Occupational Therapy

Cerebral Palsy - What is involved?

A diagnosis of Cerebral Palsy may result in minor muscle stiffness or spasticity. With these symptoms, you may be able to perform day to day activities with little to no difficulty.

On the other hand, cerebral palsy may result in a more severe level of impairment. This is referred to in the NDIS as high support needs.

Cerebral Palsy and High Physical Support Needs

High physical support needs involve a high level of person-to-person support and the use of assistive technology. 

Person-to-person support may involve one person or two people helping you with the various routines that make up your day, including showering, eating, drinking, toileting, etc.

These tasks typically involve manual handling, where you may require assistance to transfer or reposition. 

Manual handling involves the practice of safe movements and lifting to reduce the risk of injury to the participant and support workers involved. In this case, using assistive technology may be necessary. This is to keep you and your support workers or carers safe.

Due to cognitive impairment that may be associated with your cerebral palsy diagnosis, it may not be safe to operate assistive technology independently. In most cases, assistance is needed to operate devices to ensure your safety and the safety of others.

What Assistive Technology Will Help Participants with Cerebral Palsy?

There is a wide range of assistive technology that can support NDIS Participants with cerebral palsy.

A common question our NDIS Navigators get is "What assistive technology can I use my NDIS funds for to help with cerebral palsy?"

We asked our resident OT to tell us what type of equipment she regularly prescribes to assist NDIS Participants with cerebral palsy.

Here are the main assistive technology solutions she mentioned:

• ​Mobility Devices such as a wheelchair
• Transfer Assistive Technology such as hoists and slings
• Bedroom Assistive Technology such as adjustable beds and pressure mattresses
• Bathroom Assistive Technology such as shower commodes and toilet equipment
• Living and Dining Assistive Technology such as seating and special trays
• Kitchen Assistive Technology such as tools to help you cut and prepare food
• Communication Assistive Technology such as the use of ipads or tablets with communication applications
• Hearing Devices such as hearing aids
• Assistive Technology for Children during Early Intervention including therapy aids.

Mobility Devices to Support NDIS Participants with Cerebral Palsy

Manual and Powered Wheelchairs

A manual wheelchair involves a seat and backrest attached to a frame with two large wheels with push-rims. Either the user self-propels the wheelchair, or it is attendant propelled via handlebars positioned at the rear of the backrest.

It can be difficult to accommodate seating and positioning needs for someone with a cerebral palsy in a manual wheelchair.

A powered wheelchair involves a base with motorised wheels that are controlled by a joystick. Attached to the base include a cushion, backrest, armrests and any other postural supports required.

A powered wheelchair offers a high level of customisation for seating and postural supports. This is often necessary for individuals with an cerebral palsy with significant impact to their functional capacity.

To operate a powered wheelchair, the joystick can be placed at the front of the armrests for the user to operate, or at the top of the backrest for carers to operate (or both). Carer operation may be necessary if you also have an intellectual disability.

Specialised seating and positioning aids may be necessary when cerebral palsy has resulted in postural changes and contractures that require additional support.

Ankle Foot Orthosis

An Ankle Foot Orthosis (AFO) is a brace worn to support one or both ankles which may be weak due to cerebral palsy.

AFO’s are to help with ankle and lower leg alignment and positioning.

Depending on your needs, an AFO may be hinged (made to bend at the ankle) or solid (no movement at the ankle). AFO’s can be worn underneath and inside your shoe to assist with walking.

Walking Aid - Walking Stick or four-wheeled Walker

Walking aids and devices are helpful for people with cerebral palsy who have the capacity to stand and walk with varying difficulty, and therefore may need a bit of extra support for some or all of the time.

There are various types of walking sticks, walking frames and walkers available, depending on your mobility needs.

Transfer Assistive Technology

Mobile Hoist

A mobile hoist is a device that is designed to lift and carry (transfer) you from one surface to another. This may be from your bed to your wheelchair, or from your wheelchair to shower commode.

It has a mobile base that can be wheeled from room to room, so long as there are no steps inside the home or other obstacles. Typically, two support workers or carers are required to operate a mobile hoist.

Ceiling Hoist

A ceiling hoist is a device attached to a frame that is built into your ceiling. It can transfer you between surfaces, and can sometimes travel between rooms.

It is usually easier to handle compared to a mobile hoist and usually requires one or two support workers or carers to operate.

Sling

Both a mobile hoist and a ceiling hoist require the use of a sling that attaches to the hoist via straps. A large fabric sling supports your whole body when you are lifted between surfaces.

Slings can come in all different shapes and sizes, and be made of different materials and straps designed for a variety of hoists.

Standing Hoist

If you can weight-bear, but require a bit of additional support to stand up, a standing hoist can help you with completing transfers i.e. standing from sitting at the edge of your bed, wheelchair, or recliner chair.

Various slings and straps are available to assist you in using your standing hoist. Typically, a standing hoist is operated by one support worker or carer.

Bedroom Assistive Technology

Hi-lo Adjustable Bed

Bedroom assistive technology involves a hi-lo adjustable bed.

An electronically powered hand remote is available to adjust the power features of the bed. 

The power features have various benefits, including:

• Raised back section - elevates the head and body for comfort, positioning, breathing, and eating.
• Lower limb elevation and knee break - supports the lower limb in an elevated position for comfort, pressure care management, management of swelling etc.
• Height adjustability - the bed can be lowered to assist you with standing transfers (if completed), or raise the bed to a height best suited for support workers or carers providing care to you in bed.

An adjustable bed is beneficial for someone with cerebral palsy who has difficulty adjusting and repositioning in bed.

Pressure Relieving Mattress

Various pressure relieving mattresses are necessary for individuals with cerebral palsy.

Pressure-relieving mattresses may be:

• Foam mattress - consisting of various layers of foam to immerse the body and distribute pressure
• Alternating air mattress - Air cells within a mattress that are inflated and deflated by an automated pump to redistribute pressure throughout the body for pressure care management
• Combination of foam and air mattress - a pump-free mattress that combines air cells and foam padding to achieve comfort and pressure care management

Bed Positioning Aids/Sleep Systems

In some cases, additional cushions and support pads are required to support someone with cerebral palsy sleep and rest in bed.

Their purpose is to provide support that may be necessary for hip alignment and supporting contractures caused by spasticity to improve comfort.

Bathroom Assistive Technology

Mobile Shower Commode

A mobile shower commode is a waterproof wheeled device that has a similar setup to a wheelchair. It may be helpful for you if you cannot stand to shower and/or require support for personal-care routines.

A mobile shower commode typically has an oval gap in the centre of the padded commode seat, similar to the inside of a toilet seat. This is beneficial as the commode can be wheeled over a toilet so that it can also be used for toileting.

A mobile shower commode requires an accessible bathroom. This involves level (flat) access into a shower recess which ideally does not contain glass screens or doors. The toilet seat needs to be low enough for the commode to wheel over.

Mobile shower commodes are more commonly required by people with cerebral palsy who require a hoist to complete transfers. This is because they may not be able to transfer on and off a standard toilet or shower chair. Additional positioning aids and supports can be attached to the commode.

Over Toilet Aid

An over toilet aid is a frame that can be positioned over your toilet to assist with sit to stand transfers. This is beneficial for people with cerebral palsy who can stand and walk, and need a little more support with transfers.

An over-toilet aid can promote your independence and reduce the need to rely on a support worker or carer to get on and off the toilet.

Shower Chair

In some cases, a shower chair may be the support you require in the shower if standing and balancing during your showering activity is difficult.

Shower chairs come in all shapes and sizes, including shower stools with or without backrests and armrests.

Living and Dining Assistive Technology

Living and dining supports can often be overlooked when mobility and transfer assistive technology are prioritised. For someone with cerebral palsy and high physical support needs, a standard couch or armchair is unlikely to meet your needs and sitting upright and maintaining comfort will be a challenge.

In this case, a disability-specific recliner chair with additional positioning features is required, to provide an opportunity to sit somewhere else that isn’t your wheelchair or bed for relaxation, leisure and social engagement.

A tray table on wheels that is compatible with the recliner chair is beneficial for eating meals and performing activities.

