HWSN and National Disability Insurance Agency (NDIS) - [2025] ARTA 1816

HWSN and National Disability Insurance Agency (NDIS) [2025] ARTA 1816 (15 September 2025)
Applicant/s:  HWSN
Respondent:  National Disability Insurance Agency
Tribunal Number:                2023/8186
Tribunal:Senior Member A Clues
Place:Hobart
Date:15 September 2025

Decision:The Tribunal sets aside the decision under review pursuant to section 105(c)(ii) of the Administrative Review Tribunal Act 2024 (Cth) and remits the matter to the respondent for reconsideration in accordance with the orders that:
(a)Within 14 days of this decision, the applicant’s statement of participant supports is to include:
(i)Core Support Funding for a Support Worker (Level 2) of 37 hours per week, calculated as follows:
·         Assistance with daily life and self-care - 5 hours per day, each week day at the week day rate.
·         Assistance with daily life and self-care – 2 hours per day, on the weekends at the respective Saturday and Sunday rates.
·         Community access to social and recreational activities - 4 hours per day, on the weekends at the respective Saturday and Sunday rates.

(ii)Core Support Funding for a Support Coordinator (Level 3) for 26 hours per annum, to be applied on a pro rata basis over the length of the applicant’s new plan.
(iii)Capacity Building Supports
·         1 hour per week of occupational therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         1 hour per week of speech therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         1 hour per week of behaviour support therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         12 hours per week for a Level 2 Therapy Assistant.
·         3 hours for an assessment by a Continence Nurse Consultant

(iv)Consumables
· Quotes to be obtained in conjunction with the assessment by a Continence Nurse Consultant or negotiated directly with the respondent.

(b)The date by which the respondent must reassess plan is on or before 10 February 2026.

Senior Member A Clues
Catchwords
NATIONAL DISABILITY INSURANCE SCHEME –- reasonable and necessary core and capacity building supports – consideration of s 34 National Disability Insurance Scheme Act 2013 (Cth) – autism – inability to access therapy required – underutilisation of capacity building supports – support worker assistance – support coordinator – what is reasonable to expect from families.
Legislation
Administrative Review Tribunal Act 2024 (Cth).
National Disability Insurance Scheme Act 2013 (Cth).
Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth).
National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (Cth).
National Disability Insurance Scheme (Supports for Participants) Rules 2013.
Education Act 1990 (NSW)
Cases
Shi v Migration Agents Registration Authority [2008] HCA 31; (2008) 235 CLR 286.
Esber v The Commonwealth [1992] HCA 20; (1992) 174 CLR 430, 440.
Frugtniet v Australian Securities and Investment Commission [2019] HCA 16; (2019) 266 CLR 250.
QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189.
Statement of Reasons

The applicant has just turned six years old. He was born in England. His family moved to Australia in November 2022. On 14 July 2023, the applicant was granted access to the National Disability Insurance Scheme (NDIS) on the basis of Global Developmental Delay (GDD). The applicant was subsequently diagnosed with Autism Spectrum Disorder, level 3 (ASD). The respondent has accepted that the applicant has impairments resulting from these conditions.
The applicant is an only child who lives with his mother and father in New South Wales. He is cared for full-time by his mother, who is in receipt of the Carer Allowance from Centrelink.[1] His father works extended and non-traditional hours including weekends. He is the sole income earner for the household.[2] The family currently has no access to informal or formal support networks.[3]
[1] JTB 2.
[2] JTB 924.
[3] JTB 925.
On 21 August 2023, a Statement of Participants Supports (SOPS) was issued to the applicant. The applicant sought a review of that decision under section 100 of the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act). On 18 October 2023, the respondent affirmed the original decision. On 2 November 2023, the applicant applied to the Administrative Appeals Tribunal (AAT) for a review of that decision under section 103 of the NDIS Act. The AAT was abolished on 13 October 2024 and the Administrative Review Tribunal (the Tribunal) began on 14 October 2024. By virtue of the transitional provisions of the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth)(the Transitional Act), applications for review to the AAT that were not finalised before 14 October 2024 are taken to be an application for review to the Tribunal. The Transitional Act gives the Tribunal the authority to continue and finalise any aspect of the review not already completed by the AAT. Further, the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (Cth) (the Back on Track Act) commenced on 3 October 2024 and made significant amendments to the NDIS Act. The amendments pursuant to section 34 of the NDIS Act will apply to this review.[4]
[4] See s129 of the Back on Track Act.
The Hearing
The hearing took place on 14, 15 and 16 July 2025, via Microsoft Teams video. The applicant was represented by Mr Buckley. The respondent was represented by Ms Thornton, counsel, who was instructed by Ms Ramnoruth of Moray and Agnew.
The following documents were admitted into evidence by consent:
E1, joint tender bundle (JTB) pages 1-1376.
E2, applicant’s evidence bundle pages 1-28.
Oral evidence was given at the hearing by the following witnesses for the applicant:
·R, the applicant’s mother.
·J, the applicant’s father.
·C Kennedy, psychotherapist.
·J Lee, occupational therapist.
·A Papanicolaou, senior support worker.
·S, director and educational leader.
·KS, lay witness.
No witnesses were called on behalf of the respondent.
Role of the Tribunal
The role of the Tribunal is to make the correct or preferable decision based on the material before it.[5] In reviewing the decision:
(i) the Tribunal stands in the shoes of the delegate/internal reviewer and must make the correct or preferable decision based upon the evidence and other material before it,[6] and
(ii) the scope of the Tribunal’s jurisdiction is determined by reference to the scope of the internal reviewer’s powers under section 100 of the NDIS Act, which is in turn informed by the scope of power under section 33(2) of the NDIS Act.[7]
[5] Shi v Migration Agents Registration Authority [2008] HCA 31; (2008) 235 CLR 286.
[6] Esber v The Commonwealth [1992] HCA 20; (1992) 174 CLR 430, 440; Frugtniet v Australian Securities and Investment Commission [2019] HCA 16; (2019) 266 CLR 250.
[7] QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189.
The relevant provisions under the Administrative Review Tribunal Act 2024 (Cth) (the ART Act) are sections 54 and 105.
THE LEGISLATIVE SCHEME
The objectives of the NDIS Act are set out in section 3. A participant’s plan must include a SOPS, approved in accordance with section 33 of the NDIS Act. Section 34 of the NDIS Act identifies what establishes a ‘reasonable and necessary’ support under the scheme. It states as follows:
Reasonable and necessary supports
(1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:
(aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);
(a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations;
(b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation;
(c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;
(d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;
(e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks, and the community to provide;
(f) the support is a NDIS support for the participant.
Note: For the purposes of paragraph (aa):
(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and
(b) a participant’s disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.
The relevant rules in respect of this review are the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth) (the Supports for Participant Rules). Rules 3.1 to 3.5 of the Supports for Participant Rules relate specifically to sections 34(1)(c) - (e) and state:
Value for money
3.1 In deciding whether the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support, the CEO is to consider the following matters:
(a) whether there are comparable supports which would achieve the same outcome at a substantially lower cost;
(b) whether there is evidence that the support will substantially improve the life stage outcomes for, and be of long-term benefit to, the participant;
(c) whether funding or provision of the support is likely to reduce the cost of the funding of supports for the participant in the long term (for example, some early intervention supports may be value for money given their potential to avoid or delay reliance on more costly supports);
(d) for supports that involve the provision of equipment or modifications:
(i) the comparative cost of purchasing or leasing the equipment or modifications; and
(ii) whether there are any expected changes in technology or the participant’s circumstances in the short term that would make it inappropriate to fund the equipment or modifications;
(e) whether the cost of the support is comparable to the cost of supports of the same kind that are provided in the area in which the participant resides;
(f) whether the support will increase the participant’s independence and reduce the participant’s need for other kinds of supports (for example, some home modifications may reduce a participant’s need for home care).
Effective and beneficial and current good practice
3.2 In deciding whether the support will be, or is likely to be, effective and beneficial for a participant, having regard to current good practice, the CEO is to consider the available evidence of the effectiveness of the support for others in like circumstances. That evidence may include:
(a) published and referred literature and any consensus of expert opinion;
(b) the lived experience of the participant or their carers; or
(c) anything the Agency has learnt through delivery of the NDIS.
3.3 In deciding whether the support will be, or is likely to be, effective and beneficial for a participant, having regard to current good practice, the CEO is to take into account, and if necessary, seek expert opinion.
Reasonable family, carer, and other support
3.4 In deciding whether funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks, and the community to provide, the CEO is to consider the following matters:
(a) for a participant who is a child:
(i) that it is normal for parents to provide substantial care and support for children; and
(ii) whether, because of the child’s disability, the child’s care needs are substantially greater than those of other children of a similar age; and
(iii) the extent of any risks to the wellbeing of the participant’s family members or carer or carers; and
(iv) whether the funding or provision of the support for a family would improve the child’s capacity or future capacity, or would reduce any risk to the child’s wellbeing;
...
(c) for all participants—the desirability of supporting and developing the potential contributions of informal supports and networks within their communities.
Supports appropriately funded or provided through the NDIS
3.5 Schedule 1 sets out matters for the CEO to have regard to in considering whether supports are most appropriately funded or provided through the NDIS, rather than through other service systems (service systems is defined in paragraph 6.4).
Part 5 of the Supports for Participant Rules sets out the general criteria for supports:
General criteria for supports
5.1 A support will not be provided or funded under the NDIS if:
(a) it is likely to cause harm to the participant or pose a risk to others; or
(b) it is not related to the participant’s disability; or
(c) it duplicates other supports delivered under alternative funding through the NDIS; or
(d) it relates to day-to-day living costs (for example, rent, groceries and utility fees) that are not attributable to a participant’s disability support needs.
5.2 The day-to-day living costs referred to in paragraph 5.1(d) do not include the following (which may be funded under the NDIS if they relate to reasonable and necessary supports):
(a) additional living costs that are incurred by a participant solely and directly as a result of their disability support needs;
(b) costs that are ancillary to another support that is funded or provided under the participant’s plan, and which the participant would not otherwise incur.
Schedule 1 of the Supports for Participant Rules outlines supports appropriately funded, as referenced in Rule 3.5, as follows:
Early childhood development
7.8 The NDIS will be responsible for personalised supports, specific to a child’s disability (or developmental delay), which are additional to the needs of children of a similar age and beyond the reasonable adjustment requirements of early childhood development service providers.
7.9 The NDIS will be responsible for early interventions for children with disability (or developmental delay) which are:
(a) specifically targeted at enhancing a child’s functioning to undertake activities of daily living, but not supports which are specifically for the purpose of accessing a universal service such as school readiness programs that prepare a child for education; and
(b) likely to reduce the child’s future support needs, which would otherwise require support from the NDIS in later years, including through a combination and sequence of supports.
7.10 The NDIS will not be responsible for:
(a) meeting the early childhood education and care needs of a child with a developmental delay or disability required by children of a similar age including through inclusion supports that enable children to participate in early childhood education and care settings; or
(b) supports, which are clinical in nature provided in the health system, including acute, ambulatory or continuing care; or
(c) new-born follow-up provided in the health system, including child and maternal health services.
A further consideration is section 5(f) of the NDIS Act which contains the general principle guiding the actions of people who may do acts or things on behalf of others under the scheme. It provides as follows:
...
(f) if the person with disability is a child – the best interests of the child are paramount, and full consideration should be given to the need to:
(i) protect the child from harm; and
(ii) promote the child's development; and
(iii) strengthen, preserve and promote positive relationships between the child and the child's parents, family members and other people who are significant in the life of the child.
The purposes and objects of the NDIS Act must be considered in conformity with section 34(1) and the Supports for Participant Rules, noting that if one of the requirements in ss 34(1)(aa)-(f) is not satisfied, the support will not be funded under the NDIS.
Scope of the Review
At the time of publishing this decision, the applicant will be six years of age. It is compulsory for children in New South Wales to be enrolled in and attend school from six unless they are granted a certificate of exemption from enrolment.[8] As at the date of the hearing no decision had been made in relation to the applicant’s schooling . At the hearing, the Tribunal determined pursuant to section 53 of the ART Act, that the scope of this review would be limited to determining the reasonable and necessary supports for the applicant until the commencement of the 2026 school year on 27 January 2026.
[8] JTB 1357 and the Education Act 1990, section 22.
Plan utilisation
On 1 July 2025, the applicant’s plan manager sent an email to the applicant’s mother providing details of the applicant’s plan utilisation from 21 August 2023 until 1 July 2025. The email states that the plan ended on 20 August 2025. The email confirms that the applicant had funding for Capacity Building Supports as follows:

