ZWXT and National Disability Insurance Agency

This matter concerned an application by ZWXT, a child participant in the National Disability Insurance Scheme (NDIS), for review of a decision made by a delegate of the Chief Executive Officer of the National Disability Insurance Agency (NDIA). The dispute centred on whether funding for Applied Behavioural Analysis (ABA) therapy and other supports should be included in ZWXT's NDIS plan, specifically whether these supports qualified as "reasonable and necessary" under section 34(1) of the *National Disability Insurance Scheme Act 2013* (Cth). The Administrative Appeals Tribunal (AAT) considered the effectiveness and benefit of ABA therapy for ZWXT, given his age and genetic condition (Down Syndrome), and whether it would duplicate other therapeutic interventions.

The legal issues before the Tribunal were whether ABA therapy and other requested supports were "reasonable and necessary" under the NDIS Act. This required the Tribunal to assess the evidence regarding the efficacy of ABA therapy for a child of ZWXT's age and with his specific disability, and to determine if such therapy would be duplicative of existing supports such as speech pathology, occupational therapy, and psychology services. The Tribunal also had to consider the overall composition of ZWXT's NDIS plan to ensure it adequately addressed his goals and needs.

The Tribunal reasoned that the NDIA's contention that ABA therapy was generally only effective for younger children and lacked evidence for individuals with Down Syndrome was not sufficiently supported by the material before it. It considered evidence presented by ZWXT's father and expert reports, including one from Dr. Ken MacLean, a paediatrician and clinical geneticist. The Tribunal ultimately found that ABA therapy, along with other requested supports including increased hours of speech pathology, occupational therapy, psychology services, assistive technology, swimming lessons, cleaning services, and multidisciplinary meetings, were reasonable and necessary for ZWXT.

The Tribunal set aside the NDIA's decision and remitted the matter with a direction that a new statement of participant supports be approved for ZWXT. This new statement was to include funding for the existing supports, the additional supports identified as reasonable and necessary, and a reassessment date of 12 months from the approval of the new statement.