Determining Substantial Reduction in Functional Capacity (SRFC)

April 2025

Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

Housekeeping

Session Overview

• Typical Development
• Substantially Reduced Functional Capacity (SRFC)
• Examples of SRFC
• Decision making and professional opinion
• Questions

Typical Development

Typical Development 2/3

• Early childhood (EC) partner expertise, experience and understanding of child development
• Consider:
  • Developmental milestones and the Early Years Learning Framework and the National Quality Standards
  • Ages and Stages
  • Raising Children’s Network

Typical Development 3/3

Matt is 16 months old, he is the youngest child, with four older siblings. His older sister (6 years) loves to look after him, carry him around all the time and will often incorporate him in play. Matt’s siblings are all at school, his family are very busy. He spends a lot of time in the car and at his siblings’ extra-curricula activities. Matt will shuffle on his bottom to move around the room at home and has only just commenced taking independent steps. Is Matt delayed in walking?

Sarah is 3.9 years and is not, yet toilet trained. Sarah’s mum (Jo) has a medial condition and shared that she had rushed to toilet train Sarah when she was 3:2 years old as Jo was having surgery. Jo reported that after complications, she was not able to start training Sarah again until after winter and by this time Sarah was 3:9 years old. Is Sarah delayed in toileting?

Jake is 4.5 years and has just started preschool. Jake is an active boy and loves spending time outdoors. His mum (Liz) reports that he loves building with small Lego but has never been interested in drawing and craft. Is Jake delayed in his fine motor skills?

Facilitation

Opportunities and context

Parents may not have had the opportunity to support self-care independence or follow through with routines and this may have some impact on the child’s routine-based skills.

For parents who are yet to send their child to childcare or preschool may have impacts on interactions with their peers.

Where children who haven’t had the opportunity at home to engage in problem solving opportunities (e.g. puzzles, interactive play) we may see delayed cognitive development.

Children with limited access to books and being read to have delayed communication and comprehension skills.

Limited outdoor or active play can hinder physical development

Substantial Reduction in Functional Capacity (SRFC) 1/2

Substantial Reduction in Functional Capacity (SRFC) 2/2

According to the [Applying to the NDIS (external)](redacted) guideline, substantially reduced functional capacity means that the child has a significantly lower ability to do everyday activities, when compared to children of the same age, or the child does things in a significantly different way to other children their age. The child would also need much more support to do the activity, compared to other children the same age.

Cognitive skills to document SRFC

• Remember - recall facts and basic concepts
• Understand - explain ideas or concepts
• Apply - use information in new situations, interpret
• Analyse - draw connections among ideas, compare
• Evaluate - justify a stand or decision, critique, weigh-up
• Create - produce new or original work

Examples of SRFC

Major life activity areas

The NDIS guideline defines the major life activity areas as follows:

• Self-care: how children take care of themselves, shower, bathe, dress, eat, drink, toilet, groom, and sleep.
• Receptive and expressive language: skills such as gesture, sign language, listening, giving, and receiving information, communicating wants and needs through facial expressions, vocalisations or speech, and interaction with others.
• Cognitive development: learning and applying knowledge.
• Motor development: This includes participation in everyday activities like moving around the home and community and manipulating objects.

Self-care - washing

Not SRFC redacted: [[s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

SRFC redacted: s47E(d) - certain operations of agencies

Self-care - dressing

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Receptive language - non-verbal messages

Not SRFC redacted: [[s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

SRFC redacted: s47E(d) - certain operations of agencies

Expressive Language - talking 1/2

Not SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Expressive Language - talking 2/2

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - attention and problem solving 1/3

Not SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - attention and problem solving 2/3 (1 of 2)

SRFC (1 of 2) redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - attention and problem solving 2/3 (2 of 2)

SRFC (2 of 2) redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - interpersonal interactions 1/2

Not SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - interpersonal interactions 2/2

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - maintaining relationships

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Motor - changing position

Not SRFC redacted: [[s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

SRFC redacted: s47E(d) - certain operations of agencies

Motor - hand and arm

Not SRFC redacted: [[s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

SRFC redacted: s47E(d) - certain operations of agencies

Motor - moving around

Not SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Motor - moving around

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

A word on children’s behaviour

More support than an individual discipline providing a unilateral response to a single problem.

This means the child needs support from more than one professional supporting one area of delay.

A child may be eligible if:

• support is required from two or more professionals from different disciplines even though it is required in one major life activity area only, or
• support is required from two or more professionals from different disciplines as there are supports needs in more than one major life activity area

A child is unlikely to be eligible if a support is required from one professional only.