Support category

Budget

Spend to date

Left to spend

% Spend

Improved life choices

$1798.47

$1485.12

$313.35

82.58%

Improved daily living skills

$34,676.76

$14,573.72

$20,103.04

42.03%

Total

$36,475.23

$16,058.84

$20,416.39

44.03%

The applicant’s plan contains no funding for Core Supports or Capital Supports.[9]
[9] JTB 29.
The applicant’s position
In an email to the respondent’s solicitor dated 7 May 2025,[10] the applicant’s mother advised the respondent as follows:
The following are disputed supports:
·Request 1 - 96 hours of Support Coordination.
·Request 3 - 40 hours per week of Support Worker Assistance.
[10] JTB 857.
In the applicant’s response to the respondent’s statement of facts issues and contentions (SOFIC), the following supports are requested for the applicant:[11]
·Support with transport in the community. The applicant submits that without assistance with transport outside the home, he has reduced access to child care, therapies, health supports and the community. Consequently, the applicant has only used 44% of his already inadequate supports over the two years since his plan has been in dispute.
·A program of intervention that includes; 25 – 30 hours per week of therapy; seven hours per week with a behavioural clinician; 10 – 20 hours of reporting and assessment.
·96 hours of support coordination as there is no evidence supporting the respondent’s position of 24 hours per year of support coordination, level 2.
[11] JTB 23.
The respondent’s position
According to the respondent’s SOFIC, the applicant’s current plan is based on 89 hours of capacity building supports, early childhood intervention.[12]
[12] JTB 2.
With regard to the disputed supports, the respondent considers the following reasonable and necessary:
·Support Coordination level 2 for a total of 24 hours per year.
·Specialised home based assistance for a child at 10 hours per week over 52 weeks.[13]
[13] JTB 2.

