(a) The internal review decision dated 7 August 2024 confirming the SOPS approved on 8 April 2024. This SOPS ceased to be in effect on 29 August 2024 pursuant to s 37 of the NDIS Act; > > (b) The SOPS approved on 30 August 2024. This SOPS ceased to be in effect on 5 August 2025 pursuant to s 37 of the NDIS Act > > (c) The SOPS approved on 6 August 2025 (which is currently in effect and forms part of the Applicant's current plan)

7. In this application the Tribunal has jurisdiction to make the correct and preferable decision regarding funding for reasonable and necessary supports in each of the three SOPS referred to above.[8]

1. The Tribunal's role in this review is to reach its own conclusion as to whether the reviewable decision that the requested supports are not reasonable and necessary supports is the correct and preferable decision.[9] This involves a re-assessment of the evidence that was before the delegate of the Respondent when the reviewable decision was made as well as an assessment of the additional documentary evidence and witness evidence that was before the Tribunal at the time of the hearing.[10] Section 34(1) of the NDIS Act provides that for the purposes of specifying the reasonable and necessary supports that will be funded in a SOPS, the Respondent must be "satisfied" of each of the matters set out in that section in relation to the funding of each such support. In this review, the Tribunal must also be so satisfied. This is a state of positive satisfaction or relative certainty which must be attained in relation to each criterion specifically.[11] Therefore, while neither the Applicant nor the Respondent bear any formal onus of proof, the Applicant does bear the practical onus of placing before the Tribunal, or pointing to material before the Tribunal, that can persuade it that the supports in dispute are reasonable and necessary.[12]

1. The hearing took place on 14,15,16 October and 24 November 2025, by video. The Applicant was represented by Mr Buckley (Autism Advocate). The Respondent was represented by Ms Douglas-Baker (Counsel) who was instructed by Moray & Agnew Lawyers.
2. The Tribunal had the following material before it:

E2: Summary of Current Plan - Budget Breakdown: page 1.

E3: Report dated 12 October 2025 prepared by Ms Karishma Khullar: pages 1-10.

E4: Comprehensive Behaviour Support Plan: pages 1-17.

1. Oral evidence was given at the hearing by the following witnesses for the Applicant:
   • Ms S, the Applicant's mother.
   • Ms Karishma Khullar, Positive Behaviour Support Consultant.
   • Ms Danielle Higgins, Behaviour Consultant.
   • Ms Karen Rodriguez, Speech Pathologist.
2. Oral evidence was given at the hearing by the following witnesses for the Respondent:
   • Dr David Pincus, Consultant Paediatrician.

1. The Applicant's current SOPS dated 6 August 2025 provides funding in the total amount of $46,934.93 for a 6 month period as follows:[13]

Current Approved Support Details-NDIS Plan 06/08/2025 - 05/02/2026 (6-month plan)

• Early Childhood Intervention - Other Early Childhood Professional 53 hours/6 months

• Early Childhood Intervention Professional Therapy Assistant Level 2 - 12 hours per week x 26 weeks

• 20 hours (for 6 months) of Level 2 Support Coordination

• Specialist Behavioural Intervention Support - 10 hours/6 months

• Behaviour management Plan Including Training in Behaviour Management Strategies - 22.5 hours/ 6 hours

• Sensory bubble tube - $500
• Swing stand and platform - $2,500
• Stepping stones - $300
• Beanbag - $200
• Theraputty - $60

Speech Therapy - 1 hour per week plus 2 hours for reports

Occupational Therapy - 1 hour per week plus 4 hours for reports

Exercise Physiology - 1 hour per week plus 4 hours for reports

12 hours per month with ABA Supervisor plus 6 hours per year for reports (150 hours per year)

25 hours per week with ABA Assistant (level 2) (1300 hours per year)

40 hours per year of Level 2 Support Coordination - self or plan managed

1. At the hearing it was submitted that the Applicant did not seek any funding for Behaviour Support which is currently provided for in his current SOPS.

1. As stated by the Respondent in its Statement of Facts, Issues and Contentions (SOFIC) at paragraphs 32-34 (footnotes omitted):

The phrase "reasonable and necessary" is not defined in the NDIS Act. Each of the adjectives "reasonable" and "necessary" qualify the noun "support" but they do so as "a composite phrase" rather than two separate and distinct requirements. It is neither appropriate to consider each requirement separately nor to seek an authoritative or exhaustive judicial definition of the phrase.

