NDIA Accountability Project

NDIS ECEI approach delays for children with hearing loss

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Sydney ∙ Macquarie ∙ Liverpool ∙ Wollongong ∙ Canberra ∙ Online & Telepractice Website: www.shepherdcentre.org.au

ABN: 61 000 699 927

Submission to the Joint Standing Committee on the NDIS inquiry into the provision of services under the NDIS Early Childhood

Early Intervention Approach

Dr Jim Hungerford, CEO

August 2017

This submission focusses on the impact that the NDIS ECEI approach has on children with hearing loss.

In contrast to many other disabilities that impact early childhood, there are existing pathways that provide for the rapid diagnosis of children with deafness or hearing loss. Following this initial diagnosis, the children then require highly specialised early intervention focussed on their language development.

As documented by numerous previous submissions to the Committee, children who rapidly progress through to a specialised provider of listening & spoken language therapy will normally then go on to develop spoken language at the same level and at the same rate as other children without hearing loss. However, delays of even a few months in the provision of this specialist assistance can result in potentially permanent delays in language development. The previous Australian practice resulted in children commencing specialised therapy at about 6 months of age – enabling language acquisition at the same rate as children without hearing loss.

Children are screened for hearing loss in the first few days of life, under the Australian Universal Newborn Hearing Screening approach. If children do not pass this screen they are guided to expert centres in each State which diagnose the children within a few weeks. Following diagnosis the children are then guided to Australian Hearing, the statutory authority established by the Government to be the national provider of hearing services and aids for children. This entire process is normally complete at around 2-3 months of age.

The Shepherd Centre – NDIS ECEI approach, August 2017 Page 1 of 2

Families then enrol with a specialist early intervention provider of their choice and commence receiving therapy. This therapy has been funded immediately, as the specialist providers have been block funded by the various States and Territories.

Unfortunately the current implementation of the ECEI approach is forcing significant delays on to children with hearing loss. As a result services around Australia are already seeing children being presented to them at much older ages with significant delays to language. This is due to:

  1. The ECEI approach introducing 5 extra steps in the pathway between diagnosis and accessing a specialist service, as detailed in the NDIS ECEI Pathway:

  2. “Connecting with an ECEI Partner”

  3. “Get some helpful information”

  4. “Work out support needs”

  5. “Referral services and supports”

  6. “NDIS Access”

  7. Early Childhood Partners are not specialists in paediatric hearing loss and therefore are unaware of the specific therapy required, the need for immediate action, and the nature of the NDIS plans these children need.

  8. Once the need for a NDIS plan has been identified within the ECEI Pathway, there is then a 3-6 month delay prior to having the NDIS plan approved – as a result funded services are not available for an extended period even after their need has been identified. This is in contrast to the previous State-funded approach, where specialist providers were pre-approved for service and as a result funding was available immediately.

Because of all of the above issues, the current implementation of the NDIS ECEI approach is not suitable for children with hearing loss.

However, relatively minor adaptations of the system would allow the ECEI approach to work well for these children.

These adaptations are:

  1. Appointment of Australian Hearing as the single designated Early Childhood Partner across Australia. The current process of diagnosed children being referred to Australian Hearing would continue and Australian Hearing would then provide specialist ECEI support for these children.

  2. As part of its role as Early Childhood Partner, Australian Hearing would be funded (as with any other Early Childhood Partner) to develop the appropriate NDIS Plan for the children, utilising the national reference packages that are currently under development.

  3. Given the independent and expert involvement of Australian Hearing, the NDIS would be able to approve the proposed plans immediately.

  4. As part of its role as Early Childhood Partner, Australian Hearing would then support the family to enrol with the specialist service provider of their choice (as with any other Early Childhood Partner), according to their desires for their child. These services would then be accepting children with funded plans and would be able to provide service immediately.

As an Early Childhood Partner, Australian Hearing could not also be a provider of early intervention services. Whilst Australian Hearing does currently provide some services in this area, it is not a significant area of activity and could presumably be halted.

Recommendation: Australian Hearing be appointed as the single designated Early Childhood Partner for children diagnosed with hearing loss across Australia.

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