Concerns regarding changes to supports for children with disabilities (Provider experience)

Submission 2496

1 June 2026

To: Committee Secretary, Community Affairs Legislation Committee

Re: Inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for

Future Generations) Bill 2026

As a Paediatric Occupational Therapist, I work alongside children and families every day who rely on the NDIS to access the supports that allow them to participate in education, family life, community activities, self-care, communication, and social relationships. I am deeply concerned about the proposed legislative changes to the NDIS and the impact they may have on some of the most vulnerable members of our community.

What does the NDIS mean for you right now?

The NDIS is far more than a funding scheme. For the children and families I support, it represents access to therapy, communication supports, assistive technology, behaviour support, social participation opportunities, and early intervention. It provides families with hope, practical assistance, and a pathway toward greater independence and inclusion.

The NDIS enables children with  disabilities to develop essential  life  skills, participate

meaningfully in their education, build relationships, and engage in their communities. It also provides critical support to parents, siblings, carers, and extended family members who often carry significant caregiving responsibilities.

Without these supports, many children would experience greater barriers to participation,

poorer  developmental outcomes,  increased mental  health  challenges, and reduced

opportunities to reach their potential.

How do you feel about the proposed changes to the NDIS Act?

I am concerned that many of the proposed changes appear to prioritise cost containment and administrative efficiency over the lived experiences and support needs of people with disability.

While sustainability of the scheme is important, changes that restrict access, narrow eligibility criteria, reduce participant choice and control, or increase barriers to obtaining supports risk undermining the foundational principles upon which the NDIS was built.

The proposed reforms around eligibility, functional capacity assessments, planning processes, and definitions of permanence create significant uncertainty for families and clinicians alike. Many of the children I work with have lifelong disabilities, yet their support needs can

Submission 2496

fluctuate considerably across developmental stages. Disability does not remain static simply because a diagnosis is permanent.

There  is a  real  risk that standardised assessment processes and narrower  eligibility

interpretations may   fail  to  capture  the  complexity  of  disability,  particularly  for

neurodevelopmental conditions, psychosocial disabilities, rare conditions, and children with multiple co-occurring diagnoses. Concerns have also been raised across the disability sector regarding increased reliance on standardised assessments and automated decision-making processes.

Do you feel these changes have been explained clearly enough?

No.

Many families, carers, clinicians, and disability advocates remain uncertain about how these changes will operate in practice. While government communications describe the reforms as necessary to improve sustainability and clarify eligibility, there remains a significant lack of detail regarding implementation, assessment processes, appeal pathways, and how individual circumstances will be considered.

Families are asking questions that currently have no clear answers:

• Who may lose eligibility under the new framework?
• How will “functional capacity” be measured?
• What evidence will be considered?
• How will children with fluctuating or evolving support needs be assessed?
• What safeguards will exist if decisions are incorrect?
• What alternatives will be available if supports are removed? The uncertainty itself is causing considerable distress within the disability community.

What would these changes mean for children, family, carers, or community?

The impact would extend far beyond individual participants.

When disability supports are reduced, responsibility does not disappear—it shifts. Families, schools, healthcare services, community organisations, and informal carers absorb the burden.

Parents often reduce work hours or leave employment entirely to provide care. Siblings may

experience reduced  family  attention and  increased  responsibilities. Schools are  left

attempting to manage complex support needs without adequate resources. Community participation decreases, social isolation increases, and family stress escalates.

Submission 2496

As a clinician, I regularly witness the consequences when families cannot access appropriate supports. The effects are not limited to the child with disability; they ripple through entire family systems and communities.

For many families, NDIS-funded therapy and supports are the difference between maintaining stability and reaching crisis point.

Social and community participation supports are often misunderstood as optional or recreational. In reality, they are fundamental to inclusion, wellbeing, skill development, and long-term independence.

These supports enable children to:

• Build friendships and social competence.
• Develop emotional regulation skills.
• Access community environments safely.
• Participate in sport, recreation, and cultural activities.
• Build confidence and self-determination.
• Reduce social isolation. Without these supports, many children would become increasingly isolated from their peers and communities. Opportunities to practise real-world skills would diminish, resulting in poorer long-term outcomes and increased reliance on services in adulthood.

The removal of social and community supports would not reduce disability. It would simply reduce opportunities for participation.

What would happen if your capacity-building supports were reduced or removed?

Capacity-building supports are among the most valuable investments the NDIS makes.

Occupational Therapy, Speech Pathology, Psychology, Physiotherapy, Behaviour Support, and

other capacity-building interventions help children develop skills that can reduce future support needs and improve lifelong outcomes.

Without access to these services:

• Developmental delays may widen.
• Functional skills may not emerge.
• School participation may deteriorate.
• Behavioural challenges may escalate.
• Mental health concerns may increase.
• Family stress and burnout may intensify.

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• Future dependence on intensive supports may increase. As Occupational Therapists, our goal is not to create dependence on services. Our goal is to build capacity, independence, participation, and quality of life. Removing or limiting access to these supports risks creating greater long-term costs, both financially and socially.

Early intervention and ongoing capacity-building are not luxuries. They are evidence-based investments that improve outcomes and reduce future service reliance.

Concerns Regarding the Proposed Definition of “Permanence”

One of the most concerning aspects of the proposed legislation relates to changes surrounding how the NDIA defines permanence and eligibility.

The proposal that individuals may need to exhaust all “appropriate” treatment options before

their  disability  is considered permanent  raises  significant concerns  for children with

developmental disabilities, neurological conditions, psychosocial disabilities, and complex support needs. Reports indicate that future eligibility assessments may increasingly focus on whether impairments could potentially be improved through treatment or intervention.

This approach fails to reflect the realities of paediatric disability practice.

Many disabilities are lifelong, even when therapies improve function. Occupational therapy, speech therapy, physiotherapy, psychology, and educational supports do not “cure” autism, intellectual disability, cerebral palsy, genetic syndromes, or many neurological conditions. Instead, they help individuals maximise participation and independence.

Improvement should never be interpreted as evidence that a disability is not permanent.

In paediatric practice, we celebrate developmental gains. We encourage skill acquisition. We support children to achieve greater independence. Yet under a more restrictive interpretation of permanence, there is a risk that therapeutic progress could paradoxically be used to question eligibility.

Children should not be required to demonstrate ongoing deficits or failure to improve in order to maintain access to essential supports.

A definition of permanence that does not adequately account for developmental trajectories, fluctuating support needs, and the distinction between improving function and eliminating disability risks excluding individuals who continue to experience substantial and lifelong disability-related barriers.

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The NDIS was established to recognise that people with disability deserve the same opportunities for participation, inclusion, and self-determination as all Australians. Any reforms must preserve these principles.

As a Paediatric Occupational Therapist, I urge policymakers to ensure that legislative changes are developed transparently, informed by genuine co-design with people with disability, families, carers, and clinicians, and grounded in evidence regarding the long-term benefits of early intervention, capacity building, and community participation.

The sustainability of the NDIS is important. However, sustainability cannot be achieved by reducing access to the very supports that allow people with disability to participate, develop skills, maintain wellbeing, and contribute meaningfully to their communities. The voices of participants, families, carers, and frontline clinicians must remain central to any decisions that shape the future of the NDIS.

Yours sincerely