Whether a support is "reasonable" requires a different assessment to whether a support is "necessary." It has been suggested that an assessment of what is "reasonable" requires a consideration of the factors identified in sub-paragraphs 34(1)(d) to (f), but an assessment of what is "necessary" requires consideration of the factors identified in sub-paragraphs 34(1)(a) to (c). It has, however, been emphasised that the list of factors identified in each of the sub-paragraphs in s 34(1) is not an exhaustive list. However, the phrase must be applied, having regard to the context, objects and guiding principles of the Act, to the facts of each case, so as to justify the expenditure of public funds on the specific support for the benefit of a particular participant.

Whether in respect of a particular NDIS participant a particular support constitutes a "reasonable and necessary support" is a question of fact to be determined by reference to the evidence before the decision-maker. Whether a particular support may be characterised as a "reasonable and necessary support" for a particular participant has a "qualitative aspect" to it and allows the decision-maker some "decisional freedom," subject to rationality and legal unreasonableness. It is possible that reasonable minds will differ as to whether a particular support is "reasonable and necessary" for a particular participant.

1. Section 34 of the NDIS Act identifies what establishes a 'reasonable and necessary' support under the scheme. It states as follows:

(1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:

(aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);

(a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations;

(b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation;

(c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;

(d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;

(e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks, and the community to provide;

(f) the support is a NDIS support for the participant.

(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and

(b) a participant's disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.

1. The relevant rules in respect of this review are the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth) (Supports for Participant Rules). Rules 3.1 to 3.5 of the Supports for Participant Rules relate specifically to sections 34(1)(c) - (e) and state:

3.1 In deciding whether the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support, the CEO is to consider the following matters:

(a) whether there are comparable supports which would achieve the same outcome at a substantially lower cost;

(b) whether there is evidence that the support will substantially improve the life stage outcomes for, and be of long-term benefit to, the participant;

(c) whether funding or provision of the support is likely to reduce the cost of the funding of supports for the participant in the long term (for example, some early intervention supports may be value for money given their potential to avoid or delay reliance on more costly supports);

(d) for supports that involve the provision of equipment or modifications:

(i) the comparative cost of purchasing or leasing the equipment or modifications; and

(ii) whether there are any expected changes in technology or the participant's circumstances in the short term that would make it inappropriate to fund the equipment or modifications;

(e) whether the cost of the support is comparable to the cost of supports of the same kind that are provided in the area in which the participant resides;

(f) whether the support will increase the participant's independence and reduce the participant's need for other kinds of supports (for example, some home modifications may reduce a participant's need for home care).

Effective and beneficial and current good practice

3.2 In deciding whether the support will be, or is likely to be, effective and beneficial for a participant, having regard to current good practice, the CEO is to consider the available evidence of the effectiveness of the support for others in like circumstances. That evidence may include:

(a) published and refereed literature and any consensus of expert opinion;

(b) the lived experience of the participant or their carers; or

(c) anything the Agency has learnt through delivery of the NDIS.

3.3 In deciding whether the support will be, or is likely to be, effective and beneficial for a participant, having regard to current good practice, the CEO is to take into account, and if necessary, seek expert opinion.

3.4 In deciding whether funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks, and the community to provide, the CEO is to consider the following matters:

(i) that it is normal for parents to provide substantial care and support for children; and

(ii) whether, because of the child's disability, the child's care needs are substantially greater than those of other children of a similar age; and

(iii) the extent of any risks to the wellbeing of the participant's family members or carer or carers; and

(iv) whether the funding or provision of the support for a family would improve the child's capacity or future capacity, or would reduce any risk to the child's wellbeing;

(c) for all participants - the desirability of supporting and developing the potential contributions of informal supports and networks within their communities.

1. Schedule 1 of the Supports for Participant Rules outlines supports appropriately funded, as referenced in Rule 3.5, as follows :

7.8 The NDIS will be responsible for personalised supports, specific to a child's disability (or developmental delay), which are additional to the needs of children of a similar age and beyond the reasonable adjustment requirements of early childhood development service providers.

