The Jurisprudential Basis for Kinship-Centred Disability Support: Aligning NDIS Funding with UNDRIP and International Human Rights Precedents

Uluru also known as Ayers Rock

Dr Jorandi (Jo) Kisiku Sa’quawei Paq’tism Joseph Randolph Bowers PhD

Executive Summary

The intersection of disability support and Indigenous rights in Australia represents a critical frontier in the pursuit of substantive equality and self-determination. Central to this discourse is the tension between the administrative protocols of the National Disability Insurance Scheme (NDIS)—specifically its restrictive stance on funding family members—and the collective rights of Aboriginal and Torres Strait Islander peoples as articulated in the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP).

The current NDIS framework is built upon a Western social and medical model of disability that prioritizes individual autonomy and market-based service delivery.1

However, for First Nations Australians, disability is often understood through a cultural lens where the individual’s well-being is inseparable from their connection to family, community, and Country.3

The National Disability Insurance Agency (NDIA) generally prohibits the payment of family members to provide supports, citing a perceived conflict of interest and an expectation that families will provide "informal support" as a matter of course.5

This report argues that this general rule constitutes a form of structural discrimination that fails to account for the unique kinship structures and historical traumas of Indigenous Australians. By drawing on UNDRIP, the National Agreement on Closing the Gap, and international precedents from New Zealand and Canada, a compelling case emerges for a broad and culturally informed exception to the conflict-of-interest rule. This exception is not merely a matter of administrative flexibility but a requirement for compliance with international human rights standards and domestic legal obligations.

The International Human Rights Imperative

UNDRIP and Collective Self-Determination

The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), adopted by the UN General Assembly in 2007 and endorsed by Australia in 2009, serves as the authoritative international framework for the protection of Indigenous rights.7

It establishes minimum standards for the survival, dignity, and well-being of Indigenous peoples globally, emphasizing both individual and collective rights.8

For Indigenous Australians with disability, UNDRIP provides a robust legal and moral foundation for demanding that disability supports reflect their cultural identity and social structures.

 

Articles 3 and 4: The Right to Self-Determination and Autonomy

At the heart of UNDRIP is the right to self-determination. Article 3 states that Indigenous peoples have the right to freely determine their political status and pursue their economic, social, and cultural development.7

In the context of the NDIS, self-determination remains hollow if participants are denied the right to choose the most culturally appropriate and safe person to provide their care.10 When the NDIA imposes an external provider on an Indigenous family, it effectively overrides the participant's right to determine the nature of their social and cultural development.

Article 4 extends this by affirming the right to autonomy or self-government in matters relating to internal and local affairs, as well as the "ways and means for financing their autonomous functions".7

This principle suggests that Indigenous communities should have a degree of control over how NDIS funds are allocated within their kinship networks. Financing an "autonomous function" can be interpreted as funding the existing community-led support systems that have sustained Indigenous people for millennia. The refusal to fund these systems while funding external, often non-Indigenous commercial entities, is a direct contradiction of the right to autonomy in financial and local affairs.3

 

Article 5: Maintenance of Social and Cultural Institutions

Article 5 upholds the right of Indigenous peoples to maintain and strengthen their "distinct political, legal, economic, social and cultural institutions".7

For Aboriginal and Torres Strait Islander peoples, the extended family or kinship system is the primary social and legal institution. It is the mechanism through which lore is passed, care is managed, and social cohesion is maintained.1

The NDIS’s "informal support" policy—which expects these institutions to operate without financial recognition—undermines their economic viability. By categorizing kinship care as a "conflict of interest" to be avoided, the NDIA treats an essential Indigenous institution as a problem to be mitigated rather than a right to be protected.2

 

Article 24: The Right to Health and Traditional Practices

Article 24 of UNDRIP specifically addresses the right to health, stating that Indigenous peoples have the right to their traditional medicines and to maintain their "health practices".7

It also affirms that Indigenous individuals have an equal right to the "highest attainable standard of physical and mental health".7

For many First Nations people, the act of a family member providing care is a traditional health practice rooted in cultural concepts of reciprocity and communal responsibility.2

Cultural safety is an essential component of the "highest attainable standard" of health; without it, Indigenous participants frequently experience "double discrimination" and may withdraw from the scheme entirely to avoid traumatizing interactions with culturally incompetent external providers.1

 

Article 22: Special Needs of Persons with Disabilities

UNDRIP Article 22 explicitly demands that "particular attention shall be paid to the rights and special needs of indigenous elders, women, youth, children and persons with disabilities".7

This creates a positive obligation on the state to tailor its disability schemes to the specific needs of Indigenous people. A one-size-fits-all approach that ignores the primacy of kinship care fails this obligation by not providing the "full protection and guarantees" promised under the declaration.7

The Australian Context

The NDIS and the Conflict-of-Interest Doctrine

The National Disability Insurance Scheme Act 2013 was designed to promote the "independence and social and economic participation" of people with disability.15

However, the operationalization of these goals through the "choice and control" framework often results in a rigid adherence to Western market norms that do not align with Indigenous realities.

The General Rule and the "Informal Support" Expectation

The NDIA’s Operational Guidelines regarding "Sustaining Informal Supports" state that the agency will generally only fund family members to provide supports in "exceptional circumstances".5

The underlying logic is two-fold: first, that paying a family member may be "detrimental to family relationships," and second, that families have a natural obligation to provide unpaid support.6

It is argued that these gross and inappropriate assumptions are inherently colonial in bias and institutionally imbalanced in practice. The following table shows the structural and practical impact of these prejudicial policies on Indigenous Australian families.

Defining "Exceptional Circumstances"

The NDIA currently recognizes three broad categories of exceptional circumstances where family members may be paid:

1 Risk of Harm or Neglect: When the participant would be unsafe with an external provider.5

2 Religious or Cultural Reasons: When cultural norms dictate that only certain people can provide intimate or close care.20

3 Strong Personal Views: When the participant’s dignity or privacy is at stake.5

While these exceptions exist, they are often applied so narrowly that they become inaccessible to many First Nations participants. The burden of proof placed on a family to demonstrate that they are the only suitable provider is often insurmountable, particularly when the NDIA adopts a "deficit-focused model" that ignores the strengths of Indigenous kinship systems.17

Thin Markets and the Failure of Choice

The market-based model of the NDIS assumes that there is a pool of providers from which a participant can choose.

In many remote and regional areas, this market is non-existent.1

The Disability Royal Commission found that the lack of available, accessible, and culturally appropriate services for First Nations people is a "national crisis".24

In these "thin markets," the choice is not between a family member and a culturally safe external provider; it is between a family member and no support at all.3 Refusing to fund a family member in a region where no other provider exists is a failure to provide "reasonable and necessary" supports as required by Section 34 of the NDIS Act.19

International Precedents for Family-Based Funding Models

Comparative analysis of other Commonwealth nations reveals that Australia's restrictive approach is out of step with global trends toward Indigenous self-determination in social services.

 

The New Zealand Model: Whānau Ora and Funded Family Care

New Zealand’s Whānau Ora framework is a world-leading example of a culturally grounded, holistic approach to disability and health. It puts the whānau (extended family) at the centre of decision-making, acknowledging that individual well-being is dependent on collective health.25

In 2020, the New Zealand government significantly reformed its "Funded Family Care" policy to address human rights concerns. Previously, New Zealand had legislation (Part 4A of the NZ Public Health and Disability Act) that limited the rights of families to challenge funding decisions.27 The repeal of this discriminatory law allowed for a more compassionate and rights-based approach. The table below highlights these reforms.

The New Zealand experience demonstrates that paying family members does not degrade the quality of care; rather, it "restores dignity" and recognizes the "important work family carers do".27 For Māori and Pacific families, who make greater use of these schemes, this policy is an essential tool for health equity.28

The Canadian Precedent: Jordan's Principle and Substantive Equality

In Canada, the legal framework for Indigenous disability care is driven by the principle of "substantive equality." This is most clearly seen in "Jordan's Principle," a child-first legal rule ensuring First Nations children can access all government-funded services without delays caused by jurisdictional disputes.29

Following a series of rulings by the Canadian Human Rights Tribunal, the federal government was found to have discriminated against First Nations children by narrowly defining essential services and underfunding Indigenous-led agencies.31 This led to a historic $23.34 billion settlement for families who were denied or delayed in receiving services.29

Furthermore, Canada's An Act respecting First Nations, Inuit and Métis children, youth and families (2020) affirms the "inherent right" of Indigenous peoples to exercise jurisdiction over their own child and family services.33

This provides a direct precedent for Indigenous Australians to argue that the NDIA must respect Indigenous-led designs of service delivery, including those that prioritize kinship care over external commercial providers.

National Policy Drivers

Closing the Gap and the Royal Commission

The Australian policy landscape is shifting toward a greater recognition of Indigenous sovereignty and the need for structural reform in disability services.

The National Agreement on Closing the Gap (2020)

The National Agreement on Closing the Gap is a pledge by all Australian governments to "do things differently" by working in genuine partnership with Aboriginal and Torres Strait Islander communities.35

The agreement is built around four "Priority Reforms" that directly challenge the current NDIS operating model.

Priority Reform 1: Shared Decision-Making: Governments must give Indigenous people a say in all decisions that affect them.35

This includes the design of individual NDIS plans and the choice of providers.

Priority Reform 2: Building the Community-Controlled Sector: Funding should be prioritized for organizations designed and controlled by Aboriginal people.35

A kinship-based funding model is the ultimate form of a "community-controlled" service.

Priority Reform 3: Transforming Government Organisations: Governments must address unconscious bias and systemic racism in their processes.35

The categorical dismissal of kinship care as a "conflict of interest" can be analysed as a systemic bias that devalues Indigenous social structures.

Findings of the Disability Royal Commission

The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (2023) highlighted that Indigenous people with disability are "culturally safe when people understand, respect and celebrate their First Nations identity".4

The Commission recommended that governments fund First Nations Community Controlled Organisations to provide "flexible supports and services".4

Crucially, the Commission acknowledged that "cultural safety, family, community, and connectedness are central to service delivery and engagement".40

This creates a powerful mandate for the NDIS to move away from the mainstream as well as "medical model" toward a "cultural model of inclusion".3

Legal Mechanisms for Advocacy

Human Rights Acts and the ART

Advocates in Australia have several domestic legal levers to challenge restrictive NDIA decisions regarding family funding.

The Queensland Human Rights Act 2019

The Human Rights Act 2019 (Qld) is a significant piece of legislation for Indigenous Australians. It protects fundamental human rights, including the "cultural rights of Aboriginal peoples and Torres Strait Islander peoples".41

Section 28 of the Act specifically protects the right of Indigenous people to:

·      Maintain and strengthen their distinct political, legal, economic, social, and cultural institutions.41

·      Conserve and maintain their heritage and distinctive spiritual and cultural practices.42

Under Section 58 of the Act, "public entities" (which include registered NDIS providers and government departments) must act and make decisions in a way that is compatible with these human rights.43

An NDIS decision that refuses to fund a kinship-based support model could be seen as an unlawful limitation on the right of an Indigenous family to maintain their cultural institutions.42 While the NDIS is a federal scheme, the High Court and superior courts have increasingly recognized that state-based human rights obligations can influence the exercise of administrative discretion by federal delegates.41

The Administrative Review Tribunal (ART) and Merits Review

Participants who are dissatisfied with an NDIA internal review can appeal to the Administrative Review Tribunal (formerly the AAT). The Tribunal conducts a "merits review," meaning it steps into the shoes of the NDIA to make the "preferable decision".46

Advocates appearing before the Tribunal can argue that:

Cultural Necessity is an "Exceptional Circumstance": Drawing on the Operational Guidelines to prove that external care is inappropriate for the specific participant’s cultural needs.5

Market Failure and Reasonableness: Arguing that in the absence of other providers, funding a family member is the only "reasonable and necessary" way to achieve the goals in the participant's plan.4

Consistency with NDIS Objects: Arguing that Section 4 of the NDIS Act requires the role of families and carers to be "acknowledged and respected," which should extend to financial support in circumstances of economic hardship and service gaps.15

 

The Economic and Social Impact of Reform

The refusal to fund kinship care is not just a human rights issue; it is a failed economic policy that perpetuates intergenerational poverty.

Quantifying the Service Gap

Indigenous NDIS participants are 28% less likely to receive care than non-Indigenous participants.24

The "utilization gap" represents a significant failure in the NDIS’s promise of equity: it is the difference between the funding the government legally allocates to a participant and the amount that is actually spent on their care. Currently, First Nations participants utilize their funding at a rate of 72%, significantly lower than non-Indigenous participants .

This disparity is most acute in remote regions where "thin markets"—the total absence of external service providers—prevent participants from spending their budgets . We can calculate this systemic failure as a "Lost Benefit" ($B_{lost}$) to the community using the following model:

$$B_{lost} = F \times (1 - U_{util})$$

Where $F$ is the total funding allocated and $U_{util}$ is the utilization rate.

When the utilization rate ($U_{util}$) drops in remote areas, the "Lost Benefit" to the community is maximized.

By refusing to pay family members for care, the NDIA ensures this money remains unspent in government coffers rather than being used to support the participant. Reforming this rule would allow these funds to be "reclaimed" by the community. Instead of unspent potential, the funding would become a local salary, creating an economic multiplier that supports Indigenous employment and acts as a preventative safeguard against the types of family crises that lead to state-driven child removal .

Breaking the Cycle of Child Removal

A critical "third-order" insight is the relationship between NDIS funding and child protection.

In the Tennant Creek case, the withdrawal of NDIS funding for a boy with cerebral palsy led directly to his removal by the state.48

This highlights how rigid administrative rules can inadvertently contribute to "Closing the Gap" failures, particularly Target 12 (reducing the rate of children in out-of-home care).38

Funding kinship care is therefore a "safeguard" that promotes and protects an individual's right to live with their family.6

Actionable Recommendations for NDIS Advocacy

Based on the research and international precedents, advocacy for an exception to the conflict-of-interest rule should be framed around the following pillars:

Asserting UNDRIP Compliance: Argue that the NDIS Act must be interpreted consistently with UNDRIP Articles 3, 5, and 24. Any decision that ignores the primacy of kinship care is a breach of the right to self-determination and the maintenance of cultural institutions.7

Documenting Market Failure: In areas with no culturally safe providers, advocates must demand that the NDIA fulfill its "reasonable and necessary" obligation by funding the only available support: the family.1

Leveraging the First Nations Strategy: Use the NDIA’s own First Nations Strategy 2025-2030 to hold the agency accountable to its commitments of "community-centred" and "culturally safe" support.49

Challenging the "Informal Support" Myth: Dispute the assumption that Indigenous families have an "unlimited" capacity for unpaid labour. Highlight that in contexts of systemic poverty, "informal support" is a luxury that families cannot afford without sacrificing their own health and economic security.1

 

A Mandate for Structural Change

The data around the rights of Indigenous Australians reveals a profound disconnect between the aspirational language of the NDIS and the bureaucratic reality of its implementation.

