Joint Standing Committee on the National Disability Insurance Scheme
PO Box 6100
Parliament House
Canberra ACT 2600
Submission
Inquiry into the implementation, performance and governance of the National Disability Insurance Scheme (NDIS), examining the provision of services under the NDIS Early Childhood Early
Intervention (ECEI) Approach
Author
Kids Plus Foundation (KPF)
163 Myers St Geelong Victoria 3220
About the Author
KPF delivers family focused services including assessment, therapy and family support. Our programs include: e specific therapy interventions to improve the abilities of children and young people across a range of developmental areas; e developmental screening and enhancement for babies born pre-term or other risk factors associated with developmental delay.
We specialise in interventions across the life-span for babies, children and young people with neurological disorders. KPF has particular expertise supporting young people with cerebral palsy. Our focus is to work in partnership with families to understand their individual needs, values and abilities. We value sharing our knowledge with families, early learning centres and schools to create more inclusive communities. Our service aims to empower families and improve capability to maximise potential and enhance participation in everyday activities.
A registered NDIS service provider, KPF provides physiotherapy, occupational therapy, speech pathology, music therapy and social work programs and supports.
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Terms of Reference
To date, KPF has not had direct exposure to accessing ECE! pathway services and supports under the NDIS model. KPF operates in Geelong (Barwon VIC). The Barwon region appointed ECE! partner, Barwon Child Youth and Family, is due to commence operations in Geelong in October 2017.
KPF has however considerable experience working with infants and young children.
Under the KPF ‘Baby Program’, KPF provides specialist therapy and surveillance for babies at developmental risk. Eligibility for the program is for either:
e extremely preterm infants (less than 28 weeks gestation and 1000 grams weight);
e term infants with brain injury due to cerebral palsy, stroke or related conditions;
e infants at high developmental risk due to other factors e.g., complex medical conditions.
We believe that KPF’s experience supporting infants will be of interest and benefit to the Committee as they consider how best ECE! pathways can support families.
When considering the following specific terms of reference:
e the eligibility criteria for determining access to the ECEI pathway
e the timeframe in receiving services under the ECEI pathway
e the costs associated with ECEI services, including costs in relation to initial diagnosis and testing for potential ECE! participants
- the following are KPF’s insights into current gaps in ECE] pathways for babies 0-6 months of age: i. ‘early’ early intervention has long term impact: by routinely seeing infants during the first six months, on average either fortnightly or monthly, results in
e reducing long term physical impairment - there is a growing body of research indicating the benefit of “early” early intervention to babies as this can influence the neural plasticity of the brain, leading to better long-term outcomes in learning motor skills;
e family benefit - parents are in need of support during this often traumatic period in their baby’s development — early intervention is focused as much on supporting parents as it is on supporting infants. It is crucial to provide confidence to families on how to care and support their baby;
Evidence indicates that babies born extremely pre-term, low birth weight, or suffering from a hypoxic event are 50% more likely to have ongoing developmental concerns, or disabilities like Cerebral Palsy. Early intervention provides a combination of parent support, education and direct intervention to enhance the baby’s outcomes. It has been shown that this intervention needs to occur early in life, and that access to services and supports immediately is critical for reducing parental anxiety and depression.
Kids Plus Foundation
163 Myers St Geelong VIC 3220 + info@kidsplus.org.au + kidsplus.org.au + 03 5223 1475
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ii. at present, clinical evidence under 6 months of age is not highly regarded — For a NDIS funding plan to be approved, the child will typically be required to show a developmental delay of more than 6 months, even with the presence of medical reports and investigations indicating impairments. This is detrimental to infants aged less than 6 months of age. Sophisticated medical diagnosis capabilities mean that long term developmental outcomes can be predicated with high degrees of accuracy early on, often within the first few months of life. The sooner surveillance, intervention and support can commence, the better the long-term outcomes for the child and their family. Best practice for infants is to have video observation before 6 weeks post birth, then follow-up at 9 weeks, 12 weeks and 15 weeks, and developmental assessments including the Alberta Infant Motor Scale at 16 weeks, and 32 weeks. Current ECEI pathways do not support this approach.
iii. highly specialised field within paediatrics — therapists working with babies in the neo-natal period need to undertake additional training in the use of specialist clinical assessment and diagnostic tools for this age group. Not all early intervention therapists have the skills and expertise required to deliver a model of care for babies presenting with, or at risk of developmental disabilities. In addition to current knowledge, the field of early intervention is advancing at an incredible rate. Therapists need to continually maintain and update their clinical competencies to ensure they are providing best practice care and models of service.
iv. absence of available funding for infants — in the absence of an NDIS funding plan, service providers are at present absorbing the service delivery cost of providing support to infants. Currently in the VicWest Barwon region babies and infants with identified medical conditions or concerns are waiting, on average, 6 months before funded supports are provided through the NDIS. These babies and their families have no access to funded services and supports within this critical developmental period. The Kids Plus Foundation continues to provide early intervention services when there is an identified need in the absence of funding. On average babies are receiving between 12 — 20 hours of service before their NDIA plan is active.
As an individual based funding model becomes more complete, services providers will not be able to sustain providing services to clients which are not directly fundable.
Contact details
Shaun Cannon
Chief Executive
Kids Plus Foundation
03 5223 1475
Kids Plus Foundation
163 Myers St Geelong VIC 3220 + info@kidsplus.org.au + kidsplus.org.au + 03 5223 1475