7.9 The NDIS will be responsible for early interventions for children with disability (or developmental delay) which are:

(a) specifically targeted at enhancing a child's functioning to undertake activities of daily living, but not supports which are specifically for the purpose of accessing a universal service such as school readiness programs that prepare a child for education; and

(b) likely to reduce the child's future support needs, which would otherwise require support from the NDIS in later years, including through a combination and sequence of supports.

(a) meeting the early childhood education and care needs of a child with a developmental delay or disability required by children of a similar age including through inclusion supports that enable children to participate in early childhood education and care settings; or

(b) supports, which are clinical in nature provided in the health system, including acute, ambulatory or continuing care; or

(c) new-born follow-up provided in the health system, including child and maternal health services.

1. A further consideration is section 5(f) of the NDIS Act which contains the general principle guiding the actions of people who may do acts or things on behalf of others under the scheme. It provides as follows:

(f) if the person with disability is a child-the best interests of the child are paramount, and full consideration should be given to the need to:

(iii) strengthen, preserve and promote positive relationships between the child and the child's parents, family members and other people who are significant in the life of the child.

1. The purposes and objects of the NDIS Act must be considered in conformity with section 34(1) and the Supports for Participant Rules, noting that if one of the requirements in ss 34(1)(aa)-(f) is not satisfied, the support will not be funded under the NDIS.
2. The NDIS has Operational Guidelines in relation to 'reasonable and necessary supports' in a participant's plan. The Tribunal is not bound by the Guidelines and any policy set out in them. However, the Federal Court has held that the Tribunal should consider relevant government policy which is not inconsistent with the provisions or objects of the legislation.[14]
3. The Guidelines relevant to this review are the NDIS Reasonable and Necessary supports[15] and Early Childhood Approach.[16] The latter relevantly states at page 2:

Best practice recognises children learn and develop in everyday settings. This includes their own home, and other places, such as childcare, playgroup or preschool, where they play with family or friends. This means the adults they are with need information, tools, and support to help the child's development and participation. Being included in these everyday activities gives children with developmental delay or disability the same opportunities as all children. It provides them with opportunities to develop friendships, interact with others and be a part of their community.

Best practice not only considers broad early childhood intervention research, but also evidence relating to the needs of children with a specific diagnosis, such as autism spectrum disorder or cerebral palsy.

