NSW Government
Submission
Senate Select Committee on Autism
June 2020
We
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Contents
Introduction 4
Health Care, Assessment and Diagnostic Services 5
Social and Emotional Wellbeing 7
Suicide Prevention 8
Access to Educational Support 9 Interactions and Access to the National Disability Insurance Scheme 10 Support for People with ASD in the Correctional System 11
NSW Disability Policy and Legislation 13
References 14
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Introduction
The NSW Government welcomes the opportunity to provide a submission to the Senate Select Committee on Autism (the Select Committee). We commend the Select Committee’s focus on the experiences, needs and futures of people with autism, their families and care networks in Australia. We acknowledge that Australia is a signatory to the United Nations Convention on the Rights of Persons with Disability. Its purpose is to promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms for people with disability, which is relevant to services and supports for people with Autism Spectrum Disorders (ASD).
ASD are described under existing diagnostic standards, including but not limited to:
e Autistic Disorder
e Asperger’s syndrome e Pervasive developmental disorder not otherwise specified (PDD-NOS).
ASD is an overarching term but the experience of disability for people with autism is highly individual and may include variable levels of functional impairment across domains of social engagement, communication, participation in activities of daily living and roles and contribution to community. ASD affects people across the lifespan, from a variety of backgrounds and with varying cognitive abilities.
The nature and structure of disability governance nationally and within NSW is currently in transformation and the recent impacts of COVID-19 on people with disability further underlines the need to adopt a strategic approach in the disability policy area.
As part of the once in a generation redesign of disability services through the introduction of the National Disability Insurance Scheme (NDIS), funding and responsibility for many of NSW’s disability services has transferred to the National Disability Insurance Agency (NDIA). Provision of services in NSW including assessment and diagnosis services, Early Intervention services, Positive Behaviour Support intervention and planning, school support services, respite care and alternative accommodation options have been transitioned to NDIS providers. People with autism spectrum disorders represent a large and growing proportion of people with disability entering the National Disability Insurance Scheme and interacting with a range of service providers.
New South Wales welcomes the role of the Select Committee in exploring the availability of supports to enhance the social and economic participation of people with ASD, their families and carers. This submission focuses on access to support for people with ASD to address the social determinants and systemic barriers to access and equity for people with ASD in the areas of suicide prevention, education, behaviours of concern and the over-representation of people with ASD in the justice and correctional systems.
The development of a National Autism Strategy presents an opportunity to create systemic change across government, community managed and private services to facilitate enhanced quality of life outcomes for people with ASD. The NSW Government supports the collaborative development of a strategy that considers the needs of people with ASD and their families alongside the capacity of key stakeholders to provide integrated systems of support.
We look forward to the findings of the Select Committee.
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Health Care, Assessment and Diagnostic Services
Access to health care, assessment and diagnostic services has been identified as a focus of the Select Committee. In NSW, these services are coordinated across the clusters of NSW Health, Department of Communities and Justice and in collaboration with NDIA and primary health care services.
Childhood Development
In 2019, NSW Health published a policy directive requiring all NSW Health Local Health Districts and Specialty Health Networks to ensure that strategies to implement the First 2000 Days (conception to age 5) Framework appear within their local plans, commencing by 1 July 2019. The Framework draws on the evidence that shows the importance of improving children’s development in the early years of life, while developmental plasticity is at its greatest.
The First 2000 Days Framework has three objectives that support a proportionate universal approach to providing services, including child health and development surveillance, screening, assessment and diagnostic services.
Childhood developmental assessments in NSW follow a range of important steps from birth, leading down a range of different clinical and support pathways. These pathways start with routine health and developmental checks, or the identification of a developmental concern by a parent or carer.
NSW Health recommends that all parents take their children for well-child health and developmental review and screening from birth to age four, either from a Child and Family Health Nurse or from their general practitioner. These appointments are a form of primary health check. The recommended checks are listed in the child Personal Health Record (Blue Book) provided to every child born in NSW. The Blue Book also contains the Learn the Signs. Act Early developmental checklists to help parents recognise when their child may be showing signs of not meeting their milestones. These checklists are complemented by the Milestones Matter resources on the NSW Health Website and the Love, Talk, Sing, Read, Play App that provides parents with simple ways to support their child’s development.