The "conflict of interest" rule, while well-intentioned in a commercial context, acts as a barrier to cultural safety and self-determination when applied to Indigenous kinship networks.

The United Nations Declaration on the Rights of Indigenous Peoples provides the necessary framework to challenge this status quo. Combined with the successes of the Whānau Ora model in New Zealand and the "substantive equality" victories in Canada, the path forward is clear:

The NDIS must move beyond viewing family members as a "risk" and instead recognize them as the most effective, culturally safe, and sustainable providers of disability support.

The "cultural reasons" exception must be broadened from a rare, grudgingly granted concession to a standard operating procedure for First Nations participants.

This shift is not only supported by international law and national agreements like Closing the Gap but is essential for the NDIS to fulfill its promise of an inclusive and equitable Australia.

By funding the kinship structures that have always cared for Indigenous people, the NDIS can transition from a colonial institution of "structural neglect" into a genuine partner in Indigenous well-being and self-determination.

While we live in hope – hope is not enough for our current clients who are stuck in the colonial wheels of a mechanistic system that disempowers their voice, denies their cultural wisdom, and prevents them from exercising fundamental human rights to choice and control informed by their cultural and undisputed historical sovereignty.

For families dealing with crisis now, today, the NDIS presents an administrative system that even within escalated complex cases under senior planners continues to deny funding even when clinical needs are argued by medical and specialist expert analysis and under reasonable and necessary criteria.

This paper reflects on the discomforting nature of the NDIA as a broken institution that practices inequitable delivery of funding and demonstrates numerous biases and prejudicial policies and practices. These issues very much require attention and reform. But more so, current NDIS participants who are Indigenous Australians deserve so much better.

Action to address Indigenous NDIS participant’s needs must happen now – not in future years or under some future reform agenda.

Works cited

1.     Improving Disability Services for Aboriginal People in the Northern Territory | AMSANT, accessed December 18, 2025, https://www.amsant.org.au/wp-content/uploads/2025/03/Improving-Disability-Services-for-Aboriginal-People-in-the-Northern-Territory.pdf

2.     Full article: Indigenous experiences and underutilisation of disability support services in Australia: a qualitative meta-synthesis - Taylor & Francis Online, accessed December 18, 2025, https://www.tandfonline.com/doi/full/10.1080/09638288.2023.2194681

3.     The NDIS Workforce and First Nations People, accessed December 18, 2025, https://www.ndisreview.gov.au/sites/default/files/2023-11/FPDN_Workforce_Paper.pdf

4.     Final Report - Volume 9, First Nations people with disability, accessed December 18, 2025, https://disability.royalcommission.gov.au/publications/final-report-volume-9-first-nations-people-disability

5.     Has anyone had family approved as paid support due to culture? : r/NDIS - Reddit, accessed December 18, 2025, https://www.reddit.com/r/NDIS/comments/1jmhf3h/has_anyone_had_family_approved_as_paid_support/

6.     Informal Supports - Peer Connect, accessed December 18, 2025, https://www.peerconnect.org.au/oldsite/index.php/download_file/544/534/

7.     United Nations Declaration on the Rights of Indigenous Peoples and In Plain Sight - Gov.bc.ca, accessed December 18, 2025, https://engage.gov.bc.ca/app/uploads/sites/613/2021/03/UNDRIP-and-IPS-FINAL.pdf

8.     UN Declaration on the Rights of Indigenous Peoples | OHCHR, accessed December 18, 2025, https://www.ohchr.org/en/indigenous-peoples/un-declaration-rights-indigenous-peoples

9.     United Nations Declaration on the Rights of Indigenous Peoples, accessed December 18, 2025, https://www.un.org/development/desa/Indigenouspeoples/wp-content/uploads/sites/19/2018/11/UNDRIP_E_web.pdf

10. TRANSFORMING DISABILITY ACCESS for Indigenous Australians, accessed December 18, 2025, https://www.iuih.org.au/wp-content/uploads/2024/05/IUIH-Submission-Disability-Royal-Commission.pdf

11. United Nations Declaration on the Rights of Indigenous Peoples, accessed December 18, 2025, https://www.un.org/esa/socdev/unpfii/documents/DRIPS_en.pdf

12. Support coordinators and conflict of interest | NDIS, accessed December 18, 2025, https://www.ndis.gov.au/providers/working-provider/support-coordinators/support-coordinators-and-conflict-interest

13. Conflicts of interest in the NDIS provider market, accessed December 18, 2025, https://www.ndis.gov.au/providers/provider-compliance/conflicts-interest-ndis-provider-market

14. The United Nations Declaration on the Rights of Indigenous Peoples - ohchr, accessed December 18, 2025, https://www.ohchr.org/Documents/Issues/IPeoples/UNDRIPManualForNHRIs.pdf

15. Empowering the Unpaid Carer in the NDIS Framework - Special Voices, accessed December 18, 2025, https://www.specialvoices.com.au/empowering-the-unpaid-carer-in-the-ndis-framework/

16. Including Specific Types of Supports in Plans - NDIS, accessed December 18, 2025, https://www.ndis.gov.au/media/8008/download?attachment

17. Can I Be My Child's NDIS Support Worker? - 24seven Plan Management, accessed December 18, 2025, https://24sevenplanmanagement.com.au/am-i-allowed-to-be-my-childs-support-worker/

18. What are conflicts of interest? (DOCX 54.9KB) - NDIS, accessed December 18, 2025, https://www.ndis.gov.au/media/7392/download?attachment

19. OG - Reasonable and Necessary Supports | PDF | Caregiver | Disability - Scribd, accessed December 18, 2025, https://www.scribd.com/document/910151450/OG-Reasonable-and-Necessary-Supports

20. Your burning questions answered - My Plan Manager, accessed December 18, 2025, https://myplanmanager.com.au/burning-ndis-questions-answered/

21. Reasonable and Necessary Supports | NDIS, accessed December 18, 2025, https://www.ndis.gov.au/media/7772/download?attachment

22. Download Delivering Parent Pathways Guidelines – Part B - Department of Employment and Workplace Relations, accessed December 18, 2025, https://www.dewr.gov.au/download/16588/delivering-parent-pathways-guidelines-part-b-operational-guidance/41183/delivering-parent-pathways-guidelines-part-b-operational-guidance/docx

23. We contest the NDIA's justification for NDIS independent assessments - People with Disability Australia, accessed December 18, 2025, https://pwd.org.au/wp-content/uploads/2021/04/SUPP-SUB-08042021_JSC-Critique-of-NDIA-Independent-Assessment-Submission.._.pdf

24. The lack of NDIS services for First Nations people with disability 'a national crisis', accessed December 18, 2025, https://disability.royalcommission.gov.au/news-and-media/media-releases/lack-ndis-services-first-nations-people-disability-national-crisis

25. Whānau Ora | RANZCP, accessed December 18, 2025, https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/whanau-ora

26. The Whānau Ora Outcomes Framework - Te Puni Kōkiri - Ministry of Māori Development, accessed December 18, 2025, https://www.tpk.govt.nz/docs/tpk-wo-outcomesframework-aug2016.pdf

27. Government restores fairness for family carers | Beehive.govt.nz, accessed December 18, 2025, https://www.beehive.govt.nz/release/government-restores-fairness-family-carers

28. Government to deliver family carers $2000 pay rise, expand scheme to spouses this year, accessed December 18, 2025, https://www.beehive.govt.nz/release/government-deliver-family-carers-2000-pay-rise-expand-scheme-spouses-year

29. FAQ | First Nations Child and Family Services and Jordan's Principle Settlement, accessed December 18, 2025, https://fnchildclaims.ca/resources-support/faq/

30. Without denial, delay, or disruption: - Canadian Child Welfare Research Portal, accessed December 18, 2025, https://cwrp.ca/sites/default/files/publications/jpreport_final_en.pdf

31. Reformed Approach to Child and Family Services, accessed December 18, 2025, https://fncaringsociety.com/sites/default/files/2024-03/38504%20Reformed%20Approach%20to%20CFS%20v7f.pdf

32. Timeline: Jordan's Principle and First Nations child and family services, accessed December 18, 2025, https://www.sac-isc.gc.ca/eng/1500661556435/1533316366163

33. Celebrating Five Years of Indigenous-led Child and Family Services Law - Canada.ca, accessed December 18, 2025, https://www.canada.ca/en/indigenous-services-canada/news/2025/01/celebrating-five-years-of-indigenous-led-child-and-family-services-law.html

34. Annual Report to Parliament 2024 - Indigenous Services Canada, accessed December 18, 2025, https://www.sac-isc.gc.ca/eng/1728913460798/1728913482672

35. National Agreement on Closing the Gap | Communities and Justice - NSW Government, accessed December 18, 2025, https://dcj.nsw.gov.au/content/dcj/dcj-website/dcj/community-inclusion/improving-aboriginal-outcomes/national-agreement.html

36. Closing the Gap | NIAA - National Indigenous Australians Agency, accessed December 18, 2025, https://www.niaa.gov.au/our-work/closing-gap

37. The National Agreement on Closing the Gap - Coalition of Peaks, accessed December 18, 2025, https://www.coalitionofpeaks.org.au/national-agreement-on-closing-the-gap

38. Closing the Gap - Australian Government Department of Social Services, accessed December 18, 2025, https://www.dss.gov.au/closing-gap

39. Closing the Gap - Parliament of Australia, accessed December 18, 2025, https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/Research/Briefing_Book/47th_Parliament/ClosingTheGap

40. Summary and Overview: - Royal Commission into Violence, Abuse, Neglect, and Exploitation of people with Disability Final Report - Mental Health Coordinating Council, accessed December 18, 2025, https://mhcc.org.au/wp-content/uploads/2023/11/MHCC_Summary_-Overview_-Disability-Royal-Commission-4F-7.11.2023.pdf

41. Human Rights Law in Queensland, accessed December 18, 2025, https://queenslandlawhandbook.org.au/wp-content/uploads/2022/06/64.-human-rights-law-in-queensland-december-2020.pdf

42. Human Rights Act 2019 - Queensland Legislation, accessed December 18, 2025, https://www.legislation.qld.gov.au/view/whole/html/current/act-2019-005

43. Human rights | Your rights, crime and the law - Queensland Government, accessed December 18, 2025, https://www.qld.gov.au/law/your-rights/human-rights

44. Human Rights of People with Disability - Queensland Law Handbook, accessed December 18, 2025, https://queenslandlawhandbook.org.au/the-queensland-law-handbook/health-and-wellbeing/disability-and-the-law/human-rights-of-people-with-a-disability/

45. Strengthening Queensland's human rights act, accessed December 18, 2025, https://brq.org.au/strengthening-queenslands-human-rights-act/

46. National Disability Insurance Scheme | Administrative Review Tribunal, accessed December 18, 2025, https://www.art.gov.au/applying-review/national-disability-insurance-scheme

47. Chapter 10 – Parliament of Australia, accessed December 18, 2025, https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/National_Disability_Insurance_Scheme/NDISPlanning/Final_Report/section?id=committees%2Freportjnt%2F024487%2F73192

48. Tennant Creek boy with cerebral palsy placed in care after NDIA pulls funding | National disability insurance scheme | The Guardian, accessed December 18, 2025, https://www.theguardian.com/australia-news/2018/jul/11/tennant-creek-boy-with-cerebral-palsy-placed-in-care-after-ndia-pulls-funding

49. First Nations Strategy | NDIS, accessed December 18, 2025, https://www.ndis.gov.au/strategies/first-nations-strategy

Disclaimer

The content provided in this article is for general informational purposes only and does not constitute legal, clinical, or specialist behaviour support advice. It should not be relied upon as such.

All information is provided in good faith, however, we make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, or completeness of any information. The information pertaining to NDIS and related issues must be individually determined by each person’s circumstances and their specialist therapist teams, and is a very complex evolving context and support needs and methods are subject to change.

This article is not a substitute for professional advice from your qualified GP or specialist for from your NDIS Behaviour Support Practitioner. You should always consult with an appropriate professional to address your specific circumstances. Under no circumstance shall Ability Therapy Specialists Pty Ltd have any liability to you for any loss or damage incurred as a result of the use of this information. Reliance on any information provided in this post is solely at your own risk. This article, website, and your participation are governed under the Client Booklet - Privacy Policy: Disclaimer, Terms, Conditions as a necessary provision under Australian service quality standards.

The Evolving Landscape of Autism Support (2020–2025): Neurological Mechanisms, Applied Interventions, and the Paradigm Shift in Level 2 Care

Coloured circles on white background with the letters A U T I S M on small square blocks.

Editor’s Note

This post comes from our study of Autism - by way of wanting to review the literature up to the end of 2025. When I was researching, my interests were to review findings on state of the art support and therapy for behavioural support. Because many of our cases tend to be ASD Level 2, Requiring Substantial Support, this was my choice of focus for this particular moment.

This is an in-depth post. It may take about 30-40 minutes to read once, and you will find yourself needing to read it at least two times. While that is a big time investment, you will not find this level of information in many places. Our work in these lengthy posts is to provide a curated summary of high quality and value.

Like our work with clients, we tend to be comprehensive when necessary and when useful to the person’s support needs and funding reviews. I hope you find this information useful and helpful. To our Australian readers, I apologise for the spelling and terminology - the international nature of the research as well as the dominant voice appears to have an American tone. I gave a thot to changing/editing the paper once we had the first draft completed, and simply do not have the time before Christmas this year.

We appreciate this paper - because the science confirms much of our clinical experience and moves our understanding further due to the significant insights from recent scientific findings. We suspect that with the dawn of AI post 2025, the next 2-5 years will see significant advances in our understanding Autism from medical, psychotherapeutic, and disability support perspectives.

A word of caution - this paper is NOT clinical advice at all. People are advised to seek your behaviour specialist, occupational therapist, or medical doctor for treatment specific questions. This paper is in fact an exploration of the literature to gain insights about new advances in high level clinical perspectives. In fact, many of the insights here are more relevant to American contexts for example, the paper highlights certain treatment shifts in the USA.

Our primary audience is Australian - and this paper’s weakness is that it does not translate and discuss implications to the Australian context. That said, sharing this paper rather than holding it back for 3-4 months to write more seemed the most practical. It is up to therapists, doctors, and specialists to take this information and explore implications and treatment options in local contexts.

For parents and people with Autism, copy the URL of this page and share this with your GP or therapist. Ask them to read the information, and to provide you with practical advice. Rely on your GP and your specialist therapist input - do not rely on anything you read here. The pace of change and what is most relevant or current is shifting very quickly - get your advice from your GP and the therapist specialists they recommend.