The respondent also considers the following additional capacity building supports are reasonable and necessary:
·65 hours of Specialised Behaviour Support (45 hours for specialist behaviour intervention and 20 hours of behaviour management plan and training).
·120 hours of Level 2 Therapy Assistant to assist with implementing therapies in the home environment.
The respondent submits that there are a number of recommendations from allied health professionals and treating practitioners that the applicant requires regular therapeutic intervention. The applicant’s mother has been informed of the support available to the applicant in his plan that can be used to access supports such as occupational therapy, speech therapy and behavioural therapy. The applicant has not yet engaged with effective regular therapeutic intervention. The applicant’s mother reports that the applicant’s NDIS plan has not been utilised as she does not have the ability to coordinate supports.[14]
[14] JTB 3.
The respondent contends that the requested level of support appears to be based on liberating the applicant’s mother from her caring role/parental responsibility and thus runs counter to section 34(1)(e).[15]
[15] JTB 5.
The respondent relies upon rules 3.4 (a) and (b) of the NDIS Supports Rules which state that when determining whether a support should be provided, the Tribunal needs to takes into account what is reasonable to expect families, carers, informal networks and the community to provide for a participant who is a child. Further, the Tribunal is to consider the following:
·That it is normal for parents to provide substantial care and support for children.
·Whether, because of the child’s disability, the child’s care needs are substantially greater and those of other children of a similar age; and
·The extent of any risks to the well-being of the participant’s family member or carer or carers.
·Whether the funding or provision of the support for a family would improve the child’s capacity or future capacity or would reduce any risk to the child’s well-being.
·The desirability of supporting and developing the potential contributions of informal supports and networks within [the participant’s] communities.
Issues
The issues for the Tribunal to determine are as follows:
·Is the applicant entitled to support worker assistance and if so, how much?
·Is the applicant entitled to support coordination and if so, how much?
·What capacity building supports are reasonable and necessary for the applicant?
THE EVIDENCE
R, the applicant’s mother
R gave oral evidence at the hearing and provided a very detailed carer statement.[16]
[16] JTB 734-756.
Put simply, R’s evidence is that she is unable to manage the applicant. She wants him to access therapy, treatment and the community, but she cannot manage getting him anywhere on time by herself. She does not drive, her husband works full-time and irregular hours and she has no informal support.
R finds it very difficult to get the applicant out of the house at all and he refuses to allow anyone into the house. He is totally reliant and dependent upon R and often rejects his father when he is trying to assist. Due to this behaviour R cannot get the applicant to child care or to any of the assistance and therapy that he needs.
At this time, the applicant will not tolerate anyone coming into the home. R believes that she could get the applicant ready in the morning but needs a support worker to get him to childcare. For safety reasons, the applicant requires a full harness safety seat. R needs to be in the back seat of the car with the applicant as he often tries to take the harness off. R finds it very difficult to catch public transport with the applicant because of his unpredictable behaviour. Often, he refuses to get on the bus, and he displays unsafe behaviour whilst on the bus. When using public transport, it can take her between 2 to 4 hours to get the applicant to childcare when it should only take around 45 minutes. When her husband is available to drive them to childcare it only takes about 20 minutes.
R would like a support worker to arrive at their home at 8:30 AM each weekday to take the applicant to childcare for arrival by 9 – 9:30 AM each day.
Due to the applicant’s reliance upon R, his difficult behaviours and her inability to get him anywhere on time (without the assistance of her husband), R has not been able to access any of the therapy and treatment that the applicant requires. She would like to work with a support coordinator and a support worker to ensure the applicant can access the therapy and treatment he needs.
In the extensive carer’s statement that R prepared, she says that the applicant:
·Is not able to communicate verbally his needs and he has difficulty understanding instructions. This causes him frustration and distress, including crying and ‘meltdowns’ that can last for up to 2 hours at a time.
·Needs help with getting dressed. He can become fixated on wanting to wear the same clothes and shoes every day.
·Does not go to bed at a normal time for a child his age.
·Has no safety awareness. For example, when trying to get onto a bus, he may try to run out on the road, he may have a meltdown and will not get on the bus, he will not remain seated and often runs on the bus.
·Has difficulty separating from R and often rejects assistance from his father.
·Finds it difficult to engage with other children. When he has to wait in a line in a busy place such as a shopping centre or play area, this often leads to agitation and disruptive behaviour.
·Has difficulty with movement of his body, particularly when at the park. He becomes upset and distressed when he sees other children being able to play and climb.
·Is constantly on the go and cannot be left unattended or unsupervised due to safety risks.
·Has challenging eating habits. Many of his tantrums are related to his sensory needs and eating preferences. He often does not finish food prepared for him. He has to have his food cut into tiny pieces to prevent choking. If something falls on the floor, he gets very upset and has a meltdown.
·Does not cope well when R or his father have food on their plates that he does not like and he will try to stop them from eating it.
·Is particular about his bath routine. He needs the same colour bath bomb each night.
·Is not toilet trained and wears nappies. Taking his nappy off causes anxiety and an outburst of disruptive behaviour.
·Dictates when they can leave the house, the route they take and how long they stay somewhere. For example, at the grocery store he may become agitated and start crying and will not allow R or his father to use a trolley or basket which makes it impossible to get essential items.
·Does not allow his parents to start eating their food until he is ready. They cannot enjoy meals out together as a family.
·Will not attend a football game with his parents because he becomes overwhelmed. They have tried using noise cancelling headphones without success. They cannot enjoy family outings and expose the applicant to new experiences.
·Will grab anything he can find and play with it and/or put it in his mouth, which means he requires constant supervision.
·Relies upon R for all of his needs and activities. He often does not let his father assist him and tends to push him away. This makes it hard for R to leave the applicant with her husband or anyone. As a result, R cannot attend to her own needs, she does not get a break at any time and needs to clean the house and prepare food for the next day when the applicant finally goes to sleep. R cannot receive treatment for her own health issues and is unable to take driving lessons.
·Will often not allow R to use her phone which makes it very difficult for her to call therapists and arrange the treatment the applicant needs. R needs help from a support coordinator to understand the NDIS system and the supports she may be able to access.
·Has not been able to utilise the funding for therapy that is in his NDIS plan because R does not have the ability to coordinate supports, due to the difficulty in talking on the phone (because the applicant seeks her attention) and due to the high level of support that she needs to provide the applicant throughout the day.
R believes that once the applicant has the intense support he needs, he will be able to get into a routine and make a positive start on his development, and will be able to express himself better, which will help his meltdowns, and improve his well-being. R fears that if the applicant does not access morning support, and support to access the community including transition support, he will not be able to successfully attend childcare, and this will have a profound effect on his development, and ability to attend future school education.
J, the applicant’s father
J gave oral evidence at the hearing and prepared a brief statement.[17] In J’s statement he says:
I work full-time to support our family. I have read the statement provided by my wife and I concur with it. The lack of appropriate transport support means that the entire burden of managing these challenges in routines and transitions out in the community falls on my wife. Without funded transport support [the applicant’s] ability to access therapies and community activities is severely limited. A plan that funds the therapies but provides no safe way to get there is not going to be effective. This has been the case since 2023. Getting to and from a medical appointment, childcare/education, park, soft play centre, therapy. All of these require supervision to ensure [the applicant] is safe. I have taken time off work and help with this wherever I can. I cannot continue to do that.
[17] JTB 959
J gave evidence that he works as a traffic controller. He regularly works 60 hours per week on a 13-day fortnight. His hours and places of work vary. He often leaves for work between 5 and 6 AM so he often goes to bed before the applicant does and he is not around to assist in the mornings. He tries to meet R in transit after he finishes work and they pick the applicant up from childcare together. His wife needs to be with him when they pick up the applicant because he will not go with his father by himself. When he has driven the applicant to childcare with his wife in the morning, there have been occasions when the applicant has refused to get out of the car and they have had to get the childcare director to come to the car and assist.