The primary health checks recommended in the Blue Book are designed to monitor child health and provide developmental surveillance, and are a first step in identifying developmental problems issues early. These checks usually have little or no wait time. If concerns of developmental delay or disability are identified, children may be referred for a medical assessment.
Developmental delay and developmental disability are broad terms that cover a wide range of developmental issues, from mild through to severe. As there is such a range of conditions within this broad category, many children may be appropriately diagnosed by a general paediatrician. However, others may require a multidisciplinary assessment due to the complexity of their needs.
Childhood developmental assessments in NSW are available at various stages from birth, leading down a range of different clinical and support pathways. Comparing specific waiting times is not straightforward nor particularly helpful in understanding roadblocks or pressure points.
Appointments for further assessment and diagnosis for children identified through a health and developmental check are triaged based on need. Children with the most pressing needs are seen first. Those on the waiting list may be provided with interventions they can start in the meantime. The waiting time varies depending on individual need, local demand and other factors. Factors affecting wait times and access for this assessment include:
e clinical and developmental need
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e the collection and collation of assessment information which can take weeks, or sometimes months, before a child’s assessment can be finalised.
Paediatric Services
There are a range of services available that support the assessment and diagnosis of children with suspected ASD. These services span the public, non-government and private health care sectors. Private providers include pediatricians, general practitioners, and allied health services. In the public system, services are primarily provided through outpatient clinic and community health settings.
There is diversity in the way services are provided along with diversity in the type, severity and complexity of developmental delay and disability. In different parts of the state, local pathways for the assessment and diagnosis of developmental concerns vary depending on the services available. Initial assessment and referral is available locally through general practice, public or private pediatricians and public clinics in sites where these are available.
For particularly complex presentations, children may be referred to a specialised clinic or service. Specialised developmental diagnostic and assessment services also vary in their staff complement and service model.
The Paediatric Developmental Program (PDP) provided by the non-government organisation Royal Far West is funded in part by NSW Health. The PDP is delivered in partnership with the health and education sectors. It provides a comprehensive multidisciplinary assessment, diagnosis, review and treatment service for children with complex developmental and behavioural issues. It is targeted to families from rural and remote NSW (north of Taree, west of Lithgow, or south of Nowra) for children under 12 years of age, with health, learning and developmental concerns that fit the program criteria. Royal Far West also received funding between 2018/19 - 2019/20 to deliver the Regional Assessment Service (RAS). The RAS was funded to provide assessment and diagnostic support to local paediatric assessment and diagnostic teams for the early assessment and diagnosis of developmental disability and ASD rural and regional areas.
The Child Development Unit at the Children’s Hospital Westmead, provides multidisciplinary support for children with complex development problems, including ASD. Paediatricians can refer children to the Child Development Clinic. Referrals must include a clear statement of goals for assessment and any previous primary or secondary services information/reports. The clinic works in collaboration with NSW Department of Education to support the NSW Centre for Effective Reading (CER). Other services provided within the Sydney Children’s Hospital Network for children with ASD, intellectual and developmental disabilities include:
e Developmental psychiatry team that specialises in tertiary cases of autism spectrum disorder and/or intellectual disability. Comprehensive assessments for care planning consider the wellbeing of parents, the quality of family relationships, and providing intervention where appropriate.
e Westmead Feelings Program, an intervention program for primary school aged children with autism spectrum disorder, which involves parents and teachers in having the skills to be able to support development in the child with autism spectrum disorder.
e Child and Adolescent Psychiatry Outreach Service (CAPTOS) which provides support to local health districts in providing assessment and care planning. It facilitates a partnership between behaviourally orientated paediatricians, and child and adolescent mental health services, to provide comprehensive support planning for young people and their families.
e The Sydney Children’s Hospital Network Mental Health- Intellectual Disability Hub, a State-
wide tertiary service offered where a child with intellectual disability and/or a pervasive developmental disorder such as ASD, also experiences mental health difficulties.
