By 2019–2020, it is expected that 47 000 of the 460 000 total NDIS Participants with approved Plans will be children aged between 0–6. The NDIA estimates that a further 59 000 children aged between 0–6 may identify as having a developmental delay or disability but are not expected to need individualised funded supports.

The ECEI Approach is designed to individually determine and facilitate the most appropriate support pathway for each child aged 0–6 years with a disability or developmental delay (regardless of diagnosis), and their family.

The Approach is intended to uphold the eligibility criteria of the NDIS, while helping to ensure that less severe cases are supported outside of the Scheme.

The committee recognises that the ECEI Approach is in its infancy, however, it is concerned that the current access arrangements are potentially advantaging families who can afford to source expensive assessments and reports to expedite their child's access to the Scheme.

Improvements to the ECEI

The committee acknowledges the efforts being made by the NDIA to continually improve the operation and access to the ECEI pathway. However, the committee understands concerns regarding the ECEI eligibility criteria, and is of the view that unclear eligibility criteria increase risk of misinterpretation and conflicted understanding.  The repeated confusion over whether one, or more than one area of developmental delay determines access to the ECEI pathway illustrates that more work is required to clearly annunciate which children will be eligible for support.  Publication of clearer guidance around all aspects of entry to the pathway would assist all stakeholders. 

The NDIA have recently made significant improvements to the Participant pathway, however the committee remains troubled by reports that Planners have poor understanding of the needs of the children they are developing Plans for. Planners should, at the least, have awareness of recommended intervention guidelines and therapies for the major disability cohorts, and demonstrate sensitivity in their communications with families.

Assessment tools

The committee is concerned by reports that the PEDI-CAT tool is unsuited to assessing the functional capacity of children with a developmental delay, including those with Autism Spectrum Disorder (ASD), yet it is being used by the NDIA and its Partners to inform access and funding decisions and track children's developmental progress. The potential inaccuracy of the PEDI-CAT in determining a child's functional needs leads to broader concerns about whether the number of children with developmental delay accessing the NDIS and the level of their delay is correct.

ECEI participant assessments and diagnosis

The committee is concerned that some families have had to fully or partially fund assessment and diagnosis reports to ensure their child could access ECEI services and have adequately funded plans. As discussed in chapter 2, there should be no need for families to provide these costly assessment and diagnosis reports at the time of lodging the access request for ECEI services with the NDIA or during the planning process.

Plans

The committee is concerned with the numerous reports of significantly underfunded plans for ECEI participants. The committee noted that the funding shortfalls and inconsistencies in plans appear to particularly affect children with ASD and those with hearing impairments.

Underfunded plans for children with ASD

The report also explores evidence in relation to recurring funding shortfalls in plans for children with ASD. It appears that the level of funding granted in many plans does not meet participants' needs and does not align with recommended evidence-based practice guidelines. This is resulting in those children not accessing the right level of support and therapies to achieve optimal outcomes.

Alarmingly, the committee heard that NDIS funding levels are often lower than previous national funding models such as Helping Children With Autism. It is concerning that some participants and their families are potentially worse off than under previous funding models.

With almost 40 per cent of NDIS participants age 0–6 years having ASD as their primary disability, it is of paramount importance that the NDIA urgently addresses the issues of scope and level of funding in plans for children with ASD.

Assistive technology

The committee believes that approval of funding for assistive technology should be systematically and consistently based on the participant's individual needs to achieve optimal outcomes. The funding decision should not be based on minimising costs. As a result, the committee is concerned that some submitters suggested that participants were given inappropriate assisted technology equipment to reduce costs.  

Supports for families and carers

The committee believes access to supports for families and carers should be integral to the ECEI Approach. The committee agrees that, to date, the role of siblings of children with disability has been overlooked within the framework of the NDIS and its ECEI Approach. The committee believes that the NDIA should consider the development of sibling specific supports and how these could be integrated into the ECEI Approach. Development of tailored programs should be considered and delivered through the ILC.

Delays in accessing plans

The committee is concerned with widespread reports of delays in accessing and receiving services for ECEI participants with a plan. This can significantly impact on the success of therapies and the ability of participants to achieve optimal outcomes.

Where delays can be attributed to staffing pressures in the Agency the committee is of the view that the staffing cap currently in place should be removed to facilitate further resources being provided to address systemic blockages.

Delivery in rural and remote locations

The committee understands there can be significant additional costs to deliver services in rural and remote areas, including costs associated with travel. The committee noted that the new NDIA Price Guide introduced on 1 July 2017, incorporates a series of changes, including an increased price loading to apply for the delivery of supports to participants in remote and very remote parts of Australia. However, it appears that the issue of travel costs remain a significant cause of concern for services providers

NDIS website

The committee acknowledges that the NDIA has made efforts to publish a range of ECEI-related material on its website. However, it agrees with submitters' that the quality of information currently available for families and carers could be improved. The NDIA should ensure that information on the NDIS website is logically presented. All information should be clearly dated, indicate if it has been superceded, and identify related historical information. Information relevant to the ECEI Approach should consolidate information from multiple sources, and remove redundant and contradictory information.

Assertive outreach

The committee is of the view that ECEI Partners do not currently have the capacity or funding to conduct essential outreach and support services for vulnerable cohorts. The committee agrees with the Productivity Commission that adequately resourcing Information, Linkages and Capacity Building (ILC) is critical to ensure people with disability are connected with appropriate services.

Access for Aboriginal and Torres Strait Islander families

The committee is troubled by reports that there are Aboriginal and Torres Strait Islander families unable to use allocated funding because they are unsure how to access services. The committee considers that resources should be developed in co-design with people with disability, Aboriginal and Torres Strait Islander populations, and CALD communities to assist them to understand the Scheme, and how to use their funds to access services.

The work undertaken by the NDIA in developing an Aboriginal and Torres Strait Islander Engagement strategy is a positive step. However, it is imperative that the NDIA develop a specific strategy to ensure that culturally appropriate early intervention services are delivered for this community by specialised staff.

Conclusion

The committee received a wealth of information and evidence throughout the inquiry and thanks all those who participated. As a result, the committee has made 20 recommendations, which aim to strengthen the effectiveness of the Scheme to ensure that children can be appropriately supported to reach their full potential.

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