Writing reports for the NDIS

Please find below responses to questions Speech Pathology Australia (SPA) members frequently ask writing reports for the NDIS

The information contained in this document is of a general nature. For specific advice tailored to your individual needs private practitioners are encouraged to seek independent legal or professional advice.

If you have further questions please do not hesitate to contact Speech Pathology Australia on 03 9642 4899 or 1300 368 835 or [email protected]

How do you write a report for an NDIS review, is it the same as a normal progress report?

The NDIS requires you to report on the participant's progress towards the goals for which the support item you are claiming for has been provided. This reporting also provides an opportunity to explore 'barriers' the participant may face to being able to achieve the goals in their plan, and how speech pathology might help find eliminate or ameliorate these.

The NDIS is focused on supporting functional (participation focussed) outcomes - which has implications for what and how speech pathologists report. For example - the NDIS reporting would include what impact changes in the child’s skills, abilities, and developmental opportunities (what additional sounds a child has acquired, or additional language skills) may have on the child's ability to understand or be understood by their family and peers, or take their turn in book reading. In some cases, you may want and need to link these outcomes with the potential to achieve further medium to longer term goals e.g. the child's willingness and capacity to sit and listen in group time at pre-school or their ability to follow instructions during swimming classes etc. The Association has produced a general guide to report writing that members can download from the SPA website.

You may want to explore using Goal Attainment Scaling (and adaptations thereof) as a framework for adding greater objectivity when you are not able to report change using standardised measures. Equally, when writing reports for younger children it may be appropriate to identify how your interventions are aligned with the ECIA best practice guidelines.

The NDIS may request age equivalency scores on standardised assessments. Where the provision of these scores isn't possible, or doesn't contribute to the functional picture of the client’s skills, you should include this information in your report, and include an explanation as to why this is the case. If a participant hasn't made any progress towards their goals, you will need to include information in your report about any factors which contributed to this lack of progress e.g. the participant had a significant illness, they were only able to attend three sessions.

When writing a report for the NDIA, it may be helpful to reflect upon several evaluative questions such as:

• What could someone of their age be expected to do, and how would their life look?
• How is this participant’s life and participation in his/her community and daily activities different, as a direct result of their disability?
• How would/did/will therapy help?

The NDIA have documented some of their guidelines when they are considering what supports would be reasonable and necessary for different participants at different ages. This document discusses what would be expected of a child or person of that age, and what areas they may need funded supports to help achieve their goals.

The NDIA has also provided a list of questions for participants as part of preparation for planning, which might be helpful to reflect upon:

• What would a good life be for you?
• What are some words or pictures that help you prepare for your future?
• What do you like?
• What are you good at?
• What needs to change to get the life you need?
• Who else is in your life you can include?
• What supports now are helping and which are not?
• What would need to happen for you to be able to participate more actively in your community?

Is there a pro-forma that I can use for my reports?

All of the goals and therapy outcomes need to be relevant to the individual participant. Pro-formas can be a helpful springboard, or outline, but it is essential that therapists reflect upon the participant’s specific difficulties (activity limitations and/or barriers to participation) and needs, and also their progress (the reduction to the activity limitations and/or increased participation) when writing to support the review process, or for the client to become a participant of the NDIS.

The NDIA has provided a template for children being seen under Early Intervention that can be accessed on the NDIS website. They have also provided some general advice for plan review reports for allied health professionals.

Can I use my usual speech goals for NDIS reports and plans?

This will depend on how your goals are written. The NDIS has stated that it is aligning to the World Health Organisation's International Classification of Function, Disability, and Health (ICF). This model has a strong emphasis on participation and the impact of disability on activity e.g. those things that we all do as part of daily life. Explicitly thinking about activity involvement and participation, as compared to more traditional therapy goals, can require us to reframe our desired outcomes.