The following initiatives also address the needs of children with ASD:
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e Stepping Stones Parent Training Program
e “Meet Jessica” mental health awareness training e SCHN School-Link program
Services when there is additional complexity
There are a range of services that support people, including those with ASD, when there is additional complexity. NSW Health has established Specialised Intellectual Disability Health Teams that see people who have complex health conditions, intellectual disability and:
e acurrent unresolved health problem
e health care needs that cannot be met by usual care providers and pathways, and
e anexisting primary treating clinician/team to implement care plan recommendations and follow through with care.
The teams and positions provide:
e comprehensive assessment of current needs
e ahealth care plan with recommendations
e referrals to health and other services
e advice, information and resources to the client’s primary treating team (GP or other clinicians) who provide ongoing care and can implement the plan recommendations.
People with autism who have complex support needs may also be eligible for support through the Integrated Service Response (ISR) when their wellbeing is threatened by crisis that is unable to be resolved locally. The ISR works with the NDIA, NSW Government agencies, non-government organisations, NDIS providers and the private sector to promote engagement, collaboration and innovation to effectively manage or resolve highly complex situations.
The development of a National Autism Strategy should include diagnosis, assessment and intervention for people with ASD and the provision of support for parents.
Social and Emotional Wellbeing
Addressing mental health care needs
People with ASD experience higher rates of physical and mental health conditions and lower rates of employment and post-secondary education participation than the general population (Lawson et al, 2020). Numerous research studies have highlighted the mental health, emotional wellbeing and social participation issues experienced by people with ASD as key barriers to facilitating equal participation. Recent studies indicate that up to 87% of autistic people have a current or lifetime history of receiving a psychiatric diagnosis. In this study, most of the group experienced mood and anxiety disorders (Cvejic et al, 2018).
People with ASD who also experience mental health conditions can access care from NSW Health mental health services across inpatient and community care settings. NSW Health is actively working to enhance access to mental health care for people with intellectual disability, including people with autism. To facilitate this, the NSW Government has committed $4.4 million over four years for people in NSW living with an intellectual disability wno need treatment for mental illness. People will have access to a specialist service, where they can be assessed and supported by clinicians who are experienced in the care of people with both conditions. This funding will also help local health services enhance the effectiveness of mental health care offered to people with an intellectual disability.
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Service gaps continue to exist for people with ASD and their families. Mental illness is challenging for clinicians to identify and diagnostic uncertainty and overshadowing present barriers for people with ASD and their carers in accessing appropriate mental health care. Specific challenges within Mental Health Services include:
e Restrictive environments that do not easily facilitate the use of sensory regulation skills
e Exposure to others presenting with acute behavioural disturbance which may impact on an person’s ability to self-regulate.
e Skills and confidence of staff to effectively meet the needs of people presenting with severe challenging behaviours
To begin to address these challenges, NSW Health has worked closely with Professor Julian
Trollor, Chair of Intellectual Disability Mental Health and the Department of Developmental
Disability Neuropsychiatry (3DN) at the University of NSW to develop and implement The Guide: Accessible Mental health Services for People with an Intellectual Disability and the Intellectual Disability Mental Health Core Competency Framework and Toolkit for Mental Health Professionals. These tools support the development of skills and resources in the mental health system to better meet the needs of people with intellectual disability and cognitive impairment.
Restrictive Practices
The use of restrictive practices, includes:
Prescription of psychotropic medications to manage behaviours of concern Restricting a person’s access to environments or objects
The use of restraint devices or physical restraint
Seclusion
NSW continues to note difficulties reported by disability support providers, medical professionals and private practitioners in accessing registered behaviour support practitioners to provide strategies for the positive and proactive management of challenging behaviour. This access gap contributes to the increased rate and volume of psychotropic medication prescription for people with ASD and the continued use of restrictive practices.
The use of restrictive practices for this population is a complex issue that impacts access to care, accommodation and services. The NSW Government is responsible for the regulation of restrictive practices used in NSW.