They try to have family time together in the evenings, but this is difficult. If they go out to dinner, the applicant will not let him sit down or face him when he is eating. They try to take the applicant to different places including to parks and beaches. He said they recently took the applicant to see ‘Disney on Ice.’ The applicant got stuck in a lift and during the first 20 minutes of the show he was crying and upset, so they left.
He believes the applicant is regressing. For example, he used to know his alphabet but does not any more. He believes that if the applicant can get into a routine, he would be better. His wife puts in a lot of effort, but the applicant is a great struggle to manage by herself.
R’s family lives in England. J’s family reside in New South Wales but not close to them. His mother has leukaemia and his father is her full-time carer. They are ‘old school’ and do not understand the applicant’s autism. He does have an older sister, but they are not close and he rarely sees her. They have no contact with any other family members.
Ms C Kennedy (psychotherapist)
Ms Kennedy prepared four reports in relation to the applicant and one letter regarding her observations of R. She received a summons from the respondent and attended the hearing to give evidence.
Ms Kennedy said that her assessment of the applicant involved three formal telehealth appointments, between 3 to 6 discussions with R and email clarification with R. She found the preparation of the report very difficult because she was unable to talk freely with R because she was constantly distracted by the applicant. She reviewed photos and videos of the applicant in various settings but did not see him physically.
In her report dated 20 May 2025, Ms Kennedy provides the following clinical profile for the applicant:
·ASD Level 3 with co-occurring PDA (pathological demand avoidance).
·Extreme difficulty regulating emotional states in high demand or unpredictable environments.
·Compound trauma due to loss of familiar social structure and perceived unpredictability.
·Acute separation anxiety with somatic features (e.g. loss of speech, hypervigilance).
She says:
These difficulties are not due to oppositional behaviour but rather a neurodevelopmental need for predictability, autonomy, and attuned therapeutic intervention. Misinterpreting these behaviours as “defiance” risks significant harm and exclusion from services.[18]
[18] JTB 909.
In Ms Kennedy’s report dated 21 May 2025 she states that the applicant presents with significant impairments in emotional regulation, social development, adaptive behaviour, and environmental engagement. She provides a number of examples of these impairments.[19]
[19] JTB 915.
Ms Kennedy prepared two reports dated 22 May 2025. In her first report of that date, she lists the following participation barriers for the applicant:
·Home environment:
oRequires constant 1:1 (often 2:1) supervision for all activities.
oExperiences frequent meltdowns, shutdowns and immobilisation when overwhelmed.
oRelies entirely on mother for daily care, communication interpretation, toileting routines and transitions.
·Community engagement
oDue to the lack of necessary supports in place [the applicant] is not currently accessing early childhood education consistently. He also has no opportunity for any consistent social interaction outside the home due to extended transitions and public dysregulation episodes.
oKnown flight risk in all open or busy environments; prone to bolting behaviour without awareness of road or environmental dangers.
oEmotional responses in public include extended crying, collapse, or physical withdrawal - often triggered by sensory input, perceived demands, or unpredictable events.
·Therapy access
o[The applicant’s] severe separation anxiety and rigid routines mean therapy access has been sporadic or unavailable.
oAll prior attempts to engage services without additional support has failed; this includes OT, early intervention, and paediatric follow-ups.
oWithout a support worker and support coordination, meaningful access remains unattainable.[20]
[20] JTB 918-919.
In her second report dated 22 May 2025, Ms Kennedy requests that the applicant be provided with immediate allocation of funding for:
·Support worker services (2:1 supervision where required).
·Support coordination (to assist with implementation).
·Play based, trauma informed therapy supports (e.g. OT, creative counselling).
·small group programs for social and emotional development.[21]
[21] JTB 922.
Ms Kennedy also prepared a ‘voluntary letter of concern and support’ dated 23 May 2025.[22] She decided to write this letter wholly of her own accord, in line with her ethical responsibility as a trauma informed practitioner, having directly witnessed the extensive psychological deterioration and psychosocial distress experienced by [R] as a direct result of ongoing system neglect, procedural unfairness, and the unrelenting burden placed on her over the past two and a half years in her attempts to secure adequate support for her son.
[22] JTB 939-940.
Ms Kennedy says in her letter that since her first contact with R she has received urgent and panicked communications which are often delivered in hushed or interrupted tones, as she is frequently forced to conceal her attempts to seek help out of fear of emotional dysregulation from the applicant. It has been common for her to abruptly terminate conversations due to the applicant’s distress. Ms Kennedy states that R is logistically unable to make appointments, coordinate care, or maintain access to critical supports. She concludes her letter by stating:
I hold serious concern for the wellbeing of this family.
Ms J Lee, (occupational therapist)
Ms Lee prepared two reports in relation to the applicant. She received a summons from the respondent and attended the hearing to give evidence.
Ms Lee saw the applicant on 28 September 2024 for approximately 1.5 hours. Her assessment of the applicant was conducted in person at her therapy clinic. The applicant attended with his mother and father, who requested that she complete a functional capacity assessment report with recommendations for the NDIS.
Ms Lee said that the applicant was very difficult to assess and displayed a lot of behaviours of concern. She noted that the applicant’s play based skills were limited. He had sensory concerns, a rigid mindset and a limited diet. He was not toilet trained, he was unable to follow simple instructions and he did not sit during the assessment. She said that based on her observations the applicant required occupational therapy, speech therapy, behavioural support therapy and a continence assessment. She noted the parents had been unable to coordinate ongoing therapy for the applicant. She advised that she was unable to provide the applicant with a regular appointment time that suited his family. They wanted a clinic-based appointment on a Saturday. She could not assist them.
There was a long gap between the dates Ms Lee initially assessed the applicant in her clinic on 28 September 2024 and the date she provided her report dated 19 May 2025. The reason for the delay was the length of time it took for the applicant’s mother to complete the tests she was provided with.
Ms Lee noted that a therapy team had not been put in place for the applicant and the reason for this was the applicant’s inability to access this therapy. She said it was important to increase the applicant’s ability to attend the therapies he needed. She felt the applicant required supported transportation. She formed the view that the applicant required a support worker to make capacity building supports more accessible and to provide him with support in the home and the community. She said the applicant required support to work alongside a multidisciplinary team of therapists.
In her report of 19 May 2025, she says:[23]
[23] JTB 878-879.
[The applicant]… is dependent on his mother for all aspects of daily life. He is at further risk of isolation due to his anxiety and rigid ideation for his daily sequence of events affecting his community participation and ability to transition and leave the house. He is unable to participate in daily activities that are not set by his terms and experiencing high levels of distress and meltdowns on a daily basis.
From the functional assessments used (PEDICAT) and Vineland-3 results from October 2024 via the child development unit, it is evident that [the applicant’s] adaptive skills are in the Low Range.
[The applicant] has the ability to develop his skills and outcomes with capacity building support as well as increasing his communication skills and social skills by attending therapy at home or in the community setting. It is evident that these supports will improve the following domain areas:
·Cognitive development - learning new skills required on a daily basis, being able to follow directions through play-based development.
·Behaviour management - increasing his flexibility and ability to cope with changes, his emotional regulation and reducing his distress on a daily basis.
·Developing positive relationships in the community - developing interactions with other adults and therapists. Developing autonomy of skill and reducing reliance on his mother, reduction in separation anxiety and increasing [the applicant’s] community integration and participation.
·Communication skills and social skill development – [the applicant] does not respond to instructions or others, he is isolated as he does not have siblings or friendships due to the level and nature of his autism spectrum diagnosis. He plays on his own (i.e. solitary play) and often refuses to leave the home to attend childcare or educational facilities. This will impact on his economic and social participation in the long-term.
·Self-care skills (e.g. toileting, dressing, feeding) and coping with sensory difficulties affecting his self-care areas and general hygiene.
·Mobility (i.e. including gross and fine motor skill development).
·Safety awareness and community participation.