1. Ms S gave evidence at the hearing. She said that from a very early age the Applicant would cry from approximately 6pm until midnight and she could not stop him. When she went for check-ups with health care professionals, she advised them that the Applicant was delayed in meeting all of his milestones. She was advised that everything was okay and that sometimes boys can be delayed. She noted that at 18 months the Applicant made no eye contact, was not sleeping at night, he could not stand up and that he was 'stimming' (performing repetitive movements) non-stop. Her General Practitioner (Dr Ranjit Thomas) suggested that the Applicant may be autistic and referred him to Dr Paul Tannous (Consultant Paediatrician). In December 2023 Dr Tannous made a diagnosis of ASD. She applied for and the Applicant received funding from the NDIS.
2. The Applicant's impairments resulting from his diagnoses of ASD and GDD include:
   • Communication - restricted ability to understand and follow instructions and express himself with understandable words.
   • Social interaction - inability to cope in social group situations and significant emotional dysregulation.
   • Learning - significant limitations in his ability to learn.
   • Self-care and self-management - he is dependent on his parents for many activities of daily living including toileting, feeding and dressing.
3. The therapy that the Applicant has received to date has been varied and inconsistent. Ms S's evidence about exactly what therapy the Applicant has received and is currently receiving was at times vague and difficult to follow. It has included:
   • Speech therapy. He initially saw Ms Emma Sampedro in December 2023. He then saw Ms Karen Rodriguez in February 2024. This ceased because the Applicant was too tired as a result of lack of sleep and he was sleeping during the sessions. The Applicant then commenced speech therapy sessions at home with Ms Anousha Zada in May 2024 until August 2024. He subsequently resumed speech therapy with Ms Rodriguez in about late 2024. She does not work during school holidays. He has made some progress with his speech. He will say short sentences such as "I want water or food" or "I want to go outside" and he uses some signing to communicate. He enjoys writing the alphabet on his board and singing the ABC song. He cannot express his emotions and this can result in him screaming and crying.
   • Occupational therapy. He initially saw Ms Maria Ventouris in March 2024. He commenced seeing Ms Sumit Saha in May 2024. She recommended the consumables that are part of the Applicant's request for supports, namely the sensory bubble tube, a swing stand and platform swing, stepping stones, bean bag and theraputty. The Applicant then commenced receiving Occupational Therapy at Brain and Body Health. He has received therapy that has focussed on his balance and his twisted foot and has made progress.
   • Applied Behaviour Analysis (ABA) therapy. Initially the Applicant saw an ABA therapist at a clinic approximately 1 hour and 15 minutes away from his home and the cost was approximately $300-$400 for a 45 - 50 minute session. The Applicant then commenced ABA therapy with Ms Danielle Higgins, a Behaviour Consultant and Behaviour Analyst from STARS Behaviour Services. Ms Higgins came to their home and made progress with the Applicant. He reduced his head banging and he could communicate his basic needs by using sign language. The Applicant now receives ABA therapy for 4 hours per week from Ms Sowmya Bejil.
   • Positive Behaviour Support (PBS). The Applicant commenced therapy in October 2024 with Ms Karishma Khullar (Behaviour Support Practitioner). Ms Khullar has recently prepared a Behaviour Support Plan and some PBS to the Applicant.
   • He has consulted an Exercise Physiologist, an Audiologist and a Food Therapist.
   • He does swimming lessons with the Rainbow Club.
   • He currently attends childcare twice a week (Thursday and Fridays) and family day care with a smaller group of children three times per week (Monday, Tuesday and Wednesday).
4. As at the date of the hearing the Applicant's weekly routine is as follows:
   • Monday - occupational therapy at Brain and Body Health between 9-10am or 10-11am, then family day care until pick-up at 5:30pm.
   • Tuesday - ABA therapy with Ms Bejil at home between 8:30 - 10:30am, then family day care until pick-up at 5:30pm.
   • Wednesday - speech therapy with Ms Rodriguez between 11:10am-12:10pm, then family day care until pick-up at 5:30pm.
   • Thursday - childcare Ms Khullar has provided some assistance help the Applicant integrate into childcare.
   • Friday - childcare Ms Bejil provides ABA therapy at childcare for 2 hours.
5. Ms S gave evidence that family day care do not allow therapists to attend with the Applicant. Her wish is for the Applicant receive ABA therapy in the childcare setting 5 days per week. She intends to send the Applicant to full-time childcare by the end of 2025. She would like the Applicant to return to Ms Higgins for therapy but understands that Ms Higgins may not have the capacity/availability to provide any ABA therapy to the Applicant.