A key principle for the NSW Government is working towards the elimination of restrictive practices. This include promoting alternative evidence-based practices, improving access to behaviour supports and developing frameworks that limit the use of restrictive practices unless no other alternative exists.
The NSW Government recommends that the National Autism Strategy harmonise with
national Mental Health and Suicide Prevention Plans and National Disability Strategies and
includes consultation with mental health services and stakeholders to improve access to mainstream mental health and social support services for people with ASD and their families.
Suicide Prevention
People with ASD are reported to be between two and seven times more likely to die by suicide compared to the general population (Schendel et al, 2016). Given these statistics that demonstrate
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people with ASD die younger from non-accidental injury (Hwang et al, 2018), there remains a policy gap on the needs of people with ASD in targeted suicide prevention approaches.
The Fifth National Mental Health and Suicide Prevention Plan, Contributing Lives Framework,
National Disability Strategy 2010-2020 and the Strategic Framework for Suicide Prevention in NSW 2018- 2023 do not specifically identify and respond to the needs of people with ASD. These strategic documents do highlight the needs of people with disability which supports some access to care for people with ASD with comorbid intellectual or physical disability. This has been more fully explored in an international context with the United Kingdom’s Autism Act, Think Autism Strategy and the Fourth Progress Report on Preventing Suicide in England noting the impact of suicide on the autistic community and committing to do more to meet the specific needs of people with ASD at risk of suicide.
The NSW Government recommends that the development of a National Autism Strategy harmonises with national Mental Health and Suicide Prevention Plans and National Disability Strategies to ensure that suicide prevention approaches for people with ASD are prioritised in policy with appropriate resources to create systemic change.
Access to Educational Support
Funding and supports for students with autism in NSW public schools
Students with ASD have a wide range of learning and support needs, requiring different levels of support. The type of additional learning support schools provide is determined in consultation with the student, where appropriate, and their parents or carers. NSW public schools receive resources to ensure they can provide the supports students need.
Every mainstream public school has a learning and support teacher allocation to work directly with students who have additional learning and support needs, including students with ASD. More than 1,889 learning and support positions work directly in NSW public schools supporting teachers and their students with additional learning and/or behaviour needs in mainstream schools. Of these positions, 689 are in rural and remote schools. A cohort of assistant principals (learning and support) work across schools to support the work of learning and support teachers and provide additional support to schools.
NSW public schools are supported by School Services staff who provide advice, support and professional development to staff. Schools also have access to a range of specialist support staff, examples include specialist transition support teachers who provide advice on planning for life after school; specialist teachers with expertise in out of home care and attendance; Network Specialist Facilitators who support schools to manage complex issues; and National Disability Insurance Scheme (NDIS) Coordinators who help resolve NDIS-related issues.
In addition to staffing allocation for a learning and support teacher and access to other specialist support, every mainstream public school receives flexible funding based on the number of enrolments in the school and the learning and support needs of their students. In 2020, more than $294 million will be provided to schools through the Resource Allocation Model (RAM) as the Low level adjustment for disability loading. Principals can use this funding flexibly to best meet the needs of more than 125,000 (more than 15 per cent) students with disability in NSW public schools. This includes over 19,983 students with autism.
Students with moderate to high levels of learning and support needs, enrolled in mainstream classes, are supported through the Integration Funding Support Program, which provides additional resources to support students with a confirmed disability. At the start of 2020, about
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4,918 students were allocated Integration Funding Support for ASD in mainstream classes. This represents a 92% increase in students supported by this program since the start of 2016.
In 2020, there are more than 1,770 specialist support classes for students with ASD in mainstream public schools and public schools for specific purposes (SSPs). This represents a 63% increase in the number of classes that support students with ASD since 2016.
The NSW Department of Education has a Memorandum of Understanding (MOU) with Autism Spectrum Australia (ASPECT) which allows ASPECT to operate satellite classes in NSW public schools. The classes cater to ASPECT students with autism that may benefit from the transition to mainstream education. There are 21 ASPECT classes which operate across nine public schools.