Ms Lee states that the applicant requires:
· Capacity Building Supports, of occupational therapy, speech pathology and behavioural therapy to develop his skills throughout his lifespan to increase his independence and participation in daily activities and reduce his refusal and dependency on others.
· 1:1 Core Support Funding - for his Daily Activities/Community Participation and Self-Care Skills. At this stage in the applicant’s development he requires 2:1 supports to participate in the community as well as in self-care tasks, which is not available with one parent at home. It is therefore recommended that the family be provided with a 1:1 Support Worker (Level 2) skills and training based on his behavioural needs.[24]
[24] JTB 879.
Ms Lee states that including core support funding in the applicant’s current plan will reduce the risk of harm to him and the family unit. It will also improve his relationships and the sustainability of his supports. As the applicant continues capacity building through the years, it is likely that his support worker hours will reduce over time as his integration with social and community activities develop and improve.[25]
[25] JTB 879.
In relation to support workers, Ms Lee makes the following recommendations relating to the applicant’s requirements for self-care and daily assistance, including community participation.
·Assistance with daily life/self-care - including going for a walk, going to the park, shops, library, therapy and medical appointments. This also includes developing some 1:1 interactions with [the applicant] at home, including engaging in his preferred activities; to support his needs throughout the day. This includes transportation to/from his community appointments with his mother. Currently [the applicant] takes a significant amount of time to get out of the house.
·Self-care - assistance with toileting, showering, brushing teeth, mealtimes, dressing skills in the home environment with support to integrate skills from his OT/ behavioural support practitioner.
·Community access to social and recreational activities - the support includes access to community events such as the park, pool, beach, museums so [the applicant] can develop interactions in the community and eventually integrating with his peers.[26]
[26] JTB 877.
Ms Lee recommends the following capacity building supports:
·Occupational therapy – weekly
·Speech pathology – weekly
·Behaviour support practitioner – weekly
·Continence nurse - continence assessment
Ms Lee recommends the following core supports:[27]
·Assistance with daily life and self-care - 5 hours per day, each week day at the week day rate.
·Assistance with daily life and self-care – 2 hours per day, on the weekends at the respective Saturday and Sunday rates.
·Community access to social and recreational activities - 4 hours per day, on the weekends at the respective Saturday and Sunday rates.
[27] JTB 878 and 880.
Ms Lee also recommends:[28]
·Consumables - nappies for incontinence - based on quotes using NDIS guidelines.
·Assistive technology - augmentative alternative communication (AAC) - following assessment and equipment trials with speech pathologist.
·Support coordination - 26 hours per annum.
[28] JTB 881
Ms A Papanicolaou (senior support worker)
Ms Papanicolaou attended the hearing and gave evidence on behalf of the applicant. She Is the Senior Social Worker at the Child Development Unit at the Children’s Hospital at Westmead. She was part of an assessment team from the hospital that prepared a substantive report in relation to the applicant. That report is undated but relates to a formal assessment that was conducted on 31 October 2024 by a team of five specialists comprising; a paediatric registrar, a clinical neuropsychologist, a speech pathologist, a specialist development paediatrician and herself.[29]
[29] JTB 796-807.
Ms Papanicolaou together with a specialist paediatrician prepared a ‘National Disability Insurance Scheme Support Letter,’ dated 22 May 2025, making recommendations of NDIS supports with respect to the applicant.[30]
[30] JTB924-929.
Ms Papanicolaou gave evidence at the hearing that at the formal assessment on 31 October 2024, the applicant was formally observed by a number of specialists between 9 AM and 2 PM, his parents were also interviewed. Ms Papanicolaou said that it was difficult to get the applicant to engage in any of the assessment tasks. He was distressed the entire time and required a lot of support. She advised that subsequent to that assessment, she had been in contact with R, as a mother of a child who has significant support needs. She is of the view that as a result of the applicant’s requirement for constant support and care by R, as well as his extreme behavioural rigidity and his need to control his environment, there was a risk of family breakdown.
The report prepared by the team of specialists includes the following summary:
[The applicant] is a 5 year 1 month old boy whose clinical presentation meets the DSM-TR diagnostic criteria for Autism Spectrum Disorder requiring very substantial support (Level 3 for social and restricted repetitive behaviour). On history and formal assessment, [the applicant] demonstrates difficulties in social communication (e.g. poorly modulated eye contact) and restricted, repetitive behaviour (e.g. rigid thinking patterns). This occurs in association with DSM-TR Unspecified Intellectual Developmental Disorder (Intellectual Disability) in the context of his low adaptive function. It is encouraging to note that [the applicant] demonstrated attachment to his parents. [The applicant] has not yet engaged with effective regular therapeutic intervention. He will benefit from multi-disciplinary therapies through autism specific services.[31]
[31] JTB 802.
The report dated 22 May 2025, summarises the applicant’s support needs as follows:
[The applicant] requires maximum care and support across multiple areas, including communication and social interaction, self-care, learning, rigidity, emotional dysregulation, intense emotional responses and ongoing safety concerns. He requires full-time, one to one support. Currently, [the applicant’s] daily care needs far exceed those typical for a five year old, placing considerable strain on his parents - particularly his mother, who is unable to manage his complex needs on her own, as it is not feasible to provide continuous care 24 hours a day, seven days a week.[32]
[32] JTB 925.
Ms M Ferrerira (occupational therapist)
Ms Ferrerira prepared a report dated 21 March 2025, updated on 7 May 2025.[33] She received a summons from the respondent and attended the hearing to give evidence.
[33] JTB 848-856.
In her report, Ms Ferrerira states that the applicant’s parents requested an occupational therapy assessment and possible therapy due to concerns that the applicant has difficulties in all areas of daily living due to the challenges relating to the diagnosis.[34] She says:
[The applicant] has a thirst for learning as seen in his passionate interest in learning and writing letters, numbers, and words in English and multiple languages (which he self-taught since the age of 1), doing detailed drawings, solving complex puzzles, and an eagerness to learn the mechanics of how things work, to name but a few. However, [the applicant] has severe challenges with his expressive language development, social communication, reciprocal play skills, sensory processing, emotional regulation, coping with transitions such as between his home and day care and to/from therapies, separating from his mother, and all areas of personal care including toileting, dressing, and eating. [The applicant] therefore requires constant supervision and support.[35]
[34] JTB 848.
[35] JTB 849.
The applicant’s mother initially made contact with Ms Ferrerira in October 2024. Ms Ferrerira assessed the applicant using the following tools:
·Various telephone conversations, email exchanges, and WhatsApp/text message exchanges with parent [R] from point of contact between October 2024 and the date of the report.
·Information gathering session completed with parent [R] via telephone 11 December 2024.
·Online client information form, completed comprehensively by parent [R] and submitted on 12 March 2025.
·Oversight of numerous photos and videos of the applicant provided by R.
·Clinical observation of general function during an in-person assessment on 6 March 2025 lasting approximately 2.5 hours, attended by the applicant and his parents.
·Review of the following reports:
oDr Pankaj, consultant general and developmental paediatrician, dated 6 November 2024.
oThe Children’s Hospital at Westmead, Child Development Unit, dated 31 October 2024.
oPaula Murakami, NDIS review occupational therapy supporting information, dated 8 October 2024.
Ms Ferrerira said that she made recommendations in her report based on the above. She noted that it was not possible to conduct any standardised assessments with the applicant during the in-person assessment as she deemed it unsuitable based on the applicant’s presentation.
Ms Ferrerira states that the applicant needs constant supervision and assistance to ensure his safety at home and when in the community. He has marked difficulties with separating from his mother which makes it difficult for her to attend to most activities relevant to her role. She recommends that a support worker accompany them to therapy and other appointments to ensure his safety.[36]
[36] JTB 855.
Ms Ferrerira recommends occupational therapy sessions for the applicant directed towards the achievement of the following goals:[37]
[37] JTB 856.
·Core strength: the applicant needs to improve his core strength to enable him to climb in and out of the bath independently, stay upright during dressing tasks and climb confidently on playground equipment in the park with minimal assistance from his parents.
·Occupational performance:
oToileting: the applicant’s parents need support to investigate additional strategies regarding toilet training to help him towards independent use of the toilet.
oDressing: the applicant needs to be able to undress himself fully and start putting on shirts independently.
·Attentional regulation: the applicant needs to be able to concentrate on an adult directed learning task, for at least two minutes.
·Emotional regulation:
oThe applicant’s parents need to develop an increased awareness of the impact of his sensory needs/profile on his ability to regulate his emotions and participate in age-related activities; and develop appropriate sensory based strategies to help regulate him throughout the day.
oThe applicant’s parents need support to investigate additional strategies to help him transition between his home and the childcare environment with less emotional upset.
In order to achieve these goals, Ms Ferrerira suggests that occupational therapy initially be provided in the following manner:
·One parent only consultation session every four weeks, delivered online (50 minutes face-to-face with 20 minutes non-face-to-face four session related administration)
·One therapy session in person every four weeks, lasting up to 2 hours to allow the applicant to settle and possibly engage in relevant therapeutic activities (120 minutes face-to-face with 20 minutes non-face-to-face four session related administration)
Ms Ferrerira said that no appointments were made because R said that it was not possible for her or the applicant to get to any appointments at this time. Ms Ferrerira said that the applicant requires a support worker to assist R get him to appointments. R wants the applicant to attend therapy but needs a support person to get him there. Ms Ferrerira said that she recommends a support worker for the applicant and that this is warranted and reasonable in his circumstances because he requires constant supervision for his safety and often becomes dysregulated. She said the support worker needs to be someone who is trained in relation to the applicant’s needs.
Ms S (Director and Educational Leader, Early Learning Centre)
Ms S attended the hearing and gave evidence on behalf of the applicant. She is the Director and Educational Leader at the Early Learning Centre, where the applicant has been enrolled since 19 July 2024, for 5 days per week.
Ms S gave evidence that the applicant is unable to attend the Early Learning Centre on a regular basis because of the challenges he has around transitioning. She often has to provide him with help to transition away from his mother when he arrives at the childcare centre.
Ms S said she is in constant contact with R to find out whether he will be attending the centre that day. They need to know if he is coming in because they need to prepare special food for him. When she contacts R, she can often hear the applicant in distress, crying and screaming.
Ms S became emotional when giving her evidence. She said that the applicant needs more support. He displays some behaviours that they do not understand at the centre and he needs support with those behaviours. She said the educators at the centre are not trained in certain areas that the applicant requires support in and this is creating barriers that they do not know how to overcome.
Ms S said that it is much better for the structure of the applicant’s day if he arrives at the centre in the morning. She said he needs to come consistently early so that he develops a routine. The majority of the children arrive between 8 and 10 AM and it would be best for the applicant to arrive by 9:30 AM. Due to the applicant’s food aversions they need to prepare the food that he likes so that he feels engaged during eating sessions. By 10 AM each day, the centre starts its learning program and it is disruptive to the applicant and the other children when he arrives late. It often takes the applicant between 30 minutes to 2 hours to settle him at the centre. Further, he can become distressed during the day for all sorts of reasons. For example, he does not like the educators to sit on a chair and he has an adverse reaction to the food trolley. She said there is scope for occupational therapists, speech therapists and behavioural therapists to attend the centre to provide therapy to the applicant. In the past they have tried to engage therapists to attend the centre to provide therapy to the applicant. However, because the applicant could not make the appointment times, that arrangement could not continue. She advised that one of the main problems for the applicant attending the centre is that it takes so long for the applicant and R to travel there using public transport. She would like to see the applicant supported with transport to the centre. The applicant is enrolled for five days per week. He does attend most days but there are some days where he arrives late which makes it very difficult to structure his day. Due to the inconsistency associated with his attendance the applicant has no definite pattern at the centre. When the applicant’s father is available to drive, he is able to attend the centre at an earlier time. If the applicant’s father tries to pick him up alone, the applicant will become very dysregulated.
Ms S believes that if the applicant could develop a consistent routine with his attendance, the centre could accommodate the applicant receiving therapy whilst he attends. She believes they could accommodate an occupational therapist, a speech therapist and a behavioural therapist over three different days of the week, for example on Mondays, Wednesdays and Fridays.
In a report dated 17 February 2025 prepared by Ms S, she sets out the struggles the applicant has with transportation getting to childcare (including by car, bus and train). She notes that the applicant’s behaviour on public transport is dangerous and it can often take him 2 – 4 hours to get to childcare. She says the applicant’s mother “is doing everything she can, but she is exhausted and living in constant fear for his safety when travelling. Without help, [the applicant] will keep missing childcare, therapy and the routine he needs - and worse, we have safety concerns when he travels.”[38]
[38] JTB 811.
In the report prepared by Ms S dated 21 May 2025[39], she says:
·The applicant very often arrives at the centre late in the day, during rest or sleep times, which results in him missing out on critical parts of the program, including group activities and shared meal times. Mealtime used to be a positive experience for the applicant as enjoyed eating in a group, which reduced the pressure around food and helped him eat more effectively.
·When the applicant was attending consistently earlier in the year, he showed more engagement, better regulation, and improved participation in group activities.
·The applicant’s ability to engage, regulate emotions, and participate in learning is significantly affected by irregular attendance, especially when arriving during quiet times or when most children are already tired. Most days he arrives at 2 PM which is where routines are less consistent at the centre as children start to get picked up from 3 PM and staff shifts begin to finish.
·The applicant continues to require assistance with; dressing and undressing; encouragement to eat regularly and a sufficient amount of food; nappy changing and toileting routines; transitions between settings (e.g. bus stop to centre, classroom to playground, or indoor to outdoor play); developing self-regulation skills around particular anxieties (separating from mum, transitioning on public transport safely).
[39] JTB 911-914.
Ms S concludes her report by stating that the childcare centre that the applicant attends hopes to utilise the time they have with him as best they can before he attends school next year.
KS, (lay witness)
Ms KS gave evidence and provided a statement about an incident she observed on 14 August 2024 when R was attempting to catch a bus with the applicant. In her statement she says:
On the morning of 14 August 2024 at approximately 09:45am, I was approaching the bus stop….As I got closer, I noticed a young woman with a child. The boy was visibly distressed, screaming, hitting, and trying to pull away from his mother. It quickly became clear that this was not a typical tantrum, but rather the behaviour of a neurodivergent child.
The mother, who later introduced herself as R, was visibly distraught. Recognising the urgency of the situation, an older lady and I immediately stepped in to assist her. The bus stop is located on a busy road, and there was a sincere concern that the child might break free and run into traffic, putting himself in great danger.
It took all three of us to try and keep the child safe until the bus arrived. Despite our efforts, he would briefly calm down only to scream, throw himself around, and try to pull away again. During this time, R expressed that this is a daily struggle for her. She explained that she manages her son on her own during the day, as her husband works long hours, and she has no other family support. It was evident to me that R is a dedicated and fierce advocate for her son, doing everything she can to keep him safe and well.[40]
[40] JTB1002.
Ms KS gave evidence that she provided the statement at the request of R and that she was happy to provide that statement in relation to the very dangerous incident she witnessed. She said that with ‘one slip’ the applicant could have been on the road. She said it was obvious from the short time that she observed the applicant that R needed help to manage him. She said the applicant is very strong and she was very concerned about what could have happened if she had not assisted.
CONSIDERATION