Decision making - SRFC

• Unlikely SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)
• Likely SRFC redacted: s47E(d) - certain operations of agencies
• Highly likely SRFC redacted: s47E(d) - certain operations of agencies

Resources

Work Instruction: How to complete the EODD form

Appendix B – Work Instruction: How to complete the EODD form

Toolbox Talk – Information Gathering

Our Guidelines

What about children younger than 6 with developmental delay? | NDIS

Questions

Feedback

Children’s Practice Toolbox Talks

Complete Feedback Survey

Contact details

National Disability Insurance Agency

• 1800 800 110
• ndis.gov.au
• redacted: s47E(d)@ndis.gov.au
• Find us on Facebook/NDISAus
• Follow us on Twitter @NDIS

For people with hearing or speech loss

• TTY: 1800 555 677
• Speak and Listen: 1800 555 727

For people who need help with English

• TIS: 131 450

Self-care - Toileting

Not SRFC John (4 years) has recently become toilet trained during the day but continues to have accidents during the day, especially when engaged in play. He continues to require a night nappy and will request a nappy for a bowel motion during the day and home and childcare.

SRFC John (4 years) is not toilet trained. He will move to the corner of the room when having a bowel motion but does not yet indicate he has done a motion or when he has a very wet nappy to adults. He resists having his nappy changed and Jane reports needing to give him her phone to watch ‘Bluey’ to change his nappy on a mat on the floor. The EC partner coordinator observed nappy change time at home and the difficulties Jane is experiencing. At childcare, resistance to nappy changes is also reported - he requires the support of 2 educators - one to distract him and one to change his nappy. Jane and his childcare centre started to toilet train him 3 months ago by supporting him to sit on the toilet regularly throughout the day (again requiring encouragement and distraction). When regulated he will sit and has successfully done a “wee” a few times but continues to show very little toileting awareness. His childcare centre has introduced visual supports to help him learn and sequence of the toileting routine and report that he will not look at the visuals.

Receptive language - Spoken messages

Not SRFC Sarah (3 years) follows 1-2 step instructions when familiar and/or related to her daily routine. She requires adults to prompt her when an instruction is more than 2 steps and unfamiliar or unrelated. She is beginning to engage in simple conversations with adults by answering simple questions (Where is? What’s that?). Janine (mum) reports that she has noticed that Sarah pauses for a few seconds before answering and will also respond to some questions out of context.

Receptive language - Spoken messages

SRFC redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

Cognitive - purposeful experience

Not SRFC Pablo (5 years) has just started formal schooling. Prior to starting school, he did not attend ECEC and had limited exposure to children his own age. Diego (dad) shared that they spend time with extended family, including Pablo’s older cousins. At these times, his cousins will often lead his play and engage in rough and tumble play (functional impact).

Diego shared that Pablo enjoys construction play at home. During the observation at home, the EC partner observed Pablo building with his construction toys and did not incorporate pretend play when prompted (delay).

Pablo’s schoolteacher reported that during periods of free play, he will only engage in the same play experiences. She has observed that during tasks, he will observe his peers and copy the task (e.g. tabletop activities such as writing) (impairment).

Cognitive - purposeful experience

SRFC Pablo (5 years) has just commenced formal schooling. His schoolteacher has observed that he will often move away from his peers during learning tasks and becomes dysregulated (function). At these times he will fidget, move his chair away from the table, and has had 4 episodes when he hit a peer. His teacher reports that this is impacting his ability to engage in learning tasks and learn from others, as she has not observed him imitating his peers and instead withdraws from them (impairment). During free play and learning experience, she has also observed that he needs his toys or learning tools presented in the same way and will approach a task in the same order (impairment, function). In free play, he plays the same way and becomes frustrated when a peer enters his play and/or touches his toys (impact). When observing Pablo at home, the EC partner observed him lining up his toys and engaging in simple play which at times was not functional. Diego (dad) confirmed this rigidity in play and shared that he had not seen him engage in pretend play at home (delay, impairment, function). He also shared that he had limited exposure to his peers before starting school and when playing with his older cousins he would engage in physical play (e.g. chasing games) (opportunities)

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Information gathering to inform effective decision making

Children’s Taskforce

ndis.gov.au | November 2024

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Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

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Housekeeping

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Session Overview

• Purpose of information gathering and documentation
• Is a complex task
• Common practice gaps and tips
• Resources available
• Next steps
• Questions

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Learning Outcomes

By the end of the session, early childhood partners will:

1. Understand purposes of gathering information to inform decision making
2. Consider different ways to collate information to inform decision making
3. Reflect on best practices for gathering and presenting information
4. Explore how to avoid common gaps when presenting information
5. Identify key resources available to support process and practice

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Purpose of information gathering and documentation