- Dr Jorandi (Joseph Randolph) Bowers PhD

1. Introduction: The State of Autism Research and Practice in 2025

The half-decade between 2020 and 2025 represents a seminal epoch in the history of autism research, characterized by a fundamental decoupling of "pathology" from "identity" and a simultaneous explosion in mechanistic biological understanding. As the prevalence of Autism Spectrum Disorder (ASD) in the United States has risen to approximately 1 in 31 children as of 2025—a figure that demands robust public health and educational responses—the scientific community has moved beyond merely describing symptoms to elucidating the neural circuitries that drive them.1

For individuals classified as requiring "Level 2" support (Substantial Support Needs), this era has been transformative. Historically, this demographic—often characterized by marked deficits in verbal and nonverbal social communication skills, social impairments apparent even with supports in place, and limited initiation of social interactions—occupied a precarious middle ground. They were often too "complex" for light-touch interventions yet possessed potential for autonomy that was frequently stifled by the heavy-handed custodial models used for Level 3 populations.3 The research of 2025 has corrected this imbalance, offering targeted, dignity-affirming, and biologically grounded strategies specifically for those with substantial support needs.

The convergence of molecular neuroscience and social science has yielded a dualistic progression. On one front, the "Medical Model" has achieved unprecedented granularity, identifying specific thalamocortical gating failures and synaptic pruning deficits that explain sensory overwhelm with physiological precision.4 On the other, the "Social Model" and the neurodiversity movement have reshaped clinical ethics, forcing a departure from compliance-based therapies toward those that prioritize regulation, autonomy, and mental health.6

This paper synthesizes the exhaustive body of literature from 2020 through late 2025, providing a comprehensive analysis of the neurological underpinnings of emotional regulation, the efficacy of Naturalistic Developmental Behavioral Interventions (NDBI), the critical role of the Low Arousal Approach, and the emerging technological landscape supporting executive function. It serves as a roadmap for clinicians, researchers, and families navigating the complex terrain of substantial support needs in 2025.

1.1 Prevalence, Demographics, and the Identification Gap

The epidemiology of autism has shifted dramatically. The Centers for Disease Control and Prevention (CDC) reported in April 2025 that the prevalence of ASD had reached 3.2% (1 in 31) of 8-year-old children, a sharp increase from 1 in 36 just two years prior.1 This rise is not merely a statistical artifact of better counting; it reflects a broadening of diagnostic criteria and improved identification in historically underserved communities.

However, disparities persist. While identification has improved, the "diagnosis age" remains stagnant at an average of 4 years, despite the American Academy of Pediatrics recommending screening at 18 and 24 months.7 This delay is critical for Level 2 support, as early intervention windows for establishing communication systems are often missed. Furthermore, the 2025 data indicates that while 1 in 3 children with autism also has an intellectual disability, the specific needs of the "Level 2" cohort—who may have average IQ but severe adaptive functioning deficits—are often obscured in aggregate data.2

1.2 The Autism Data Science Initiative (ADSI)

Recognizing the complexity of these demographic shifts, the National Institutes of Health (NIH) launched the Autism Data Science Initiative (ADSI) in late 2024. This $100 million endeavor utilizes advanced machine learning and "exposome-wide" analyses to disentangle the gene-environment interactions contributing to the rising prevalence.1 Unlike previous genomic studies that sought a "smoking gun," ADSI focuses on heterogeneity, attempting to map specific biological subtypes (biotypes) to specific support needs. This initiative represents a move toward "precision medicine" in autism, where a child’s specific neural connectivity profile could eventually dictate whether they receive sensory integration therapy, pharmaceutical support, or intensive communication coaching.

2. Neurological Frontiers: Brain Function, Connectivity, and Emotional Regulation

The interval from 2020 to 2025 has been pivotal in moving beyond descriptive neuroanatomy to mechanistic understandings of autistic brain function. The "black box" of the autistic brain—particularly regarding why sensory inputs often lead to catastrophic emotional dysregulation—has been illuminated by breakthrough findings in thalamic gating and synaptic architecture. These findings are not merely academic; they provide the physiological rationale for the "Low Arousal" and "Sensory Safety" therapeutic approaches discussed later in this report.

2.1 The Reticular Thalamic Nucleus: The Gatekeeper of Consciousness

One of the most consequential findings of 2025 is the identification of the Reticular Thalamic Nucleus (RT) as a primary driver of sensory and behavioral anomalies in autism. Research conducted at Stanford Medicine and published in Science Advances (August 2025) has elucidated that hyperactivity in the RT—a shell-like structure acting as a "gatekeeper" for sensory information—can drive behaviors traditionally associated with autism, such as social withdrawal and repetitive movements.4

2.1.1 The "Leaky Thalamus" Hypothesis and Sensory Gating

The thalamus serves as the central relay station for sensory information (visual, auditory, tactile) traveling from the periphery to the cortex. It is the brain's mixing board. The RT, composed largely of inhibitory GABAergic neurons, regulates this flow. In neurotypical functioning, the RT inhibits or "gates" irrelevant background noise (e.g., the hum of an air conditioner, the feeling of a tag on a shirt), allowing the cortex to focus on salient information.

The 2025 findings, utilizing the Cntnap2 knockout mouse model (a robust genetic model for autism), revealed that the RT in autistic brains exhibits hyperexcitability and burst firing.12 This hyperexcitability paradoxically disrupts the gating mechanism. Instead of smoothly filtering stimuli, the RT functions erratically, potentially allowing an overwhelming flood of sensory data to reach the cortex—a phenomenon termed the "leaky thalamus" hypothesis.14

For an individual with Level 2 autism, this means the brain is literally besieged by unfiltered sensory data. The behavioral output—covering ears, humming, or retreating—is not "non-compliance" but a physiological necessity to manage cortical saturation.

2.1.2 Causal Links and Therapeutic Implications

The causal link established in the Stanford study is robust. Researchers utilized chemogenetics (DREADDs) to manipulate the RT. When they suppressed the hyperactivity of the RT using a specific drug (Z944, a T-type calcium channel blocker), they observed a reversal of autism-like behaviors. The mice showed improved social interactions and reduced repetitive behaviors.4 Conversely, stimulating the RT in neurotypical mice induced autism-like behaviors.

This finding overlaps significantly with epilepsy research. Epilepsy is present in approximately 30% of autistic individuals compared to 1% of the general population.9 The shared mechanism of thalamic hyperexcitability suggests that drugs targeting these specific calcium channels could serve dual purposes: managing seizures and reducing the painful intensity of sensory processing disorders in autistic populations.

2.2 Synaptic Density and the Hyper-Connectivity Theory

Parallel to the functional findings in the thalamus, structural imaging studies in 2024 and 2025 have solidified the theory of altered synaptic pruning. A landmark study utilizing Positron Emission Tomography (PET) scans with the radiotracer 11C-UCB-J allowed researchers to visualize synaptic density in living brains for the first time, moving beyond post-mortem analysis.5

2.2.1 The Pruning Deficit

During typical development, the brain produces an excess of synapses in early childhood, which are subsequently "pruned" during adolescence to increase efficiency and signal clarity. The 2025 data indicates that autistic brains retain a significantly higher density of synapses. In some cortical regions, the reduction in synapses during adolescence was found to be only 16% in autistic brains, compared to the typical 50% drop observed in neurotypical controls.15

This finding challenges the older "under-connectivity" theories. The autistic brain is likely hyper-connected at the local level. While this density might theoretically support enhanced memory or attention to detail (strengths often seen in Level 2 autism), it creates a "noisy" neural environment.16

2.2.2 Functional Implications of Hyper-Connectivity

The retention of excess synapses correlates with the "Intense World Theory" of autism. A brain with too many connections may process specific stimuli with excruciating intensity but struggle to integrate information across distant brain regions (long-range under-connectivity).

• Monotropism: The hyper-connected local networks may explain "monotropism," the tendency to have a singular, intense focus. The neural hardware is wired to lock onto one stream of information deeply, making "task switching" (which requires disengaging that robust local network) metabolically expensive and emotionally distressing.17

• Sensory Amplification: Combined with the RT dysfunction, high synaptic density ensures that once sensory data breaches the thalamic gate, it is amplified by the dense cortical networks, leading to rapid overstimulation.

2.3 Neural Circuits of Emotional Regulation

Emotional dysregulation—rapid shifts in mood, prolonged distress, and difficulty returning to baseline—is a core challenge for individuals with substantial support needs. Research through 2025 has mapped these challenges to specific disconnects between the Prefrontal Cortex (PFC) and the Limbic System.

2.3.1 The Prefrontal-Amygdala Disconnect

Functional MRI (fMRI) studies involving cognitive reappraisal tasks—where participants are asked to "reframe" a negative image to reduce their emotional response—have shown distinct activation patterns in autistic adults.

• Neurotypical Response: Regulation involves increased activation of the Dorsolateral Prefrontal Cortex (DLPFC), which sends inhibitory signals to the Amygdala (fear center) and Nucleus Accumbens (reward/emotion center), effectively "cooling down" the reaction.

• Autistic Response: The 2025 studies found that while autistic participants understood the task, their brains showed significantly less modulation of the Amygdala and Nucleus Accumbens by the PFC.18

This suggests a mechanistic decoupling: the "top-down" regulatory commands from the PFC do not effectively reach or influence the "bottom-up" emotional centers. This provides a physiological basis for why cognitive strategies (e.g., "Tell yourself it's okay," "Count to ten") are often ineffective for Level 2 autistic individuals during moments of high arousal. The neural pathway required for logic to soothe emotion is functionally impaired.

2.3.2 Structural Variations: Amygdala and Hippocampus

Structural analyses have further nuanced our understanding of the "social brain." While earlier studies offered conflicting data on amygdala size, 2025 consensus points toward developmental trajectories where the amygdala is often enlarged in early childhood (linked to anxiety and over-responsivity) and remains structurally distinct in adulthood.16 Furthermore, the hippocampus, critical for memory, is often enlarged. This may explain the intense, specific memories associated with special interests or, conversely, the deep encoding of traumatic sensory events (e.g., a specific loud fire alarm) that can trigger phobic responses years later.16

2.4 Interoception and the Insular Cortex

A critical area of research that bridges neurology and therapy is Interoception—the sensing of internal bodily states (hunger, heart rate, bladder fullness, pain). The Insular Cortex (Insula) is the primary hub for interoception. Research indicates that autistic individuals often show hypo-activity or aberrant connectivity in the right Anterior Insula (rAI) and its interaction with the Default Mode Network (DMN).20

2.4.1 The Mechanism of Alexithymia

This insular dysfunction provides the neurological mechanism for Alexithymia (difficulty identifying and describing emotions), which affects approximately 50% of the autistic population. If the brain does not accurately process the physiological signals of an emotion (e.g., recognizing a racing heart as "anxiety" or a growling stomach as "hunger"), the individual cannot label the state or engage in regulation until the physical sensation becomes overwhelming.

• Implication for Level 2 Support: Behaviors labeled as "sudden aggression" are often the result of unrecognized internal pain or hunger that the individual could not feel until it reached a threshold of agony. The "Interoceptive Discrimination Difficulty" is a primary target for modern therapeutic interventions.21

3. The Paradigm Shift: Neurodiversity-Affirming Practice in 2025

The period from 2020 to 2025 has witnessed a decisive ethical and clinical pivot. The "Medical Model," which views autism as a set of deficits to be cured or normalized, has been largely superseded in research and progressive practice by the "Neurodiversity Paradigm." This shift is particularly critical for Level 2 support, where the intensity of intervention previously led to restrictive or compliance-based practices that are now recognized as harmful.

3.1 From Compliance to Autonomy

Traditional behavioral approaches often prioritized "compliance"—teaching a child to follow directions immediately, maintain "quiet hands," or suppress stimming (self-stimulatory behavior). By 2025, a significant body of literature, including guidelines from professional bodies like the American Occupational Therapy Association (AOTA), has re-evaluated these goals.6

3.1.1 The Trauma of "Quiet Hands" and Masking

Research into Autistic Burnout has identified "masking" (the suppression of autistic traits to fit in) as a primary contributor to mental health crises, depression, and suicidality in autistic adults.24 Interventions that enforce "quiet hands" or forced eye contact are now understood to increase cognitive load and anxiety, thereby reducing the capacity for genuine learning or social connection.

• The 2025 Consensus: Stimming is a necessary regulatory mechanism. Suppressing it deprives the individual of a tool to manage the "leaky thalamus" discussed in Section 2.

• Clinical Shift: Therapists are now trained to distinguish between harmful behaviors (self-injury) and autistic behaviors (flapping, rocking). The latter are to be respected and protected.17

3.2 The Double Empathy Problem

The Double Empathy Problem, a theory proposed by Dr. Damian Milton, has gained robust empirical support through 2024-2025. It posits that communication breakdowns between autistic and non-autistic people are mutual, not solely the fault of the autistic person.

• Research Findings: Studies show that autistic people communicate effectively with other autistic people; the transfer of information is accurate and rapport is high. The "deficit" only appears in mixed neurotype interactions.17

• Impact on Therapy: This shifts the burden of intervention. Instead of solely training the autistic individual to mimic neurotypical social skills, interventions now focus on "two-way" understanding. Families, teachers, and peers are trained to interpret autistic communication styles (e.g., infodumping, echolalia, avoidance of eye contact) as valid and meaningful.25

3.3 Neuro-Affirming Goal Setting

In 2025, clinical goals for substantial support needs have moved away from "normalization" toward "quality of life" and "self-determination."

This shift is documented in updated frameworks for speech-language pathology and occupational therapy, which explicitly warn against goals that induce masking.17

4. Applied Therapeutics for Substantial Support Needs (Level 2)

Individuals with Level 2 autism require "substantial support." The 2020-2025 research literature highlights that effective intervention for this group must be intensive yet naturalistic, robustly supported by technology, and centered on physiological regulation rather than behavioral suppression.

4.1 Naturalistic Developmental Behavioral Interventions (NDBI)

NDBIs represent the evolution of behavioral science, merging the principles of Applied Behavior Analysis (ABA) with developmental science. Unlike Discrete Trial Training (DTT), which occurs in a structured, often artificial setting, NDBIs (such as JASPER, Early Start Denver Model, and Project ImPACT) are implemented in natural environments like play and daily routines.

4.1.1 Efficacy in Group and Telehealth Settings

Recent studies (2024-2025) have validated the scalability of NDBIs, which is crucial given the shortage of providers.

• Group-Based NDBI: A study published in Journal of Speech, Language, and Hearing Research (2025) examined group-based NDBI for young autistic children. It demonstrated significant increases in "active engagement" and social relatedness over a 10-month period.28 The study highlighted that while the group average improved, individual trajectories varied based on baseline social pragmatic skills, suggesting that Level 2 children may need "priming" or 1:1 breakout sessions to fully benefit from group work.