Kitchen Assistive Technology

Meal preparation aids can be beneficial for individuals with cerebral palsy that may have difficulties engaging in the kitchen for meal preparation. Due to reduced finger strength, hand strength and range of motion, difficulties can be experienced completing some tasks.

Some examples of kitchen and meal preparation aids include:

• Modified chopping board
• Spreader boards
• Modified knives and utensils (thicker or different handle designs)
• Easy open devices - one-touch bottle, jar and can openers
• Kettle tipper device
• Thermomix (in some cases if deemed appropriate following trial with an OT)

Communication Assistive Technology

Communication difficulties may be experienced by someone with cerebral palsy due to muscle spasms in the throat, mouth and tongue. This can impact word formation.

With limitations in the ability to communicate, it can be challenging and frustrating to express wants, needs and emotions.

There are a wide variety of communication aids available, ranging from low technology solutions to high technology solutions.

Low Technology Communication Aids:

• Picture exchange
• Symbol boards
• Printed word board with common phrases
• Communication books
• Sign language

High Technology Communication Aids:

• Electronic communication boards
• Software vocabularies with voices
• Eye-tracking devices
• Difficulties with typing and writing may also be necessary if impaired hand function is experienced.

Typing and Writing Aids

Typing Aids

Typing aids may involve a modified keyboard and mouse. This is to accommodate people with limitations in upper limb skills.

There is also talk to type software available which may be beneficial for you if your speech is not impacted but your physical capacity to access computer controls and accessories is limited.

Writing Aids

Adaptive writing aids and tools are beneficial, particularly for children, who may have difficulties with grasping a pencil or pen, or manage writing tasks on a level desk.

Writing aids may include:

• Specialist pencil grips and writing claws
• Handcuffs or cuffs
• Wrist supports
• Slanted writing board

Hearing Devices

Hearing loss is prevalent in the cerebral palsy population. There are several hearing devices available, including hearing aids and the cochlear implant.

The Hearing Services Program, funded by the Australian Government, provides partially and fully subsidised hearing device options.

The NDIS funds hearing support for NDIS participants aged 26 and over who are not eligible for the HSP. The NDIS also funds additional reasonable and necessary hearing support for participants if they are not available through the HSP. This includes people under 26.

See resources below:

Hearing Services available through the Health Department

Understanding NDIS and other Government Services Hearing Supports

Assistive Technology for Therapy

Assistive technology can play a large role in therapy and capacity building, particularly in the early intervention stages of your NDIS journey.

Assistive technology and adaptive equipment for therapy can include:

• seating systems
• standing frames
• gait trainers
• Electronic gaming devices, such as Mouseware - https://dextrowaredevices.com/mouseware/

Summary

There is a wide range of assistive technology available, with only some of the useful daily living aids discussed above. To learn what is right for you, you may benefit from a Functional Capacity Assessment from an Occupational Therapist.

Find an Occupational Therapist

The MyCareSpace NDIS Navigators can connect you with support workers who have experience with cerebral palsy in your area.

Find a Support Worker 

What is Capacity Building?

Capacity building is a term the NDIS used to describe funded services and supports to help build your independence and skills to help you pursue your goals.

Capacity building typically refers to allied health therapists who provide interventions to address your goals and build your capacity.

There are other service providers who can also work with you to build your capacity, such as support workers and employment services.

Capacity Building and Intellectual Disability

An intellectual disability affects how a person thinks, learns and processes information.

An intellectual disability can result in difficulties in a range of areas related to understanding, communicating, socialising and emotions.

Working with an allied health professional or another professional with training in capacity building for intellectual disability may assist you in developing skills to achieve your goals. These skills can be across a wide range of activities that make up your life at home, school, work and out in the community.

Capacity building intervention may be beneficial for people with intellectual disability across the lifespan, including children to adults.

Who can provide capacity building services for an intellectual disability?

Capacity building services can be provided by a therapist, such as:

• Occupational Therapist
• Speech Pathologist
• Physiotherapist
• Psychologist
• Social Worker

Under the NDIS, there are other early childhood support professionals that can be explored, such as:

• Developmental Educator
• Early Childhood Teacher or Educator
• Early Childhood Therapy Assistant
• Early Childhood Counsellor
• Keyworker

Learn more about keyworker services here: Keyworker in the NDIS

Capacity Building for Children

Depending on the needs of the child, there is a wide range of capacity building options to be explored.

Capacity building for young children is described as early intervention, which seeks to address difficulties experienced by a child at a young age to reduce the severity or impact experienced later in life.

Capacity building can be accessed in a variety of methods listed below.

Individualised Therapy

This gives the child direct attention with a therapist to focus on their goals in a one-one-one setting. Sessions may occur at a clinic setting, at home or in school, depending on what works best for the child and therapist.

Group Therapy

Group programs provide opportunities for children to work towards their individualised capacity building goals, while benefiting from engaging in a group environment. This provides them the opportunity to develop play and social skills, learning from others, sharing and turn taking etc.

Intensive Therapy Programs

These therapy blocks are designed around the principles of neuroplasticity to accelerate skill development over a short period of time. Intensive therapy programs can be delivered 1:1 or in a group setting, depending on the goals and interventions addressed.

Parent Training

This is a key component of capacity building, where a therapist is reliant on a parent or caregiver to implement interventions and recommendations into daily routines. Parent training enables children to continue to work towards their therapy goals at home.

Find out more about childhood supports for intellectual disability funded by the NDIS

Capacity Building for Adolescents

There is a huge scope for capacity building for adolescents, as these are the formative years where independence is explored and boundaries can be pushed.

Daily Living Interventions

Capacity building can seek to increase independence and participation in daily routines at home. Areas for capacity building includes:

• Personal care routines, such as showering, dressing, grooming & hygiene
• Meal preparation activities, including the planning and preparation of small and larger meals
• Domestic activities, such as laundry tasks, cleaning and maintaining a home

An Occupational Therapist would typically work with you to address goals related to these areas.

Social Skills Interventions

Effective social communication skills are essential to establish and build meaningful relationships with others. This enhances daily interactions across a range of settings.

Social communication interventions may address:

• Forming and maintaining authentic, meaningful relationships
• Self-advocacy and conflict resolution
• Conversation skills
• Understanding social differences
• Job interview skills
• Work readiness
• Interpreting social cues (understanding emotions, sarcasm and social context)

A Speech Pathologist would usually be involved to address goals related to these areas.

Community Participation Interventions

Engaging in your local and broader community is a key part of life. Due to your intellectual disability, you may require additional support to develop skills across the following:

• Shopping, attending appointments and running errands
• Work, in mainstream workplaces and supported employment
• Transport, such as using public transportation and driving
• Participation in community-based activities and events

Depending on your goals related to these skills, a variety of therapists may be involved to build your capacity to increase your independence.

Capacity Building for Adults

Capacity building interventions for adults can be similar to those addressed in adolescent years. Particularly if someone did not have access to capacity building supports throughout their childhood or adolescence, there is much to be gained from capacity building intervention throughout your adult years.

Typically, the primary goal of capacity building interventions for adults is to improve independent daily living skills at home and in the community. This can be addressed by a wide range of therapists and service providers to build your capacity.

Capacity Building NDIS Budget

Unlike your Core Supports budget, your Capacity Building Supports budget cannot be moved from one support category to another.

Funding can only be used to purchase approved individual supports that fall within that Capacity Building category.

The Capacity Building categories are:

• Support Coordination
• Improved Living Arrangements (referred to as CB Home Living)
• Increased Social & Community Participation (referred to as CB Social Community and Civic Participation)
• Finding & Keeping a Job (referred to as CB Employment)
• Improved Relationships (referred to as CB Relationships)
• Improved Health & Wellbeing (referred to as CB Health and Wellbeing)
• Improved Learning (referred to as CB Lifelong Learning)
• Improved Life Choices (referred to as CB Choice and Control)
• Improved Daily Living (referred to as CB Daily Activity)

Funding for an allied health provider (a therapist) is available in the Improved Daily Living category. 

How do I find a therapist for a child, teenager or adult with an intellectual disability?

At MyCareSpace, we are connected with many therapy providers. 

More importantly, we monitor their capacity real-time could be the perfect match for you. Let us help you navigate the NDIS and find the therapist you need.

