WKZQ and National Disability Insurance Agency

This matter concerned an application by WKZQ, a participant in the National Disability Insurance Scheme, for review of a decision by the National Disability Insurance Agency (NDIA). WKZQ, diagnosed with Autism Spectrum Disorder, required substantial support. The dispute centred on whether proposed early childhood intervention therapies, specifically Applied Behaviour Analysis (ABA) therapy and speech therapy, constituted "reasonable and necessary supports" as defined by the *National Disability Insurance Scheme Act 2013* (Cth). The NDIA had proposed a "keyworker model" of support, which differed from the applicant's preferred intensive therapy approach.

The Tribunal was required to determine several key issues regarding the supports for WKZQ. These included the appropriate number of therapy hours, the type of therapy supports to be funded, the cost-effectiveness of the proposed therapies, and the optimal environment for WKZQ to participate in therapy. The central question was whether the ABA and speech therapies, as sought by WKZQ's parents, met the criteria of being "reasonable and necessary" under section 34(1) of the Act, or if the NDIA's proposed keyworker model was more appropriate.

In its reasoning, the Tribunal considered extensive evidence regarding WKZQ's diagnosis, developmental needs, and the efficacy of various early intervention strategies for Autism Spectrum Disorder. It applied the principles for assessing "reasonable and necessary supports" as outlined in case law, focusing on whether the supports would assist WKZQ in pursuing his goals, represented value for money, and were of a kind and quality that could be reasonably expected to be funded by the scheme. The Tribunal found that while there was a tension between the parents' preference for clinical settings and best practice favouring natural environments, the proposed ABA and speech therapies, at specific hours and costs, met the statutory criteria.

Consequently, the Tribunal set aside the NDIA's original decision. The matter was remitted to the NDIA with a direction to fund 18 hours of ABA therapy per week and two hours of speech therapy per week for WKZQ, with specified costs for each, to be used flexibly over a 12-month period.