• Telehealth Efficacy: A mixed-methods pilot study of Project ImPACT delivered via telehealth showed statistically significant decreases in peer interaction challenges.30 This confirms that parents can be effectively coached to deliver high-fidelity NDBI strategies at home, a vital finding for addressing health equity in underserved regions.

4.2 The Low Arousal Approach

For individuals with Level 2 support needs, who may experience frequent dysregulation or "meltdowns" due to the thalamic gating issues described earlier, the Low Arousal Approach has emerged as a gold standard in crisis management.31

4.2.1 Mechanism and Application

The approach is predicated on the understanding that challenging behavior is often a panic response (Fight/Flight) fueled by sensory and emotional overload.

• Reducing Demands: In a moment of escalation, the immediate goal is safety, not compliance. The Low Arousal protocol dictates dropping all demands to lower the cognitive load.

• Sensory Reduction: Interventions involve lowering lights, reducing verbal input (stopping the "talking at" the person), and increasing physical space to reduce the perception of threat.

• Affect Regulation: The caregiver must manage their own emotional state ("Peace of mind is contagious") to prevent emotional contagion, where the caregiver's stress further escalates the autistic individual.32

Unlike restraint or seclusion, which increase physiological arousal and trauma, this approach aims to lower the "temperature" of the interaction. It shifts the focus from "consequences" to "antecedent management"—changing the environment before the crisis occurs.

4.3 Augmentative and Alternative Communication (AAC)

For Level 2 individuals, communication barriers are a primary source of frustration and behavior. The 2025 landscape for AAC emphasizes "Robust AAC" systems and the presumption of competence.

4.3.1 Moving Beyond "Requesting"

Historically, AAC for substantial support needs often focused on "wants and needs" (e.g., asking for a cookie). Current best practices 34 emphasize a Core Vocabulary approach—teaching high-frequency words (go, stop, more, help, different) that allow for a wide range of communicative functions, including commenting, protesting, and asking questions.

4.3.2 Techno-Ableism and Multi-Modal Communication

A critical 2025 discourse involves "techno-ableism"—the assumption that high-tech devices are superior or curative. Research cautions that while speech-generating devices are powerful, they must not replace multi-modal communication.36 Gestures, leading an adult by the hand, vocalizations, and low-tech picture boards are all valid forms of language. The goal is autonomous communication, not just the use of a device.

4.4 Interoception-Based Interventions

Given the insular hypoconnectivity and alexithymia common in Level 2 autism, teaching interoception has become a therapeutic priority. The work of Kelly Mahler and others has been adapted specifically for non-speaking clients.37

4.4.1 The Curriculum for Non-Speakers

Standard interoception curricula often rely on verbal dialogue ("How does your stomach feel?"). Adaptations for 2025 involve:

1. Modeling: The therapist narrates their own bodily sensations ("I am yawning; my energy feels low").

2. Tactile Exploration: Using "Body Experiments" (e.g., holding an ice cube vs. a warm towel) to help the individual connect sensation to vocabulary without requiring verbal output.39

3. Co-Regulation: Using the therapist's regulated state to help the client feel safe enough to notice internal signals.40

4.5 Peer-Mediated Instruction and Intervention (PMI)

PMI involves training neurotypical peers to support autistic students. While highly effective for social inclusion, 2025 reviews note a gap in research for students with substantial support needs.41 However, when adapted—for instance, training peers to use the autistic student's AAC device or to engage in the autistic student's preferred "special interest" play—PMI promotes genuine inclusion and breaks down social isolation.42

5. Daily Life Assistance, Executive Function, and Technology

For individuals with Level 2 autism, the "executive function" gap—planning, organizing, initiating tasks, and working memory—is often a greater barrier to independence than social deficits. The 2020-2025 period has seen a surge in "Assistive Tech" that acts as a prosthetic for executive function.

5.1 AI-Driven Executive Function Support

Artificial Intelligence has moved from novelty to utility in autism support. By 2025, apps like Tiimo and Thruday utilize AI to create dynamic, visual schedules that adapt to the user's needs.44

• Predictive Scheduling: Newer algorithms can analyze behavioral data (if integrated with wearables) to predict "triggers." If a user typically becomes dysregulated after 20 minutes of a specific task, the AI can suggest a break before the meltdown occurs.46

• Visualizing Time: Time blindness is a common feature of autism. Apps that use visual timers (e.g., a disappearing red disk) provide concrete representations of abstract concepts, reducing anxiety during transitions.47

5.2 Video Modeling for Daily Living Skills (DLS)

Acquiring daily living skills (hygiene, cooking, cleaning) is a primary goal for Level 2 support. Video Modeling has proven exceptionally effective for this population.

• Mechanism: It bypasses the social-processing demand of face-to-face instruction. The individual watches a video of the task (from a first-person perspective) and imitates it. This aligns with the "visual learning" strength of many autistic people.

• 2025 Efficacy Data: Case studies and meta-analyses confirm that video modeling is effective for complex chains of behaviors (e.g., washing dishes, doing laundry) and that skills are maintained over time without the need for constant supervision.49

• Implementation: Using tablets to display the video step-by-step at the point of performance (e.g., an iPad mounted in the bathroom playing a "brushing teeth" clip) allows for real-time prompting.

5.3 Safety Skills and Elopement

Elopement (wandering) remains a critical safety concern for Level 2 families. Interventions in 2025 focus on Behavioral Skills Training (BST) and environmental modification.

• Water Safety: Given the high risk of drowning, specialized swim instruction that includes clothes-on swimming and safety commands is essential. Programs now focus on "survival swimming" rather than stroke technique.52

• Tech Solutions: Passive measures like GPS trackers and door alarms are standard, but active safety involves teaching "stop" commands using high-reinforcement protocols (e.g., practicing stopping at a curb for a high-value reward).53

5.4 Transition Support Strategies

Transitions are a flashpoint for dysregulation due to Monotropism (the intense, single-track focus of the autistic mind). Evidence-based strategies for substantial support needs include:

1. Priming: Warning the individual about what is coming next well in advance to allow for cognitive shifting.

2. Visual Countdowns: Using a visual countdown (5-4-3-2-1 cards) rather than just a verbal one, which may be missed if auditory processing is overwhelmed.

3. Transitional Objects: Allowing a preferred item (e.g., a toy car) to travel from activity A to activity B to maintain a sense of continuity and safety.47

6. The Lifespan Perspective: Adulthood and Systemic Support

The "Services Cliff"—the drastic reduction in support after high school—remains a critical issue in 2025. With 1 in 31 children now diagnosed, the wave of autistic adults entering the system is unprecedented.1

6.1 The State of Adult Services

• Employment: While 8 out of 10 eligible autistic adults enroll in job training, only half secure employment. This discrepancy highlights a systemic failure in "transition" planning and workplace accommodation. The focus is often on training the individual, rather than modifying the workplace to be sensory-friendly.57

• Housing: 1 in 4 families with an autistic child faces housing insecurity, exacerbated by the lack of specialized, affordable adult housing options that provide Level 2 support (e.g., semi-independent living with drop-in support).57

• Day Programs: For Level 2 adults, day programs are shifting from "custodial care" to "community integration." Programs like Avondale House and university-based initiatives (e.g., IMPACT at the University of Cincinnati) focus on vocational skills, communication, and recreation rather than mere supervision.58

6.2 Social Isolation and Mental Health

Loneliness is a significant health risk for autistic adults, comparable to smoking in its physical effects. Research in 2025 clarifies that autistic adults desire connection but often lack the "neuro-affirming" spaces to find it.60

• Affinity Groups: Groups based on shared interests (Special Interests) are more successful than general "social skills" groups. When autistic adults gather around a shared passion (e.g., anime, coding, trains), social barriers often dissolve.

• Adult Support Groups: Organizations like AANE and The Autism Project offer online and in-person groups that validate autistic identity rather than trying to "cure" it. These "closed" groups allow adults to discuss burnout, sensory issues, and navigation of the neurotypical world with peers who understand.62

7. Pharmacological, Genetic, and Medical Updates (2025)

While behavioral and educational interventions are primary, 2025 has seen notable medical updates relevant to Level 2 support, particularly concerning co-occurring metabolic and genetic conditions.

7.1 Leucovorin and Cerebral Folate Deficiency (CFD)

In September 2025, the FDA initiated approval for Leucovorin calcium for patients with Cerebral Folate Deficiency (CFD).64

• Mechanism: CFD is a condition where folate (vitamin B9) cannot cross the blood-brain barrier due to the presence of autoantibodies. This deficiency leads to developmental delays, seizures, and autistic symptoms. Leucovorin is a reduced folate that bypasses this blocked transport mechanism.

• Relevance: CFD is highly comorbid with autism (and often undiagnosed). Treating the folate deficiency can lead to significant improvements in speech and social interaction for the subset of autistic individuals with this metabolic profile.

7.2 Prenatal Acetaminophen (Tylenol) Warnings

The FDA has issued updated warnings regarding the use of acetaminophen during pregnancy, citing a "considerable body of evidence" suggesting a correlation (though not definitively causal) with increased risks of autism and ADHD.66 This remains a contentious area, but the shift in guidance represents a precautionary approach in prenatal care.

7.3 Genetic Architecture and Personalized Medicine

Research has identified 230 new genes linked to ASD as of 2024.9 The Autism Data Science Initiative (ADSI) is currently using machine learning to parse how these genes interact with environmental factors.1 This supports the move toward "personalized medicine," where interventions might eventually be tailored to an individual's specific genetic and neural profile (e.g., treating those with the Cntnap2 variance with RT-targeting therapies, while others might benefit more from oxytocin-pathway interventions).

8. Conclusion: A New Era of Informed Support

The research of 2020-2025 has coalesced into a clear, evidence-based narrative for Level 2 support: Intervention must be biologically informed but humanistically delivered.

We have moved beyond the "black box" era. We now understand the biological reality of sensory overwhelm (the Reticular Thalamic Nucleus), the structural reality of hyper-connectivity (Synaptic Density), and the social reality of the Double Empathy Problem.

8.1 Key Takeaways for Support Providers

1. Respect the Neurology: Use Low Arousal strategies not just because they are "nice," but because the Level 2 brain is physiologically wired for intensity and lacks the gating mechanisms to filter noise.

2. Prioritize Interoception: Teach the individual to feel their body (heart rate, tension) before expecting them to regulate their behavior. Emotional regulation is impossible without interoceptive awareness.

3. Leverage Technology: Use AI scheduling and video modeling to bypass executive function deficits, acting as a digital prosthetic for the frontal lobe.

4. Affirm Identity: Ensure that social support validates the autistic experience. Stop fighting the symptoms (stimming, monotropism) and start supporting the person (autonomy, safety, connection).

By aligning support strategies with the biological reality of the autistic brain—respecting its intense connectivity and unique sensory gating—we can build lives of quality, connection, and dignity for individuals with substantial support needs. The future of autism support is not about "fixing" the individual, but about optimizing the environment and the understanding of those around them.

Works cited

1. Autism Announcement Fact Sheet | HHS.gov, accessed December 13, 2025, https://www.hhs.gov/press-room/autism-announcement-fact-sheet.html

2. CDC Community Report on Autism 2025, accessed December 13, 2025, https://www.cdc.gov/autism/media/pdfs/2025/04/ADDM-Community-Report-SY2022.pdf

3. High-Level Support in Autism - Apex ABA Therapy, accessed December 13, 2025, https://www.apexaba.com/blog/high-level-support-in-autism

4. Repurposed epilepsy drugs show potential for new autism therapies - Drug Target Review, accessed December 13, 2025, https://www.drugtargetreview.com/news/184268/repurposed-epilepsy-drugs-show-potential-for-new-autism-therapies/

5. A Key Brain Difference Linked to Autism Is Found for the First Time in Living People, accessed December 13, 2025, https://medicine.yale.edu/news-article/a-key-brain-difference-linked-to-autism-is-found-for-the-first-time-in-living-people/

6. Affirming Neurodiversity within Applied Behavior Analysis - PMC - PubMed Central - NIH, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC11219658/

7. Facts About Autism: Comprehensive Overview for 2025 - Abacus Therapies, accessed December 13, 2025, https://abacustherapies.com/facts-about-autism-comprehensive-overview-for-2024/

8. Science Updates About Autism Spectrum Disorder (ASD), accessed December 13, 2025, https://www.nimh.nih.gov/news/science-updates/autism-spectrum-disorder-asd

9. Promising Autism Research Breakthroughs in 2025: New Hope for Understanding and Treatment, accessed December 13, 2025, https://linksaba.com/promising-autism-research-breakthroughs/

10. Stanford study shows autism-like behaviors can be switched off in mice - PsyPost, accessed December 13, 2025, https://www.psypost.org/stanford-study-shows-autism-like-behaviors-can-be-switched-off-in-mice/

11. Hyperactivity in reticular thalamic nucleus drives autism-like behaviors in mice, accessed December 13, 2025, https://www.news-medical.net/news/20250820/Hyperactivity-in-reticular-thalamic-nucleus-drives-autism-like-behaviors-in-mice.aspx

12. Reticular Thalamic Hyperexcitability Drives Autism Spectrum Disorder Behaviors in the Cntnap2 Model of Autism | bioRxiv, accessed December 13, 2025, https://www.biorxiv.org/content/10.1101/2025.03.21.644680v1.full-text

13. Reticular thalamic hyperexcitability drives autism spectrum disorder behaviors in the Cntnap2 model of autism - PMC - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC12366697/

14. Thalamic functional connectivity and sensorimotor processing in neurodevelopmental disorders - PMC - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10755010/

15. Children with Autism Have Extra Synapses in Brain, accessed December 13, 2025, https://www.cuimc.columbia.edu/news/children-autism-have-extra-synapses-brain

16. Autistic Brain vs Normal Brain: Decoding Neurodiversity - Yellow Bus ABA, accessed December 13, 2025, https://www.yellowbusaba.com/post/autistic-brain-vs-normal-brain

17. Neurodiversity-Affirming Therapy: Positions, Therapy Goals, and Best Practices, accessed December 13, 2025, https://therapistndc.org/neurodiversity-affirming-therapy/

18. Neural Mechanisms of Emotion Regulation in Autism Spectrum Disorder - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC4515208/

19. Neural Mechanisms of Emotion Regulation in Autism Spectrum Disorder, accessed December 13, 2025, https://cdr.lib.unc.edu/concern/articles/cf95jk09n

20. Mapping brain functional and structural abnormities in autism spectrum disorder: moving toward precision treatment - Oxford Academic, accessed December 13, 2025, https://academic.oup.com/psyrad/article/2/3/78/6815557

21. Ask a Lurie Center Researcher: Autism and Interoception: Understanding the Body's Hidden Signals, accessed December 13, 2025, https://www.massgeneral.org/assets/mgh/pdf/children/lurie-center-lurienow-autism-and-interoception.pdf

22. Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan, accessed December 13, 2025, https://research.aota.org/ajot/article/78/3/7803397010/25188/Occupational-Therapy-Practice-Guidelines-for

23. Moving Toward Neurodiversity-Affirming Occupational Therapy for Autistic People: Key Questions and Next Steps - WMU's ScholarWorks, accessed December 13, 2025, https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=2244&context=ojot

24. 2025 Neurodiversity Affirming Practice Speakers - STAR Institute, accessed December 13, 2025, https://sensoryhealth.org/basic/2025-neurodiversity-affirming-practice-speakers

25. Neurodiversity Affirming Therapy Practices: Complete Guide - ABA & Autism Therapy Services, accessed December 13, 2025, https://kctherapy.com/neurodiversity-affirming-therapy-practices/

26. Autism and communication - National Autistic Society, accessed December 13, 2025, https://www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication

27. Neurodivergent-Affirming SLT | AutisticSLT, accessed December 13, 2025, https://www.autisticslt.com/nd-affirmingslt

28. Effects of an Inclusive Group-Based Naturalistic Developmental Behavioral Intervention on Active Engagement in Young Autistic Children: A Preliminary Study - PubMed, accessed December 13, 2025, https://pubmed.ncbi.nlm.nih.gov/39879478/

29. Effects of an Inclusive Group-Based Naturalistic Developmental Behavioral Intervention on Active Engagement in Young Autistic Children: A Preliminary Study - Johns Hopkins University, accessed December 13, 2025, https://pure.johnshopkins.edu/en/publications/effects-of-an-inclusive-group-based-naturalistic-developmental-be/

30. Telehealth Pilot Study of the Effects of a Naturalistic Developmental Behavioral Intervention on Child Social Communication Outcomes in a Community Mental Health System - MDPI, accessed December 13, 2025, https://www.mdpi.com/2076-328X/15/9/1171

31. The Low Arousal Approach: A Practitioner's Guide - BCU Open Access Repository - Birmingham City University, accessed December 13, 2025, https://www.open-access.bcu.ac.uk/6544/1/the-low-arousal-approach.pdf

32. Low Arousal and Effective Crisis Management in a World of Noise - Studio 3, accessed December 13, 2025, https://www.studio3.org/post/low-arousal-and-effective-crisis-management-in-a-world-of-noise

33. What is the Low Arousal Approach and How Can It Benefit My Family?, accessed December 13, 2025, https://autismawarenesscentre.com/what-is-the-low-arousal-approach-and-how-can-it-benefit-my-family/

34. AAC in Autism, accessed December 13, 2025, https://www.advancedautism.com/post/aac-in-autism

35. Communication in Autistic Adults: An Action-Focused Review - PMC - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC12271282/

36. Full article: Dismantling societal barriers that limit people who need or use AAC: lived experiences, key research findings, and future directions - Taylor & Francis Online, accessed December 13, 2025, https://www.tandfonline.com/doi/full/10.1080/07434618.2025.2508490

37. On-Demand Course: Interoception and the Non-Speaking Client - Kelly Mahler, accessed December 13, 2025, https://www.kelly-mahler.com/product/on-demand-course-interoception-and-the-non-speaking-client/

38. Interoception and Non-Speaking/Verbal Autistic Clients | Kelly Mahler, accessed December 13, 2025, https://www.kelly-mahler.com/interoception-non-speaking-autistic/

39. Interoception: Body Awareness Exercises - Autism Connection of Pennsylvania, accessed December 13, 2025, https://autismofpa.org/interoception-body-awareness-exercises-for-autistic-children/

40. Interoception and the Non-Speaking Client | Kelly Mahler Blog, accessed December 13, 2025, https://www.kelly-mahler.com/resources/blog/interoception-and-the-non-speaking-client/

41. A systematic review of peer-mediated interventions for children with autism spectrum disorder - NIH, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5087797/

42. Peer-Mediated Instruction in Autism, accessed December 13, 2025, https://www.advancedautism.com/post/peer-mediated-instruction-in-autism

43. Peer-Mediated Instruction And Intervention In Autism, accessed December 13, 2025, https://www.ambitionsaba.com/resources/peer-mediated-instruction-and-intervention-in-autism

44. Neuroinclusive AI Planning | Smarter, Adaptive Support for ADHD & Autism - Tiimo App, accessed December 13, 2025, https://www.tiimoapp.com/resource-hub/ai-planner

45. Thruday | Visual Planner & To-Do App for ADHD & Autism, accessed December 13, 2025, https://thruday.com/

46. Latest Advancements in Autism Therapy: 2025 Trends to Watch - AB Spectrum, accessed December 13, 2025, https://www.abspectrum.org/advancements-in-autism-therapy-2025/

47. Transition Time: Helping Individuals on the Autism Spectrum Move Successfully from One Activity to Another, accessed December 13, 2025, https://iidc.indiana.edu/irca/articles/transition-time-helping-individuals-on-the-autism-spectrum-move-successfully-from-one-activity-to-another.html

48. Using Technology to Support Executive Functioning Skills in Adults with Autism, accessed December 13, 2025, https://gershautismacademy.com/blog/using-technology-to-support-executive-functioning-skills-in-adults-with-autism/

49. EJ1373145 - Video Modeling and Daily Living Skills Training in Students with ASD, Journal of Educational Sciences, 2022 - ERIC, accessed December 13, 2025, https://eric.ed.gov/?id=EJ1373145

50. Examining the Effects of Video Modeling and Prompts to Teach Activities of Daily Living Skills - NIH, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC5118254/

51. Teaching Daily Living Skills to Children with Autism Through Instructional Video Modeling, accessed December 13, 2025, https://www.researchgate.net/publication/247784937_Teaching_Daily_Living_Skills_to_Children_with_Autism_Through_Instructional_Video_Modeling

52. ABA strategies for teaching safety skills - Ambitions ABA Therapy, accessed December 13, 2025, https://www.ambitionsaba.com/resources/aba-strategies-for-teaching-safety-skills

53. Strategies For Enhancing Safety For Autistic Children - Autism Learning Partners, accessed December 13, 2025, https://autismlearningpartners.com/nurturing-safety/

54. Teaching Safety Skills to Children: A Discussion of Critical Features and Practice Recommendations - PMC - NIH, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9582057/

55. Children, Autism, and Change: Tips to Make Transition Easier | Brown University Health, accessed December 13, 2025, https://www.brownhealth.org/be-well/children-autism-and-change-tips-make-transition-easier

56. Improving Transition to Adulthood for Students with Autism: A Randomized Controlled Trial of STEPS - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC8513749/

57. 2025 Autism by the Numbers Annual Report now live, accessed December 13, 2025, https://www.autismspeaks.org/science-news/2025-autism-numbers-annual-report-now-live

58. Adult Day Program - Avondale House, accessed December 13, 2025, https://www.avondalehouse.org/services-adult-day-program

59. ADULT DAY ARRAY GUIDE 2025 - Hamilton County Developmental Disabilities Services, accessed December 13, 2025, https://www.hamiltonddsohio.gov/wp-content/uploads/2025/04/2025-ADA-Provider-Guide-2.pdf

60. Friendship, Loneliness and Belonging in Autistic People - Reframing Autism, accessed December 13, 2025, https://reframingautism.org.au/friendship-loneliness-and-belonging-in-autistic-people/

61. Experiences of friendship among autistic adults: a scoping review - PMC - PubMed Central, accessed December 13, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC12034726/

62. Autistic Adult - AANE, accessed December 13, 2025, https://aane.org/autistic-adult/

63. Finding your community | Autism Speaks, accessed December 13, 2025, https://www.autismspeaks.org/finding-your-community

64. FDA Takes Action to Make a Treatment Available for Autism Symptoms, accessed December 13, 2025, https://www.fda.gov/news-events/press-announcements/fda-takes-action-make-treatment-available-autism-symptoms

65. President Trump, Secretary Kennedy Announce Bold Actions to Tackle Autism Epidemic, accessed December 13, 2025, https://www.hhs.gov/press-room/hhs-trump-kennedy-autism-initiatives-leucovorin-tylenol-research-2025.html

66. FDA Responds to Evidence of Possible Association Between Autism and Acetaminophen Use During Pregnancy, accessed December 13, 2025, https://www.fda.gov/news-events/press-announcements/fda-responds-evidence-possible-association-between-autism-and-acetaminophen-use-during-pregnancy

67. Mount Sinai Study Supports Evidence That Prenatal Acetaminophen Use May Be Linked to Increased Risk of Autism and ADHD, accessed December 13, 2025, https://www.mountsinai.org/about/newsroom/2025/mount-sinai-study-supports-evidence-that-prenatal-acetaminophen-use-may-be-linked-to-increased-risk-of-autism-and-adhd

Disclaimer

The content provided in this article is for general informational purposes only and does not constitute legal, clinical, or specialist behaviour support advice. It should not be relied upon as such.

All information is provided in good faith, however, we make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, or completeness of any information. The information pertaining to Autism and support methods must be individually determined by each person’s GP and specialist therapists, and is a very complex evolving context and support needs and methods are subject to change.

This article is not a substitute for professional advice from a qualified NDIS Behaviour Support Practitioner. You should always consult with an appropriate professional to address your specific circumstances. Under no circumstance shall Ability Therapy Specialists Pty Ltd have any liability to you for any loss or damage incurred as a result of the use of this information. Reliance on any information provided in this post is solely at your own risk. This article, website, and your participation are governed under the Client Booklet - Privacy Policy: Disclaimer, Terms, Conditions as a necessary provision under Australian service quality standards.

Double Gifted - And Fabulous

Reframing Dual Diagnosis as Giftedness

Many people with a dual diagnosis have both a disability and a mental health condition. Sometimes, this can make life harder. But what if we looked at it differently? What if we saw the special gifts behind these challenges?

Understanding Dual Diagnosis

Dual diagnosis means having two different issues at the same time. For example, a person might have autism and anxiety. Or intellectual disability and depression. These combined difficulties can be tricky to manage.

However, focusing only on the difficulties can make us forget the person’s strengths and talents. Every person has unique abilities that can shine when we pay attention.

Looking beyond the surface - the key to understanding self and others

Seeing Abilities and Strengths

When we reframe dual diagnosis as giftedness, we start to notice special skills. For example, many people with autism are very good at noticing details others miss. They might have a great memory or be strong at puzzles and patterns.

People with certain mental health challenges may have deep creativity or show enormous courage. These talents can help them and others in many ways.

Why Reframe Matters

Changing how we think about dual diagnosis matters for the person and their support team. When we see giftedness, we can build on those strengths to help the person grow.

This approach helps families, teachers and therapists provide better support. Instead of focusing on what a person can’t do, they focus on what the person can do.

Practical Steps to Appreciate Abilities

Listen carefully to each person’s interests. What do they enjoy? What makes them happy?

Encourage skills they already have. Join them in activities that use these strengths.

Create plans that include their talents. This can boost their confidence and make learning fun.

Conclusion

Dual diagnosis is challenging, but it is also a chance to see the amazing abilities in someone. By appreciating these gifts, we help people reach their potential. Focusing on strengths rather than limitations changes lives for the better.

Everyone deserves to be seen for their abilities. This way, we all grow together.

Dr Jo, PhD, is a senior Psychotherapist and Behaviour Support Specialist registered with the National Disability Insurance Scheme. He works from Armidale NSW Australia and consults across the country. He works with Dr Dwayne Kennedy with consultant services available online today. Send us a line via the form on Home Page.

"My situation is high-risk. Why don't I have a behaviour support plan?" Understanding NDIS Safety Plans vs. Long-Term Plans

Preface

This post is a special edition ‘Deep Dive’ into one of the many profound questions that come up often in our work. It provides a more comprehensive analysis that draws information together in one place, for those interested in reading further. We cite the sources as well - so all of the information provided here is up to date at the time of writing. Don’t trust our word on this however - always research the sources. The NDIS in particular is well known for changing regularly! We urge you to do your own research and keep informed.

Estimated Reading Time: 9-10 minutes

Reading Tip: Click on the articles - they open up to nice layout to read more easily.

Audio Tip: Use your favourite app to ‘read aloud’ - we suggest Google Read & Write as it has a solid free version and works with Google Chrome.

Image of a Black Page with the word ‘Plan’

Introductions

In today’s world introductions are often overlooked in their importance. While often these come at the end of articles, we’ve decided for good reason to introduce you to the author up front.

Dr Jorandi (Jo) Kisiku Joseph Randolph Bowers is a PhD in Health Counselling Psychotherapy, a qualification they earned from winning a doctoral teaching and research scholarship at UNE from 1998 to 2002. Doc Jo has three doctoral degrees, as well as many qualifications and years of experience. They worked full time as a Behaviour Specialist since 2012, well before the NDIS rolled out in Australia. His practice focuses often on highly complex cases with dual and multiple diagnosis.

Jo works with and founded Ability Therapy Specialists with another senior behavioural specialist, Dr Dwayne Wannamarra Andrew Kennedy. Dr Dwayne is a PhD in Counselling with many degrees in education and community based services. He has worked in disabilities since youth, and in specialist behaviour support since around 2016 with full time work in this area since 2018.

As many like to know more about the author, Jo earned a Doctor of Divinity in Ceramic Arts & Spirituality, received an Honorary Doctor of Divinity in Spirituality, and holds a Master of Education in Counselling Psychotherapy, Diploma in Ericksonian Hypnotherapy and Counselling, Practitioner Certification in Neuro-Linguistic Psychotherapy, and a Bachelor of Arts in Spirituality & Philosophy.

Jo is a NDIS registered specialist behaviour support practitioner and counsellor, senior honorary member with the Australian Counselling Association, senior fellow of the Australasian Society of Lifestyle Medicine, and author of over 250 works including a dozen books. Having worked in specialist behaviour support in the years prior to NDIS roll out, Joseph Randolph was asked by managers to stay in regional New England in NSW and set up a community practice. This led Jo to take up the work of Director and Senior Clinical Specialist with Ability Therapy Specialists Pty Ltd, a registered NDIS provider in Australia. Their work includes telehealth therapy for people across the country – often helping where waiting lists are extreme and in Australia’s most rural, remote and bush settings.

Jo is an author of over 250 works, with a dozen books including ‘Clay Art Therapy and Spirituality,’ ‘The Practice of Counselling,’ ‘Mi’kmaq Puoinaq Two Spirit Medicine,’ ‘Sacred Teachings from the Mi’kmaq Medicine Lodge,’ and ‘Solitude Awakens: The Heart, Forest, Mountain Way.’

A Guide for Participants and Families

We know that waiting for a behaviour support plan can be stressful, especially when you're managing high-risk situations. You may have heard about a "30-Day Rule" and are left wondering, "Why is my plan taking so long?"

This is a common and completely valid question. Here’s the simple answer:

That 30-day timeline is a specific legal safeguard that only applies when a 'restrictive practice' (like using locked doors, gates, or physical restraints) is involved. It’s a human rights rule to make sure those practices are monitored.