Find A Therapist

What is an Intellectual Disability

Intellectual disabilities are identified by the NDIA as mild, moderate, severe or profound in accordance with current DSM-5 criteria. The severity of your disability reduces your level of independence and increases your reliance on others. 

An intellectual disability affects how a person thinks, learns and processes information. As a result of a severe or profound disability, you are likely to also demonstrate high physical support needs due an associated physical impairment.

Intellectual Disability and Physical Impairment

What is physical impairment?

This describes the difficulties someone experiences moving their body to walk, sit down, roll over and move their limbs.

In severe cases, people with intellectual disability demonstrate high physical support needs. This is due the significant impact their cognitive impairment has on their physical skills and abilities.

Physical impairment may also be a result of a condition co-occurring with an intellectual disability, such as Cerebral Palsy.

Physical impairment can also be attributed to delays in achieving developmental milestones and overall physical development, whereby an intellectual disability can impact motor coordination skills.

High Physical Support Needs

High physical support needs involve a high level of person-to-person support and the use of assistive technology.  This is directly related to a physical impairment.

What is person-to-person support?

Person-to-person support may involve one person or two people helping you with the various routines that make up your day, including showering, eating, drinking, toileting, etc.

These tasks typically involve manual handling, where you may require assistance to transfer or reposition. 

What is manual handling?

Manual handling involves the practice of safe movements and lifting to reduce the risk of injury to the participant and support workers involved.

In this case, using assistive technology may be necessary. This is to keep you and your support workers or carers safe.

Due to cognitive impairment resulting from your intellectual disability, it may not be safe to operate assistive technology independently. In most cases, assistance is needed to operate devices to ensure your safety and the safety of others.

What Assistive Technology Will Help Participants with Intellectual Disability?

There is a wide range of assistive technology that can support NDIS Participants with severe or profound intellectual disability.

A common question our NDIS Navigators are asked is "What assistive technology can I use my NDIS funds for to help with my intellectual disability?"

We asked our resident OT to tell us what type of equipment she regularly prescribes to assist NDIS Participants with severe or profound intellectual disabilities.

Here are the main assistive technology solutions she mentioned:

• ​Mobility Devices such as a wheelchair
• Transfer Assistive Technology such as hoists and slings
• Bedroom Assistive Technology such as adjustable beds and pressure mattresses
• Bathroom Assistive Technology such as shower commodes and toilet equipment
• Living and Dining Assistive Technology such as seating and special trays
• Kitchen Assistive Technology such as tools to help you cut and prepare food

Mobility Devices to Support NDIS Participants with Intellectual Disability

Manual and Powered Wheelchairs

A manual wheelchair involves a seat and backrest attached to a frame with two large wheels with push-rims. Either the user self-propels the wheelchair, or it is attendant propelled via handlebars positioned at the rear of the backrest.

It can be difficult to accommodate seating and positioning needs for someone with a severe or profound intellectual disability in a manual wheelchair.

A powered wheelchair involves a base with motorised wheels that are controlled by a joystick. Attached to the base include a cushion, backrest, armrests and any other postural supports required.

A powered wheelchair offers a high level of customisation for seating and postural supports. This is often necessary for individuals with a severe or profound intellectual disability with a significant impact on their functional capacity.

To operate a powered wheelchair, the joystick can be placed at the front of the armrests for the user to operate, or at the top of the backrest for carers to operate (or both). Carer operation may be necessary to cater to your intellectual disability.

Transfer Assistive Technology

Mobile Hoist

A mobile hoist is a device that is designed to lift and carry (transfer) you from one surface to another. This may be from your bed to your wheelchair, or from your wheelchair to shower commode.

It has a mobile base that can be wheeled from room to room, so long as there are no steps inside the home or other obstacles. Typically, two support workers or carers are required to operate a mobile hoist.

Ceiling Hoist

A ceiling hoist is a device attached to a frame that is built into your ceiling. It can transfer you between surfaces, and can sometimes travel between rooms. It is usually easier to handle compared to a mobile hoist and usually requires one or two support workers or carers to operate.

Sling

Both a mobile hoist and a ceiling hoist require the use of a sling that attaches to the hoist via straps. A large fabric sling supports your whole body when you are lifted between surfaces.

Slings can come in all different shapes and sizes, and be made of different materials and straps designed for a variety of hoists.

Standing Hoist

If you can weight-bear, but require a bit of additional support to stand up, a standing hoist can help you with completing transfers i.e. standing from sitting at the edge of your bed, wheelchair, or recliner chair.

Various slings and straps are available to assist you in using your standing hoist. Typically, a standing hoist is operated by one support worker or carer.

Bedroom Assistive Technology

Hi-lo Adjustable Bed

Bedroom assistive technology involves a hi-lo adjustable bed.

An electronically powered hand remote is available to adjust the power features of the bed. 

The power features have various benefits, including:

• Raised back section - elevates the head and body for comfort, positioning, breathing, and eating.
• Lower limb elevation and knee break - supports the lower limb in an elevated position for comfort, pressure care management, management of swelling etc.
• Height adjustability - the bed can be lowered to assist you with standing transfers (if completed), or raise the bed to a height best suited for support workers or carers providing care to you in bed.

An adjustable bed is beneficial for someone with a severe or profound intellectual disability who has difficulty adjusting and repositioning in bed.

Pressure Relieving Mattress

Various pressure-relieving mattresses are necessary for individuals with a severe or profound intellectual disability.

Pressure-relieving mattresses may be:

• Foam mattress - consisting of various layers of foam to immerse the body and distribute pressure
• Alternating air mattress - Air cells within a mattress that are inflated and deflated by an automated pump to redistribute pressure throughout the body for pressure care management
• Combination of foam and air mattress - a pump-free mattress that combines air cells and foam padding to achieve comfort and pressure care management

Bathroom Assistive Technology

Mobile Shower Commode

A mobile shower commode is a waterproof wheeled device that has a similar setup to a wheelchair. It may be helpful for you if you cannot stand to shower and/or require support for personal-care routines.

A mobile shower commode typically has an oval gap in the centre of the padded commode seat, similar to the inside of a toilet seat. This is beneficial as the commode can be wheeled over a toilet so that it can also be used for toileting.

A mobile shower commode requires an accessible bathroom. This involves level (flat) access to a shower recess which ideally does not contain glass screens or doors. The toilet seat needs to be low enough for the commode to wheel over.

Mobile shower commodes are more commonly required by people with a severe or profound intellectual disability who require a hoist to complete transfers. This is because they may not be able to transfer on and off a standard toilet or shower chair.

Additional positioning aids and supports can be attached to the commode.

Over Toilet Aid

An over toilet aid is a frame that can be positioned over your toilet to assist with sit-to-stand transfers. This is beneficial for people with a moderate or severe intellectual disability who can stand and walk, and need a little more support with transfers.

An over toilet aid can promote your independence and reduce the need to rely on a support worker or carer to get on and off the toilet.

Shower Chair

In some cases, a shower chair may be the support you require in the shower if standing and balancing during your showering activity is difficult.

Shower chairs come in all shapes and sizes, including shower stools with or without backrests and armrests.

Living and Dining Assistive Technology

Living and dining supports can often be overlooked when mobility and transfer assistive technology are prioritised. For someone with a severe or profound intellectual disability and high physical support needs, a standard couch or armchair is unlikely to meet your needs and sitting upright and maintaining comfort will be a challenge.

In this case, a disability-specific recliner chair with additional positioning features is required, to provide an opportunity to sit somewhere else that isn’t your wheelchair or bed for relaxation, leisure and social engagement.

A tray table on wheels that is compatible with the recliner chair is beneficial for eating meals and performing activities.

Kitchen Assistive Technology

Meal preparation aids can be beneficial for individuals with moderate intellectual disability who may have difficulties engaging in the kitchen for meal preparation.

What are kitchen and meal preparation aids?

Kitchen and meal preparation aids are assistive technology or devices to reduce the demands of meal preparation by offering additional support, and stability and reducing the fine motor demands.

