ADHD kids the ‘poor cousins’ of those with autism when it comes to NDIS help
Parents of children with ADHD who have needs similar to children diagnosed with autism can feel rightly aggrieved about how the NDIS has operated to date.
Thousands of families who have struggled for years to access help for a child whose ADHD is seriously impacting their life – while watching other kids with an autism diagnosis receive significant support through the NDIS – will feel rightly devastated by the findings of this groundbreaking study published in Nature Human Behaviour.
The nub of the report’s conclusion is, in the words of its co-author Adam Guastella, that there is “considerable overlap” between the executive function problems in neurodevelopmental conditions, including attention deficit hyperactivity disorder and autism. Indeed, many of the children may have similar support needs, he says.
Yet the support pathways for these neurodevelopmental conditions have sharply diverged, with the National Disability Insurance Scheme offering entry on the basis of an autism diagnosis, but not for ADHD, regardless of the level of a child’s functional impairment.
Until recently, the practice of the NDIS had become if you received a Level 2 or 3 autism diagnosis you were in, and eligible for a suite of taxpayer-funded supports. And evidence emerged that against that backdrop, very few children were actually being assessed by diagnosticians at the lower level of autism, Level 1.
The amount of funding is significant, averaging $36,000 a year in payments for a person with a primary diagnosis of autism. As at June 2024, 75 per cent of the 238,934 NDIS participants with autism were 18 or under. In all, more than $8.2bn was spent on autism support in the NDIS last financial year.
This diagnostic approach to NDIS eligibility left those children with ADHD the poor cousins of those with autism when it came to receiving support. There would inevitably be many cases where the ADHD would have more impact on one child’s life than autism did in another’s.
It’s certainly true that many children with ADHD have found their way onto the NDIS through having another condition diagnosed (as many with ADHD have multiple conditions), but there would be many, many others with serious impairment whose families have had to scrabble for scant public support outside the scheme, or pay exorbitant costs in the private sector for supports.
This inequity has been recognised with the recent NDIS reforms to ensure “functional impairment” is the criteria for eligibility rather than diagnosis. It follows a recommendation from the NDIS review.
And in seeking to ensure the future NDIS is covering only those with the most profound disability, there is the expectation far fewer children with autism will be deemed eligible for the scheme in the future
Instead, their support needs will be covered by a range of “foundational supports” to be delivered outside the scheme, in settings such as schools and childcare. Once these are established, and there is still much state-federal argy-bargy ahead on this, it is anticipated those children currently on the NDIS through a diagnosis of autism will be transitioned out.
It is to be hoped that this study will be part of the consideration of the federal and state governments in coming months as they negotiate these foundational supports. Any future system of supports should be agnostic about the neurodevelopmental condition.
