Submission 2080

Submission regarding the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

I am a senior OT and director of Our Children’s Occupational Therapy, a family-run mobile occupational therapy service supporting children, teens and families across the Gold Coast. We provide our therapy within children’s everyday environments including homes, schools, kindergartens and community settings. As a mobile community-based service, we see firsthand how disability, participation and wellbeing are shaped by environmental factors, family capacity, school systems, financial stress, transport access and social supports. We are deeply concerned that many of the proposed changes within the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 fail to recognise these realities.

We acknowledge the importance of ensuring the long-term sustainability of the NDIS. However, sustainability cannot come at the expense of children losing access to essential supports, families experiencing further crisis, or providers being unable to continue delivering safe and effective services to vulnerable members of the community.

Our practice strongly supports many of the concerns raised within the Occupational Therapy Society for Hidden and Invisible Disability (OTSi) Discussion Paper and wishes to highlight several issues that will significantly impact the children and families we support.

Concerns Regarding Functional Capacity Assessments

One of our most significant concerns relates to the proposed definition of functional capacity, which assesses what a person can do without assistance, supports, environmental modifications or contextual considerations.

This approach does not reflect the lived reality of the children and families we support. Occupational therapy is fundamentally grounded in understanding how a child functions within their real-world environments. A child’s participation cannot be separated from the sensory, emotional, social, educational and relational contexts they navigate every day.

Many of the children we support present very differently across settings and over time. A child may appear capable during a brief assessment but experience overwhelming dysregulation, exhaustion, anxiety or functional shutdown at school or home. Snapshot assessments risk significantly underestimating support needs, particularly for neurodivergent children who mask difficulties during formal interactions. Children who may have low-moderate support needs on one week, may have high and substantial support needs the other. I am seeing this with many Autistic teens, unable to cope with the demands of a high school environment, and schools unable to effectively support them, leading to significant dysregulation, distress and unfortunately suspensions for the child.

As mobile occupational therapists, we often observe challenges that would never be visible within a clinic-based or standardised assessment setting. We support families in real time during moments of distress, school refusal, emotional dysregulation, unsafe behaviours, sensory overload, executive functioning breakdowns and daily living challenges. These are complex functional issues that cannot be accurately understood through reductionist or impairment-based assessment models. A child or disabled person is disabled by the context in which they are living and must be assessed effectively.

We are deeply concerned that the proposed reforms diminish the importance of treating therapist evidence and professional clinical judgement in favour of administrative or potentially automated assessment systems.

Submission 2080

Concerns Regarding Executive Functioning and Self-Management

The proposed reforms appear to narrow the understanding of disability-related functional capacity by focusing heavily on basic care activities while inadequately recognising executive functioning difficulties, social skill needs, motor skill development and sensory processing.

Many of the children and adolescents we support experience significant impairments in planning, organisation, emotional regulation, task initiation, self-management, sequencing, flexibility, emotional regulation and coping with change. These challenges profoundly affect participation in education, relationships, self-care, community access and family life.

Executive functioning difficulties are often invisible but highly disabling. Families frequently experience severe burnout while attempting to coordinate appointments, school supports, routines, emotional regulation strategies and daily living demands for their children.

These support needs are real, ongoing and intensive. They cannot be accurately captured through simplified or standardised assessment tools.

Concerns Regarding Tightened Permanence Requirements

We are extremely concerned about the proposed requirement that participants undertake “all appropriate treatment” before disability can be considered permanent.

Many of the families we support already face significant barriers accessing healthcare and therapy services, including:

• workforce shortages and waitlists

• financial stress impacting the families capacity for providing informal support or access therapy outside of the NDIS. (Increased care needs would reduce the working capacity of the informal supports, with flow in affects impacting wider community workforce and social and economic contribution to society).

• transport limitations

• school attendance difficulties

It is also deeply concerning that a child’s eligibility for disability support could depend on access to services that may be financially or geographically inaccessible.

We are concerned that therapy itself may increasingly be framed as a prerequisite to prove eligibility rather than an essential ongoing support required to maintain function, participation and wellbeing.