Some examples of kitchen and meal preparation aids include:

• Modified chopping board
• Spreader boards
• Modified knives and utensils (thicker or different handle designs)
• Easy open devices - one-touch bottle, jar and can openers
• Kettle tipper device
• Thermomix (in some cases if deemed appropriate following trial with an OT)

Summary

There is a wide range of assistive technology available, with only some of the useful daily living aids discussed above. To learn what is right for you, you may benefit from a Functional Capacity Assessment from an Occupational Therapist.

Find an Occupational Therapist

The MyCareSpace NDIS Navigators can connect you with support workers who have experience with intellectual disability in your area.

Find a Support Worker 

What is an Intellectual Disability?

An intellectual disability affects how a person thinks, learns and processes information.

It is a permanent and life-long disability that results in difficulties across a range of areas related to understanding, communicating, socialising and emotions.

In Australia, there are about 450,000 people with an intellectual disability.

Can you receive NDIS funding for an Intellectual Disability?

If you have been diagnosed with an intellectual disability, you may be able to access NDIS funding if you meet the eligibility criteria.

Funding can be used to support your needs directly related to your intellectual disability.

Intellectual Disability and NDIS Statistics

The following information has been collected by the NDIS and is up to date as of June 2023:

15% of the 610,502 active participants in the NDIS have a primary disability of an intellectual disability, making it the second most common disability for NDIS participants.

47% of participants with an intellectual disability are aged under 25 years.

57% of participants with an intellectual disability are male.

In the year ending June 2023:

89% of access decisions for applicants with an intellectual disability aged 18 years and under resulted in the applicant joining the Scheme, compared to 77% for those aged over 18 years. 

$98,100 was the average payment for a participant with an intellectual disability, an increase of 13% compared to the previous year

The number of participants with an intellectual disability has increased by 6% and 5% in the last two years.

These trends show that funded support for people with intellectual disabilities is increasing.

Childhood supports for Intellectual Disability is funded by the NDIS

Early Childhood Supports (EC) are available to children younger than 6 with developmental delays or children younger than 9 with disability.

Children younger than 6 do not need a diagnosis to get support through the NDIS early childhood approach where there are concerns about their development.

The support provided involves funding for capacity building supports in early childhood, including a key worker. Learn about the keyworker model in the NDIS here.

Funded supports are available for a child with developmental delay or disability and their family or carers across the following settings:

• Home
• Community
• Early childhood education settings

The goal for early childhood support services is to work towards increased functional independence and social participation.

This approach aligns with research that finds early intervention can improve outcomes for children and families by targeting the circumstances that make supporting children's development difficult.

Therapy Supports (9 or older) for Intellectual Disability funded by the NDIS

Therapy supports are available for participants aged 9 and over with an established and diagnosed disability. 

The goal of therapy is to facilitate functional improvement where there is no more scope from a medical perspective to improve health and function.

Therapy or capacity building can seek to address your goals and build your independence across areas of your life that are meaningful to you.

What therapy services can I access using my NDIS funding?

The following therapists and supports relevant to your intellectual disability which you may be able to access using your NDIS funding:

• Art Therapist
• Counsellor
• Developmental Educator
• Dietitian
• Exercise Physiologist
• Music Therapist
• Occupational Therapist
• Physiotherapist
• Podiatrist
• Psychologist
• Rehabilitation Counsellor
• Social Worker
• Speech Pathologist

There are also other professionals, described by the NDIA as a person who are not one of the types of professionals listed above but who the provider considers to be an appropriate professional to deliver therapeutic supports in line with the NDIS Quality and Safeguarding Commission’s requirements for the Therapeutic Supports Registration Group.

What other services can I access with NDIS funding?

NDIS funding is also available for other services outside of therapy. This includes day to day support provided by a support worker or support service.

If the support needs is related to your disability, you can access funding for a support worker to assist with:

• Self-care routines
• Cooking
• Cleaning
• Shopping
• Transport
• Programs and activities

These are just some examples of supports and services you can access using your NDIS funding related to your disability.

Our MyCareSpace Connections Team can help you navigate the NDIS and connect you with the services you need.

Get Started
 

Spinal Cord Injury - What is involved?

A Spinal Cord Injury (SCI) involves damage to the spinal cord which can impact your:

• movement
• sensation
• breathing
• organ function
• bladder and bowel function
• sexual function

Spinal Cord Injury and High Physical Support Needs

In some cases, people with a spinal cord injury demonstrate high support needs due the severe impact of their injury. High physical support needs involve a high level of person-to-person support and the use of assistive technology. 

Person-to-person support may involve one person or two people helping you with the various routines that make up your day, including showering, eating, drinking, toileting, etc.

These tasks typically involve manual handling, where you may require assistance to transfer or reposition. 

Manual handling involves the practice of safe movements and lifting to reduce the risk of injury to the participant and support workers involved. In this case, using assistive technology may be necessary. This is to keep you and your support workers or carers safe.

Due to the high complexity of your spinal cord injury, you may not have the capacity to operate some of your assistive technology. In these cases, assistance is required to operate devices to ensure your safety and the safety of others.

What Assistive Technology Will Help Participants with a Spinal Cord Injury?

There is a wide range of assistive technology that can support NDIS Participants with a spinal cord injury.

A common question our NDIS Navigators are asked is "What assistive technology can I use my NDIS funds for to help with my spinal cord injury?"

We asked our resident OT to tell us what type of equipment she regularly prescribes to assist NDIS Participants with a spinal cord injury.

Here are the main assistive technology solutions she mentioned:

• ​Mobility Devices such as a wheelchair
• Transfer Assistive Technology such as hoists and slings
• Bedroom Assistive Technology such as adjustable beds and pressure mattresses
• Bathroom Assistive Technology such as shower commodes and toilet equipment
• Living and Dining Assistive Technology such as seating and special trays
• Kitchen Assistive Technology such as tools to help you cut and prepare food

Mobility Devices to Support NDIS Participants with Spinal Cord Injury

Manual and Powered Wheelchairs

If your spinal cord injury has impacted your capacity to walk, you may require the use of a wheelchair.

A manual wheelchair involves a seat and backrest attached to a frame with two large wheels with push-rims. Either the user self-propels the wheelchair, or it is attendant propelled via handlebars positioned at the rear of the backrest.

A manual wheelchair requires the user to have sufficient trunk control to remain seated upright, as well as upper limb function required to propel the wheels.

Most people with a spinal cord injury level below C6 will have the capacity to self-propel a manual wheelchair. In addition to your injury, factors that may impact your capacity to self propel include:

• weight
• fitness
• strength
• level of pain
• the environment i.e. flat vs sloped surfaces.

If your injury is above C6, you may find a manual wheelchair does not effectively accommodate your seating and positioning needs. If this is the case, a powered wheelchair may be considered a more appropriate mobility device.

A powered wheelchair involves a base with motorised wheels that are controlled by a joystick. Attached to the base is a cushion, backrest, armrests and any other postural supports required.

A powered wheelchair offers a high level of customisation for seating and postural supports. This is often necessary for individuals with a high level spinal cord injury with a significant impact on their functional capacity.

To operate a powered wheelchair, the joystick can be placed at the front of the armrests for the user to operate, or at the top of the backrest for carers to operate (or both).

If a joystick cannot be operated due to upper limb impairment, alternative controls may be necessary, such as a head array wheelchair control system.

Transfer Assistive Technology

Mobile Hoist

A mobile hoist is a device that is designed to lift and carry (transfer) you from one surface to another. This may be from your bed to your wheelchair, or from your wheelchair to shower commode.

It has a mobile base that can be wheeled from room to room, so long as there are no steps inside the home or other obstacles. Typically, two support workers or carers are required to operate a mobile hoist.

Ceiling Hoist

A ceiling hoist is a device attached to a frame that is built into your ceiling. It can transfer you between surfaces, and can sometimes travel between rooms. It is usually easier to handle compared to a mobile hoist and usually requires one or two support workers or carers to operate.

Sling

Both a mobile hoist and a ceiling hoist require the use of a sling that attaches to the hoist via straps. A large fabric sling supports your whole body when you are lifted between surfaces.

Slings can come in all different shapes and sizes, and be made of different materials and straps designed for a variety of hoists.

Standing Hoist

If you can weight-bear, but require a bit of additional support to stand up, a standing hoist can help you with completing transfers i.e. standing from sitting at the edge of your bed, wheelchair, or recliner chair.