The applicant met access for the NDIS on the basis of GDD. The respondent accepts that the applicant has ASD, level 3 and that he meets NDIS eligibility under the disability requirements (section 24).[41]
[41] JTB 2 and 973.
As stated above the Tribunal must determine the following issues:
·Is the applicant entitled to support worker assistance and if so, how much?
·Is the applicant entitled to support coordination and if so, how much?
·What capacity building supports are reasonable and necessary for the applicant?
The Tribunal must be positively satisfied of each criterion set out in section 34(1)(aa)-(f) of the NDIS Act in relation to each of the supports requested. If the Tribunal is not positively satisfied that any one of the criteria in section 34(1) is met in relation to a particular support, then the Tribunal must find that the support is not a reasonable and necessary support and must be rejected.
Issue 1: Is the applicant entitled to support worker assistance and if so, how much?
In relation to this requested support, the following submissions were made by counsel for the respondent during her closing address:
·R is not effective in providing the applicant with what he needs. The applicant has plenty of funding in his plan for occupational therapy, speech therapy and behavioural support therapy.
·Ms S gave evidence that these therapies can be undertaken whilst the applicant attends childcare.
·The family needs to get the applicant to childcare in the morning so he can receive the therapy he needs whilst he is there.
·The provision of a support worker does not have regard to the applicant’s goals and aspirations.
·A strong structured family unit is important for the applicant to move forward. Where there is no structure in place then a support worker cannot assist the applicant.
·There is no evidence that introducing a support worker to the applicant will assist him. It is not an effective solution to bring a support worker into the picture.
·It is reasonable for the family to develop a schedule for the applicant and get him to childcare in the morning so that he develops a routine and he can receive therapy that he needs.
·The applicant’s father chooses to work long hours. During the hearing, the applicant’s father took time off work and the applicant got to childcare in the morning over those three days.
·A support worker will make R’s life easier but there is no evidence that it would positively impact the applicant’s life.
·The applicant requires a routine but does not have one. There is no evidence of commitment to a routine by R. The family needs to consider reorganising their lives and try new things.
·The family could access taxis and Ubers to get the applicant to and from childcare and appointments on time.
·R is not at work, she has a responsibility to ensure the applicant is delivered to childcare at a consistent time in the morning.
The respondent’s SOFIC includes a submission that the focus of the requested support appears to be on liberating the applicant’s mother from her caring role/parental responsibility and that support worker assistance is requested largely to support the applicant’s mother in managing the day-to-day activities rather than supporting the applicant to develop the necessary skills and become more independent.[42]
[42] JTB 5-6.
The Tribunal agrees with the submission made by the applicant’s representative, that what the respondent suggests is reasonable to expect from families and carers is ‘alarming.’ The Tribunal does not accept the respondent’s criticisms of the applicant’s mother or father. It is clear from the evidence that the applicant’s parents do not know how to manage his extreme behaviours, they are in crisis, and R is at risk of carer burnout.
The fact is that the applicant is unable to access the support he needs. The level of support that the applicant currently requires is extraordinarily high. To date, the predominant provider of all of his support has been his mother. His father assists when he can. The father is the sole income earner and his job requires him to work long hours. It is clear that it is not currently safe or feasible for the applicant’s current situation to continue. The applicant cannot continue to place the significant reliance and demands that he currently does upon R.
The Tribunal finds that the applicant requires support with all transport whether it be public or private. Public transport is not a safe or reasonable option for the applicant at the current time. It is not safe and it can take up to 4 hours for the applicant to get to childcare on public transport.
There is agreement that the applicant should be attending childcare on a regular basis and arrive there in the morning. If he can get there in the morning and is supported to regulate his emotions prior to and upon his arrival at childcare, that may enable him to receive some of the therapy he needs whilst he is attending.
The applicant requires a support worker to assist him with; travelling to and attending appointments and childcare; accessing the community and participating in day-to-day tasks.
As stated by Ms Cramp (specialist early childhood educator) in her report dated 1 August 2024, the applicant requires significantly more support than his peers for his age due to his disability. Having a support worker will allow the applicant to safely access the community, mitigating risks and promoting his participation.[43]
[43] JTB 769.
Ms Lee gave persuasive evidence in relation to this. The Tribunal accepts her evidence and determines that the applicant requires support worker funding for the following:
·Assistance with transport: including attending therapy, medical appointments and childcare.
·Self-care: assistance with toileting, showering, brushing teeth, mealtimes, dressing skills in the home environment with support to integrate skills from his occupational therapist/behavioural support practitioner.
·Community access to social and recreational activities: going for a walk, going to the park, shops, library, pool, beach, museums and integrating with peers.
The Tribunal accepts the evidence of Ms Lee that it is reasonable and necessary for the applicant to have funding for 1:1 Support Worker (Level 2), with skills and training based on the applicant’s behavioural needs. This is made up as follows:
·Assistance with daily life and self-care - 5 hours per day, each week day at the week day rate.
·Assistance with daily life and self-care – 2 hours per day, on the weekends at the respective Saturday and Sunday rates.
·Community access to social and recreational activities - 4 hours per day, on the weekends at the respective Saturday and Sunday rates.
This amounts to a total of funding of 37 hours.
In reaching this decision, the Tribunal has considered all of the relevant matters in rule 3.4 of the Supports for Participant Rules. In this case the applicant’s parents already provide substantial care and support for the applicant; because of the applicant’s disability his care needs are substantially greater than those of other children of a similar age; there is a significant risk to the well-being of the applicant’s parents, particularly R, if a support worker is not provided and the provision of a support worker would improve the applicant’s capacity or future capacity and will reduce any risk to his well-being. Further the applicant and his family have no informal supports and networks within their community and they currently have no ability to develop such supports or networks.
It is clear from the above analysis that the Tribunal is satisfied that the criteria set out in section 34(1)(aa)-(f) of the NDIS Act in relation to the provision of a support worker for the applicant are met.
·A support worker is necessary to address the needs of the applicant arising from impairments in relation to which he meets the disability requirements, section 34(1) (aa) is satisfied.
·The applicant cannot pursue the goals, objectives and aspirations stated in his plan if he cannot access the therapy that he requires to meet them. The Tribunal accepts the evidence that a support worker will assist the applicant to attend the therapy he needs to pursue his goals, objectives and aspirations, section 34(1)(a) is satisfied.
·A support worker will assist the applicant engage with the community and attend the therapy he requires to enable him to become a functioning member of society and participate socially and economically, section 34(1)(b) is satisfied.
·The respondent submits that there is insufficient evidence which demonstrates the level of support worker assistance required. As stated above there is evidence from Ms Lee (occupational therapist) which sets out the tasks that the support worker is required to undertake and the number of hours the support worker is required for. She recommends a total of 37 hours per week, which the Tribunal has accepted as reasonable and necessary. In the report dated 19 February 2024 from Ms J Parker, endorsed enrolled nurse, from 24Care Australia, she provides evidence in relation to the applicant’s current level of support needs and the extent of support required. She recommends a total of 40 hours per week,[44] which is consistent with the evidence of Ms Lee. The Tribunal finds that the provision of a support worker for 37 hours per week does represent both value for money and that it is likely to be effective and beneficial for the applicant, section 34(1)(c) and (d) are satisfied.
·For the extensive reasons outlined above the Tribunal finds that the provision of a support worker for the applicant does take into account what is reasonable to expect the applicant’s family to provide. The evidence is that the applicant’s family does not have any informal networks and are currently unable to access the community, section 34(1)(e) is satisfied.
·There is no doubt that a support worker is a NDIS support for the applicant, section 34(1)(f) is satisfied.
[44] JTB 815-816.
For these reasons, the Tribunal determines that the applicant is entitled to support worker assistance for 37 hours per week, as recommended by Ms Lee in her report.[45]
[45] JTB 880.
Is the applicant entitled to support coordination and if so, how much?
The respondent considers that support coordination (level 2) for a total of 24 hours per year is reasonable and necessary.[46] This will assist the applicant connect with an appropriate positive behaviour support practitioner and with the implementation of a behaviour support plan.[47] The respondent submits that there is insufficient evidence to demonstrate that the 96 hours of support coordination, requested by the applicant, represents value for money and will be effective and beneficial and that there is no meaningful evidence that assesses or considers the applicant’s current level of support needs and how any calculation is conducted to determine the necessary extent of the support required.[48] Further, the respondent submits that the requested support coordination is largely to support the applicant’s mother in managing the day-to-day activities rather than supporting the applicant to develop the necessary skills and become more independent.[49]
[46] JTB 2, 4 and 8.
[47] JTB 7.
[48] JTB 7.
[49] JTB 6.
The applicant requests 96 hours of support coordination.[50] The Tribunal accepts that there is insufficient evidence to support the applicant’s request for 96 hours of support coordination. However, the Tribunal does find that the applicant requires a support coordinator to assist with the implementation of the therapy he requires.
[50] JTB 857.
In relation to support coordination Ms Parker, endorsed enrolled nurse, from 24Care Australia states in her report dated 19 February 2025 that:
[The applicant] requires ongoing input from a support coordinator, to engage the appropriate services, oversee the budget, and ensure evidence is provided to the NDIS moving forward so that they can see the full picture of the challenges associated. The applicant requires the minimal level 2 coordination to gather the documentation, this would then present the risks associated and level 3 would need to be considered as throughout the reports and assessment it is clear [the applicant] requires a behaviour support practitioner and restrictive practices may need to be considered. The time spent from a support coordinator would be extensive, [the applicant] requires at least three different therapies – Speech, Occupational therapy and Behaviour support. [The applicant] also requires support with specialised home-based assistance, support workers and a learning facility (childcare or similar) all of these therapies need to be organised and have liaison with someone to provide documentation and evidence for the ongoing funding requirements. This is not practical nor feasible for [the applicant’s] minimal informal support to maintain this ongoingly [sic]. It would be reasonable to consider that [the applicant] may need change of situation should he receive adequate supports and further investigations due to his ongoing changes in support needs.[51]
Ms Parker does not provide an assessment of the hours of support coordination required by the applicant.
[51] JTB 814.
In the report prepared by Dr Ong (paediatrician) and A Papanicolaou (senior social worker) from the Children’s Hospital at Westmead dated 22 May 2025, they recommend support coordination (level 3) for the applicant to assist in navigating the complex service system, organising appropriate supports and managing the applicant’s NDIS plan effectively. They state that given the multifaceted nature of the applicant’s needs, high level coordination is essential to ensure timely access to services and continuity of care.[52] The report does not include an assessment of the hours of support coordination required by the applicant.
[52] JTB 927.
In the report of Ms Lee, occupational therapist, dated 19 May 2025, she says that the applicant does require a support coordinator to assist him coordinate his service providers under the NDIS and make best use out of his funding package due to the complexity of his accessibility and needs. She recommends 26 hours of support coordination.
Based on the evidence, the Tribunal finds that the applicant does require a support coordinator (level 3) for a total of 26 hours. The Tribunal notes this assessment of the applicant’s current level of support coordination required is based on a one year plan. It can be applied on a pro rata basis with respect to the applicant’s plan, which will be less than one year. However, all of the funding for a support coordinator should be made available to the applicant at any time during his plan. The Tribunal anticipates that the level of support coordination required at the commencement of the new plan is likely to be extensive and then reduce over the course of the plan after the appropriate therapies and support worker assistance are put in place for the applicant.
Once again, it is clear from the above analysis that the Tribunal is satisfied that the criteria set out in section 34(1)(aa)-(f) of the NDIS Act in relation to the provision of a support worker for the applicant are met.
·A support coordinator is necessary to address the needs of the applicant arising from impairments in relation to which he meets the disability requirements, section 34(1) (aa) is satisfied.
·The applicant cannot pursue the goals, objectives and aspirations stated in his plan if he cannot navigate, coordinate and access the therapy that he requires to meet them. The Tribunal accepts the evidence that a support coordinator (level 3) will assist the applicant organise appropriate supports, ensure timely access to appropriate services, help manage his plan effectively and ensure continuity of care, section 34(1)(a) is satisfied.
·A support coordinator will assist the applicant find, organise and manage the therapy he requires to enable him to become a functioning member of society and participate socially and economically, section 34(1)(b) is satisfied.
·As stated, the respondent submits that there is insufficient evidence which demonstrates the level of support coordination required. There is evidence from Ms Lee (occupational therapist) which explains the need for the applicant to have a support coordinator. She recommends a total of 26 hours per annum, which the Tribunal has accepted as reasonable and necessary. There is no evidence to support the applicant’s request for 96 hours of support coordination or the respondent’s position that 24 hours of level 2 support coordination is reasonable and necessary. The Tribunal finds that the provision of a support coordinator level 3, for 26 hours per annum does represent both value for money and that it is likely to be effective and beneficial for the applicant, section 34(1)(c) and (d) are satisfied.
·The Tribunal finds that the provision of a support coordinator for the applicant does take into account what is reasonable to expect the applicant’s family to provide. They do not have the capacity to find, organise and manage the therapy and assistance the applicant requires. The evidence is that the applicant’s family does not have any informal networks and are currently unable to access the community to seek assistance, section 34(1)(e) is satisfied.
·There is no doubt that a support coordinator is a NDIS support for the applicant, section 34(1)(f) is satisfied.
For these reasons, the Tribunal determines that the applicant is entitled to a support coordinator, level 3, for 26 hours per annum, as recommended by Ms Lee in her report.[53] This is to be applied on a pro rata basis over the length of the applicant’s new plan.
[53] JTB 881.
What capacity building supports are reasonable and necessary for the applicant?
The issue of what capacity building supports are reasonable and necessary for the applicant is complex. As submitted by the applicant due to the respondent’s failure or refusal to recognise the applicant’s need for assistance with transport outside the home, the consequence is that he has had reduced access to childcare, therapies, health supports and the community. Consequently only 44% of the supports over the two years of his plan have been utilised.[54]
[54] JTB 23.
The Tribunal has approved funding for a support worker and a support coordinator to assist the applicant to access the therapy he needs.
The respondent submits that the applicant’s statement of participants supports should include the following therapy:
·10 hours per week of Specialised Home-Based Assistance for a child.
·65 hours of Specialist Behaviour Support comprising:
o45 hours of specialist behaviour intervention.
o20 hours of behaviour management plan and training.
·120 hours of Level 2 Therapy Assistant.
The Tribunal is unable to determine from the evidence how the respondent reached the conclusion that the above are reasonable and necessary support for the applicant. As submitted on behalf of the applicant, he currently does not tolerate strangers in the family home, so home-based therapy at the present time ‘is inappropriate and undeliverable.’[55]
[55] JTB 26.
R gave evidence that initially, the support the applicant requires is to get him from the door of the house to childcare safely. Initially, it is unlikely that the applicant will allow the support worker into the home and it will take some time for him to build rapport with a support worker he is provided with. Hopefully, over time the applicant will allow the support worker to enter the home to assist him with his self-care and daily life activities.

