FOI 24/25-0913
Case Management Guide
DOCUMENT 1
Applied Behavioural Analysis (ABA)
OFFICIAL For internal Use Only
Field Content Reference Documents
Title Applied Behavioural Analysis (ABA) This document is part of a suite of guidance documents
Purpose for case managers to use in formulating their approach
P to managing individual cases before the Administrative
Review Tribunal (ART). ABA therapy refers to a non-pharmacological behavioural intervention to help children diagnosed Applied Behavioural with autism spectrum disorder (ASD), intellectual Analysis (ABA) Therapy disability or developmental delay to develop skills in | Disability Support communication, self-care, and social interaction, and Guide or reduce behaviours that are barriers to learning and
Scope Behavioural
participation.
ABA is one of several different evidence-based approaches to support children with ASD. It is characterised by intensive interventions, delivered by trained personnel in a clinical or childcare environment.
interventions | NDIS
Supporting Autistic Children Guideline |
Autism CRC
Escalation to
If a matter is within the parameters of this document,
Appeals and the Administrative Review Branch Manager may Litigation approve proceeding to hearing. Where there is Oversight substantial risk or the matter is outside the parameters Committee of this document, the matter should be referred to (ALOC) ALOC. The ART process is often seen as stressful and a. adversarial by the participants and our focus should be on resolving issues as practicably and quickly as Appendix B to the possible. The role of the NDIA is to assist the ART and Legal Services Current the participant in reaching the best possible resolution | Directions 2017 National for the participant by agreement. Section 34(1) of the Disability The NDIA will fund ABA therapy when the NDIA is National Disability Insurance satisfied it is a reasonable and necessary support. Insurance Scheme Act Agency (NDIA) | Where ABA therapy is to be funded as an early 2013 policy onthe | intervention support, the NDIA must also be satisfied Rul d f subject that it is likely to reduce a participant’s need for future ures 3.2 an 3.3 or oo the National Disability Gisabikity supports. Insurance Scheme Supports for children with ASD should be evidence- (Supports for
based and delivered using a family-centred approach that incorporates individual planning. ABA therapy is
Participants) Rules 2013
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Case Management Guide
Applied Behavioural Analysis (ABA)
OFFICIAL For internal Use Only
likely to NOT be delivered with a family centred approach and more likely to be delivered in an allied health clinic or childcare/school environment.
Operational Guideline — Applying to the NDIS
Operational Guideline
— Early childhood approach
ECIA National Guidelines — Best
Practice in Early Childhood Intervention
Council of Australian Governments (COAG) — Principles to determine
responsibilities of the NDIS and other service
systems
NDIA Posture in relation to this subject
It is important that the NDIA closely consider a participant’s unique circumstances, including their functional impairment, individual goals and aspirations, and evidence which considers their specific circumstances.
The NDIA is likely to fund up to 20 hours per week of ABA therapy where it is considered likely to be effective and beneficial.
Evidence from a meta-analysis of clinical studies indicates that it is unlikely that more than 15 hours per week of ABA will be effective and beneficial.
Where more than 20 hours of ABA is requested, the NDIA is likely to run the matter to hearing. The matter will turn on the question of the participant’s age, and their own capacity as well as their family’s capacity to meet the time obligations of ABA therapy.
Where a participant has commenced school and requests more than 10 hours of ABA per week, the NDIA must consider the capacity of the participant and their family to sustain both full-time schooling and intensive therapy.
Operational Guideline — Creating your plan CXZS v National Disability Insurance Agency [2021] AATA 511
Intervention Recommendations for Children with Autism in
Light of a Changing Evidence Base | Report, Dr M Sandbank et al (Generalised findings, specific to older children)
Autism CRC early
intervention report | NDIS
The Department of Defence (USA) | Comprehensive Autism Care Demonstration Annual Report 2021
A Multisite Randomized Controlled Trial
Comparing the Effects
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Case Management Guide
Applied Behavioural Analysis (ABA)
OFFICIAL For internal Use Only
of Intervention Intensity and
Intervention Style on
Outcomes for Young Children With Autism -
ScienceDirect
Evidence recommended to inform NDIA position in a specific matter before the Administrative Review Tribunal (ART)
To consider funding for ABA therapy, the NDIA requires evidence of a relevant diagnosis from a paediatrician, psychiatrist, psychologist, or a specialist multi- disciplinary team. The Diagnostic and Statistical
Manual of Mental Disorders, fifth edition (DSM-5) is the NDIA’s preferred diagnostic standard.
Clinical evidence that ABA therapy satisfies the criteria in section 34(1) is also required to be provided by a psychologist, occupational therapist, paediatrician or, where a participant has received ABA therapy previously - an ABA therapist.
Clinical evidence must address the link between ABA therapy and a participant’s goals and specify how the requested number of hours of ABA therapy will be effective in assisting the participant to achieve those goals.
Evidence from a behavioural paediatrician who has assessed the participant in person is recommended.
Australia’s First National Guideline for the Assessment and
Diagnosis of Autism
Spectrum Disorders | Autism CRC
List A: Conditions that are likely to meet the disability requirements
NDIS
Section 34(1) of the National Disability Insurance Scheme Act 2013
Rules 3.2 and 3.3 of the National Disability Insurance Scheme (Supports for Participants) Rules 2013
Persons Giving Expert and Opinion Evidence Guideline | Administrative Appeals Tribunal
Other considerations
The NDIA must also be satisfied that ABA therapy meets the National Disability Insurance Scheme (NDIS) funding criteria — in particular, that it:
e is unlikely to cause harm to a participant or pose a risk to others; and e is not duplicated by other funded supports.
Consider the context and circumstances of the family and their capacity to support the delivery of 15-20 hours of intervention in the learning environment of the child (usually the home or school).
Rule 5.1 of the National Disability
Insurance Scheme (Supports for
Participants) Rules 2013
How we work out if a support meets the funding criteria | NDIS
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Case Management Guide
Applied Behavioural Analysis (ABA)
OFFICIAL For internal Use Only
Also consider:
e children with greater baseline cognitive skills and higher adaptive behaviour scores at baseline have better outcomes from early
Autism CRC early intervention report |
NDIS
Section 3 of the
intensive ABA therapy; and National Disability e younger children have better outcomes from Insurance Scheme Act ABA therapy. 2013 The NDIA must also have regard to a participant’s choice and control in the pursuit of their goals and the planning and delivery of their supports. The AAT will not consider whether ABA therapy is an FRCT v National
effective early behavioural intervention strategy for children diagnosed with ASD, but whether ABA therapy satisfies the criteria in section 34(1), which will be determined on the facts of each case.
Disability Insurance Agency [2019] AATA 1478
Previous WKZQ v National matters that When considering funding for ABA therapy, the NDIA -__
. . . . Disability Insurance may advise must also consider the promotion of an applicant’s Agency [2019] AATA the NDIA choice and control in the pursuit of their goals and the
a: . . : 1480 position planning and delivery of their supports. It is the responsibility of the NDIA to show that ABA Os v National uN ational . ’ . Disability Insurance therapy can be substituted with other mainstream . . Agency [2021] AATA therapies and achieve the same outcomes for the 511 applicant. — Docume Assistant Director, Policy Continuous Improvement admin Approved Director, Continuous Improvement
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