Various slings and straps are available to assist you in using your standing hoist. Typically, a standing hoist is operated by one support worker or carer, however assistance of two may be necessary depending on the requirements of the transfer.

Bedroom Assistive Technology

Hi-lo Adjustable Bed

Bedroom assistive technology involves a hi-lo adjustable bed.

An electronically powered hand remote is available to adjust the power features of the bed. 

The power features have various benefits, including:

• Raised back section - elevates the head and body for comfort, positioning, breathing, and eating.
• Lower limb elevation and knee break - supports the lower limb in an elevated position for comfort, pressure care management, management of swelling etc.
• Height adjustability - the bed can be lowered to assist you with standing transfers (if completed), or raise the bed to a height best suited for support workers or carers providing care to you in bed.

An adjustable bed is beneficial for someone with a spinal cord injury who has difficulty adjusting, repositioning and sitting up in bed.

Pressure Relieving Mattress

Various pressure relieving mattresses are necessary for individuals with a spinal cord injury.

Pressure-relieving mattresses may be:

• Foam mattress - consisting of various layers of foam to immerse the body and distribute pressure
• Alternating air mattress - Air cells within a mattress that are inflated and deflated by an automated pump to redistribute pressure throughout the body for pressure care management
• Combination of foam and air mattress - a pump-free mattress that combines air cells and foam padding to achieve comfort and pressure care management

A high level spinal cord injury will impact your ability to reposition in bed, increasing your risk of sustaining a pressure care injury. In these cases, an alternating air mattress which offers a high level of pressure relief may be necessary.

Bathroom Assistive Technology

Mobile Shower Commode

A mobile shower commode is a waterproof wheeled device that has a similar setup to a wheelchair. It may be helpful for you if you cannot stand to shower and/or require support for personal-care routines.

A mobile shower commode typically has an oval gap in the centre of the padded commode seat, similar to the inside of a toilet seat. This is beneficial as the commode can be wheeled over a toilet so that it can also be used for toileting.

A mobile shower commode requires an accessible bathroom. This involves level (flat) access into a shower recess which ideally does not contain glass screens or doors. The toilet seat needs to be low enough for the commode to wheel over.

Mobile shower commodes can be self-propelled by users who would typically self-propel their manual wheelchair. A mobile shower commode with a tilt-in-space function may be more appropriate for a powered wheelchair used that is mobilised by care supports. Emerging assistive technology involves mobile shower commodes that can be manouvered electronially, such as the HMN M2 JOYSTICK mobile shower commode.

Over Toilet Aid

An over toilet aid is a frame that can be positioned over your toilet to assist with sit to stand transfers. This is beneficial for people with a spinal cord injury who can stand and walk, and need a little more support with transfers.

An over-toilet aid can promote your independence and reduce the need to rely on a support worker or carer to get on and off the toilet.

Shower Chair

In some cases, a shower chair may be the support you require in the shower if standing and balancing during your showering activity is difficult.

Shower chairs come in all shapes and sizes, including shower stools with or without backrests and armrests.

Living and Dining Assistive Technology

Living and dining supports can often be overlooked when mobility and transfer assistive technology are prioritised. For someone with an spinal cord injury and high physical support needs, a standard couch or armchair is unlikely to meet your needs and sitting upright and maintaining comfort will be a challenge.

In this case, a disability-specific recliner chair with additional positioning features is required, to provide an opportunity to sit somewhere else that isn’t your wheelchair or bed for relaxation, leisure and social engagement.

A tray table on wheels that is compatible with the recliner chair is beneficial for eating meals and performing activities.

Kitchen Assistive Technology

Meal preparation aids can be beneficial for individuals with a spinal cord injury that may have difficulties engaging in the kitchen for meal preparation.

Some examples of kitchen and meal preparation aids include:

• Modified chopping board
• Spreader boards
• Modified knives and utensils (thicker or different handle designs)
• Easy open devices - one-touch bottle, jar and can openers
• Kettle tipper device
• Thermomix (in some cases if deemed appropriate following trial with an OT)

Summary

There is a wide range of assistive technology available, with only some of the useful daily living aids discussed above. To learn what is right for you, you may benefit from a Functional Capacity Assessment from an Occupational Therapist.

Find an Occupational Therapist

The MyCareSpace NDIS Navigators can connect you with support workers who have experience with spinal cord injuries in your area.

Find a Support Worker

Spinal Cord Injury and NDIS

As of June 2023, there are 5,895 active NDIS participants with spinal cord injury as their primary disability. This makes up 1% of participants on the Scheme.

69% of participants with a spinal cord injury are aged 45 years and over.

$860 million of paid supports were provided to participants with a spinal cord injury, compared to $704 million in the previous year. This is an increase of 22% of funded support.

$150,600 was the average payment for a participant with a spinal cord injury, an increase of 14% compared to the previous year.

The number of participants with a spinal cord injury has increased by 8% and 6% in the last two years.

These trends show that funded support for people with Spinal Cord Injuries are increasing.

Are people with Spinal Cord Injury eligible for NDIS funding?

The NDIA has eligibility criteria for people applying to the NDIS.

You are eligible for NDIS funding if you meet the following NDIS Access Criteria:

• You are aged between 9 and 65 years
• You are an Australian citizen, permanent resident, or Protected Special Category Visa holder
• You live in Australia
• You have a disability caused by a permanent impairment (lifelong disability)

See Who is eligible for the NDIS? for further information on NDIS eligibility criteria.

NDIS Eligibility Requirements for Spinal Cord Injury

Within the NDIS eligibility requirements, the NDIA have published Condition Lists. On these lists include conditions that are considered likely to meet eligibility criteria for having a disability that results in a permanent and lifelong impairment.

If you have a condition stated in Condition List A, you are likely to meet the disability requirements to access the NDIS.

Spinal Cord Injury is included in Condition List A if the injury, as specified by the NDIA, results in paraplegia, quadriplegia or tetraplegia. Learn more about these classifications here: What is a Spinal Cord Injury?

You may be eligible for the NDIA if you have a complete or incomplete spinal cord injury.

Evidence of Spinal Cord Injury for NDIS Eligibility

The NDIS requires information about your disability when determining whether you are eligible to access the scheme.

When providing evidence to access the NDIS, you will have the best chance for success if you include information specifically about how your impairment is permanent and how your disability/condition substantially reduces your functional capacity or ability to undertake activities in one or more of the following areas:

Communicating

This involves how you speak, write, or use sign language and gestures to express yourself. Communication can involve face to face interactions and electronic communication, such as use of phone and computer for SMS, emails etc.

The NDIA considers how well you communicate with others and how your communication is impacted by your spinal cord injury.

Socialising

This involves how you make and keep friends, or interact with others in the community. The NDIA considers how you socialise with others and what barriers may be present with socialising directly related to your spinal cord injury.

Are there any conditions secondary to your spinal cord injury related to your mental health that impacts your ability to regulate your emotions and feelings in social situations?

Learning

This involves how you learn, understand and remember new things, and practice and use new skills. At the time of your spinal cord injury, was there any impact to your brain? If your cognitive abilities have been affected, this may impact how you learn and interact with the world.

Mobility

This involves how you move around your home, transfer in and out of bed, transfer on and off the toilet, in and out of the shower etc. This also involves how you move around your community and transportation. NDIA will consider whether you require use of a mobility aid or home environment modifications to promote your independence with mobility.

Self Care

How do you manage your personal care needs? Maintain hygiene? Eat and drink? Get dressed? Go to the toilet? You will need to provide information about how you complete your self-care tasks, and how much help you need from others for these routines.

Self-Management

This involves how you organise your life - How do you plan? Make decisions? Look after yourself? The NDIS considers your capacity to manage your life, involving your ability to problem solve and make your own decisions.

For further information regarding eligibility criteria, please review the NDIS Guidelines in Becoming a Participant

How do I know if I meet the NDIS eligibility criteria?

Of the activities listed above, you must be able to demonstrate impairment across one or more of these requirements.

When you submit an application to the NDIS, it will be reviewed and you will be provided with an outcome if you have been successful or not in meeting the eligibility criteria to access the NDIS.

What do I need to include in my NDIS application?

