Submission 1775

Submission to Parliament

NDIS Amendment Bill — Concern 1: Proposed Definition of Functional Capacity

Submitted by an Occupational Therapist · May 2026

ABOUT ME

I am a sole trader mobile Occupational Therapist specialising in paediatric practice. I work exclusively with autistic and neurodivergent children and teenagers, from 2 to 18 years of age, across their homes, schools and communities. I do not work within a clinic or institution — I go where my clients actually live their lives. That context is not incidental to my practice. It is the whole point.

I am submitting this because the proposed changes to the definition of functional capacity would directly affect the children and families I support every day. I write not as a policy analyst, but as a clinician who sits at kitchen tables, school desks and therapy rooms and sees, up close, what disability actually looks like in real life.

Imagine being assessed for how well you can walk — but being asked to do it without your prosthetic leg. That is the logic embedded in the proposed definition of functional capacity.

THE CONCERN

The Bill proposes that functional capacity be assessed on the basis of what a person can do without assistance, without assistive technology, and independent of environmental context. As an OT, I am concerned this will produce assessments that look administratively clean but are fundamentally disconnected from how disability is experienced.

Occupational therapy is built on one core principle: function always occurs within context. A person does not exist in isolation from their environment, their supports, or the adaptations that make daily participation possible. Stripping those away does not reveal the real person — it reveals an artificial version of them.

WHAT I REGULARLY OBSERVE IN MY WORK

As an OT, I regularly observe something that standardised assessments almost never capture: the performance gap. The children I work with are often holding themselves together in structured settings — school, clinic, community — through enormous effort. That effort has a cost, and the cost arrives later, at home, out of sight.

Submission 1775

This is called masking. It is exhausting, it is invisible, and under the proposed definition, it would make a child appear functional — possibly ineligible — because their struggle does not show up in a structured, one-off assessment setting. For participants with autism, this is not an edge case. It is the norm.

In practice, this may result in assessments that capture a performance rather than a life. A 12-year-old who answers questions calmly in an assessment room may spend the following two days unable to leave their bedroom. That recovery cost — the shutdown, the meltdown, the parental labour — will not be counted under this definition.

Many of my clients also have conditions that fluctuate significantly day to day. A single assessment cannot capture this. For participants with fluctuating or episodic disability, removing contextual factors from the equation may result in support needs being assessed on a good day — with permanently diminished access to support as a result.

WHY SUPPORTS CANNOT BE SEPARATED FROM FUNCTIONING

The children I work with function because of things the proposed definition would exclude: a parent who prompts every transition, a communication device that compensates for language differences, a support worker who manages the sensory environment, a carefully structured routine that prevents dysregulation before it begins.

Remove those things from the assessment and you do not get a clearer picture of the child. You get a distorted one. This may create serious risks relating to safety, to accurate support planning, and to the long-term wellbeing of some of the most vulnerable participants in the scheme.

HOW THESE PROBLEMS CAN BE ADDRESSED

I urge the committee to consider the following recommendations:

• Redefine functional capacity to include context. Assessments must consider environmental factors, assistive technology, informal supports, behavioural regulation strategies, fatigue, and the sustainability of function over time — not just observed performance in an isolated setting.

• Explicitly recognise masking, fluctuating conditions and invisible disability. Assessment processes must account for presentations that vary across settings and over time, particularly for autistic and neurodivergent participants.

Submission 1775

3 Require assessments to be conducted by qualified allied health professionals.

Functional assessment in paediatric neurodevelopmental contexts requires specific clinical expertise. Assessors must understand what they are looking at when a child is holding it together.

4 Broaden the definition of function beyond observed performance. Assessments should

explicitly measure safety, sustainability, real-world participation and the hidden effort required to maintain function — not just what a participant appears to do in a single session.

Disability does not occur in a vacuum. Neither does functioning. I work with children whose lives are made possible by supports, routines, and people who show up — none of which would count under the proposed definition. What I am asking is simple: assess people as they actually live, not as they appear when everything that makes life manageable has been deliberately removed from view.

The children I work with deserve a system that sees them clearly.