Professional development for staff to support students with ASD
The NSW Department of Education delivers a range of professional learning courses for principals, teachers and support staff to build their capacity to meet the needs of students with disability and additional learning and support needs, including autism. This includes an accredited specialist course ‘Autism Spectrum Disorder’. The course aims to develop the knowledge, understanding and skills of all those working with children and young people with ASD to support inclusive practice. The course is evidence-based and Department quality-assured professional learning, using a blended learning model of tutor-led sessions and self-paced online learning. Participants learn about assessment, adjusting, SMART goals, intervention strategies and personalising learning and support. There are a variety of interactive activities, and participants contribute to several online discussions.
More than 12,000 staff working in NSW public schools have undertaken this 10-week course since
- The content for the course was extensively updated in 2017 with cases studies included to reflect the NSW context. The Department also carries out regular audits of course resources to ensure that the latest evidence-based material is available to participants.
Increase in prevalence of students with autism and mental health needs
In 2019, the NSW Department of Education commissioned a report which examines the reasons for increased enrolments of students with ASD and mental health needs in NSW public schools over the period from 2013. The findings from this report will be made available in the coming months.
Interactions and Access to the National Disability Insurance Scheme
The NSW Government works closely with the NDIA to support the interface between the NDIA and NSW Health and disability services. This includes close consultation with the NDIA to resolve issues surrounding access to the scheme and necessary supports for children and adults. The NSW Government welcomes the focus of the Select Committee in relation to:
The adequacy and efficacy of the National Disability Insurance Scheme (NDIS) for people with ASD including:
e autism understanding within the NDIS,
e the utility of the Early Childhood Early Intervention Pathway for children with ASD,
e the ability of the NDIS to support people with ASD and complex needs, including those transitioning from prison settings, and
e the adequacy and appropriateness of supports to empower people with ASD to participate in the NDIS planning process, and exercise self-determination through choice and control over their support services
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People with ASD often have multiple and complex needs that require agreed escalation pathways. NSW Government advocates for NDIA responses to key pressure points such as escalation pathways, after hours crisis and participants with complex needs and/or challenging behaviour. The NDIA has implemented the following initiatives aimed at addressing these pressure points including:
e Critical Service Issues Response (CSIR)
e After Hours Crisis Response Hotline (AHRC) for mainstream services to escalate service delivery failures that threaten participant welfare
e Complex Support Needs Pathway (CSNP) that provides extra assistance to participants with identified complex needs
e Exceptionally Complex Support Needs Program (ECSNP) to develop capacity in the sector to respond to crises and broker solutions as provider of last resort.
The Early Childhood Early Intervention (ECEI) approach supports families to help children (0 —6 years) determine whether they need access to the NDIS and to support them to develop the skills they need to take part in daily activities and achieve the best possible outcomes throughout their life. NSW Health acknowledges the work of the NDIA to improve service delivery in relation to ECEI. NSW agencies including Health continues to fill the gaps in service provision for children with autism spectrum disorder. The need for timely intervention is essential in order to ensure that interventions reach children within the critical developmental windows.
The Select Committee is supported to consider the needs of people with ASD with a broad range of social vulnerabilities.
Support for People with ASD in the Correctional System
Forensic Mental Health Reforms for people with cognitive impairment
The Mental Health and Cognitive Impairment Forensic Provisions Bill 2020 (the Bill) was passed in NSW Parliament on 16 June 2020.
The Bill comprehensively redrafts the Mental Health (Forensic Provisions) 1990 Act (MHFPA) to ensure that people with cognitive impairment are considered in the forensic mental health system. This includes:
e Changing the name of the MHFPA: The name has been changed to ‘Mental Health and Cognitive Impairment Forensic Provisions Act 2020’.
e Including a definition of cognitive impairment: The Bill provides a definition of ‘mental health impairment’ and ‘cognitive impairment’ to apply across the Bill.
The definition of cognitive impairment provides that, for the purposes of the Act, a person has a cognitive impairment if:
a. the person has an ongoing impairment in adaptive functioning; b. the person has an ongoing impairment in comprehension, reason, judgment, learning or memory and;
c. the impairments result from damage to or dysfunction, developmental delay or deterioration of the person’s brain or mind that may arise from a condition set out subsubsection (2) or for other reasons.