To apply to the NDIS, you will need to complete an Access Request Form

As part of the access request process, you will be asked:

• to confirm your identity and/or a person's authority to act on your behalf
• questions to see if you meet the NDIS access requirements (age, residence and disability)
• questions about providing consent to enter the NDIS and about seeking information from third parties.

It is helpful to provide letters and reports from your treating health professionals with information regarding your spinal cord injury and the impact it has in your everyday life.

Do I need an Occupational Therapy (OT) report to access the NDIS?

While an OT report is not a requirement for an NDIS application, it is helpful to submit an OT report with your application as this will provide important information as to how your spinal cord injury impacts your functional capacity across the eligibility categories listed above.

The report will link any impairment you experience across the eligibility criteria to your spinal cord injury. 

The report may not provide specific recommendations for supports you require, but rather it should provide a broader recommendation as to whether NDIS-funded supports are considered necessary for you.

Learn more about Occupational Therapy here: Decoding Allied Health

How do I get an OT report?

An OT report is completed following an OT assessment. Any assessments and reports completed prior to accessing the NDIS cannot be funded by the NDIS.

If you are currently in hospital, you will likely have access to an in-patient Occupational Therapist to complete this assessment and prepare a report. 

If you are not linked in with spinal service, you may have to pay for the OT assessment and report privately. In some cases, you may be able to claim some of the cost through Medicare.

Does an OT assessment and report guarantee acceptance onto the NDIS?

No, as ultimately the decision is made by the NDIA. However, an OT assessment and report will be helpful in clearly demonstrating the link between your spinal cord injury and the functional impairment experienced. This is what the NDIA considers when making their decision.

Other treating health professionals can also provide complete a letter or report to assist with your application if they can provide relevant recommendations. If you have support from a social worker at hospital, they may assist you with completing the paperwork to access the NDIS.

How do I find an Occupational Therapist for an assessment to access the NDIS?

The MyCareSpace Connections Team can help you to find an Occupational Therapist with capacity in your area or via online.

Find an OT

More information on how to access the NDIS

How to Apply for the NDIS

Writing an NDIS Carer Statement for NDIS Access and Reviews

Writing Reports for NDIS Access and Plan Reviews (Reassessments)
 

Welcome to the NDIS Acquired Brain Injury Series

If you have found your way to this page, it means you are interested in learning more about acquired brain injury (ABI) and navigating the NDIS.

Our MyCareSpace NDIS Navigators have prepared a series of resources that unpack the topics frequently asked by people with acquired brain injury and their families who want to better understand how to use their NDIS funding to achieve their goals.

Each topic has a different theme and provides you with additional links and resources to further your learning. Starting off with an overview of acquired brain injury and the NDIS...

What is Acquired Brain Injury?

An acquired brain injury is the result of damage to the brain. It can be caused by:

• Trauma or injury to the head (referred to as a traumatic brain injury)
• Stroke
• Drugs, alcohol or poisons
• Lack of oxygen to the brain for an extended time (for example, a near-drowning)
• infection
• Tumour
• Neuro-degenerative conditions can impact the brain, such as:
• Parkinson's disease
• Alzheimer's disease or some other form of dementia
• ALS (amyotrophic lateral sclerosis)

As an acquired brain injury can occur in a variety of ways, brain damage can cause a range of different problems for individuals.  An acquired brain injury may impact your capacity to engage in day-to-day activities in one way or another. Support needs may be minor, moderate or maximal.

Learn all about Acquired Brain Injury:

What is Acquired Brain Injury?

Accessing the NDIS with an Acquired Brain Injury

If you have a brain injury that has resulted in permanent functional impairment, you may be eligible to the NDIS. 3% of the 610,502 active participants in the NDIS have a primary disability of an acquired brain injury

When applying to the NDIS, evidence of having a brain injury will be required for your application. You must be able to demonstrate how your permanent impairment results in a lifelong disability for it to be funded by the NDIS. 

Find out more about what you need to include in an NDIS application for an acquired brain injury:

Accessing the NDIS with an Acquired Brain Injury

Acquired Brain Injury and Assistive Technology

In some cases, people with an acquired brain injury demonstrate high support needs due the severe impact of their injury. This may result in a need for assistive technology.

Assistive technology that you can benefit from with an acquired brain injury includes:

• ​Mobility Devices such as a wheelchair
• Transfer Assistive Technology such as hoists and slings
• Bedroom Assistive Technology such as adjustable beds and pressure mattresses
• Bathroom Assistive Technology such as shower commodes and toilet equipment
• Living and Dining Assistive Technology such as seating and special trays
• Kitchen Assistive Technology such as tools to help you cut and prepare food

Find out more about how you can benefit from assistive technology:

Acquired Brain Injury and Assistive Technology in the NDIS

Supported Independent Living and Acquired Brain Injury

Supported Independent Living (SIL) is the support or supervision of daily tasks by paid support workers to help you to live as independently as possible. The support you receive through SIL relates directly to your support needs in the home. SIL support typically involves daytime and overnight support which is provided individually (1:1) or shared (1:2, 1:3, 1:4 etc)

Depending on your needs, SIL may include the following supports:

• Assistance with personal care, like showering, dressing and toileting
• Assistance with household tasks such as cleaning, preparing meals, washing clothes and cleaning
• Active overnight and/or sleepover support
• Assistance with complex medical needs
• Positive behaviour support management
• Assisting with administering medication and management of health needs related to your disability, such as bowel care, catheter, epilepsy, asthma and tube feeding

Learn all about how SIL can help you, high physcial support needs, ratio's of support etc here:

Supported Independent Living and Acquired Brain Injury

How to Get Funding for Supported Independent Living (SIL)

So you now know how SIL is funded in your NDIS plan, but how do you get approved for funding for SIL?

This resource contains helpful easy to understand information on the following topics to help you in accessing the support you need:

• SIL Eligibility
• Is SIL Reasonable and Necessary?
• What do the NDIS consider when approving funding for Supported Independent Living (SIL)?
• What is a Functional Capacity Assessment?
• How does a Functional Capacity Assessment for SIL differ to a standard Functional Capacity Assessment?
• How can I get a Functional Capacity Assessment for Supported Independent Living (SIL)?
• How do I submit a request for SIL to the NDIS?

Find answers to these frequently asked questions here:

How to Get Funding for Supported Independent Living (SIL)

How to maximise your SIL funding with an Acquired Brain Injury

A recurring question the MyCareSpace team are asked is "how do I make the most of my NDIS funding?". There is often confusion about what will and won't be funded, what is considered reasonable and necessary for the NDIS to fund, and what is considered a personal expense. These lines in particular can be blurred when in-home supports are involved, such as SIL.

To make the most of your funding, it is important to understand how funding is allocated in your NDIS plan and what services and supports this funding can be used for.

The MyCareSpace team are frequently asked the following questions related to SIL:

• Does SIL include accommodation?
• Does SIL include groceries and other day-to-day expenses?
• What happens to SIL if I am in hospital?
• Is staff training required for Acquired Brain Injury in the NDIS?
• Does SIL = shared supports?
• Will I receive SIL if I don’t need support all of the time?

This resource answers all of these questions to help you maximise your NDIS funding:

How to maximise your SIL funding with an Acquired Brain Injury

How do I find a SIL provider?

When SIL is approved in your plan, you will be provided with a sum of funding for SIL in your Core Support budget.

You are not automatically allocated to a provider, and have choice and control over which provider you engage with for SIL.

The SIL provider you select will assist in preparing a roster of care, utilising the funding allocated in your plan to cater to your needs across your week.

Need help finding a SIL provider? Get in touch with our Connections Team for assistance to nagivate the NDIS and find a SIL provider in your area.

Get In Touch

Find More Resources

MyCareSpace offers a range of resources across all topics involving the NDIS.

Review our Resource Library to learn more about how to make the most of your NDIS funding: MyCareSpace Resources

Need help Navigating the NDIS?

The MyCareSpace Connections Team can help you to navigate the NDIS and find NDIS supports that you need to achieve your goals.

Get Started

Acquired Brain Injury - What is involved?

An injury to the brain may impact how you think, move, perform your daily routines and interact with others. This may result in requiring varying levels of support across your day-to-day life.

