RQWY and National Disability Insurance Agency

This matter concerned an application by RQWY, a child with autism spectrum disorder, against the National Disability Insurance Agency (NDIA). The dispute centred on whether a specific program, the "Little Learners" program delivered by Autism Partnerships Australia (AP), constituted a reasonable and necessary support for RQWY under the National Disability Insurance Scheme (NDIS). The case was heard by Dr Stewart Fenwick, Senior Member, of the Administrative Appeals Tribunal.

The Administrative Appeals Tribunal was required to determine whether the Little Learners program, an Applied Behaviour Analysis (ABA) therapy delivered in a centre-based learning model, was a reasonable and necessary support for RQWY. This involved considering various factors outlined in the NDIS legislation, including whether the support would assist RQWY in pursuing his goals, facilitate his social and economic participation, and whether it represented value for money. The Tribunal also had to consider the evidence presented regarding RQWY's diagnosis, his developmental needs, the family's circumstances, and the efficacy of the AP program.

The Tribunal's reasoning acknowledged the parents' evidence detailing RQWY's developmental concerns from a young age, the challenges faced during lockdowns, and their efforts to find suitable early intervention services. It noted that while Dr Joffe, a paediatrician, had recommended a kindergarten environment and out-of-home intensive services, specific details regarding the origins of this recommendation and supporting clinical observations were not available due to Dr Joffe's non-attendance. The Tribunal found that the family's personal circumstances, including work commitments and the arrival of a third child, were relevant considerations. Despite some contention regarding the weight to be given to the parents' evidence on progress, the Tribunal was satisfied that medical opinion largely agreed on RQWY's diagnosis of a relatively high level of autism, accompanied by developmental and communication issues. The Tribunal concluded that the Little Learners program met the criteria for NDIS funding as an early intervention support for a child with disability or developmental delay.

Consequently, the Tribunal set aside the NDIA's previous decisions dated 5 August 2021 and 18 July 2022. The matter was remitted for reconsideration with the direction that the Little Learners program delivered by Autism Partnerships Australia is to be considered a reasonable and necessary support for RQWY.