Autism and the NDIS

I’m on the Autism Spectrum – Am I entitled to NDIS Funding?

Now, you’ve seen me write this before, but I think I should remind you of the basics and then elaborate a bit.

To be eligible for the NDIS, a person must meet the following requirements: –

Have a permanent disability that significantly affects the individual’s capacity to function in everyday life.
Be less than age sixty-five when first accessing the scheme.
Be an Australian citizen, live in Australia and hold a permanent visa or hold a Protected Special Category visa.

It will help your case if you specify when asked if you need: –

special equipment for a permanent and significant disability
help from a support worker or family member to function daily
help now to reduce future need.

https://www.ndis.gov.au/applying-access-ndis/am-i-eligible

‘Special equipment?’

AUTISM may not be a potential participant’s only disability.

‘Help now to reduce future need?’

For many people, living independently promotes maturity. Participants often flourish and live successfully with support. They have gained new skills, ensuring they may not require as much funding upon plan review. The desire to live as happily and as normally functioning a life as possible is what NDIS applicants are aiming for.

To begin the application process, download an Access Request Form

https://www.ndis.gov.au/how-apply-ndis/what-access-request-form#access-request-form

Or call NDIS on 1800 800 110 to make an Access Request
Or you can complete and submit an Access Request form via email.

For help to complete the form…

For children aged 0-7years. Parents will need to contact an Early Childhood Early Intervention Partner (ECEI)
Over the age of 7 years, parents or potential participants will need to contact a Local Area Coordinator (LAC)

The COVID-19 crisis has prevented many people from meeting with their ECEI or LAC. Some are still working from home; however, you can ring their office and the skeleton staff should email the ECEI or LAC to contact you. You can also ring the NDIS on phone 1800 800 110, or email enquiries@ndis.gov.au or webchat.

Participants in non-COVID affected areas may still be able to visit an NDIS office, but I’d advise you to make an appointment first.

When making your Access Request, you will be required to

Confirm your identity
Confirm a person’s authority to act on your behalf if required
Disclose your age, address, and disability
Disclose your nominee status with words of identification for yourself and similar relevant information about the child if you are acting on behalf of one
Give consent for third parties to provide NDIS with information if already accessing a service
Provide information/evaluations from third parties (doctors, clinicians, current providers etc).

The NDIA will require you to provide evidence of your disability

You must choose the most appropriate treating health professional; the one who advises on the primary
This health professional will need to have been your clinician for a lengthy period—not less than six months.
The clinician will need to fill in Part F of the Access Request Form.

Primary disability refers to the impairment that affects you most in your daily functioning.

In the instance of AUTISM, the primary treating professionals are usually members of a multidisciplinary team comprising

Psychologist
Occupational Therapist
Speech Pathologist/Therapist

Disability evidence (in preference order)

Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)
Vineland Adaptive Behaviour Scale (Vineland-II)
World Health Organisation Disability Assessment Schedule (WHODAS) 2.0 (17 years and over) or
PEDI-CAT (16 years and under)

Other health professionals you would access for any comorbid conditions include the following. (It doesn’t hurt to have supporting evidence.)

General Practitioner (GP)
Paediatrician
Orthopaedic surgeon
Neurologist
Psychiatrist
Physiotherapist

It is important to remember that the person helping you to gather your disability evidence cannot tell you if you meet the NDIS requirements; only the NDIA can make this decision.
https://www.ndis.gov.au/applying-access-ndis

If you already have some support in place and you want NDIA to access your records from the provider, you must give your consent to the provider to supply those records.

After completing your Access Request, NDIA may ask more specific questions, such as –

How does the disability affect you in your daily life?
If you have multiple conditions, which is your primary disability?

You will need to seek the help of your primary treating physician for Part F of the Access Request form. He/she will need to

Confirm your primary disability
Confirm the impact of your disability on the different areas of your life
Describe previous treatments and outcomes
Describe future treatment options and expected outcomes of those interventions.

You can provide current information you already have or seek the help of your treating physician to complete a Supporting Evidence form downloaded from https://www.ndis.gov.au/applying-access-ndis

Why would an individual on the Autism Spectrum be eligible?

Short answer? Without predictability and routine and the understanding of the significant people in participants’ lives, AUTISM can be a debilitating condition.

Imagine for a moment that there was a standard upon which we measured disorders.

The good news? There is. Throughout history, classifications for disorders have been organised around each era’s prevailing theories that describe the cause or set of causes of each (mental) disorder. Clinicians recognised that such classifications were likely to be helpful in the clinical management of patients.
A research agenda for DSM-V / edited by David J. Kupfer, Michael B. First, Darrel A. Regier.—1st ed. Psychiatric Association. http://psychrights.org/

The Americans came up with a method of classifying mental disorders. The set of standards devised by the American Psychiatric Association called The Diagnostic and Statistical Manual of Mental Disorders is now used by much of the world to diagnose psychiatric conditions. The current edition is the fifth. (DSM-V or DSM-5) It is now the primary system for identifying mental health disorders in Australia.

But AUTISM isn’t a mental condition, I hear you say. And you’d be right. It’s neurological—and developmental. https://medlineplus.gov

In fact, world renowned clinical psychologist, (the Autism expert,) Tony Attwood would say people with Autism have a different, rather than a defective way of thinking.

When the APA removed the words Asperger’s Syndrome and PDD-NOS (Pervasive Developmental Disorder-Not Otherwise Specified) from the DSM when updating to the DSM-V, it niggled at me a bit. Why fix something that isn’t broken, right? But on reflexion, the renaming of the entire spectrum that comprises PDD-NOS, Autistic Disorder, Asperger’s Syndrome, and Childhood Disintegrative Disorder (CDD) to Autism, has grown on me. The condition is a broad spectrum, and the PDD-NOS and AS each fit somewhere on that spectrum just as the other presentations that comprise ‘Autism’ do.

You don’t hear the term Triad of Impairments used these days either. As a concept to define Autism, it was devised about a half a century ago, by Judith Gould and Lorna Wing. It’s another definition that went by the wayside with the transition to the DSM-V. The challenges it described, impaired communication, impaired social skills, and a restrictive and repetitive way of being in the world haven’t disappeared though. The DSM-V combined impaired communication and impaired social skills into a single domain termed social and language deficits. So, to be diagnosed with Autism, an individual must have ‘deficits in social communication and social interaction’ and show restrictive and repetitive behaviours.

https://www.spectrumnews.org/opinion/dsm-5-redefines-autism/

Some challenges experienced by children and adults with Autism can impede normal functioning so significantly, that affected people may develop other conditions that fit within the American Psychiatric Association’s list of mental disorders.

The attempts of people with Autism who try to fit into a neurotypical world can often render them despondent and alone. Anxiety and depression and other disorders, which are psychiatric (or mental) conditions and are defined in the DSM-V, can, and frequently do, occur with the Autism.

There is no pharmacological treatment for Autism itself, however there are treatments for many of the comorbid conditions.

So, the quick answer is, if you have a diagnosis of Autism by a recognised clinician, you may be eligible for NDIS funding.

Rhonda Valentine Dixon
First published on NDIS Plan Management Blog, avers.com.au/