Autism NDIS eligibility criteria change | MyCareSpace

Autism NDIS eligibility criteria change

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The NDIA has recently changed the criteria for NDIS eligibility for those with autism. 

ASD level 3 is now the ONLY level of autism ‘likely to (automatically) meet the disability requirements’ of the NDIS (see List A below).

Individuals with ASD level 1 and ASD Level 2 may still qualify (see List B below), they will need to demonstrate impaired functional capacity in either: communication, social interaction, mobility, learning, self-care or self-management (see Disability Requirements below)

List A – Conditions which are likely to meet the disability requirements in section 24 of the NDIS Act 
https://www.ndis.gov.au/operational-guideline/access/list-a

'Autism diagnosed by a specialist multi-disciplinary team, paediatrician, psychiatrist or clinical psychologist experienced in the assessment of Pervasive Developmental Disorders, and assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria as having severity of Level 3 (Requiring very substantial support)'

List B – Permanent conditions for which functional capacity are variable and further assessment of functional capacity is generally required https://www.ndis.gov.au/operational-guideline/access/list-b
Conditions primarily resulting in Intellectual/ learning impairment

  • Intellectual disability
  • Pervasive developmental disorders not meeting severity criteria in List A or List C
  • Asperger syndrome
  • Autism Spectrum Disorders

The disability requirements https://www.ndis.gov.au/operational-guideline/access/disability-requirements

8.3 Substantially reduced functional capacity to undertake relevant activities

The NDIA is required to consider whether any permanent impairment, or permanent impairments when considered together, result in substantially reduced functional capacity to undertake one or more of the following activities:

  • Communication: includes being understood in spoken, written or sign language, understanding others and expressing needs and wants by gesture, speech or context appropriate to age;
  • Social interaction: includes making and keeping friends (or playing with other children), interacting with the community, behaving within limits accepted by others, coping with feelings and emotions in a social context;
  • Learning: includes understanding and remembering information, learning new things, practicing and using new skills;
  • Mobility: this means the ability of a person to move around the home (crawling/walking) to undertake ordinary activities of daily living; getting in and out of bed or a chair, leaving the home, moving about in the community, and performing other tasks requiring the use of limbs;
  • Self-care: means activities related to personal care, hygiene, grooming and feeding oneself including; showering, bathing, dressing, eating, toileting, grooming, caring for own health care needs, etc.; or
  • Self-management: means the cognitive capacity to organise one's life, to plan and make decisions, and to take responsibility for oneself, including completing daily tasks, making decisions, problem solving and managing finances.

The NDIA does not need to be satisfied that a person's impairment is 'serious', or more serious than another person's. Rather, access to the NDIS is based on a functional, practical assessment of what a person can and cannot do