National Disability Insurance Scheme Outcomes Framework Short Form Questionnaires Participants from 0 to before starting school v3.0

FOI 24/25-1267

DOCUMENT 4

National Disability Insurance Scheme

Outcomes Framework

Short Form Questionnaires

Participants from 0 to before starting school

v3.0

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Participants from 0 to before starting school

In this first section, I will ask you some background questions.

Participant information

Question	Answer
1. NDIS Participant ID number	Pre-populated NDIS participant number
2. Who does the child currently live with?	☐ With parents ☐ With other family members ☐ With people not related to participant (e.g. foster carers) ☐ Other, please specify:
3. What type of housing does the child currently live in?	☐ Private home: owned by family/carers ☐ Private home: rented from private landlord ☐ Private home: rented from public authority ☐ Other, please specify:
4. What is the annual income of the child’s household, before tax and other deductions? (Don’t include the income of people the participant only shares accommodation with, e.g. in a group home)	☐ $0-$9,999 ☐ $10,000-$19,999 ☐ $20,000-$29,999 ☐ $30,000-$39,999 ☐ $40,000-$59,999 ☐ $60,000-$79,999 ☐ $80,000-$99,999 ☐ $100,000-$149,999 ☐ $150,000-$199,999 ☐ $200,000+ ☐ Not disclosed
5. Is compensation being sought, or has compensation previously been sought, in relation to the child’s disability?	☐ Yes ☐ No

These next set of questions relate to the child’s development, use of specialist services and autonomy.

Domain 1: Daily living

#	Statement/Question	Answer options
1	Do you have any concerns about your child’s development in the following areas? Please answer Yes or No for each area.
	• Gross motor skills (e.g. crawling, standing, walking, catching a ball)	☐ Yes ☐ No
	• Fine motor skills (e.g. drawing, stacking blocks, pincer grasp)	☐ Yes ☐ No

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#	Statement/Question	Answer options
	• Self-care (e.g. washing or eating)	☐ Yes ☐ No
	• Eating/ Feeding (e.g. chewing, swallowing, transitioning to table foods)	☐ Yes ☐ No
	• Social interaction (e.g. playing with peers, interacting with others, separating from parents, behaviours such as biting, hitting, frequent tantrums)	☐ Yes ☐ No
	• Language/Communication (e.g. following directions, speaking, expressing themselves, participating in conversations)	☐ Yes ☐ No
	• Cognitive development (e.g. understanding concepts, problem solving)	☐ Yes ☐ No
	• Sensory processing (e.g. concentration, responses to changes in routine or certain textures, dislikes bath or grooming activities)	☐ Yes ☐ No
	• Please specify any other areas of concern:	Free text
2	My child uses specialist services (e.g. speech pathology, occupational therapy) that assist their learning and development	☐ Yes ☐ No
3	These services help my child gain the skills she/he needs to participate in everyday life (e.g. go to preschool)	☐ Yes ☐ No
4	These services support me to assist my child	☐ Yes ☐ No
5	Has the NDIS improved your child’s development?	☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area)
6	Has the NDIS improved your child’s access to specialist services?	☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area)

Domain 2: Choice and Control

#	Statement/Question	Answer options
1	My child is able to tell me what he/she wants	☐ Yes, without assistance ☐ Yes, with assistance ☐ No
2	Has the NDIS helped increase your child’s ability to communicate what they want?	☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area)

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These next questions and statements centre on relationships, including friendships and the family dynamic.

Domain 3: Relationships

#	Statement/Question	Answer options
1	My child gets along with his/her brother(s)/sister(s)	☐ Yes ☐ No ☐ No brothers or sisters
2	My child can make friends with people outside the family	☐ Yes ☐ With some people ☐ No
3	My child joins me when I complete tasks at home	☐ Often ☐ Sometimes ☐ Never
4	My child joins me when I complete tasks outside the home (e.g. shopping, sport)	☐ Often ☐ Sometimes ☐ Never
5	My child fits in with the everyday life of the family	☐ Yes ☐ No
6	Has the NDIS improved how your child fits into family life?	☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area)

Finally, I would like to understand a little more about your child’s social and community involvement.

Domain 4: Social, community and civic participation

#	Question	Answer options
1	Do you use any form of childcare?	☐ Yes ☐ No
2	Please specify which of the following types of childcare you use, and whether you use them when you and/or your partner are at work, or when you are not at work. Please select one answer per childcare type.
		Use while we’re at work
	• The child’s brother or sister	☐
	• Another relative who lives with you (paid or unpaid)	☐

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#	Question	Answer options
	• Another relative who doesn’t live with you (paid or unpaid)	☐
	• A friend or neighbour (caring for the child either at your home or in their home; paid or unpaid)	☐
	• A nanny or babysitter who is paid to come to your home	☐
	• A nanny or babysitter who is paid to care for your child in their home	☐
	• Family day care, long day care, any other care at a Child Care Centre	☐
	• The child goes to your (or your partner’s) work	☐
3	My child has friends that he/she enjoys playing with	☐ Yes ☐ No
4	These friends are at (choose all that apply):	☐ Preschool ☐ Playgroup ☐ Social or family gatherings (e.g. children of friends or extended family) ☐ Other community activities ☐ Other (please specify):
5	My child participates in age appropriate community, cultural or religious activities	☐ A few times a week ☐ About once a week ☐ Once every two weeks ☐ About once a month ☐ Less than once a month ☐ Never
6	At these activities, I think my child is (choose one option):	☐ Welcomed ☐ Actively included ☐ Mostly an observer ☐ Tolerated ☐ Made to feel unwelcome ☐ Is present but not really a part of the group
7	I would like my child to be more involved in community activities	☐ Yes ☐ No
8	The barriers to my child being involved in community activities are (choose all that apply):	☐ My child’s disability (e.g. ability to communicate) ☐ Other children are not welcoming ☐ Other families are not welcoming ☐ I am too busy ☐ Transport ☐ Cost ☐ Other (please specify):

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#	Question	Answer options
9	Has the NDIS improved how your child fits into community life?	☐ Yes, a lot ☐ Yes, a bit ☐ No, not at all ☐ N/A (did not need help in this area)

Conclusion

Thank you for answering these questions. To close this out I just need to record (confirm) who completed the questionnaire. You may also provide some comments if you wish.

Question	Answer options
Who responded to the questions?	☐ The participant’s mother ☐ The participant’s father ☐ The participant’s grandmother ☐ The participant’s grandfather ☐ Other, please specify:
Any comments?

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