Proving our mettle: As NDIS cuts kick in, paediatric allied health professionals must find new ways to support families

For many young children with autism or developmental delay, NDIS plan and access cuts will kick in as children are progressively switched to Thriving Kids in 2027/2028.

So far, we’ve heard a lot about information websites, playgroups, and parent programs. But we don’t yet know much about the specific direct therapy services to be funded through Thriving Kids.

In our state, Thriving Kids allied health services will include “goal-focused…therapies for children who need help for a specific period of time”. But we don’t know what this will mean in practice for young children and their families.

Many autistic children and children with developmental delay will need more than a short block of generic (possibly group) therapy at a single point in time.

To access high quality, tailored services of sufficient intensity to make functional differences to long term outcomes, lots of affected families will be thinking about whether to pay privately for allied health therapies. But this isn’t easy:

With inflation jumps, interest rate rises, and cost-of-living pressures, many families can’t afford private therapy.
For families with the financial means, it’s a hard ask going from $0 out-of-pocket to full fees for two main reasons:
- Zero-price effect: demand for services falls dramatically when a service goes from free to the client to paid (Shampanier et al., 2007).
- Reference-price anchoring: families, accustomed to $0 out-of-pocket may see departures from it as unfair (Kahneman et al., 1986).

How are we responding to changing funding models when we speak with worried families during this challenging period?

Understand the stresses families are under as disability, health and education systems change.
Be transparent about:
- fees and terms (no hidden costs, no lock-in contracts, no inducements, no testimonials).
- small business costs and tough business conditions (increased costs, decreased margins).
Help families understand rebates and other supports that may make therapy services more affordable, including:
- Medicare Chronic Condition Management Plans, with up to 5 rebated allied health sessions per calendar year;
- the expanded Medicare M10 Disability Pathway, with up to 8 rebated assessment sessions and up to 20 treatment sessions; and
- the (as yet unknown) allied health referral pathways from the new GP Medicare check for 3-year-olds;
- private health insurance extras cover that may help some families pay for allied health services.
Innovate services, using new tools and networks to find new ways of delivering evidence-based therapies in more accessible ways.
Advocate for families that cannot find, afford, or access a service, including by highlighting gaps that emerge as NDIS services contract and Thriving Kids services roll-out.
Every day, show clients and families the value of services by delivering safe, high quality and evidence-based therapies that give clients value for money, with measurable outcomes.

There are no easy answers. All systems are imperfect, and allied health professionals must adapt to new constraints and develop new ways to support young autistic children and children with developmental delay and their families.