It is still important to have specific speech pathology intervention related goals, but when writing for reviews (or access) the focus is less on a specific target such as 'Getting stable short vowels within a CV structure' and more about a concrete functional outcome e.g. 'Being able to ask for 'more' to have his/her needs met at childcare'. ‘Improving in the production of sequenced verbal explanations, including three information carrying words’ may translate to a functional goal of ‘Being able to explain to their family how they went at football practice or other after school activities’.

Some outcome measures that could be used when developing (and reporting on) more functional goals, and which can be made relevant for individual participants, include Goal Attainment Scaling (GAS), or the Canadian Occupational Performance Measure (COPM). Another option that is more specifically targeted around preschool children is the FOCUS. When considering functional goals, you can refer to the guidelines from the IAC regarding the Reasonable and necessary supports and what a person of that age would be expected to do.

Can I claim for report writing under NDIS?

In the Price Guide, the NDIA have stated that providers are able to claim for reports requested by the NDIA, including reports written for review meetings. Providers are able to charge at the hourly rate for therapy supports, but would not be able to charge a rate higher than this, unless it is for a self-managed participant who can determine their own fees. Plan managers are also bound by the price guide and therefore are unable to pay invoices beyond the prices set by the NDIA.

The NDIA does recognise that providers should be able to claim for some non-face to face activities, provided that they are directly related to an individual as part of their intervention and are discussed with and agreed by the participant. This includes progress notes, but could also involve provision of a report, to provide baseline information, or inform development of therapy goals, or to include recommendation and strategies to the family and others, as that is seen as being part of providing clinical intervention.

If you are charging for assessment reports and recommendations or other written information it must be specified and agreed to within the service agreement, in the same way as additional charges for travel etc. You will need to explain why it is necessary and clinically justify your time, in terms of how it supports the achievement of the therapeutic outcomes. Informing and including participants in this way is part of supporting and building the capacity of participants to exercise choice and control.

The NDIA will not fund reports that are written to support access requirements prior to the participant receiving a plan. Additionally, they have stated that NDIS funds can be used for reports requested by the NDIA, therefore reports for other parties, such as educational settings may not be covered.

The NDIS does undertake random audits, so it is important to be able to provide evidence of the participant’s approval for the service delivery for that date. This could be in the form of an email from the parent or participant requesting the report, or agreeing to it following your clinical recommendations.

Can I claim for reports for other professionals (in health or education)?

If what the family is wanting is a ‘progress report’ to inform the paediatrician, or as part of accessing support funds in the education setting (as this is definitely not covered by the NDIA), or anything else that ISN’T directly relatable to achieving the therapeutic outcomes for the child/participant as per the goals in their plan, then perhaps consider invoicing the family directly, as you would for a private client who does not receive any additional funding.

If the request has not come from the participant, was not part of the service agreement, and is not specified in the plan, it is unlikely that it will be able to be claimed for. It is more difficult to amend a service agreement to include this after the fact, as you would have to meet with the family, amend the agreement, adjust and justify the costs, and then have the participant/their representative sign off (or otherwise provide evidence that they have agreed to the amended plan).

What do I do if a client does not disclose that they are a self-managed participant until they request a review report?

Self-managed participants are not required to disclose that they are participants of the NDIS, however review reports are required to report on progress made towards achieving the goals within the participant’s NDIS plan. Therefore, if self-managing clients do not disclose that they are NDIS participants before they make a request for a ‘progress report’ to be provided for the review meeting, there is a risk that you may not have been explicitly targeting the goals identified in the participant’s plan.

Consider asking for a copy of the plan, in order to determine the goals that the NDIA will expect the report to be based upon. Dependent on the goals within the plan, it may or may not be appropriate for you to provide a report, as they may not be goals that have been addressed in your therapy. Again the parameters of what you will be able to provide in terms of this report, and the time it might take to prepare should be discussed and agreed upon with the family, preferably in writing.

How can I get further information or support?

Specific questions can be directed to the NDIA directly via their enquiries team at [email protected]

Members can join the disability member community on Facebook, for regular updates regarding the NDIS. Specific questions can be emailed to the Professional Practice Advisor or directed to National Office on 1300 368 835.

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Original: February 2018

Updated: March 2021

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