National Disability Insurance Scheme

Outcomes Framework

Short Form Questionnaires

Family Questions for child participants aged 0-14

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Family Questions for child participants aged

0-15

Introduction

Thank you for participating in our survey. The purpose of these questions is to find out how NDIS participants and their families and carers are going in different areas of their lives. The questions are an important part of pre-planning, and will help us to develop a plan that provides the right supports. Because we ask the questions again at plan review, we will also be able to see what progress has been made, and whether any adjustments to plans are needed. Information from the questions will also be important for tracking the progress of the NDIS, and will help to improve the Scheme.

Family member/carer information

1. Please enter the participant’s NDIS ID number	Free text (check for valid number of characters?)
2. What is your relationship to the participant?	Mother Father Other (please specify):
3. Are you currently working in a paid job?	Yes No (go to 7)
4. Is it permanent or casual?	Permanent Casual
5. What is the industry of employment?	Free text
6. What are the typical hours per week worked (range)?	0 hours More than 0 but less than 8 hours 8 hours to less than 15 hours 15 hours to less than 30 hours 30 or more hours
7. What is your annual income, before tax and other deductions? Include all sources (e.g. wages, investments and Government pensions and benefits)?	$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
8. What is the annual income of your household, before tax and other deductions? Include all sources (e.g. wages, investments and Government pensions and benefits)?	$0-$9,999 $10,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$59,999 $60,000-$79,999

CONFIDENTIAL AND NOT FOR FURTHER DISTRIBUTION

	$80,000-$99,999	$100,000-$149,999	$150,000-$199,999	$200,000+	Not disclosed

Please specify whether you currently receive any government benefits:

	Yes	No
Carer payment
Carer allowance
Other (please specify):	Free text

Are you currently studying?

Please answer the following questions about the family member/ carer

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Domain 1: Families know their rights and advocate effectively for

their child with disability

Question Number	Statement/Question	Response options
1	I am able to identify the needs of my child and family	☐ Yes ☐ I have some difficulty ☐ I have a great deal of difficulty
2	I am able to access available services and supports to meet the needs of my child and family	☐ Yes ☐ I have some difficulty ☐ I have a great deal of difficulty
3	I am able to advocate (stand up) for my child: I am able to speak up if we have issues or problems with accessing supports	☐ Yes ☐ I have some difficulty ☐ I have a great deal of difficulty
4	What barrier to access and/or advocacy have you experienced? (choose all that apply)	☐ None ☐ Limited access to information and resources ☐ Lack of knowledge or understanding about my rights/the rights of my child ☐ Time constraints (i.e. not enough time to look into or pursue) ☐ Lack of support ☐ Fear of potential consequences ☐ Other
5	Has the NDIS improved your capacity to advocate (stand up) for your child?	☐ It’s our first plan ☐ Yes ☐ No

Domain 2: Families feel supported

Question Number	Statement/Question	Response options
1	I have friends and family that I see as often as I like	☐ Yes ☐ No
2	I have people who I can ask for practical help as often as I need	☐ Yes ☐ No
3	I have people who I can ask for childcare as often as I need	☐ Yes ☐ No
4	I have people who I can talk to for emotional support as often as I need	☐ Yes ☐ No
5	I get the services and supports I need to care for my child with disability	☐ Yes ☐ I would like more support ☐ I would like different support

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Domain 3: Families are able to gain access to desired services, programs, and activities in their community

Question Number	Statement/Question	Response options
1	I am satisfied with the amount of say I had in the development of my child’s NDIS plan	☐ Yes ☐ Somewhat ☐ No ☐ We are beginning our first plan
2	I am satisfied with the amount of say I had in the implementation of my child’s NDIS plan	☐ Yes ☐ Somewhat ☐ No ☐ We are beginning our first plan
3	Has the NDIS improved your access to services, programs and activities in the community?	☐ It’s our first plan ☐ Yes ☐ No

Domain 4: Families help their children develop and learn

Question Number	Statement/Question	Response options
1	I know what specialist services are needed to promote my child’s learning and development	☐ Yes ☐ To some degree ☐ No
2	I know what my family can do to support my child’s learning and development	☐ Yes ☐ To some degree ☐ No
3	I get enough support to feel confident in parenting my child	☐ Yes ☐ To some degree ☐ No
4	How confident do you feel in supporting your child’s development?	☐ Very confident ☐ Somewhat confident ☐ Not very confident ☐ Not at all confident
5	Has the NDIS improved your ability/capacity to help your child develop and learn?	☐ It’s our first plan ☐ Yes ☐ No

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Domain 5 Families enjoy health and wellbeing

Question Number	Statement/Question	Response options
1	In general, my health is	- Excellent - Very good - Good - Fair - Poor
2	I/(my partner and I) am/are able to work as much as I/we want	- Yes (go to 4) - No, I would like to work more - No, my partner would like to work more - No, both my partner and I would like to work more
3	What are the barriers to working more? (Choose all that apply)	- Situation of child with disability - Availability of jobs - Available jobs do not have sufficient flexibility (e.g. of hours) - Other (please specify):
4	I/(my partner and I) am/are able to engage in social interactions and community life as much as I/we want	- Yes (go to 6) - No, I would like to engage more in social interactions and community life - No, my partner would like to engage more in social interactions and community life - No, both my partner and I would like to engage more in social interactions and community life
5	What are the barriers to engaging more in social interactions and community life? (Choose all that apply)	- Situation of child with disability - Limited social networks - Time constraints - Cost - Other (please specify):
6	Has the NDIS improved your health and wellbeing?	- It’s our first plan - Yes - No

Thank you for completing the family member/carer questions. If you have any further comments, please enter them below.

Any comments?