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Guide - Therapy supports Appendix B

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Guide - Therapy supports Appendix B

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a planner delegate, internal review delegate, national reassessment delegate, local area coordinator, early childhood partner, technical advisors, liaison officers (HLO/JLO) or complex support needs (CSN) planner to understand:

  • case examples of participants who need therapy supports.

Recent updates

October 2023

This guidance comes from the Practice Guide – Understanding Therapy Supports. We’ve made minor updates to change any NDIS Business System language to PACE language. We’ll make improvements to this guidance in the future.

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Case example

Arnold is 10 years old. He lives at home with his parents and two siblings. He has a diagnosis of Down Syndrome and is experiencing difficulty with communication, social skills and mobility. He attends a mainstream school where he receives support from a teacher’s aide.

During his previous plan, Arnold had difficulties building rapport with his therapists. This was due to negative behaviours and difficulty travelling to and waiting in his therapist’s office. This resulted in intermittent engagement and Arnold not using all of his capacity building supports. The Allied Health Professionals (AHPS) progress report from the previous plan period

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recommended using a multidisciplinary approach of music, occupational and speech therapy, focused on skill-building in Arnold’s natural environments to assist him to pursue his goals.

Progress report recommendations

16 hours of occupational therapy to work towards Arnold’s goal “To join in playground games with friends”:

  • Develop strategies to assist Arnold to increase motor control.
  • Develop strategies to assist Arnold to increase social skills.
  • Provide guidance to important people in Arnold’s life on ways he can be supported to join

in games and the types of exercises and games he can do to build his endurance and muscle control.

Expected outcomes: Arnold will participate in a structured climbing activity or game with two peers with minimal adult support.

12 hours of speech therapy to work towards Arnold’s goal of “Be able to tell people what I want or need”:

  • Communicate using 1-2 word phrases.
  • Support communication through picture exchange while developing speech.
  • Provide guidance to the important people in Arnold’s life on techniques specific to Arnold to assist with communication.

Expected outcomes: Arnold will use 1-2 word picture exchange to request a motivating item or a need.

7 hours of music therapy to develop strategies to motivate Arnold to engage with other therapists by:

  • Writing a song to motivate Arnold to participate in 1-2 word phrases.
  • Use rhythmic and motivational elements of music to encourage Arnold to engage and participate in gross and fine motor activities.

Outcomes: Arnold will engage with the occupational therapist, speech pathologist and music therapist to develop his communication and motor skills.

  • $300 of low cost assistive technology (AT) to develop communication supports. Picture exchange.
  • Travel associated with delivery of supports in Arnold’s natural environments

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• 10 hours of report writing.

Check-in conversation

During the check-in, Arnold and his family discussed how they and other people in Arnold’s life can assist him to develop his skills and become more independent. The strategies they discussed included:

• AHPs will meet at the start and mid-way through Arnold’s plan to discuss strategies and how these will complement each other. • Each AHP will develop strategies to assist Arnold to work towards his goals and guide the people in Arnold’s life on building his skills and independence. • The school is using picture exchange with other students and will support Arnold to use picture exchange if he is unable to verbalise his wants or needs. • Arnold’s siblings are close to him and enjoy playing games. They can find it difficult when he gets upset. Arnold’s parents and siblings have shown enthusiasm with structuring some group activities/games with the family to help him develop his social skills.

Arnold attends Scouts on a Thursday night. He has a support worker to assist him to attend and participate in activities. The support worker can implement strategies to assist Arnold to be more independent in interactions with peers.

Outcome

The included information from the check-in and progress report provides enough evidence for the planner to make a reasonable and necessary decision to include the recommended therapy support hours in Arnold’s next plan.

Core – Consumables

$300 of low cost assistive technology has been included for the development of individualised picture exchange cards as recommended by the speech pathologist. These cards will support Arnold to communicate which will develop independence and increase participation in social, school and community activities. This will reduce reliance on supports in the future. Funding has been included in Capacity Building – Improved Daily Living Skills for Arnold’s supports to receive training on implementing communication strategies.

Capacity Building – Improved Daily Living Skills

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45 hours of support has been included for a multidisciplinary team to build Arnold’s capacity in communication, mobility and social skills. The multidisciplinary team will meet at the start and mid-way through the plan period to create consistency in their approach.

Arnold had difficulties in the last plan period engaging with therapists and is highly motivated by music. The progress report from the AHPs has recommended a music therapist be engaged to develop strategies that will motivate Arnold to engage with other therapists to develop his skills. This will increase participation in school, home and community life and is likely to result in a reduced need of supports in the future.

Arnold will be assisted to implement communication, mobility and social skills strategies by his family at home, teacher’s aide at school and support worker during Scouts.

Funding has been included for:

  • 16 hours of occupational therapy to work with Arnold to achieve his goal of joining in playground games with friends. The occupational therapist (OT) will provide training to informal and formal supports on how to implement these strategies.
  • 12 hours of speech therapy to work with Arnold to achieve his goal of telling people what he wants or needs. The speech pathologist will work with Arnold to develop strategies to communicate using picture exchange, while he develops 1-2 word phrases in speech. The speech pathologist will provide training to informal and formal supports on how to implement these strategies.
  • 7 hours of music therapy to develop strategies to motivate Arnold to engage with other therapists.
  • 10 hours of report writing to understand the benefits and gains achieved by Arnold across the plan period.

Funding has been included for travel of the allied health professionals to deliver supports in Arnold’s natural environments.

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Version control

Version Amended by Brief Description of Change Status Date
0.1 BCK161 Draft Appendix B to go with Guide — Therapy supports transitioned from Practice Guide — Understanding Therapy Supports. DRAFT 2023-03-03
0.2 MJB576 Peer review DRAFT 2023-03-10
0.3 BCK161 Actioned peer review DRAFT 2023-03-15
0.4 DDO0014 EL1 review and edit DRAFT 2023-03-29
1.0 JS0082 Class 1 Approval APPROVED 2023-03-30

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Version Amended by Brief Description of Change Status Date
1.1 REB563 Continuous improvement enhancements.
Updates to formatting in alignment with
new Knowledge Article template.
Updated links and user roles added. DRAFT 2023-09-21
2.0 JSO0082 Class 1 Approval DRAFT 2023-09-22

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