A cognitive impairment may arise from any of the following conditions:
a. intellectual disability, NY Ws
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borderline intellectual functioning,
dementia,
an acquired brain injury,
drug or alcohol related brain damage, including foetal alcohol spectrum disorder, autism spectrum disorder.
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Expressly including cognitive impairment in the title of the MHFPA and providing a definition for ‘cognitive impairment’ was considered by the NSW Law Reform Commission (LRC) to be critical to advance understanding and awareness of cognitive impairment.
In its 2013 Report 138, the NSW LRC (LRC 138) acknowledged that people with cognitive impairments face difficulties in the forensic mental health system. LRC 138 also found that cognitive impairment was commonly confused with mental health impairment, and cognitive impairment itself is at times not diagnosed or identified, especially where it co-existed with a mental health impairment or where there was drug or alcohol use disorder.
The definition of cognitive impairment was developed following extensive consultation with stakeholders, particularly with forensic mental health clinicians and disability advocates.
The inclusion of this definition in the Bill means that people with ASD and cognitive impairment are included in the Bill - particularly in the following areas:
e Diversion in the Local Court, when accused of low-level offending
e Court decisions on whether a person is fit to stand trial for more serious matters
e the defence of mental health impairment or cognitive impairment, previously the common law ‘defence of mental illness’.
The Bill requires the Court to consider whether trial processes can be modified, or assistance provided to facilitate the defendant’s understanding and effective participation in the trial. This would include considerations when a defendant has an autism spectrum disorder.
The Bill also amends the Crimes Act 1990 (NSW), so that people with cognitive impairment are expressly included in relation to the defense of substantial impairment. This defense was previously known as the ‘substantial impairment by abnormality of the mind’ and the Bill changes it to ‘substantial impairment by reason of mental health or cognitive impairment’.
Corrective Services NSW (CSNSW) and people with ASD
CSNSW seeks to balance the disability needs of the inmate with the requirement to reduce reoffending. Therefore, the identification of services and programs are determined based on criminogenic needs in conjunction with disability needs.
Reducing reoffending strategies and CSNSW Case Management models are designed using evidence-based practice principles. Assessing and addressing offending behavior is underpinned by the risk, needs and responsivity model. Facilitators around the state are trained to be responsive to the specific needs of the inmate with ASD. The State-wide Disability Service provides advice and support for the more complex cases.
CSNSW has a state-wide Specific Needs team which has overarching responsibility for services and programs targeting a range of diverse needs including Mental Health, Disability and complex behavioural issues. These services include specialised Units within various correctional centres to assist in the management and delivery of services to inmates with these needs. Part of the Specific Needs Portfolio includes State-wide Disability Services (SDS). SDS is a multidisciplinary team, comprised of Psychologists, Neuropsychologists, and Services and Programs Officers (SAPOs).
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Additional Support Units, intended for inmates with intellectual or cognitive disability, are not considered suitable placement for individuals with ASD. Smaller population areas with consistent staffing are generally perceived to be more appropriate environments for the stabilisation, management and service delivery to assist this group of individuals.
The overarching Specific Needs disability policy is undergoing review and development. This includes advice for CSNSW staff on how to manage autistic traits in the offender population. Specific Needs is currently also developing a Fact Sheet, including Frequently Asked Questions, regarding behavioural presentations of individuals with ASD and the management of these issues.
The Specific Needs Resource and Training Co-ordinator provides training to all Custodial Staff on understanding and managing disabilities in a custodial environment. Specific Needs provides guidance to policy development within CSNSW regarding inclusive practices. Specific Needs and SDS regularly review documents to:
e Ensure they are beneficial to individuals with ASD. e This includes ensuring documents are clear, easy to read, and delivered in a manner that facilitates understanding by the offender.
