VXGN and National Disability Insurance Agency

This matter concerned an application by VXGN for review of a decision by the National Disability Insurance Agency (NDIA) to refuse funding for certain supports. The NDIA had affirmed its original decision on 11 January 2022, asserting that the proposed supports were neither effective and beneficial having regard to current good practice, nor represented value for money, nor were they best provided under the scheme. VXGN subsequently applied to the Tribunal for a review of this decision.

The Tribunal was required to determine whether the supports sought by VXGN were reasonable and necessary, specifically considering the criteria under section 34(1)(d) of the *National Disability Insurance Scheme Act 2013* (Cth), which mandates that supports be effective and beneficial having regard to current good practice. This involved an assessment of the available evidence regarding the efficacy and intensity of early intervention therapies for children with Autism Spectrum Disorder (ASD).

The Tribunal considered evidence from Dr. Michael Sandbank, who led the "Project AIM" meta-analysis of non-pharmacological interventions for children with ASD. Dr. Sandbank's evidence highlighted substantial methodological flaws in many studies, limiting confidence in their findings, and noted a scarcity of research on optimal intervention intensity and duration. The Tribunal also referred to the 2022 Autism CRC draft guidelines, which, developed within an evidence-based practice framework, recommended that the amount and duration of support be tailored to individual needs and cautioned that research does not support the notion that greater amounts of support consistently lead to better outcomes.

The Tribunal set aside the NDIA's decision and remitted the matter to the Respondent for reconsideration.