1. Ms Danielle Higgins is a Behaviour Consultant and Board Certified Behaviour Analyst. She has been working with autistic children for 18 years. She operates a business known as STARS Behaviour Services. The Applicant commenced ABA intervention with that service on 27 June 2024 and received approximately six weeks of intervention.[17] Ms Higgins prepared a report dated 14 August 2024[18] and a report dated 12 November 2024.[19] She also prepared a fee schedule (undated) for the yearly cost of the therapy she recommended for the Applicant.[20] In addition she gave oral evidence at the hearing.
2. When Ms Higgins initially assessed the Applicant in his home on 27 June 2024 it was apparent to her that he had significant autism and required support. Ms Higgins together with a therapy assistant provided a program of intervention to the Applicant. This program ceased in August/September 2024 and she has not seen the Applicant since that date.
3. Ms Higgins said that it took a while for the Applicant to get comfortable with her. Initially she did not ask the Applicant to do anything. She was systematic in her approach with him . She slowly introduced a few toys for him to freely explore if he wanted to. Her goal was to interact with him in a playful way and he needed to feel like he was in control. Due to the Applicant's age, the therapy has to be play based, but it is not uncontrolled, there is structure to it.
4. During her time with the Applicant, she did not observe him engaging in any self-destructive behaviours such as headbanging or pulling at his eyelashes. She did observe him engage in self-stimulating behaviour whereby he would hold a toy close to his eyes and constantly move it in front of him. She observed that he was very sensitive to noise. He was easily distracted by any noise and upset by loud noises.
5. During the 6 weeks that she worked with the Applicant and his parents, she noted progress. He was happy, relaxed and engaged with her. She was able to communicate with him to move away from something he was playing with to do something else without him displaying any problem behaviours. He was able to communicate by touching a card or tapping his chest to show he wanted to continue to play with a toy. On occasions if she asked too much of him, for example, if he was playing with something and she asked him to push a button or put a piece in a toy, this could be a trigger for problem behaviours such as crying or screaming and going to his mum.
6. Ms Higgins gave evidence that she had previously worked at Autism Partnership and the ABA therapy program they operated was conducted over 4 days per week for between 7 - 8 hours per day. She considered that because of the Applicant's significant delays across all developmental domains, which severely impact upon his ability to participate in mainstream or community services, he required intensive and focused ABA therapy of 25 hours per week.
7. In cross examination it was put to Ms Higgins that Dr Tannous, paediatrician recommended 4 sessions of ABA therapy per week. Ms Higgins did not agree with that recommendation. It was also put to her that Dr Pincus, Consultant Paediatrician, was of the view that the Applicant would benefit from 8-12 hours of ABA therapy and was concerned that 25 hours of ABA therapy was too much for the Applicant. Ms Higgins agreed that she could make progress with the Applicant in 8-12 hours per week. However, she understood that the Applicant had already been receiving that level of intervention and had not made good progress.
8. In her report dated 14 August 2024,[21] Ms Higgins noted that when she assessed the Applicant for 6 weeks from 27 June 2024, he was 2 years old. At that time, he presented with a number of behaviours of concern. He was enrolled in childcare, but this resulted in significant worsening of problem behaviour. He had attended weekly sessions of speech and occupation therapy with limited progress.[22] At the end of 6 weeks of intensive therapy with Ms Higgins, the Applicant achieved the following goals:
   • Between 80-100% of the time he was able to engage with highly preferred items in the absence of problem behaviour with Ms Higgins and was working towards this goal with his parents.
   • Between 80-100% of the time he was able to independently respond to Ms Higgins when she signalled playtime is over.
   • Between 50-70% of the time he was able to give Ms Higgins a 'high 5' (tolerance response) when his request to continue to play was denied.[23]
9. Ms Higgins recommended that the Applicant receive Early Intensive Behaviour Intervention (EIBI), which she said is part of ABA therapy, to progress in key areas of his development.[24]
10. Ms Higgins recommended that the Applicant engage in an intensive and focused 1:1 EIBI program of 25 hours per week provided by a behaviour therapist and 12 hours per month from a behaviour consultant. She based this recommendation on her assessments, clinical expertise, experience, the Applicant's lived experience and response to therapy, parental preference as well as best practice literature.[25]
11. Ms Higgins recommended 25 hours/week ABA assistant, plus 12 hours/month ABA supervisor, plus 6 hours NDIS reports.[26]
12. The estimated cost of this therapy plus reporting is $134,040.[27]
13. In her report of 12 November 2024[28] Ms Higgins set out the following proposed therapy schedule for the Applicant:

1. Ms Karishma Khullar is a Behaviour Support Practitioner, she prepared two reports that were before the Tribunal dated 10 March 2025[29] and 12 October 2025.[30] She also gave oral evidence. Her role is to provide PBS to clients. She prepares plans for people with challenging behaviours and provides training to their parents and therapists. She has worked with both the Applicant's parents and grandparents to assist them manage the Applicant's difficult behaviours. She has seen the Applicant 4 times. The Applicant is currently enrolled in childcare for 2 days per week. He has experienced difficulties integrating into that mainstream childcare setting. She has spent 2 hours assisting the Applicant to integrate. She recommends that funding be provided for her to spend 4 hours per week training the therapy assistant and the Applicant's parents.