The knowledge gap in staff that has been identified in relation to the understanding and management of individuals with ASD is being addressed through disability policy enhancement and staff training. This includes:
e NDIA Exceptionally Complex Support Needs Program (ECSNP) After Hours Crisis Referral
e Autism Training Package in development by State-wide Disability Services (SDS)
e Ongoing specialised consultation available state-wide for CSNSW staff through SDS, Specific Needs about the management of individuals with ASD.
Young People in Custody
Young people with ASD in custody frequently present with comorbidity with other psychiatric disorders. This may involve emotional dysregulation which increases the risk of aggression and violence, resulting in offending behaviour. The current research evidence base supports that ASD and autistic symptoms are more prevalent in youth forensic populations. The Justice Health and
Forensic Mental Health Network (the Network) Adolescent Mental Health service (AMH) provides
mental health and drug and alcohol nurses and consultant adolescent forensic psychiatrists with expertise in the assessment and management of ASD in young people in custody.
The AMH Adolescent Court and Community Team facilitates assessment of young people at several metropolitan and regional Children’s Courts to identify ASD and recommend relevant community mental health diversion options. The Network’s School-Link program provides consultation to schools on how to manage behaviours associated with ASD in the classroom, to advocate for young people with ASD and other mental health issues to be linked back into education.
The Network’s Community Integration Team provides community-based support for young people with ASD and other comorbid mental health and drug and alcohol issues to be linked to community treatment after release from custody.
NSW Disability Policy and Legislation
The NSW Disability Inclusion Act 2014 (The Act) aims to promote the independence and social and economic inclusion of people with disability. The Disability Inclusion Act is currently under
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review. The review will help shape NSW disability legislation, to ensure it is relevant and fit-for purpose under the National Disability Insurance Scheme (NDIS).
The Act mandated the development of the Disability Inclusion Plan and enshrines the principles of inclusion in legislation holding Government accountable to effect positive systemic change. The plan has four (4) focus areas that are aimed at creating long term change and require consistent efforts from government and the wider community. The focus areas are:
e Developing positive community attitudes and behaviours
e Creating liveable communities
e Supporting access to meaningful employment
e Improving access to mainstream services through better systems and processes.
NSW Government clusters all have a Disability Inclusion Action Plan. As of 1 July 2017, all local councils in NSW had developed Disability Inclusion Action Plans in consultation with their local communities and people with disability.
Improving employment participation for people with disability is a priority for the NSW Government and supports our commitments under the Act, the NSW Disability Inclusion Plan and Jobs for people with disability: A plan for the NSW public sector. The NSW Government launched a plan in 2017 to double the participation of people with disability in the public sector to 5.6 per cent by 2025 which in 2019 became one of the Premier’s Priorities of building a world class public service. The Public Service Commission is leading this work. To achieve the target, action will occur under four priority areas:
e improving attraction, recruitment and retention of people with disability e creating more inclusive and accessible workplaces
e supporting career development and progression
e understanding and driving sector performance.
References
Cvejic, R. C., Arnold, S. R., Foley, K. R., & Trollor, J. N. (2018). Neuropsychiatric profile and psychotropic medication use in adults with autism spectrum disorder: results from the Australian Longitudinal Study of Adults with Autism. BUPsych open, 4(6), 461-466.
Hwang, Y. I., Srasuebkul, P., Foley, K. R., Arnold, S., & Trollor, J. N. (2019). Mortality and cause of death of Australians on the autism spectrum. Autism research, 12(5), 806-815.
Lawson, L. P., Richdale, A. L., Haschek, A., Flower, R. L., Vartuli, J., Arnold, S. R., & Trollor, J. N. (2020). Cross-sectional and longitudinal predictors of quality of life in autistic individuals from adolescence to adulthood: The role of mental health and sleep quality. Autism, 24(4), 954-967. https://doi.org/10.1177/1362361320908107
Schendel, D. E., Overgaard, M., Christensen, J., Hjort, L., Jorgensen, M., Vestergaard, M., & Parner, E. T. (2016). Association of psychiatric and neurologic comorbidity with mortality among persons with autism spectrum disorder in a Danish population. JAMA pediatrics, 170(3), 243-250.
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