But what if your situation is high-risk, but doesn't involve those things? Does that mean you just wait?

Absolutely not.

Your provider's first legal and ethical duty is to your immediate safety. This is covered by different NDIS rules (the Code of Conduct and Practice Standards). In any high-risk case, a good practitioner's first step isn't to write a comprehensive plan, but to create an interim safety plan.

This "safety plan" is a vital document. It gives your support team and family clear, immediate steps on how to de-escalate and manage unsafe situations right now.

This immediate safety plan allows the practitioner to do the most important job: a proper assessment (we call it a "Functional Behaviour Assessment" or FBA) to understand the why behind the behaviour. A final plan written without this assessment is just guesswork.

In short: A "safety plan" comes first (for immediate risk). The full "behaviour support plan" comes later (for long-term change).

This article explores the details of these different NDIS rules. It's helpful for understanding your rights and what you should expect from your provider. For providers and other professionals, the fully cited analysis is included below.

Image of a person sitting with a laptop and puppy looking to the camera

Deeper-Dive Summary for Humans

For NDIS providers and practitioners, the "30-day rule" for behaviour support plans (BSPs) is a common point of focus. However, this timeline is widely misunderstood. Our analysis confirms this 30-day deadline applies only to cases involving a regulated restrictive practice (RP). This is a human rights safeguard, triggering the need for a lodged "Interim BSP" (Part 3, Section 12 of the NDIS (Behaviour Support) Rules 2018).

But what about high-risk cases where no restrictive practices are present? The Behaviour Support Rules do not set a specific deadline for these scenarios. Instead, urgency is dictated by a different, and often more immediate, set of obligations:

1. Provider's Duty: The NDIS Practice Standards (Core Module, Section 4: Risk Management) require providers to have a system to "identify, analyse, prioritise and treat" risks. A high-risk history (even if stable) is a known risk requiring proactive management.

2. Practitioner's Duty: The NDIS Code of Conduct (Section 1(d)) mandates a Duty of Care, requiring practitioners to "provide supports and services in a safe and competent manner, with care and skill."

3. Reactive Duty: If a high-risk behaviour does cause harm, the NDIS (Incident Management and Reportable Incidents) Rules 2018 (Part 2, Section 6) apply, requiring a Reportable Incident notification within 24 hours.

In all cases, the Functional Behaviour Assessment (FBA) must be completed before the Behaviour Support Plan (BSP). For the 30-day Interim BSP, the law explicitly requires it to be based on a "preliminary functional behaviour assessment" (Section 12(3)(a) of the Behaviour Support Rules). For high-risk, non-RP cases, best practice (driven by the Code of Conduct) involves an "interim safety plan" to ensure immediate safety and guide data collection for the full FBA.

Key Points

• The 30-day (1-month) timeline is for lodging an Interim BSP and is triggered only by the use of a Regulated Restrictive Practice (RP).

Source: NDIS (Behaviour Support) Rules 2018, Part 3, Section 12(1).

• This Interim BSP must still be based on a preliminary FBA. The FBA always comes first.

Source: NDIS (Behaviour Support) Rules 2018, Part 3, Section 12(3)(a).

• For cases with no RPs (even if high-risk), the 30-day rule for BSPs does not apply. The Behaviour Support Rules timelines are tied to the lodgement requirements for RPs.

• The urgency for high-risk, non-RP cases is driven by:

1. The provider's Risk Management obligations.

Source: NDIS Practice Standards, Core Module, Section 4: Risk Management.

1. The practitioner's Duty of Care.

Source: NDIS Code of Conduct, Section 1(d).

• If a high-risk behaviour results in a critical incident, the 24-hour Reportable Incident timeline is the primary legal driver for an immediate response.

Source: NDIS (Incident Management and Reportable Incidents) Rules 2018, Part 2, Section 6.

• Clinically, a practitioner should still create an "interim safety plan" for any high-risk case to manage immediate safety. This is a clinical best-practice tool derived from the duty of care, not the legislated "Interim BSP" document.

Navigating the Grey: Reconciling NDIS Timelines, High Risk, and the Functional Behaviour Assessment (FBA) -First Principles

For NDIS Behaviour Support Practitioners and providers, navigating the legislative landscape is a complex task of reconciling clinical best practice with a rule-based framework. A central point of confusion is the timeline for intervention, particularly in high-risk cases.

The framework, especially the NDIS (Behaviour Support) Rules 2018, appears to tie all urgency to the use of regulated restrictive practices (RPs). This leaves a critical question: What are the legislative provisions for a participant who presents with high-risk behaviours but has no RPs in place?

This article analyses the interplay between the NDIS Rules, Practice Standards, and Code of Conduct to clarify the required order of operations, with direct citations for verification.

Section 1: The "Known" Rule (The 30-Day RP Clock)

The most commonly cited timeline is the one-month (30-day) rule. This is found in the NDIS (Behaviour Support) Rules 2018, Part 3, Section 12.

• What it is: This rule mandates that a behaviour support plan (an Interim BSP) must be lodged with the NDIS Commission.

• When it applies: It is triggered only when a regulated restrictive practice is first used with a participant.

Source (Section 12(1)): "If... a behaviour support plan that provides for the use of a regulated restrictive practice... has not been developed, the NDIS provider... must ensure that... an interim behaviour support plan... is developed... and... a copy is lodged with the NDIS Commission... within 1 month after the use of the regulated restrictive practice..."

• What it requires: A common misunderstanding is that this 30-day rush means the BSP is written before the assessment. This is incorrect. The Rules explicitly state the Interim BSP must be:

Source (Section 12(3)(a)): "...based on a functional behaviour assessment, which may be a preliminary functional behaviour assessment..."

The legislation correctly anticipates that a comprehensive assessment is impossible in 30 days. It therefore makes provision for a "preliminary FBA." This triage-style assessment allows the practitioner to form an initial hypothesis of function, identify immediate risks, and create a plan that, first and foremost, ensures the RP is being used as safely as possible.

The 30-day clock, therefore, is a specific human-rights safeguard triggered exclusively by the use of RPs.

Section 2: The Apparent "Gap" (High-Risk, No RPs)

This brings us to the core dilemma. What provision covers a participant with a history of severe self-injury, physical aggression toward others, or dangerous absconding, but for whom no RPs are authorised or in use?

If a practitioner searches the Behaviour Support Rules 2018 for a timeline, they will not find one. This is because the legislative urgency for this scenario is not located within the Behaviour Support Rules. The timelines in Part 3 (Interim) and Part 4 (Comprehensive) are structurally linked to the lodgement and oversight of plans containing restrictive practices.

To assume no urgency is required is a critical error. The urgency is simply driven by different, and often more immediate, legal requirements.

Section 3: The True Provisions for High-Risk, Non-RP Cases

In the absence of the 30-day RP clock, a practitioner and provider must turn to three other core pillars of the NDIS framework.

1. The NDIS Practice Standards (Proactive Risk Management)

This is the provider's primary proactive obligation. Under the NDIS Practice Standards and Quality Indicators, Core Module, Section 4: Risk Management, providers must demonstrate:

"Each participant’s support plan includes a risk assessment that identifies risks to the participant... Risks are managed through a risk management system... The provider’s risk management system supports the provider to identify, analyse, prioritise and treat risks..."

A referral for a participant with a "history of high risk" (even if currently stable) is a clearly identified risk. The provider's own NDIS-audited system legally obligates them to "treat" this risk. In this context, "treatment" is the commissioning of a specialist behaviour support assessment (an FBA) to proactively mitigate that risk.

2. The NDIS (Incident Management and Reportable Incidents) Rules 2018 (Reactive Response)

This is the provider's primary reactive obligation. If the participant's high-risk behaviour results in a "Reportable Incident" (RI)—such as those defined in Section 5 (e.g., "the serious injury of a person with disability")—an immediate legal timeline is triggered.

Source (Section 6(1) & 6(2)): The provider must notify the NDIS Commission of the RI within 24 hours of becoming aware of the incident.

Following this notification, the Commission will require the provider to detail the "remedial action" taken. This action would, by necessity, include an urgent clinical response, such as commissioning an immediate FBA and safety plan. In this scenario, the 24-hour RI rule provides a far more rapid trigger for intervention than the 30-day BSP rule.

3. The NDIS Code of Conduct (Practitioner's Duty of Care)

This is the provision that governs the individual practitioner. All NDIS workers and practitioners are bound by the NDIS Code of Conduct, which is a legislative instrument under the NDIS Act 2013.

Source (Section 1(d)): The Code requires that practitioners must:

"provide supports and services in a safe and competent manner, with care and skill."

A "competent" practitioner, upon receiving a referral detailing high-risk behaviours, has an ethical and professional duty of care. They must use their clinical judgment to triage this case at a high priority. De-prioritising the case simply because it lacks an RP—and therefore a legislative lodgement deadline—would be a failure to act with "care and skill."

Section 4: The Interim Plan Dilemma (Legislative vs. Clinical)

Given these provisions, why does the legislation not offer an "Interim BSP" provision for high-risk, non-RP cases?

The answer lies in the critical distinction between a legislative document and a clinical tool.

• The Legislative "Interim BSP": This is a formal, legal document. Its sole purpose is to be lodged with the NDIS Commission to provide oversight for a human rights-impacting restrictive practice (as defined in Section 12 of the Behaviour Support Rules). Because there are no RPs in our scenario, the Commission does not require a document for lodgement. Therefore, the legislative provision is not "triggered."

• The Clinical "Interim Safety Plan": This is a best-practice tool. It is what any competent practitioner should develop in any high-risk case. It is not called an "Interim BSP" and it is not lodged with the Commission.

This clinical document is mandated by the practitioner's Duty of Care (under the NDIS Code of Conduct). Its purpose is to:

1. Provide immediate risk-mitigation guidance to the support team.

2. Outline clear de-escalation strategies.

3. Establish the specific data collection methods required to complete the full FBA.

This interim safety plan is the provision. It is the first step in the FBA process, not a replacement for it.

Image of a lady on mobile phone at a laptop outside at table in garden

Conclusion: The Functional Behaviour Assessment (FBA) is Always First

The logical and legal progression for any behaviour support case is clear, though it requires looking at the entire NDIS framework, not just one set of rules.

1. The FBA is the Priority: A BSP—whether interim or comprehensive—can never be written without an FBA. The assessment always comes first. This is explicitly stated for Interim BSPs in Section 12(3)(a) of the Behaviour Support Rules.

2. The Trigger Defines the Timeline:

• If RPs are present: The 30-day lodgement clock for an Interim BSP starts (Behaviour Support Rules, S12). The first job is a preliminary FBA.

• If RPs are absent (but risk is high): The provider's Risk Management standards (Practice Standards, Core Module, S4) and the practitioner's Duty of Care (Code of Conduct, S1(d)) create the urgency. The first job is to create an interim safety plan based on a preliminary FBA.

• If an incident occurs: The 24-hour RI rule forces an immediate organisational response (Incident Management Rules, S6).

Disclaimer

The content provided in this article is for general informational purposes only and does not constitute legal, clinical, or specialist behaviour support advice. It should not be relied upon as such.

All information is provided in good faith, however, we make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, or completeness of any information. The NDIS legislative framework, including the NDIS Act 2013 and associated Rules and Practice Standards, is complex and subject to change.

This article is not a substitute for professional advice from a qualified NDIS Behaviour Support Practitioner. You should always consult with an appropriate professional to address your specific circumstances. Under no circumstance shall Ability Therapy Specialists Pty Ltd have any liability to you for any loss or damage incurred as a result of the use of this information. Reliance on any information provided in this post is solely at your own risk. This article, website, and your participation are governed under the Client Booklet - Privacy Policy: Disclaimer, Terms, Conditions as a necessary provision under Australian service quality standards.

Thank You from Dr Jo - And Safe Holidays Ahead

We wanted to take this moment as we head to end of November - can you believe it? To say Thank You to all the people who supported our service this year with referrals and to clients who rely on our roles in their lives - a huge thank you.

Positive Behaviour Support 101

Seeing Strengths in Support

When we think about behaviour support, it often sticks to psychology as just a discipline. But there’s a better way to look at it.

A Person-Centred Approach

Person Centred Psychotherapy focuses on the whole person. It uses a strength-based approach. This means the language is friendlier, easier to understand, and more caring.

Enjoy each moment.

What Does Support Really Mean?

Support is about helping someone. It means enabling them and walking alongside them on their journey. Support is also about listening carefully. When we listen well, we open up new possibilities.

Working Together to Find Strengths

We create plans with the people we support. Even those with profound disabilities have strengths and abilities. Instead of looking at what’s missing, we look at what’s there. People often see the glass as half-empty. But therapy helps us see it as half-full.

Celebrating What You Can Do

Focusing on your skills feels good! You can celebrate what you already have. Then we ask, how can we build on that? Positive behaviour support moves from just managing problems to encouraging growth and change.

Being Different is Okay

What seems radical or different for one person might be normal for another. Only the person and their supporters truly know what works best. Skilled therapists can help challenge and support everyone.

Every person is different, same with flowers.

Transforming Disability into Strength

Don’t underestimate ability.

Turn what some see as a disability into strength and capacity.

‘Invig-ability’ means giving energy and life to someone who might feel stuck. It’s about moving forward with new energy.

That’s the path to real change.

Dr Jo is a Counselling Psychotherapist and registered provider with the National Disability Insurance Scheme.

Behaviour Support, for real.

A Family Affair

One couple set their marriage at stake on the answer. One wanted to use a passive nurturing method. The other wanted to use firm discipline. And don't assume one is male and the other female. You would be wrong if you did. 

Needless to say. The marriage ended at a stale mate. You know why?

Because nothing can last on extremes. If you want a marriage to work you need compromise. If you want behaviour support to work you need balance.

Balance of Factors

Not between extremes. To find balance you need reason and feeling in sync. Kids are not an abstract formula. Kids are real people with complex needs.

Too much of one. Things do not work. Too much of the other. Things do not work. 

More Like a Circle

But not so much this and that - behaviour support is more about plus this and then more. You look for the whole view - the ways things flow in real life.

We call this ecology, some say ‘holistic.’

We think this perspective comes from observing life and relationships. And not a tad of wisdom. Buckets might help.

Nurturing the Flow

• Structure and nurturing. Yes.

• Boundaries and a bit of limited choices. Yes.

• Freedom appropriate for the child's development. Yes.

• But freedom is the partner of responsibility. Without one the other will fail.

So, it goes. The mix is unique for each child. Each person. Yet don't we want to get it right? Yes. Indeed.

Behavioural support in real life is about balance and flow. It is keeping relationships healthy, and finding ways to support our needs and the needs of others.

We look at the behavioural life of two-legged (humans) as highly flexible and yet given to patterns, routines, and cumulative processes. One things leads to the next, and the narrative is not always easy to understand.