Currently, the only place that the applicant is familiar with and can get to on a regular basis is childcare. The evidence is that the applicant needs to get to childcare in the morning by around 9:30 AM every day to achieve the best results in relation to his engagement, self-regulation and participation in group activities.
Ms S gave evidence that arrangements can be made for the applicant to receive therapy whilst attending the childcare centre. She suggested that the applicant could have occupational therapy on a Monday, speech therapy on a Wednesday and behavioural support therapy on a Friday. The evidence supports a finding that initially this would be the most appropriate setting for the applicant to receive the much needed therapy he requires. However, the Tribunal does accept that it may not be possible to arrange this and the applicant may need to consider attending therapy in a private clinic setting.
There is a significant amount of evidence indicating that the applicant requires occupational therapy, speech therapy and behavioural support therapy at least once a week.[56] In addition to therapy from these allied health practitioners, the applicant will also require support implementing what he learns at therapy into his activities of daily living and self-care.
[56] JTB 879-880.
The respondent submits that the following capacity building supports are reasonable and necessary for the applicant:
·65 hours of Specialised Behaviour Support (45 hours for specialist behaviour intervention and 20 hours of behaviour management plan and training).
·120 hours of Level 2, Therapy Assistant to assist with implementing therapies in the home environment.[57]
Accordingly, the respondent does accept that behaviour support therapy and the provision of a Level 2, Therapy Assistant is reasonable and necessary for the applicant. The Tribunal accepts the evidence of Ms Lee, occupational therapist, that the applicant requires not only behaviour support therapy but also occupational therapy and speech therapy once per week. The Tribunal also finds that the applicant requires a Level 2, Therapy Assistant. That therapy assistant could work with the occupational therapist, speech therapist and behavioural support therapist, during each one hour session per week and then work with the applicant to assist him implement the strategies he is taught by those allied health professionals. The Tribunal is of the view that this would need to be for three hours, three days per week to coincide with the therapy from the allied health practitioner and there should be an additional three hours per week in a community setting.
[57] JTB 2.
The Tribunal finds that the following Capacity Building Supports are reasonable and necessary for the applicant:
·1 hour per week of occupational therapy (plus travel time if required, and two hours of report writing).
·1 hour per week of speech therapy (plus travel time if required, and two hours of report writing).
·1 hour per week of behaviour support therapy (plus travel time if required and two hours of report writing).
·12 hours per week for a Level 2, Therapy Assistant (plus travel time if required).
The Tribunal is of the view that any additional therapy for the applicant per week would, at this stage, be too overwhelming for him. The Tribunal accepts that at least initially it will continue to be challenging to get the applicant to the therapy he requires. The applicant’s parents will need to work hard together with the support worker to ensure that the applicant develops a routine and attends therapy and childcare on a consistent basis to ensure that his engagement self-regulation and participation in group activities improves.,
The evidence from Ms Lee, occupational therapist, in her report dated 19 May 2025 is that the applicant is incontinent and wears nappies throughout the day. He is unable to indicate that he has urinated or experienced bowel movements. He is unable to wipe himself and refuses to sit on the toilet. The applicant understands the steps to toileting but will refuse to perform these. Ms Lee recommends that the applicant has an assessment with a continence nurse - under Capacity Building Supports and has funding for his continence aids (i.e. nappies) under Consumables.[58] The respondent’s overall position in its SOFIC is that three hours for an assessment by a continence nurse consultant is reasonable and necessary.[59] The Tribunal accepts this is reasonable and necessary. During the hearing, the applicant submitted a request for $3119 for Incontinence Products (Consumables), calculated as follows:
[58] JTB 874.
[59] JTB 3.