For many children, occupational therapy is not about “curing” disability. It is about supporting emotional safety, independence, participation, regulation, skill development, family functioning and long-term wellbeing. Therapy often prevents deterioration, school disengagement, mental health crises and family breakdown.

Concerns Regarding Funding Reductions and Reduced Access to Therapy

Our practice is deeply concerned about the proposed powers allowing broad funding reductions across participant groups.

Submission 2080

Children requiring early intervention and capacity-building supports are particularly vulnerable to funding cuts. Early therapeutic support often prevents significantly higher long-term costs associated with school refusal, mental health admissions, family breakdown, crisis services and long-term support dependence.

Reducing therapy supports may create short-term financial savings while significantly increasing long-term social and economic costs.

Families already report high levels of fear, uncertainty and distress regarding these proposed reforms. Parents are increasingly concerned about losing access to therapies that their children rely upon to participate safely in school, develop independence, regulate emotions and engage in community life.

As a small family-run practice, we are also concerned about the impact of pricing restrictions and reduced funding on workforce sustainability within community-based paediatric occupational therapy. Mobile therapy services involve significant demands including travel, collaboration with schools and support teams, report writing, care coordination and family communication. These elements are essential to safe and effective therapy outcomes but are increasingly difficult to sustain under ongoing funding pressures.

Concerns Regarding Automated Decision-Making

We strongly oppose the use of fully automated systems for eligibility determination, functional assessment or funding allocation.

Disability is nuanced, relational and contextual. Children’s functioning fluctuates significantly depending on sensory environments, emotional safety, trauma history, communication supports, family circumstances and educational settings.

No automated or algorithmic system can adequately interpret the complexity of human functioning, family stress, environmental barriers or neurodivergent presentation.

The children and families we support deserve decisions made with compassion, professional judgement, procedural fairness and genuine understanding of their lived experiences.

Concerns Regarding Increased Reliance on Informal Supports

We are deeply concerned that many proposed reforms appear to rely more heavily on unpaid family care.

Parents and caregivers of disabled children are already under enormous pressure. Many families reduce work hours, leave employment entirely, manage ongoing advocacy demands and experience chronic emotional, physical and financial strain.

In our work, we regularly see the impact of caregiver burnout, mental health deterioration, relationship breakdown and financial stress associated with inadequate formal supports.

The NDIS was designed to reduce these inequities, not increase them, enabling choice and control for participants and their families, accessing individualised and high quality care.

We are deeply concerned that NDIS participants, likely children, will be removed from the scheme with this new legislation, without effective and accessible systems actually in place, where the children and families deserve to access the high quality, experienced OTs from the private sector for long term support.

Submission 2080

Recommendations

As an experienced OT working with children for over 10 years, I would like to make the following recommendations based on my expert opinion and that of other OTs, advocates and lived experience of the families we support.

• Delay implementation of the Bill pending meaningful consultation with disabled people, families and allied health professionals.

• Retain environmental, relational and contextual factors within functional capacity assessments.

• Protect the role of treating therapist evidence and professional clinical judgement in decision-making processes.

• Prohibit fully automated eligibility, assessment and funding decisions.

• Protect access to therapy and capacity-building supports for children and young people.

• Remove or substantially limit broad Ministerial powers to reduce funding across participant groups.

• Ensure foundational supports and community systems are properly established and available before restricting NDIS access.

• Protect participants’ rights to refuse treatment without losing access to disability supports.

• Strengthen safeguards around reassessment, communication and plan suspension processes.

As an occupational therapist, I see every day the life changing impact that meaningful occupational therapy and disability supports can have for children and families.

We support children to participate in school, develop friendships, regulate emotions, build independence, advocate for themselves and experience a sense of belonging within their communities. We also support families to better understand their children, reduce stress within the home and build sustainable routines and supports.

The proposed reforms risk moving the NDIS away from person centred, individualised and evidence based support toward a system increasingly driven by cost reduction and administrative simplification.

We acknowledge the importance of sustainability. However, true sustainability must include investment in early intervention, safeguarding, family wellbeing, participation and long-term outcomes.

We urge the Committee to ensure that any reforms strengthen, rather than weaken, the dignity, safety, participation and human rights of disabled Australians and their families.