Acquired Brain Injury and High Physical Support Needs

In some cases, people with an acquired brain injury demonstrate high support needs due to the severe impact of their injury. High physical support needs involve a high level of person-to-person support and the use of assistive technology. 

Person-to-person support may involve one person or two people helping you with the various routines that make up your day, including showering, eating, drinking, toileting, etc.

These tasks typically involve manual handling, where you may require assistance to transfer or reposition. 

Manual handling involves the practice of safe movements and lifting to reduce the risk of injury to the participant and support workers involved. In this case, using assistive technology may be necessary. This is to keep you and your support workers or carers safe.

Due to cognitive impairment caused by your acquired brain injury, it may not be safe to operate assistive technology independently. In most cases, assistance is needed to operate devices to ensure your safety and the safety of others.

What Assistive Technology Will Help Participants with Acquired Brain Injury?

There is a wide range of assistive technology that can support NDIS Participants with acquired brain injury.

A common question our NDIS Navigators get is "What assistive technology can I use my NDIS funds for to help with acquired brain injury?"

We asked our resident OT to tell us what type of equipment she regularly prescribes to assist NDIS Participants with acquired brain injury.

Here are the main assistive technology solutions she mentioned:

• ​Mobility Devices such as a wheelchair
• Transfer Assistive Technology such as hoists and slings
• Bedroom Assistive Technology such as adjustable beds and pressure mattresses
• Bathroom Assistive Technology such as shower commodes and toilet equipment
• Living and Dining Assistive Technology such as seating and special trays
• Kitchen Assistive Technology such as tools to help you cut and prepare food

Mobility Devices to Support NDIS Participants with Acquired Brain Injury

Manual and Powered Wheelchairs

A manual wheelchair involves a seat and backrest attached to a frame with two large wheels with push-rims. Either the user self-propels the wheelchair, or it is attendant propelled via handlebars positioned at the rear of the backrest.

It can be difficult to accommodate seating and positioning needs for someone with a severe brain injury in a manual wheelchair.

A powered wheelchair involves a base with motorised wheels that are controlled by a joystick. Attached to the base include a cushion, backrest, armrests and any other postural supports required.

A powered wheelchair offers a high level of customisation for seating and postural supports. This is often necessary for individuals with an acquired brain injury with a significant impact on their functional capacity.

To operate a powered wheelchair, the joystick can be placed at the front of the armrests for the user to operate, or at the top of the backrest for carers to operate (or both). Carer operation may be necessary if the acquired brain injury has impacted your cognitive capacity.

Transfer Assistive Technology

Mobile Hoist

A mobile hoist is a device that is designed to lift and carry (transfer) you from one surface to another. This may be from your bed to your wheelchair, or from your wheelchair to shower commode.

It has a mobile base that can be wheeled from room to room, so long as there are no steps inside the home or other obstacles. Typically, two support workers or carers are required to operate a mobile hoist.

Ceiling Hoist

A ceiling hoist is a device attached to a frame that is built into your ceiling. It can transfer you between surfaces, and can sometimes travel between rooms. It is usually easier to handle compared to a mobile hoist and usually requires one or two support workers or carers to operate.

Sling

Both a mobile hoist and a ceiling hoist require the use of a sling that attaches to the hoist via straps. A large fabric sling supports your whole body when you are lifted between surfaces.

Slings can come in all different shapes and sizes, and be made of different materials and straps designed for a variety of hoists.

Standing Hoist

If you can weight-bear but require a bit of additional support to stand up, a standing hoist can help you with completing transfers i.e. standing from sitting at the edge of your bed, wheelchair, or recliner chair.

Various slings and straps are available to assist you in using your standing hoist. Typically, a standing hoist is operated by one support worker or carer.

Bedroom Assistive Technology

Hi-lo Adjustable Bed

Bedroom assistive technology involves a hi-lo adjustable bed.

An electronically powered hand remote is available to adjust the power features of the bed. 

The power features have various benefits, including:

• Raised back section - elevates the head and body for comfort, positioning, breathing, and eating.
• Lower limb elevation and knee break - supports the lower limb in an elevated position for comfort, pressure care management, management of swelling etc.
• Height adjustability - the bed can be lowered to assist you with standing transfers (if completed), or raise the bed to a height best suited for support workers or carers providing care to you in bed.

An adjustable bed is beneficial for someone with acquired brain injury who has difficulty adjusting and repositioning in bed.

Pressure Relieving Mattress

Various pressure relieving mattresses are necessary for individuals with acquired brain injury.

Pressure-relieving mattresses may be:

• Foam mattress - consisting of various layers of foam to immerse the body and distribute pressure
• Alternating air mattress - Air cells within a mattress that are inflated and deflated by an automated pump to redistribute pressure throughout the body for pressure care management
• Combination of foam and air mattress - a pump-free mattress that combines air cells and foam padding to achieve comfort and pressure care management

Bathroom Assistive Technology

Mobile Shower Commode

A mobile shower commode is a waterproof wheeled device that has a similar setup to a wheelchair. It may be helpful for you if you cannot stand to shower and/or require support for personal-care routines.

A mobile shower commode typically has an oval gap in the centre of the padded commode seat, similar to the inside of a toilet seat. This is beneficial as the commode can be wheeled over a toilet so that it can also be used for toileting.

A mobile shower commode requires an accessible bathroom. This involves level (flat) access to a shower recess which ideally does not contain glass screens or doors. The toilet seat needs to be low enough for the commode to wheel over.

Mobile shower commodes are more commonly required by people with acquired brain injury who require a hoist to complete transfers. This is because they may not be able to transfer on and off a standard toilet or shower chair. Additional positioning aids and supports can be attached to the commode.

Over Toilet Aid

An over toilet aid is a frame that can be positioned over your toilet to assist with sit to stand transfers. This is beneficial for people with acquired brain injury who can stand and walk, and need a little more support with transfers.

An over-toilet aid can promote your independence and reduce the need to rely on a support worker or carer to get on and off the toilet.

Shower Chair

In some cases, a shower chair may be the support you require in the shower if standing and balancing during your showering activity is difficult.

Shower chairs come in all shapes and sizes, including shower stools with or without backrests and armrests.

Living and Dining Assistive Technology

Living and dining supports can often be overlooked when mobility and transfer assistive technology are prioritised. For someone with an acquired brain injury and high physical support needs, a standard couch or armchair is unlikely to meet your needs and sitting upright and maintaining comfort will be a challenge.

In this case, a disability-specific recliner chair with additional positioning features is required, to provide an opportunity to sit somewhere else that isn’t your wheelchair or bed for relaxation, leisure and social engagement.

A tray table on wheels that is compatible with the recliner chair is beneficial for eating meals and performing activities.

Kitchen Assistive Technology

Meal preparation aids can be beneficial for individuals with acquired brain injury who may have difficulties engaging in the kitchen for meal preparation.

Some examples of kitchen and meal preparation aids include:

• Modified chopping board
• Spreader boards
• Modified knives and utensils (thicker or different handle designs)
• Easy open devices - one-touch bottle, jar and can openers
• Kettle tipper device
• Thermomix (in some cases if deemed appropriate following trial with an OT)

Summary

There is a wide range of assistive technology available, with only some of the useful daily living aids discussed above. To learn what is right for you, you may benefit from a Functional Capacity Assessment from an Occupational Therapist.

Find an Occupational Therapist

The MyCareSpace NDIS Navigators can connect you with support workers who have experience with acquired brain injury in your area.

Find a Support Worker 

Waiting for an OT?

With an increase in demand for Occupational Therapy, you may find yourself waiting months for your assessment and therapy. You may be spending more time on a waitlist than you’d like. Or you may not be able to access services at all in your area.

This can be discouraging when you are striving to use your NDIS funding to achieve your goals.

What if you were told you could work towards your NDIS goals while waiting for your OT to come on board?

To start this process, you must take a closer look at the goals in your NDIS plan and consider what other NDIS services and supports can be explored for you to achieve your goals.

It is important to keep in mind that one service, i.e. Physiotherapy, cannot replace another service, such as Occupational Therapy. However, an alternative service can address aspects of your goals to help you work towards building your capacity.

This can be viewed as supplementing your Occupational Therapy services while waiting for your superstar OT - win, win!