Nappies

$2000

Wet wipes

$727.48

Sudocream

$179.95

Reusable bed pad

$62

Waterproof pants

$149.70

Total

$3119

The Tribunal accepts that the applicant is entitled to funding for consumables for his continence aids but is unable to determine whether this request for consumables is reasonable. The amount to be allowed for the applicant’s consumables can be calculated based on quotes to be obtained in conjunction with the assessment by the continence nurse consultant or by direct negotiation with the respondent.
The Tribunal determines that the above Capacity Building Supports:
·Are necessary to address the needs of the applicant arising from impairments in relation to which he meets the disability requirements, section 34(1) (aa) is satisfied.
·Will assist the applicant pursue the goals, objectives and aspirations included in his statement of goals and aspirations, section 34(1)(a) is satisfied.
·Will assist the applicant to undertake activities, so as to facilitate his social and economic participation, section 34(1)(b) is satisfied.
·Represent value for money because there are no comparable supports which would achieve the same outcome at a substantially lower cost; there is evidence that they will substantially improve the life stage outcomes for, and be of long-term benefit to, the applicant; they are likely to reduce the cost of the funding for supports for the applicant in the long-term and will increase the applicant’s independence and need for more supports, section 34(1)(c) is satisfied.[60]
·Will be, or are likely to be, effective and beneficial for the applicant having regard to current good practice, the consensus of expert opinion as well as the lived experience of the applicant and his parents, section 34(1)(d) is satisfied.[61]
·Do take into account what is reasonable to expect the applicant’s family to provide. The applicant and his family have no informal networks. The applicant’s parents are his sole carers. He currently has extremely limited access to the community due to his disability. His parents already provide substantial care and support for the applicant. Due to his disability his care needs are substantially greater than those of other children of similar age. There is a risk of carer burnout with respect to the applicant’s mother and there is a risk to the general well-being of the applicant’s parents. The overwhelming evidence is that the applicant requires capacity building supports to improve his capacity or future capacity and to reduce the risks to his well-being, section 34(1)(e) is satisfied.
·Are NDIS supports for the applicant, section 34(1)(f) is satisfied.
[60] Rule 3.1, Supports for Participants Rules.
[61] Rule 3.2, Supports for Participants Rules.
CONCLUSION
Taking into account all of the above the Tribunal determines that the following Supports are reasonable and necessary:
a)Core Support Funding for a Support Worker (Level 2) of 37 hours per week, calculated as follows:
·         Assistance with daily life and self-care – 5 hours per day, each weekday at the weekday rate.
·         Assistance with daily life and self-care – 2 hours per day, on the weekends at the respective Saturday and Sunday rates.
·         Community access to social and recreational activities – 4 hours per day, on the weekends at the respective Saturday and Sunday rates.
b)Core Support Funding for a Support Coordinator (Level 3) for 26 hours per annum, to be applied on a pro rata basis over the length of the applicant’s new plan.
c)Capacity Building Supports
·         1 hour per week of occupational therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         1 hour per week of speech therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         1 hour per week of behaviour support therapy (plus travel time if required, and 2 hours over the course of the plan for report writing).
·         12 hours per week for a Level 2 Therapy Assistant.
·         3 hours for an assessment by a Continence Nurse Consultant.
d)Consumables
·         Quotes to be obtained in conjunction with the assessment by a Continence Nurse Consultant or negotiated directly with the respondent.

123.    I certify that the preceding 122 (one-hundred and twenty-two) paragraphs are a true copy of the reasons for the decision herein of Senior Member A. Clues.

124.    ........................[SGD].........................

125.    Associate

126.    Dated: 15 September 2025

127.

Dates of hearing: 14, 15 and 16 July 2025

Counsel for the Respondent: Ms Josephine Thornton

Solicitors for the Respondent: Ms Nishta Ramnoruth

Support category	Budget	Spend to date	Left to spend	% Spend
Improved life choices	$1798.47	$1485.12	$313.35	82.58%
Improved daily living skills	$34,676.76	$14,573.72	$20,103.04	42.03%
Total	$36,475.23	$16,058.84	$20,416.39	44.03%

Nappies	$2000
Wet wipes	$727.48
Sudocream	$179.95
Reusable bed pad	$62
Waterproof pants	$149.70
Total	$3119

Dates of hearing:	14, 15 and 16 July 2025
Counsel for the Respondent:	Ms Josephine Thornton
Solicitors for the Respondent:	Ms Nishta Ramnoruth