National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1743
To whom it may concern,
I am an early career occupational therapist working with children with autism and developmental delays in a paediatric setting. In my work, I support children, families, and schools to build skills for everyday participation in self-care, learning, play, and community life. I appreciate the opportunity to contribute to discussion on the proposed NDIS reforms and offer the following reflections grounded in clinical practice.
Consistent with what is widely recognised in paediatric practice, early and ongoing support plays a critical role in shaping long-term outcomes. When children can access timely intervention, they are more likely to develop functional communication, independence, and meaningful engagement in education and social environments. These gains reduce the likelihood of more complex challenges later in life. In contrast, when support is delayed or reduced, I often see small developmental gaps widen. Children who had been making gradual progress may become anxious, disengaged, or dysregulated when therapy is interrupted, and often require more intensive input later. Early and consistent support is not only clinically appropriate, it is a practical and cost- effective investment.
A key concern relates to the increasing reliance on standardised or snapshot-style reassessments. Many children I work with do not present consistently across settings. They may appear capable in structured, one-to-one assessment environments, while experiencing significant difficulty in classrooms, at home, or in the community. This can be due to masking, sensory overload, fatigue, and the cumulative demands of daily life. These factors are not easily captured in brief assessments, yet they significantly impact functional participation. Without incorporating real-world context, there is a risk that reassessments underestimate support needs, resulting in reduced funding despite ongoing challenges.
The reassessment process can also place a considerable burden on families. Parents frequently describe the emotional strain of needing to repeatedly justify their child’s disability, often in deficit-focused ways. This is alongside the practical demands of organising reports, attending appointments, and managing uncertainty about future supports. For families already navigating complex needs, this contributes to stress and burnout, and can undermine a strengths-based, neuroaffirming approach to care.
There is also concern that tighter thresholds may shift the system toward a more reactive model, where support is accessed only once difficulties become severe. Many children present with moderate but significant needs. They may be coping in some environments, but only with substantial effort and informal support. Without appropriate intervention, they are at risk of disengagement from school, escalating behavioural and emotional challenges, and later mental health concerns. If they no
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1743
longer meet eligibility criteria, these children may fall into a gap between systems, with needs that are real but not adequately supported.
The broader economic implications of reduced access to early and ongoing support are significant. When children are supported to participate in education and build independence, they are more likely to contribute to the workforce over time. Their parents are also better able to maintain employment. In contrast, insufficient support often leads to reduced parental workforce participation, increased reliance on income support, and greater demand on health, mental health, and education systems. These outcomes carry substantial long-term costs and represent a loss of human potential.
Continuity of care is another important consideration. Effective paediatric therapy relies on trust and consistency between the clinician, child, and family. Progress is often gradual and relational. When funding instability disrupts this, children may lose access to trusted clinicians, and rebuilding engagement can take time and resources. Maintaining continuity supports better outcomes and more efficient use of services.
It is also important to recognise that much of the paediatric allied health workforce now operates within private practice. Reducing funding stability risks further workforce pressures, including clinicians leaving the sector, longer waitlists, and reduced access, particularly in already underserved communities. A stable system is essential to maintain capacity and prevent widening inequities.
Across all of these factors, effective supports are those that are flexible, functional, and responsive to real-world participation. Neuroaffirming, relationship-based approaches recognise the complexity of children’s needs and allow support to be tailored to their environments and developmental stage.
Reform of the NDIS is important to ensure long-term sustainability. However, it is equally important that changes do not unintentionally reduce access to early, preventative, and ongoing supports that are known to improve outcomes and reduce long-term costs. A balanced approach that recognises real-world functioning, reduces reassessment burden, maintains access for children with moderate needs, and supports continuity of care will better serve children, families, and the broader community.
Thank you for considering the perspectives of clinicians, children, and families who engage with these systems every day. I remain hopeful that future reforms can achieve a balanced approach that supports both long-term sustainability and the ability for children and young people with disability to participate meaningfully, develop safely, and reach their potential within their homes, schools, and communities.
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 1743
Kind Regards,
Ella Fleming (she/her)
Occupational Therapist