About ATS

ATS is a registered behavioural specialist service under NDIS, with practitioners PhDs Jo Bowers and Dwayne Kennedy. We are members of the Australian Counselling Association, and the Australasian Society for Lifestyle Medicine. We work via telehealth with NDIS participants in behaviour support, counselling, and therapy assessment funded areas.

Life is a balance, sometimes even a dance.

How to Learn from Experience

Here are a few simple steps to learning from experience - any experience at all.

Reflect on these questions while day dreaming, writing, drawing, painting, or creating something, even cooking.

1. What happened? Describe it.

2. How did you feel? What was your inner reaction?

3. What thoughts went through your mind during, and not long after?

4. How do you feel now about the experience?

5. What questions or unresolved issues remain, if any?

Some clients use this format for writing an email to a therapist. It gives them a more clear focus.

They end up learning heaps from the exercise, and then they get helpful feedback from their counsellor.

Learning is fun. Who says?

People who live with disability often learn through these steps.

1. Have an experience.

2. Repeat it.

3. Briefly talk about it, see if you like it.

4. Try it again. Repeat.

5. If it feels good, keep doing it.

The trick is not to think too much. Disability often involves making things simple, or things are kind of simple already.

When you think too much, it can complicate things. Just do it. Try it. Repeat.

Once behaviour becomes a habit - it sticks. You do not need to think too much.

Habits form fast when they are fun. It is when we are trying too hard to change that change gets hard.

But even shifting into a new habit to replace something not safe or helpful can be easier.

The key is to find the smallest way to change that is fun, feels better, and has a bit of motivation.

Motivation is everything.

Behaviour Support and Human Rights

Behaviour Support does not exist in a vacuum.

All behaviour support happens in familial, social, community, legal, legislative national, and international policy contexts.

Simple but potent sign on a street post says it all - every human has rights.

Key Human Rights

Here are a few of the basic human rights involved in behaviour support practice.

These touch on relationships in families, communities, and nations. These come directly out of international, national, and state based policy and practice standards.

Every person has the right to:

• Dignity and respect

• Live in and be part of a community

• Realise their individual potential and capacity for physical, social, emotional,  intellectual, psychological, and spiritual development

• Access services on an equal footing to others in society that support a reasonable quality of life

• Choose their own lifestyle and to have access to information

• Participate in decisions that affect their lives and future

• Receive services in a way that results in least restriction of personal rights and opportunities and human freedoms

• Address any grievance or complaint without fear or recrimination from service providers including fear of the discontinuation of services

• Protection from neglect, abuse, exploitation, and harrassment

Citation: Behaviour Support: Policy and Practice Manual Part 1, NSW Department of Ageing, Disability and Home Care, 2009

Dr Dwayne and Dr Jo are PhDs and senior counselling psychotherapists and behaviour specialists, registered with NDIS so funding is available for NDIS participants. We work across Australia via telehealth - online using zoom, facetime or your favourite app. Get in touch via the form on home page.

Beautiful display of colour showing respect.

Beyond Talk Therapy - Getting Positive Outcomes

I Have Tried Psychology and Counselling for Years. I Have Talked Through My Problems Endlessly, and Nothing Has Changed.

Many people feel stuck after years of talking therapies. They may say, "I have tried psychology and counselling for years. I have talked through my problems endlessly, and nothing has changed." If this sounds familiar, you are not alone. While talking is important, practical change is what makes a difference.

Personal time is key. Relaxing with yourself.

Moving Beyond Talking

Talking about problems is helpful to some extent. It helps you understand your feelings and challenges. However, without action, nothing shifts. Our approach at Ability Therapy Specialists is different. We focus on practical behavioural change. We help you learn new skills that work in real life.

Practical Behavioural Change

We do not just explore your feelings. We work with you to find solutions you can try immediately. This could be changing a routine, building skills to manage stress, or learning new ways to communicate. We focus on what will work best for your everyday life.

Solutions That Fit Your Life

Every person is unique. What works for one may not work for another. That is why we tailor our plans to suit you. We involve you in making the plan. This way, you feel confident to use the strategies. Our goal is to make changes simple and achievable.

Having Fun While Changing

Change can be hard. It can feel overwhelming and tiring. We believe change should also be enjoyable. Our therapists bring creativity and fun into the process. Using games, activities, and positive reinforcement, we help you stay motivated. Learning new skills becomes a positive experience, not a struggle.

People love talking about their life - and good therapists actually listen!

Leaning Into Positive Change

Small steps can lead to big changes. We encourage you to lean into positive change at your own pace. Our support helps you celebrate every success, no matter how small. With consistent practice, new habits form, and life starts to feel better.

In Summary

If you have tried talking therapies without seeing change, consider a fresh approach. Ability Therapy Specialists offer practical, solution-focused therapy. We help you create real changes in your life. Together, we make therapy useful, fun, and effective. This approach empowers you to move forward, build skills, and enjoy a better quality of life.

Send us a line via form on home page.

Understanding Relationship Behaviour Support

Relationship behaviour support is an important part of helping people with disabilities and mental health needs build positive connections with others. At Ability Therapy Specialists, we focus on providing practical strategies that improve interactions and reduce challenges in relationships.

What is Relationship Behaviour Support?

Relationship behaviour support involves understanding behaviours that affect how people relate to family, friends, carers, and others around them. It looks at reasons behind behaviours and works to promote respectful and positive communication.

All relationships need support - behaviour therapy is a practical way to help

Why is it Important?

Good relationships contribute to a person’s overall wellbeing. Difficult behaviours can lead to misunderstandings, frustration, and isolation. Support helps people express their needs clearly and develop skills to interact comfortably with others.

Who Can Benefit?

People with disabilities, mental health needs, parents, families, and support staff all benefit from relationship behaviour support. It helps everyone involved understand each other better and work together to solve challenges.

How Does It Work?

Our approach begins with listening to the person’s story. We then assess behaviours in everyday life to identify what causes stress or conflict. Using functional assessments, we create personalised behaviour support plans tailored to each individual’s needs.

Practical Solutions for Everyday Life

Support includes teaching practical skills such as:

• Managing emotions

• Communicating needs effectively

• Building social skills

• Responding calmly in difficult situations

We also provide guidance for families and carers on how to create supportive environments that encourage positive behaviours.

Using Telehealth and Online Services

Ability Therapy Specialists offer telehealth and online consultations to reach people nationwide. This means support is accessible regardless of location, enabling consistent help for clients and their support networks.

We meet you where you are at - on your device. One day soon, in your eye glasses too.

The Role of Behaviour Support Plans

A behaviour support plan is a detailed guide that outlines strategies to encourage positive behaviour and reduce challenging behaviour. Plans are regularly reviewed and updated with input from the person and their team.

Working Together for Success

Relationship behaviour support is most effective when everyone involved collaborates. This includes the person receiving support, family members, carers, and professionals. Together, we create a respectful and understanding environment that nurtures positive connections.

Contact Ability Therapy Specialists

If you or someone you care about needs help with relationship behaviours, Ability Therapy Specialists offer expert guidance and practical solutions. Our professional team supports you to improve everyday interactions and build stronger relationships across Australia.

See our contact form on the home page and get in touch. We are NDIS Registered for funding using your NDIS Plan.

Understanding Behaviour Support

Behaviour support is a way to help people whose actions or behaviours are causing problems in their lives.

Sometimes, behaviours become too intense, happen too often, or last for a long time.

When this happens, it can affect a person’s quality of life and even their physical safety.

Behaviour support focuses on understanding these behaviours and finding ways to improve the situation.

Our clients meet us online - sharing intense and real life events. This is life-changing work.

When Is Behaviour Support Needed?

People may need behaviour support if their behaviours:

• Happen very often (high frequency)

• Last for a long time (long duration)

• Are very strong or intense (high intensity)

These behaviours might cause harm to themselves or others. They can also make it hard for the person to take part in everyday activities, enjoy life, or be safe.

How Behaviour Support Helps

Behaviour support uses different strategies to help the person and those around them. The goal is to reduce the intensity, frequency, or duration of difficult behaviours. This can make life safer and better for the individual.

Support often begins by understanding why the behaviour happens. People don’t act in difficult ways without a reason. Behaviour support specialists look at what might be causing the behaviour, such as:

• Health issues

• Communication difficulties

• Environment or setting

• Emotional needs

What Behaviour Support Includes

Behaviour support can include:

• Functional assessments to understand behaviour triggers and needs

• Creating behaviour support plans that are safe and practical

• Teaching new skills or ways to communicate

• Training families, staff, and others who support the person

• Regular reviews to see how well the plan is working

Practical therapy is more than good intentions - it is making real life changes that matter.

Benefits of Behaviour Support

Effective behaviour support can:

• Improve safety for the person and others

• Enhance the person’s independence and participation in daily life

• Reduce stress and anxiety for the person and their support network

• Offer practical solutions to everyday concerns

Conclusion

Behaviour support is about helping people whose behaviours affect their safety and quality of life.

By understanding the reasons behind these behaviours and working with the person, families, and support staff, behaviour support can create positive changes that make life better and safer.

At Ability Therapy Specialists, we are committed to providing professional, respectful, and practical behaviour support to help individuals reach their full potential.

Get in touch with Dr Dwayne and Dr Jo via the form on home page, or give us a ring and leave a message.

What is Functional Assessment of Behaviour - Why Do I need it?

Most Practical and Useful of All

Base your effort on a functional assessment - and your intervention is twice as likely to be useful.

Said another way, get a functional assessment of behaviour and your path to change can be easier. Not always true in every case of course, but the general wisdom holds. The more we get what is happening - the easier it is to make changes.

Struggling with a behavioural problem is no fun, and can be dangerous to health and safety. The path to change and learning can sometimes be hard. Therapy is here to make this process a bit more manageable.

Solid Assessments are Key

By useful we mean that behaviour support based on solid assessment and intervention planning seeks to

1. increase safety wherever possible,

2. provide insight and hope,

3. create options and choices, and

4. reduce behaviours of concern and/or change environments and supports that then contribute to changes in behaviours.

In many cases these positive outcomes are documented by the behavioural therapist. This is accepting the fact that every situation is unique and that there are no guarantees.

Vital Assistance - Key Insights

Research and professional practice - over many years - shows that counselling and behaviour support assessments and interventions provide significant assistance to clients, families, and staff.

Smith et al (2016) looked at the relationship between biological setting events and problem behaviours.

Then they worked through a "functional analysis of each participant’s problem behaviour in relation to two context factors: fatigue and task demands."

By implementing a multi-component intervention to address both the biological setting factor and the behaviours of concern they reported a dramatic reduction in problem behaviour. The implications show that understanding and assisting with setting events contributes to addressing behaviours of concern.

No doubt life is complex at times - we simplify things so the path is a bit easier.

What You Know, What You Need to Know

In behaviour support, what you know is often not enough. People in everyday life miss the boat. That is natural. We are not trained to see what is underlying in behavioural patterns.

Specialists are trained and with experience to pick up on the patterns, to investigate the data, to uncover the motivations. These insights help sort what is happening. More important - how to make changes more easily.

Source: Christopher E. Smith, Edward G. Carr, Lauren J. Moskowitz, 2016, Fatigue as a biological setting event for severe problem behavior in autism spectrum disorder, Research in Autism Spectrum Disorders, Volume 23, March 2016, Pages 131–144.

Dr Jo and Dr Dwayne are senior counsellor psychotherapists and behaviour specialists - focused on real life therapy with people in everyday life via your smart phone or devices. They work on zoom, facetime or your fav apps. They reach out across Australia and are paid via your NDIS Funding Package Plan. Their private books are closed at the moment but let them know if you are interested in therapy - maybe they can find room to assist. Contact via the form on home page.

Great thing about assessment is - the therapist does the hard work.

Behaviour Support and Counselling Telehealth in Perth and Western Australia

Living in Perth or anywhere in Western Australia offers many benefits, but access to specialised therapy and behaviour support services can sometimes be challenging due to the vast distances involved.

At Ability Therapy Specialists, we bridge that gap through our professional telehealth services.

Tailored Hours for Western Australia Clients

Our telehealth sessions are structured with your convenience in mind. For clients based in Perth and throughout Western Australia, we typically schedule appointments during business hours from 8 am to 2 pm local Perth time. This timing ensures that you can easily fit therapy sessions into your day without disrupting essential routines, school, or work commitments.

If you happen to coordinate with others in the eastern states, please note that our workday hours adjust to 10 am to 4 pm Sydney time. This flexibility means our support can function seamlessly across time zones without compromising quality care.

We are delighted to work with NDIS participants in Perth and across WA - providing specialist behaviour support and counselling

Access Senior PhD Specialist Assistance Nationwide

Unlike many local-only providers, Ability Therapy Specialists offers the exceptional advantage of accessing senior clinicians with PhD-level expertise and decades of hard won experience. No matter where you are in Australia - you can enjoy this advantage.

With telehealth, distance is no barrier to receiving high-quality, evidence-based assessments and therapy.

Our team specialises in service delivery to people with disabilities and mental health needs, as well as their families and support networks.

Whether you are in a remote region of Western Australia or in metropolitan Perth, you gain access to practical, tailored solutions informed by years of clinical research and direct experience.

Why Choose Our Telehealth Services in WA?

• National Reach: No matter how remote your location in WA, our services come to you in your home.

• Convenient Scheduling: Dedicated appointment windows aligned with WA business hours.

• Expert Support: Receive guidance from highly qualified clinicians, including those holding PhDs.

• Comprehensive Services: Therapy, behaviour support plans, functional assessments, and ongoing consultations.

From Perth to Broome, we honour the spirit of Australia and are delighted to connect in service as senior specialist counsellor psychotherapists

Serving the Vast, Beautiful State of Western Australia

Western Australia’s vastness and natural beauty are unique, but accessing specialist therapy doesn’t have to be difficult.

We encourage families, support staff, and individuals across this great state to embrace telehealth as a reliable, effective way to achieve meaningful outcomes.

If you seek expert assistance from senior specialists who understand your specific needs and circumstances, contact Ability Therapy Specialists.

Our telehealth service is your pathway to professional support that transcends distance and time zones.

Ability Therapy Specialists is an NDIS-registered provider committed to offering equitable, accessible therapy and behaviour support services for all Australians who make this connection with our tailored boutique service.

Experience the advantages of telehealth — expert care is just a call or click away. Use our Contact form on Home Page, we look forward to hearing from you.

Supporting Families Across Brisbane and Queensland in Behaviour Support and Counselling

At Ability Therapy Specialists, we proudly support families across Brisbane and throughout Queensland, specialising in telehealth online therapy for complex and specialist cases. Being based in northern NSW is no barrier - we work with people across the country.

We recognise the unique challenges that mothers and fathers face when raising children with special needs.

That’s why we provide tailored parenting coaching designed to empower and guide parents every step of the way.

