Lizard Centre NDIS Quick Guide

The National Disability Insurance Scheme (NDIS) is a new way of providing funded supports to people with disabilities and their families. The National Disability Insurance Scheme (NDIS) funds reasonable and necessary supports that help a participant to reach their goals, objectives and aspirations, and to undertake activities to enable the participant’s social and economic participation. The NDIS is positioned to replace existing funding sources, including Helping Children with Autism (HCWA) funding and Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) funding.

To learn more about the roll out of the NDIS in your area, please visit:

• New South Wales
• Victoria
• South Australia

Step 1: Determine Your Eligibility

If the child has a condition that has already been identified as always resulting in permanent impairment and substantially reduced functional capacity, or as always benefiting from early intervention, then the NDIS does not require any further information. These conditions include:

1. Intellectual disability
2. Global Developmental Delay
3. Autism Spectrum Disorders (diagnosed by a specialist multi-disciplinary team, paediatrician, psychiatrist or clinical psychologist experienced in the assessment of Pervasive Developmental Disorders/Autism Spectrum disorders, and assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria)
4. Autism
5. Asperger’s disorder
6. Childhood disintegrative disorder
7. Pervasive developmental disorder – not otherwise specified /Atypical autism

Step 2: Complete your Access Request Form

1. Determine if the NDIS is available in your area
2. Ensure you meet the residency requirements
3. Ensure your child meets the disability requirements
4. Submit an Access Request Form
5. Wait to be contacted by an Access Partner, Local Area Coordinator or Planner
6. Participate in a planning meeting to discuss your needs

For the most up to date access requirements by region, please click here:

To complete a questionnaire to determine if you meet the access requirements, please click here:

Step 3: Prepare for Your First Planning Meeting

The following workbooks may help you prepare for your initial plan:

• NDIS Planning Workbook One
• NDIS Planning Workbook Two

1. Think about and write down your short and long term goals for your child
2. Highlight first and foremost any goals related to communication, treatment of challenging behaviour, and personal independence (e.g., dressing, toileting, mobility, community access, etc.)
3. Review the NDIS price guide
4. Think about your daily and weekly routines. Put a calendar together of a typical week for your child. Indicate where you need assistance to help your child with activities of daily living (core supports; e.g., meals, toileting, hygiene, social and recreation, transportation)
5. Think about any assistive technology or special equipment your child will need (capital supports)
6. Think about specialised supports that your child will need to learn new skills and become more independent (capacity building supports)
7. Think about the informal supports (e.g., childcare, other family members) that you already have
8. At its core, the NDIS values the social inclusion of people with disabilities. Highlight the ways in which your goals and therapy supports will help your child be socially included

Step 4: Familiarise Yourself with Key Supporting Documents

Review key supporting documentation, which will help you advocate for early intensive behavioural intervention and ABA therapy:

1. Lizard Centre position paper on ASD interventions
   1. This paper summarises the evidence for ABA and Early Intensive Behavioural Intervention, the importance of intensity, how therapy is designed to support the social inclusion of the child with autism, and summarises cost-benefit analyses of intensive early intervention
2. ABA Guidelines for ASD for healthcare funders
   1. This paper describes the Board Certified Behaviour Analyst Credential, how treatment goals are formulated and monitored, the components of an ABA therapy program, and the recommended intensity and duration of intervention
3. The Early Intervention Guidelines for Good Practice (2012)
   1. This paper was commissioned by the Australian Government to inform funding for autism treatment under HCWA and FaCHSIA. Be sure to highlight and be prepared to discuss:
      • Page 4, which describes the key elements of effective intervention, all of which are included in a Lizard program. Key elements are further described on pages 6-9
      • Page 5, which describes recommended intensity of intervention

• Page 12, which indicates that ABA and EIBI are the only autism interventions with a rating of ER: Eligible for funding based on established research evidence

1. The Autism Spectrum Disorder: Evidence-based, evidence-informed practice for supports provided to preschool children, their families, and carers (2016)
   1. This paper was commissioned by the Australian Government to inform funding for autism treatment under NDIS. Be sure to highlight and be prepared to discuss:
      • Page 11, which describes recommended intensity of intervention
      • Page 12, which describes how often intervention plans should be reviewed and the importance of individualised planning, which are included in a Lizard program
      • Page 23, which describes how only evidence-based interventions should be used. ABA and EIBI are the only autism interventions with established scientific support
      • Page 26 – all of the highlighted intervention components are firmly rooted in ABA and are included as part of an ABA intervention package which is individualised for the child
      • Page 33 – See table referencing intensity of intervention

