencies.

Complaints and Review: Ensuring the ADC’s complaints process is accessible and autism-friendly to address instances where a person’s will and preferences are being ignored or capacity is unfairly assessed.

e) possible changes to the functions of the ADC, including legislative amendments to the Act, to enhance supported decision-making

Aspect would propose the following enhancements:

Statutory Mandate for Supported Decision Making: A legislative amendment to the Ageing and Disability Commissioner Act 2019 to explicitly require the promotion and facilitation of Supported Decision-Making as a core function, giving it equal standing with the current focus on abuse, neglect, and exploitation.

Supported Decision Making Registry/Accreditation: Establishing a formal function for the ADC to either register or accredit formal Supported Decision-Making agreements, providing legal recognition and clarity (though some may caution against over-formalisation).

Oversight of Substitute Decision-Makers: Enhancing the ADC’s monitoring functions to specifically review whether court-appointed guardians (substitute decision-makers) have adequately demonstrated that they considered and exhausted all supported decision-making options before seeking a restrictive order.

f) measures to ensure that substitute decision-making is an alternative approach that is employed in appropriate and limited circumstances

Aspect’s agrees independent or supported decision-making should be sought, and substitute decision making should be the last resort.

Legislative Test: The legislative test for appointing a substitute decision-maker should be fundamentally reformed. It should not simply be about