See below for examples of how different therapists and services can address various skills to contribute toward your goal attainment:

Key Worker Model

A key worker can be an allied health professional (therapist) who has specialist skills in working with children in an early intervention capacity. The idea is that you have one key worker for your child who delivers therapy across a range of disciplines under the guidance of a treating therapist. The key worker will also coordinate communication and information sharing between the therapists working with the child and the family.

Learn more about the Role of an NDIS Key Worker

Is telehealth an option for an Occupational Therapy assessment?

Telehealth involves online consultation, assessment and intervention with healthcare practitioners from the convenience of your home. 

A telehealth assessment can be completed in place of a face-to-face assessment in most cases. The assessment will involve detailed discussions with you and if needed, a family member and carer. It will also involve observations of you in your home environment and performing activities of daily living via video. This is where a laptop or portable device with a camera and microphone is necessary.

Some standardised assessments completed by therapists are designed to be administered via telehealth.

Learn More

To understand more about the different therapists working in the NDIS, review this resource: Decoding Allied Health - Finding the Therapist Right For Me

For a deeper understanding on the relationship between OT and Physio, review this resource: What is the Difference Between Occupational Therapy and Physiotherapy in the NDIS?

How do I find a therapist to achieve my NDIS goals?

The MyCareSpace Connections Team are in touch with therapy providers across Australia. Connect with our team to find the right therapist for you today.

Find a Therapist

What is an Acquired Brain Injury?

An acquired brain injury (ABI) is the result of damage to your brain.

This can involve trauma to the brain, or be a result of a stroke, drugs, alcohol or poisons, lack of oxygen to the brain, infection or tumor.

An acquired brain injury may be a result of a neurodegenerative condition, such as Parkinson's disease or dementia.

Acquired Brain Injury and the NDIS

Some interesting facts...

• 3% of the 610,502 active participants in the NDIS have a primary disability of an acquired brain injury
• Over the past year, 80% of acquired brain injury NDIS applications were successful
• The number of participants with an acquired brain injury has increased by 12% and 8% in the last two years
• $138,600 was the average payment per participant with an acquired brain injury in 2023. This has increased by 15% since the year before
• 15% of participants with an acquired brain injury had SIL funded in their NDIS plan throughout 2023 

In summary, funding for brain injury is on the rise. More Autralian's with an acquired brain injury are accessing the services they need to achieve their goals.

Acquired Brain Injury and eligibility for NDIS funding?

If you have a brain injury that has resulted in permanent functional impairment, you may be eligible to the NDIS.

The NDIS has eligibility criteria for people applying to the NDIS. You are eligible for NDIS funding if you meet the following NDIS Access Criteria:

• You are aged between 9 and 65 years
• You are an Australian citizen, permanent resident, or Protected Special Category Visa holder
• You live in Australia
• You have a disability caused by a permanent impairment (lifelong disability)

What is impairment? When your capacity to complete a task as easily or quickly as “normal” is reduced due to your acquired brain injury.

What is “normal”? This is how you may have completed the task prior to acquiring your brain injury, or how people of a similar age and demographic who do not have a brain injury may complete a task.

See Who is eligible for the NDIS? for further information on NDIS eligibility criteria.

NDIS Eligibility Criteria

Within the NDIS eligibility requirements, there are two lists of conditions for NDIS eligibility - Condition List A and Condition List B.

NDIS Condition List A includes conditions that are likely to meet the disability eligibility requirements for people seeking to access the NDIS. 

Brain Injury is included in Condition List A, however there is no further information or details regarding any specific condition that is classified as a brain injury by the NDIA.

NDIS Condition List B is the second list which outlines conditions that are likely to result in a permanent impairment. If the presence of a permanent impairment can be established, then the application will likely meet the disability eligibility requirements. 

The following conditions included in Condition List B are considered acquired brain injuries:

• Alzheimer’s dementia
• Vascular dementia
• Parkinson’s disease
• Brain stem stroke syndrome
• Cerebellar stroke syndrome
• Hydrocephalus, which can in some cases be caused subsequent to a brain injury

There are other types of brain injury not included in this list. However, this does not mean that you are unable to access the NDIS.

When applying to the NDIS, evidence of having a brain injury will be required for conditions stated in both List A and List B. 

Due to List B including conditions that are likely to result in a permanent impairment, further evidence is required to establish that the impairment is considered lifelong. 

Remember, a permanent impairment resulting in a lifelong disability is typically funded by the NDIS. 

If your condition is not considered permanent or lifelong, the NDIS may not be right for you. If this is the case, there may be alternative services and funding available to you through the health system or other departments or agencies.

Evidence of Acquired Brain Injury for NDIS Eligibility

When providing evidence to access the NDIS, you will have the best chance for success if you provide information on your permanent impairment, and how it substantially reduces your functional capacity or ability to undertake activities in one or more of the following areas:

Communicating

This involves how you speak, write, or use sign language and gestures to express yourself.
The NDIA considers how well you understand people and how others understand you, and how this is impacted by your brain injury.

Socialising

This involves how you make and keep friends, or interact with others the community.
The NDIA considers how you socialise with others, and also want to know about your behaviours and how your brain injury impacts your ability to cope with feelings and emotions in social situations.

Learning

This involves how you learn, understand and remember new things, and practice and use new skills.
The NDIA will consider how your acquired brain injury impacts your cognitive abilities, which impacts how you learn and interact with the world.

Mobility

This involves how you move around your home, transfer in and out of bed, transfer on and off the toilet, in and out of the shower etc. This also involves how you move around your community.
NDIA will consider whether you require use of a mobility aid or home environment modifications to help with your mobility.

Self Care

How do you manage your personal care needs? Maintain hygiene? Eat and drink? Get dressed? Go to the toilet?
The NDIA will require information about how you complete your self-care tasks, and how much help you need for these routines.

Self-Management

This involves how you organise your life - How do you plan? Make decisions? Look after yourself?

The NDIS considers your capacity to manage your life, involving your ability to problem solve and make your own decisions.

For further information regarding eligibility criteria, please review the 

NDIS Guidelines in Becoming a Participant

How do I know if I meet the NDIS eligibility criteria?

Of the activities listed above, you must be able to demonstrate impairment across one or more of these activities.

When you submit an application to the NDIS, it will be reviewed and you will be provided with an outcome if you have been successful or not in meeting the eligibility criteria to access the NDIS.

What do I need to include in my NDIS application?

To apply to the NDIS, you will need to complete an Access Request Form

As part of the access request process, you will be asked:

• to confirm your identity and/or a person's authority to act on your behalf
• questions to see if you meet the NDIS access requirements (age, residence and disability)
• questions about providing consent to enter the NDIS and about seeking information from third parties.

It is helpful to provide letters and reports from your treating health professionals with information regarding your acquired brain injury and the impact it has in your everyday life.

Do I need an Occupational Therapy (OT) report to access the NDIS?

While an OT report is not a requirement for an NDIS application, it is helpful to submit an OT report with your application as this will provide important information as to how your acquired brain injury impacts your functional capacity across the eligibility categories listed above.

The report will link any impairment you experience across the eligibility criteria to your acquired brain injury. The report may not provide specific recommendations for supports you require, but rather it should provide a broader recommendation as to whether NDIS-funded supports are necessary.

How do I get an OT report?

An OT report is completed following an OT assessment. Any assessments and reports completed prior to accessing the NDIS cannot be funded by the NDIS.

This assessment must be paid for privately. In some cases, you may be able to claim some of the cost through Medicare.

Does an OT assessment and report guarantee acceptance onto the NDIS?

No, as ultimately the decision is made by the NDIA. However, an OT assessment and report will be helpful in clearly demonstrating the link between your acquired brain injury and the functional impairment experienced. This is what the NDIA consider when making their decision.

Other treating health professionals can also provide complete a letter or report to assist with your application.

How do I find an Occupational Therapist for an assessment to access the NDIS?

The MyCareSpace Connections Team can help you to find an Occupational Therapist with capacity in your area or via online.

Find an Occupational Therapist
 

More information on how to access the NDIS

LINK: How to Apply for the NDIS

LINK: Writing an NDIS Carer Statement for NDIS Access and Reviews

LINK: Writing Reports for NDIS Access and Plan Reviews (Reassessments)