1. Intensive Early Intervention using Behavior Therapy is the Single Most Widely Accepted Treatment for Autism. It is No Longer to be Considered either an Experimental or an Investigative Treatment. In fact, it is the only evidence-based treatment available for autism (Larsson, 2008)
   1. This paper summarises independent reviews of early intensive behavioural intervention and ABA therapy
2. Is Applied Behavior Analysis (ABA) and Early Intensive Behavioral Intervention (EIBI) an Effective Treatment for Autism? A Cumulative History of Impartial Independent Reviews (Larsson, 2013)
   1. Builds on the 2008 paper. States that impartial independent review panels consistently agree that ABA and EIBI treatments for autism are effective, and that the extensive body of research meets high standards of scientific evidence. These reviews also report that ABA and EIBI significantly improves the net health outcome in Autism in substantial and far-ranging ways.

Step 5: Decide How You Will Manage Your Funds

You have choice and the control over how you use funded supports in your plan. That includes choice of how the supports are given and which service providers you use. There are five ways that plans can be managed:

1. Agency Managed – this is where the providers claim directly from the NDIA.
2. Plan Manager – funding in your plan is allocated for a third party to manage the financial transactions in your plan.
3. Self Managed – you (or your nominee) directly manage the funds – the participant for services rendered completes all transactions.
4. Automated Payments (transport only) – these funds can be deposited into an NDIS bank account weekly, fortnightly or monthly.
5. Combination- A combination of the above 4 options can be used together to meet your individual needs.

Step 6: What Happens When Its Time To Review Your Plan

Your plan may be reviewed after 3, 6, or 12 months. Your Access Partner/Local Area Coordinator/Planner will state this when you receive your initial plan. Begin the planning process TWO MONTHS prior to the end date of the current plan. When preparing for your plan review, think about:

1. Your child’s progress toward goals on the current plan
2. Any needed re-assessments and any new assessments
3. Your goals for the upcoming year
4. The individual skills that will need to be taught as part of each larger goal
5. If you have had any change in circumstance. If your personal circumstances change significantly and this affects the supports you need from the NDIS, you can request a plan review at any time by completing the change of circumstances form here.

Step 7: What To Do If You Are Not Happy With Your Plan

Certain decisions made by the NDIS are reviewable. Reviewable decisions include those:

1. Relating to access and whether an applicant meets the eligibility criteria
2. Revoking someone’s status as a participant
3. Approving the statement of participant’s supports in the plan
4. Whether the NDIS will review a participant’s plan
5. Refusal to approve a person or entity as a service provider
6. Direction that a participant take reasonable action to claim or recover compensation
7. Decisions relating to recovery of NDIS amounts following an award of compensation from another source
8. Decisions about whether or not a person is accepted into the NDIS as a participant can be reviewed, and decisions about whether a particular support is funded can be reviewed

Step 1: Request an Internal Review:

1. An application for internal review must be made within 3 months of receiving notice of decision
2. The application can be made in writing, by phone, in person or by form (available online)
3. The NDIS must review decision “as soon as practicable” after receiving request and provide written notice that the decision has been confirmed, varied or set aside and substituted with a new decision
4. The original decision remains effective while it is being reviewed

Step 2: Request an External Review:

Following internal review, a participant may request review by the Administrative Appeals Tribunal (AAT):

1. The AAT is a ‘no costs’ jurisdiction
2. The application is made by writing a letter or filing out a form
3. A contact officer is assigned, who will assist participant through process
4. A participant is entitled to legal representation but will have to fund it themselves (for now)

The AAT process:

1. The AAT contact officer will contact the participant within 3 days
2. The contact office also notifies the Agency, who is then obliged to send the participant and the AAT all documents relevant to the application for review
3. A case conference with usually follow, which is an informal meeting to discuss the application and see if it can be resolved by agreement
4. The matter may also be listed for conciliation, which is another informal attempt to resolve the matter by agreement
5. If the matter is not resolved by agreement, it will be listed for hearing. A fast-track hearing can also be requested
6. The AAT’s decision is final