1. Ms Karen Rodriguez is a Speech Pathologist. She prepared a report that was before the Tribunal dated 19 June 2024 and she was summonsed to give oral evidence at the hearing by the Respondent. She gave evidence that she first saw the Applicant in February 2024. She continued seeing the Applicant on a weekly basis until about June 2024. She resumed seeing him in late 2024. She only works during school terms. She has been seeing him on a regular basis in her clinic during school terms since February 2025. The Applicant was 1 year and 9 months old when she started seeing him and at that time, he was non-verbal. At the time of the hearing, he was 3 and years 5 months old, and he is now verbal. He can name objects and he can use words. He is unable to answer questions such as "how are you?" or "why are you crying?" The Applicant is mostly compliant during speech therapy but he often looks at the door or the window and he is easily distracted from the task he is doing by things such as a door opening or motor vehicles going past. He has ongoing problems with receptive and expressive language and she recommends that he continues with speech therapy on a weekly basis with her during school terms, which amounts to approximately 40 weeks per year. The therapy would continue to be in her clinic with a parent present. She needs to work with the parents so that they are aware of the goals and what needs to be done. The current goal for the Applicant is for him to be able to explain his wants and needs. She has observed stimming behaviour by the Applicant. For example, if she uses picture cards, he will hold them in front of his eyes and 'stim.' If she is running late or is repetitive during a session that can lead to the Applicant having a 'meltdown.'

1. Ms Elizabeth Rieder is a Behaviour Analyst at Bright Eyes. The Applicant commenced EIBI at Bright Eyes on 30 April 2024[31] when he was nearly 2 years old. Ms Rieder prepared a report dated 6 May 2024.[32] She evaluated the Applicant using the Vineland-3 Comprehensive Parent/Caregiver Form. He scored in the extremely low range in adaptive behaviour composite and in the domains of communication, daily living skills, socialisation and motor skills.[33] Under the heading 'Recommendations', she says:

Research has shown that EIBI with 20-40 hours per week is often recommended for young children with ASD. In short, that an increase in treatment hours predicted a higher number of mastered learning objectives in children with ASD.[34]

However, she goes on to state that she 'aims to be realistic in asking for what the NDIS is likely to provide' and has therefore recommended funding for:

• Behavioural Support: a minimum of 6 hours of weekly behaviour therapy sessions with the Program Supervisor for the duration of the plan plus an additional 20 hours per year for program updates, developmental assessment, family support, multi-disciplinary consultations and reports.
• Therapy assistant (level1): 6 hours per week.
• Speech and occupational therapy: continuing at current level (with Ms Ventouris, Occupational Therapist and Ms Sampedro, Speech Therapist.)[35]

1. Ms Maria Ventouris is an Occupational Therapist. The Applicant commenced seeing her when he was 1 year and 10 months old in March 2024. She prepared a report that is before the Tribunal dated 10 April 2024.[36] In that report she says that due to limited funding and limited sessions there was not sufficient time to work on any of the Applicant's goals to make progress. In March of 2024, the Applicant had 3 face to face sessions with Ms Ventouris. The focus of these sessions was to develop rapport, and emotional engagement as well as make an observational assessment of the Applicant's abilities. In relation to occupational therapy, she recommended that the Applicant receive weekly 75-minute sessions for 52 weeks per annum plus 4 hours per annum for NDIS report management.[37] She also recommended that the Applicant receive Sensorimotor Therapy and Speech Therapy as well as one or more other therapies including a Dietician, a Feeding Therapist and a Psychologist.

Ms Sumit Saha is an Occupational Therapist who commenced providing therapy to the Applicant on 6 June 2024 just prior to his second birthday. He was receiving that therapy twice a week. She no longer provides occupational therapy to the Applicant. It is unknown exactly when she ceased providing therapy to the Applicant. She prepared two reports that are before the Tribunal dated 14 October 2024[38] and 13 January 2025.[39] In her report dated 14 October 2024 she recommends that the Applicant's parents attend courses or workshops that provide deeper insight into understanding autism, managing anxiety and addressing sensory challenges. She states such resources would equip them with strategies to support the Applicant's progress at home.[40] She also recommended the procurement of specific consumable items for use at home to extend the benefits of therapy sessions and actively engage the Applicant outside of the clinic. She considered these items would allow for more consistent practice and help reinforce the skills developed in therapy. Those consumables are listed in paragraph 14 above. In her report dated 13 January 2025, she provides an explanation of each consumable recommended.