Tailored Parenting Coaching

Parenting a child with special needs can be overwhelming.

Our specialised coaching focuses on equipping mothers with practical strategies and emotional support.

We explore personalised approaches that work best for each family, helping to build confidence and resilience in daily parenting.

We love helping NDIS participants and their parents in Brisbane and across Queensland with counselling and specialist behavioural therapy - get in touch today

Compassionate Counselling and Behaviour Support

Our experienced team offers compassionate counselling and behaviour support to individuals with autism and other disabilities.

We develop customised behaviour support plans that address specific challenges, aiming to improve daily functioning and enhance quality of life.

Our focus is on solutions that are effective and easy to implement within everyday routines.

Accessible Telehealth and Online Services

Understanding that families may be spread across different locations, we provide accessible telehealth and online services.

This ensures that expert support from our team is available wherever you live in Queensland.

Our remote therapy sessions and consultations offer convenience without compromising the quality of care.

Practical and Personalised Solutions

At Ability Therapy Specialists, we believe every family deserves personalised therapy and comprehensive behaviour support.

Our approach is holistic and practical, designed to meet your family’s individual needs.

Whether it’s through one-on-one coaching, assessment, or ongoing therapy, we work collaboratively with you to achieve the best possible outcomes.

Every family needs a community of support to raise their children

Ability Therapy Specialists

Choosing the right support team is crucial for your child’s development and your family’s wellbeing.

Ability Therapy Specialists is known for expert guidance, compassionate care, and tailored interventions.

Together, we can help navigate the complexities of disability and mental health needs with solutions that truly make a difference.

Find our contact form on the home page or give us a ring.

Servicing Melbourne and Victoria for Behaviour Support and Counselling

Specialist Behaviour Support at the Ready

At Ability Therapy Specialists, we proudly support NDIS participants across Melbourne and Victoria with tailored telehealth and online services designed to meet your unique needs.

Whether you or your family require therapy, behaviour support plans, or functional assessments, our experienced team delivers practical, evidence-based solutions directly to you, no matter where you are.

ATS works with clients in Melbourne and Victoria to assist with personalised therapy

Diverse Challenges - Personalised Support

We understand the diverse challenges faced by people with disability and mental health conditions, and we work closely with participants, families, support workers, and staff to provide personalised care that promotes independence and wellbeing.

Our NDIS registered services include:

• Telehealth counselling and therapy sessions

• Comprehensive behaviour support planning

• Functional assessments and goal-oriented strategies

• Support for families and carers to navigate daily challenges

Serving Victoria and Melbourne community members, we are committed to accessible, efficient, and compassionate support that fits your lifestyle.

Connect with Ability Therapy Specialists to ensure your NDIS plan is maximising your potential with expert guidance every step of the way.

Supporting Greater Sydney NDIS Participants

Access Expert NDIS Telehealth Behaviour Support and Counselling Services

NDIS participants in Greater Sydney can now access specialised therapy, behaviour support, and counselling services without the lengthy wait times commonly experienced in metropolitan areas.

Based in Northern NSW, Ability Therapy Specialists offers convenient telehealth and online appointments, delivering high-quality support directly to your home or preferred location.

We are delighted to assist NDIS participants in greater Sydney NSW

Key Benefits for Sydney-Based Participants:

• Bypass Long Waiting Lists: Skip delays often faced with in-person services in Sydney by accessing immediate telehealth appointments.

• Flexible Scheduling: Choose times that fit your lifestyle, reducing travel time and disruption.

• Comprehensive Support: Receive therapy, behaviour support plans, and functional assessments tailored to individual needs.

• NDIS Registered: Fully compliant services that meet the requirements of your NDIS plan.

• National Access: Benefit from expert care delivered seamlessly across state lines from Northern NSW to Sydney.

Experience timely, professional, and personalised support without the wait.

Connect with Ability Therapy Specialists to maximise your NDIS plan and improve outcomes through convenient telehealth services.

Choosing an NDIS Behaviour Support Provider: A Guide for Participants & Families

Choosing the right NDIS behaviour support provider is important for achieving meaningful outcomes. Services can differ in delivery, expertise, and approach. The industry culture is informed by quality reviews and standards.

This guide outlines key quality factors to consider when comparing providers. For the sake of learning we provide an easy comparison between two providers.

Provider 1 example demonstrates strengths. Provider 2 shows what is often available and could be improved.

Service Delivery

Personalisation

• Provider 1: Tailored truly person-centred support plans developed by PhD-level clinicians with decades of real-life experience.

• Provider 2: Standardised plans with less individualisation.

Service Scale

• Provider 1: Limited caseloads with focus on relationship building with world-class quality to ensure focused attention.

• Provider 2: Larger caseloads may reduce individual focus.

Delivery Mode

• Provider 1: Primarily telehealth, no travel for clients, in-home access on your device, offering flexibility nationwide.

• Provider 2: Combination of in-person and telehealth; may be location-limited.

Personalised therapy where you need it - in your home and daily life.

Expertise and Qualifications

Clinical Expertise

• Provider 1: PhD-level clinicians with extensive experience with relevant specialisations.

• Provider 2: Varies; may include psychologists, OTs, or social workers.

Specialisations

• Provider 1: Person-centred experts with diverse specialisations and focus on complex cases and dual diagnoses.

• Provider 2: Generalist approach across conditions.

Industry Recognition

• Provider 1: Highly regarded for expert reports, clinical assessments, behaviour support plans, funding and plan reviews.

• Provider 2: Recognition varies; may not specialise in complex cases.

Therapeutic Approaches

Therapy Modalities

• Provider 1: Integral-cognitive-holistic, solution-focused outcomes, with creative methods (art, clay, gaming, symbols).

• Provider 2: Primarily traditional talk therapy.

Innovative Techniques

• Provider 1: Uses innovative methods to enhance engagement, learning, and personalised outcomes.

• Provider 2: Standardised interventions.

Engagement Strategies

• Provider 1: Focus on enjoyment, learning, empowerment, motivation, and positive life-changing outcomes.

• Provider 2: Typically behaviour modification focused.

Personalised access to counselling and behavioural therapy now is critically important.

Accessibility and Support

Service Availability

• Provider 1: Flexible scheduling often employed to meet client needs, with texting, video, and email access.

• Provider 2: Fixed hours; flexibility may be limited.

Family Involvement

• Provider 1: Active therapy-process engagement and guidance for parents, siblings, and families.

• Provider 2: Family involvement varies; may be optional.

Geographic Reach

• Provider 1: Services available nationwide via telehealth - while our Sydney timezone focus this a bit - this is adaptable.

• Provider 2: Limited to specific regions.

Wherever you are - we are there with you. Therapy is not just person-centred, it meets real needs and nurtures change.

Conclusion

When you compare all the above quality indicators, you would probably choose Provider 1. Maybe Provider 2 sounds familiar in some or many ways. The point is to evaluate what you need and to seek a provider if you can who demonstrates more strengths.

Selecting an NDIS behaviour support provider or a counsellor for that matter involves considering service delivery, expertise, therapy approaches, and accessibility. There are many quality indicators that typify the industry - not just from the counselling and behaviour therapy sides.

These quality frameworks include the NDIS Commission Quality Standards Framework. Ask your provider how they square with the NDIS Quality Framework review and how they did on their last NDIS external audit.

Call to Action

To explore how ATS can support your family, please contact us or learn more about our services.

Seasoned Reflections on What is Therapy

What is Therapy? Can you tell me?

Here are some answers from clients and others who use therapy.

• Seeking change, opening to new horizons.

• Therapy is a learning experience.

• Therapy is also an adventure, even during times of grief and loss...

• Understanding the two sides of the one coin of human experience often brings challenges mixed with opportunities.

• Therapy of the mind, heart, and soul may lead to spiritual healing, insight, and growth.

• Therapy can be painful - when you face your heart.

• Uplifting.

• It is OK when my therapist walks with me.

How do you spell therapy?

Therapy is...

• Using the mind and heart for a change, with the strategic help of another soul.

• How you enable change.

• Opening up to healing, then development. One step at a time.

• That leads to transformation - but not all at once.

• Is stepwise small routine changes, in daily life, with a therapist-helper.

When you need a hand, therapy is there.

• Addressing issues and patterns, moving forward, and gaining vital self-knowledge.

• Growing into your identity, as you work together with Life to create your sense of purpose.

• Moving on while appreciating your story, respecting where you are from, and supporting who you are.

• Enlisting the help of another person with vital skills, capacities, and knowledge.

Therapy is soul-awakening. Heart-changing. Life-nurturing.

Sometimes therapy is radical, incredible, and yes, even awesome and inspiring.

When we expect therapy to create change - therapy tends to surprise us with even more.

Supporting Parents of Children with Disabilities: Building Strength, Reducing Isolation

Understanding the National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme (NDIS) is a government initiative that supports Australians with disability. It provides funding for services and support tailored to individual needs. This allows people to live more independently and participate fully in their community.

Who Can Benefit from NDIS?

NDIS supports people with permanent and significant disability. This includes individuals with physical, intellectual, sensory, and psychosocial disabilities. The scheme also assists families, carers, and support workers to improve care and outcomes.

Our Role at Ability Therapy Specialists

At Ability Therapy Specialists, we are an NDIS registered service. We offer telehealth, online, and in-person therapy nationwide. Our focus is on helping people with disabilities and mental health needs.

Really connecting with a therapist is dynamic and can be life changing

What Services Do We Provide?

We deliver a range of services, including counselling therapy and behaviour support plans. Functional assessments are also available to understand individual capabilities better. We offer practical solutions tailored to everyday challenges faced by our clients.

Tailored Support for Every Individual

Each person’s needs are unique. That’s why we create customised plans. These plans help maximise independence and quality of life. Our team works closely with clients, their families, and support networks.

The Importance of Accessible Therapy

Many people find it hard to access therapy due to location or mobility. Our telehealth and online services overcome these barriers. This ensures more Australians can receive the help they need in their own homes.

Partnering with Families and Support People

Disability support is a team effort. We engage parents, families, and support workers in every step. This collaborative approach strengthens care and ensures consistency.

Parents need support and friendship with people they can trust - who understand their needs

Getting Started with Ability Therapy Specialists

If you or someone you know needs support, contact Ability Therapy Specialists.

Our professional team is ready to help you navigate the NDIS and provide quality care. Together, we can make everyday life easier and more fulfilling.

Having a Child with a Disability

Having a child with a disability can bring many challenges for families. Parents often work very hard to care for their child’s needs while managing everyday life. It is important to support these parents so they feel strong and not alone.

One big challenge parents face is feeling isolated. Sometimes they don’t meet many people who understand what they are going through. This can make them feel lonely and stressed.

Building Connections - Forming Relationships

By building connections with other families, parents can find friends who share similar experiences. Support groups and community programs can help families meet each other and share advice.

Another way to support parents is by providing information and practical help.

Practical Help, Information, and Insights

Many parents need guidance about therapies, services, and ways to help their child learn and grow. Trained professionals, like therapists and support workers, can offer useful ideas and plans tailored to each child’s needs. This can reduce worry and make daily life easier for the family.

It is also important for parents to take care of their own health. When parents look after themselves, they have more energy and patience for their children. Friends, family, and community services can help by offering breaks or learning new skills.

Caring is full time work and is part of the parental role - how important to have support

Friendships and Self-Care for Parents

In summary, supporting parents of children with disabilities means building strong friendships, providing useful information, and helping them look after themselves.

This support reduces feelings of isolation and gives parents the strength they need.

When parents are supported, children with disabilities can have a better chance to live happy and full lives.

For more information visit our Frequently Asked Questions, or contact us via the form at the Home Page.

Creative Counselling Approaches: From Art and Symbols to Gaming and Clay

Creative counselling approaches

There are so many alternative ways to spice up therapy - people are surprised that therapy can be fun and enjoyable. In fact, we say that learning and healing is best when enjoyable. Research shows that humans learn more when relaxed and when they can integrate new experience more easily.

Counselling is not meant to be a really serious talk-fest. In fact, our approach is not so much about talking. We are more action oriented.

When you want to learn something, you do not talk about it. You practice. You take action.

Counselling with creativity offers innovative pathways for individuals to explore their emotions, thoughts, and behaviours beyond traditional talk therapy.

Potential to change heal and grow - in your hands

At Ability Therapy Specialists, we recognise the transformative potential of using art, symbols, gaming, and clay as simple action-oriented expressive tools in therapeutic settings. We are Counselling Psychotherapists - so our focus is not on creative arts therapy. We are rather focused on healing, learning, and creating opportunities for change and growth.

Our work is focused on solutions - practical ways to move forward in life and with relationships.

This is even more particular and important for people with complex disabilities and mental health needs. How vital to be practical. To understand your needs. And help you to feel heard, to have someone really understand for a change.

The power of tech is everywhere today - even in therapy

How creative therapies work in counselling psychotherapy

Counselling therapy that uses a bit of art through drawing, painting, gaming, clay work and other visual mediums actively helps people to communicate feelings that may be difficult to verbalise.

Through symbols, colours, shapes, and forms, individuals can express what they are feeling. The inner experiences get to be expressed often for the first time. Then flows insight and emotional release.

Symbols really do play a crucial role in this process. Symbols serve as personal language. They embody personal stories, narratives, values, or conflicts.

Tech in counselling moves forward in so many ways these days

Gaming is an expression of the technology of online culture. The youth are well into this in spades.

Us older folks have a harder time understanding. But gaming is not just about playing the game - it is also about sharing, communicating, having challenges, facing obstacles, finding pathways through the maze, and turning defeat into lessons.

NDIS does not fund gaming therapy. And we do not offer gaming therapy in a formal sense. All of our creative therapies are used inside of our primary funded goals and approaches - used sparingly to assist inside of the NDIS goals contracted under our service agreement.

Our NDIS funded work is focused in behaviour support and counselling, and relevant therapeutic assessment associated with our scope of practice.

Actively using the tech in therapy is really creative itself - and can be fun and engaging

Clay work in counselling

Clay work or sculpting offers tactile, sensory engagement, grounding clients in the present moment.

By modelling clay, individuals tap into the inner heart. Hidden information surfaces. Another form of knowing happens.

This subconscious material expresses feelings in powerful ways. These experiences happen through three-dimensional forms - as symbols of shifting and growing.

The hands-on nature of clay work encourages mindfulness and can be particularly beneficial for individuals with sensory processing differences.

Self discovery and skill building insights

Incorporating these creative modalities into counselling aligns with our commitment at Ability Therapy Specialists to provide practical, person-centred interventions.

Such approaches honour diverse communication styles. We love making therapy more accessible and meaningful.

Ultimately, creative counselling enriches the therapeutic journey by opening new avenues for healing, growth, and understanding in the lives of people with disabilities and their support networks.

Creative therapies are fun, engaging, and teach many skills