Submission 466
Mindful Occupational Therapy
Submission to the Senate Community Affairs Legislation Committee Inquiry
National Disability Insurance Scheme Amendment (Securing the NDIS for Future
Generations) Bill 2026
I am an occupational therapist and sole trader operating a mobile paediatric occupational therapy practice in North Melbourne. I support children and young people in their homes, schools, and community environments. I primarily work with autistic children and young people, including children with significant sensory, emotional regulation, developmental and functional support needs.
My current work is community-based and relationship-focused, with many families accessing support through my service over several years. This long-term involvement allows me to observe how developmental support, regulation, participation, family functioning and school engagement evolve and change over time.
I support efforts to improve the long-term sustainability and integrity of the NDIS. However, I hold significant concerns regarding the practical impacts of several aspects of the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.
My concerns are particularly focused on:
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The proposed definition of functional capacity
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Increasing reliance on standardised assessments and automation
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Restrictions on reassessment and review
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Broad ministerial powers regarding funding reductions
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Narrowing practical access pathways for children with complex or context-dependent support needs
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The interaction between these reforms and the rollout of Foundational Supports
Functional Capacity and Real-World Functioning
I hold significant concerns regarding the proposed definition of “functional capacity” under section 9B of the Bill.
In paediatric occupational therapy practice, functioning cannot be meaningfully separated from environmental context, sensory demands, emotional safety, communication supports, co regulation and family or school scaffolding.
Many autistic children function very differently depending on the environment and supports available around them. For example, I regularly work with children who can verbally engage for short periods in structured environments but are simultaneously experiencing school refusal, shutdowns, emotional exhaustion or significant dysregulation at home.
Many children also mask distress in formal settings or rely heavily on environmental adaptations and co-regulation to maintain participation.
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Submission 466
Mindful Occupational Therapy
I am concerned the proposed definition of functional capacity may privilege brief observations and standardised measures over nuanced understanding of real-world disability and participation.
This may disproportionately disadvantage:
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Autistic children
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Children with fluctuating presentations
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Children with sensory and emotional regulation difficulties
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Children whose functioning is highly dependent on environmental supports. I respectfully recommend that functional capacity assessments continue to incorporate:
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Real-world environmental functioning
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Family and educator observations
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Executive functioning
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Emotional regulation
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The cumulative impacts of developmental and psychosocial factors.
Narrowing Access and Foundational Supports
I am concerned that several aspects of the Bill may unintentionally create significant service gaps for children and families.
My concern relates particularly to:
- Proposed changes to functional capacity under section 9B
- Proposed section 25B regarding “alternative supports”
- The tightening of access pathways and permanence requirements. The Bill appears likely to narrow practical access to the NDIS while increasing reliance on alternative supports and mainstream systems that may not be consistently accessible across communities.
In practice, I am concerned this may result in some children losing access to supports without realistic or equivalent alternatives being available.
This is particularly relevant for:
- Autistic children with moderate but significant functional impacts
- Children with fluctuating support needs
- Children whose support needs are highly context-dependent Page 2 of 5
Submission 466
Mindful Occupational Therapy
- Children who require ongoing developmental support over many years rather than short- term intervention alone.
Early and ongoing support matters significantly in child development. Delays in accessing therapy, regulation support and participation-based interventions can have cumulative impacts on:
- School engagement
- Emotional wellbeing
- Communication
- Independence
- Family functioning
- Long-term mental health outcomes. Many families spend years building trusted therapeutic relationships with clinicians who understand their child’s communication style, sensory profile, emotional regulation patterns and developmental history. For neurodivergent children particularly, these relationships are often central to engagement and progress.
If children lose access to NDIS supports before realistic alternative supports are available, there is a significant risk that developmental opportunities may be missed during critical periods of childhood.
Workforce Sustainability and Community-Based Providers
I am deeply concerned about the potential workforce impacts associated with the Bill.
My concerns relate particularly to:
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Proposed ministerial funding reduction powers under section 34A
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Reductions to capacity building and participation supports
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Increasing standardisation of planning and funding processes
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Broader uncertainty regarding future funding and pricing structures. Many private paediatric providers already operate under substantial pressure, including:
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Extensive waitlists
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Workforce shortages
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Clinician burnout
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Increasing administrative burden
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Rising operational costs. Page 3 of 5
Submission 466
Mindful Occupational Therapy
Small community-based providers currently support a substantial proportion of children accessing developmental and disability services across Australia. In many communities, particularly regional and outer metropolitan areas, smaller mobile providers fill gaps that larger systems cannot consistently service.
I am concerned that increasing uncertainty regarding funding structures, pricing and participant eligibility may contribute to:
- Workforce attrition
- Worsening waitlists
- Reduced continuity of care
- Reduced service accessibility for children and families. I am also concerned that increasingly standardised funding, assessment and administrative processes may unintentionally disadvantage smaller experienced providers despite these providers already delivering flexible, relationship-based and community-focused models of support.
If experienced community-based providers become financially unsustainable or leave the sector, the impacts are likely to extend beyond individual businesses and place further pressure on:
- Schools
- Public health systems
- Hospital services
- Families
- Already overstretched developmental and mental health supports.
Recommendations
I respectfully recommend that the Committee consider:
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Amending section 9B to ensure functional capacity assessments reflect real-world functioning, including environmental context, co-regulation, executive functioning, communication supports and the cumulative impacts of developmental and psychosocial factors
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Ensuring decisions regarding eligibility, planning and funding are not based solely on standardised assessment tools or automated processes without meaningful human clinical oversight
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Ensuring participants are not excluded from NDIS access under proposed section 25B on the basis of alternative supports that are not realistically accessible, timely or equivalent in practice
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Preserving meaningful pathways for reassessment and review, particularly for children and participants with fluctuating, developmental or context-dependent support needs
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Submission 466
Mindful Occupational Therapy
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Ensuring future funding reduction powers under section 34A remain subject to strong transparency, consultation and safeguarding mechanisms
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Protecting access to capacity building and participation supports, recognising their role in long-term developmental outcomes, independence, school participation and community engagement
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Ensuring future funding, pricing and administrative reforms do not unintentionally destabilise the paediatric allied health workforce or reduce service accessibility for children and families
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Ensuring smaller experienced community-based providers remain able to participate within future service systems and are not unintentionally excluded through highly standardised commissioning or administrative processes
Closing Statement
I appreciate the opportunity to provide this submission.
I support thoughtful reform and understand the importance of maintaining a sustainable and effective NDIS. However, I respectfully encourage the Committee to ensure that reforms remain grounded in the real-world experiences of children, families and communities who rely on these systems every day.
Children with developmental, sensory, emotional regulation and functional support needs often require flexible, relational and long-term support approaches that cannot always be captured through highly standardised or administratively driven systems.
For many children, developmental support is not simply about therapy sessions. It is about maintaining participation in school, building emotional regulation, supporting communication, strengthening family functioning and helping children engage safely and meaningfully within their communities.
Careful consideration should be given to the potential long-term impacts of reduced support access, delayed intervention and disruption to continuity of care, particularly during critical developmental periods of childhood. Policy settings that unintentionally reduce access to timely and appropriate supports may create long-term impacts for children, families and broader community systems well beyond immediate budget savings.
Kind regards,
Melissa Earl
Occupational Therapist
Mindful Occupational Therapy
North Melbourne, Victoria
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