• Ensures a positive NDIS journey right from the start
• Informs decisions at specific points along the pathway – partner and delegate decisions
• Ensures positive outcomes are achieved for children and their families
• Reduces the number of times families tell their story
• Can also inform organisational priorities

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Information gathering and documenting to inform decisions

• Your daily decisions can vary in complexity and impact
• Many tasks required to inform decisions require high levels of cognitive skills and require sufficient time
• Tools such as checklists and templates may help to streamline parts of the process but cannot replace the higher order thinking and writing skills required
• Consider how your notes may be used

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Cognitive skills required for quality information gathering and documentation to inform decisions

• Remember - recall facts and basic concepts
• Understand - explain ideas or concepts
• Apply - use information in new situations, interpret
• Analyse - draw connections among ideas, compare
• Evaluate - justify a stand or decision, critique, weigh-up
• Create - produce new or original work

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Community Connections – practice gaps and tips

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Community Connections – practice gaps and tips

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Community Connections – practice gaps and tips

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Ecomap - example 1

Accessible slide

[Diagram showing relationships around Tom (aged 4y, 5m) and Jo (mum), including Dad (Dan), Stepmum (Sue), Paternal grandparents (John and Jacky), Maternal grandparents (Gill and Jack), Maternal aunt (Sonya), ABC ECEC, Playgroup, and Dr Who (GP)]

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Ecomap – example 2

Accessible slide

[Diagram showing detailed ecomap relationships for Tom and Jo (mum), including Dan, Sue, grandparents, aunt, ABC ECEC, Playgroup at the church, Child and Family Nurse, Dr Who (GP), 123 Speech Therapy, and ALL Swim School, accompanied by a key]

Key

redacted: [s47E(d) - certain operations of agencies](/foi-library/releases/bc455e3f7247-foi-24-25-0515-documents/document-015__47e-d-certain-operations-of-agencies/)

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Community Connections EODD – practice gaps and tips

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Community Connections EODD – practice gaps and tips

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Community Connections case study

• Met with a mother and her child (3-year-old) for an early connections meeting
• The child was non-verbal and had significant functional impacts across most domains
• Routines Based Interview and ecomap completed – this identified challenges for the family unit in various areas of their daily life, limited connections and beliefs limiting the child’s exposure to learning opportunities
• The Coordinator used the relationship she had formed to support mum to understand that these opportunities would be beneficial for her child – read to the child and take him to the park
• The coordinator received a call 3-4 weeks after the meeting from mum letting her know that the child had started to make verbalisations and was starting to engage in play at the playground

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Early Supports – practice gaps and tips

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Early Supports - practice gaps and tips

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Early Supports - practice gaps and tips

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Personal Environmental Circumstance (PEC) - practice gaps & tips

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Plan Implementation – practice gaps and tips

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Check-ins - practice gaps and tips

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Plan Change Case – practice gaps and tips

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Available resources

• Previous Toolbox Talks
• Masterclasses
• Knowledge Articles – check for updates to ensure the most current version
• PACE Assist modules
• Operational Guidelines and Booklets and Factsheets
• Work Instruction: How to complete Form – Evidence of developmental delay
• Published EODD examples
• Factsheets – Evidence of developmental delay, and How to Download, Sign and View the Form-EODD
• Form – EC – Applying best practice principles in early supports (self-evaluation and reflection resource)

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Key messages and next steps

• Spend time using your professional expertise to develop relationships and to un-pack, analyse, interpret, formulate, update and to document information to high standard
• When done well it informs the correct decisions are made – your decisions, for your organisations, but also for others in the Agency throughout a child’s NDIS journey
• Enables the child and family’s unique story is captured with consistency and without need to re-tell the story multiple times
• Scheme sustainability principle – the right children are getting the right supports at the right time
• Reflect on any tips you can develop further and start using in your daily work
• Use available resources and embed a continuous improvement culture into your workplace

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Questions

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Accessible ecomap example 1

• This slide shows a visual representation of an ecomap
• It shows Tom and his Mum in the middle with arrows pointing out from their box out to other boxes listing informal supports
• There are also arrows out from the middle box to other boxes listing a childcare centre, playgroup and GP
• There is no details about the strengths any of these supports provide Tom and his Mum

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Accessible ecomap example 2

• This slide shows a visual representation of an ecomap with more detail
• This example includes a key with different colours representing different strengths of the supports shown in boxes
• This example also shows more detail included in the boxes for the childcare centre, the playgroup and the General Practitioner (GP)
• This example includes more boxes offering support to Tom and his Mum
• Boxes are the Child and Family Health Nurse, a Speech Pathologist and a swim school
• Again, more detail is included in these boxes as well as differently coloured arrows indicating the strengths these supports provide.

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