1. Dr Paul Tannous is a Consultant Paediatrician. He prepared two reports that were before the Tribunal dated 9 January 2024[41] and 22 April 2024.[42] He initially saw the Applicant when he was 19 months old. At that time, he recommended NDIS funding for:
   • Weekly speech pathology to improve his receptive and expressive language skills, as well as his social pragmatic skills.
   • Weekly occupational therapy to assist with fine motor skills and sensory processing skills.
   • Physiotherapy to assist with gross motor skills acquisition.[43]
2. In his April 2024 report he expressed his support for increased NDIS funding for ABA therapy which he believed the Applicant would benefit from. He said that the Applicant 'has been enrolled to start seeing a therapist at Bright Eyes Early Intervention Behavioural Therapy. Each session costs approximately $270 and will require up to 4 sessions a week.'[44]

1. Ms Sowmya Bejil is a Certified Behaviour Instructor for Autism. She has been providing ABA therapy to the Applicant. She commenced providing ABA therapy to the Applicant on 25 March 2024. She ceased providing therapy for a period of time. She recommenced providing therapy sometime later and currently provides ABA therapy of 4 hours per week. She states in her report dated 23 June 2024:[45]

Based on high-quality evidence (Roberts and Williams et al. 2016), it is recommended that a child with ASD receives 15-25 hours of therapy support.

At that time, she was providing 4 hours of weekly ABA therapy sessions to the Applicant. She says the Applicant 'requires weekly at least 6 hours or weekly 3/4 of intensive 1:1 support Session [sic].'[46]

1. Dr David Pincus is a Consultant Paediatrician. He prepared a report that is before the Tribunal dated 25 May 2025.[47] The solicitors for the Respondent requested Dr Pincus to conduct an independent medical examination (IME) of the Applicant and prepare a report. Dr Pincus offered to perform an IME by video conference on 16 May 2025. The Applicant did not consent to an IME. Therefore, his report was prepared entirely on the papers. He notes that the reports he was provided with were mainly more than six months old and did not include up-to-date developmental reports. They also focused on the Applicant's weaknesses rather than any areas of strength. He said that written reports can be misleading and that a video conference with the Applicant and his parents would have been very helpful up-to-date information with respect to the Applicant. A video conference would have allowed him to observe and interact with the Applicant and get an understanding of his strengths as well as his weaknesses.
2. In his report Dr Pincus states that based on the outdated reports he read, the Applicant has a number of impairments resulting from his diagnoses of ASD and GDD in the domains of communication, social interaction, learning, mobility, self-care and self-management.[48]
3. Dr Pincus was extremely encouraged by the information that the Applicant has a significant interest in letters and numbers. He said it was likely that the Applicant had good non-verbal learning abilities, which improved his prospects of learning at school and gaining employment.
4. Dr Pincus gave evidence that the Applicant's attendance at family day care and childcare was positive. He said that children learn from watching and imitating others. If a child with dietary limitations sees other children eating certain foods they may be inclined to eat it too. Also, if they see other children going to the toilet, that becomes a normal behaviour.
5. In cross examination, Dr Pincus was asked about his expertise in treating children with autism. He advised that 80 to 90% of his patients are children with ASD and/or ADHD. He said he had practised as a paediatrician for 30 years and he had seen many autistic children over that time. He said that in the last 12 to 18 months he had conducted between 30 and 50 IMEs in relation to children. The majority of them related to ABA therapy. He said that he tries to work with families to ensure they get the best possible outcome and he often recommends more therapy for a child than the NDIS has provided. He supports ABA therapy. He accepted that there was some evidence that some children received good results with 25-40 hours of ABA therapy per week. He said every child has different treatment needs and not every child needs 25 - 40 hours of therapy per week. Some children do well with ABA therapy and some do not. A non-verbal child often does not respond well to ABA therapy. Dr Pincus said that he had spoken to a number of families about their experience with ABA therapy. He estimated that approximately 80% of families said it made no difference to their child and approximately 10 to 20% said it worked well.
6. Dr Pincus referred to the fact that during the Covid-19 pandemic many children with autism were forced to stop therapy for between 6 and 12 months. As a result, the family had more time with their child and many parents were amazed with the rate of progress during this long break from therapy.
7. Dr Pincus said that reading the literature relating to ABA therapy has led him to conclude that he needs to work with the family to determine what therapy will be in the best interests for a particular child. It was put to him that the family want 25 hours of ABA therapy for the Applicant per week. Dr Pincus accepted that is what they wanted but said he did not agree with that for the following reasons:

(i) 25 hours per week of therapy is not supported by the current literature. > > (ii) He strongly supports the rights of a child to have leisure time and 25 hours of ABA therapy plus other therapy is an enormous amount of therapy for a young child. > > (iii) Whilst he currently supports ABA therapy, he may be wrong about its benefits and is concerned that it could end up having negative effects on a child. (He has concerns as to whether it is neurodiverse affirming and whether it can be traumatic for children. He notes that there are comments about the Applicant being distressed during therapy which may indicate his lack of consent to participate.)[49]

8. Dr Pincus is of the view that the Applicant will progress by playing with other children. He believes that 8 to 12 hours of ABA therapy would be just as effective for the Applicant as 25 hours. Dr Pincus urged caution in relation to a child spending significant hours in therapy. He noted that the following therapy was requested for the Applicant:
   • 25 hours per week of direct ABA therapy plus 3 hours per week of ABA supervision.
   • 1 hour per week of occupational therapy.
   • 1 hour per week of speech therapy.
   • 1 hour per week of exercise physiology.

This amounts to a total of 31 hours of therapy per week. Dr Pincus said this was an enormous number of therapy hours for a child that is 3 ½ years old. He noted that when neurotypical children commence year one at school, they only do 30 hours per week in total and they do Maths and English learning in the morning when they have more cognitive energy. He is of the view that expecting the Applicant to participate in 31 hours of intervention a week is markedly excessive and likely to exacerbate his behaviour and dysregulation.[50]

1. Dr Pincus supports trialling ABA therapy for the Applicant for 2 hours per day or 8-12 hours per week over a period of 6-12 months. He said it was important that the therapist and the child get on well . In his experience a child can progress well with therapy in one place and not in another. In his report he notes that it is imperative that there is an active plan to transition the Applicant from one-to-one ABA to smaller then larger group situations to ensure that he does not become reliant on one-to-one intervention, especially when there are significant concerns regarding the generalisability of gains made within such an intensive intervention milieu.[51] He said that cognitive training of this nature can be very draining for a child. He said he respected the Applicant's right for leisure and relaxation time. He said the Applicant must be allowed time to do the things he likes. He should not spend a lot of time in therapy.
2. In Dr Pincus's report, he says:
   • There is a complete lack of adequate documentation to enable me to make any judgement on any specific gains made over particular periods of time and whether these may or may not be related to provided interventions. It may well be that all progress is intrinsic and not related to the provided interventions.[52]
   • From the information supplied to me I have hesitations as to whether speech therapy and occupational therapy has proven beneficial for the Applicant. I would still support involvement of a speech pathologist and occupational therapist for at least 10 visits per year to provide appropriate monitoring and supervision.[53] He further states that whilst he is a strong supporter of occupational and speech therapy, it is not inappropriate to have a six month break from such therapy while a child is receiving ABA intervention and is regularly attending an early childhood education centre with appropriate facilities.[54]
   • The Applicant is living in Sydney NSW where there is availability for early intervention through the Education Department. It is highly likely that he will eventually be attending a specialised school for children with autism and intellectual impairment. Such schools generally provide 1 to 2 days per week of intervention services for children aged 3 years and 2 to 3 days per week for children aged 4 years. I think this would provide an excellent backbone for intervention. These specialised schools have small classes, highly trained staff, and the appropriate social and community opportunities as well as leisure opportunities that would be so beneficial for the Applicant. This may well be very helpful for his emotional dysregulation.[55]
   • I see no role for psychology, or exercise physiology. The Applicant will not be available for psychological intervention with his current cognitive status, his physical growth motor skills are perfectly adequate for his general development and can be assisted by usual daily activities such as attending parks or play centres.[56]
3. With respect to the literature in the last 30 years relating to ABA therapy, Dr Pincus notes that it would have excluded children such as the Applicant, as the previous editions of DSM did not allow a diagnosis of autism when there was another underlying condition which would account for the presenting symptoms such as an intellectual disability.[57]
4. In relation to the consumables referred to in paragraph 14 above and recommended by Ms Saha, occupational therapist, Dr Pincus does not support any of these requested items. He considers they have been recommended to assist with the Applicant's sensory issues, which in his experience generally settle with time. He believes there would need to be a more thoroughly formed case from the Applicant's current occupational therapist before such items could be considered.[58]

1. As can be seen from the tables in paragraph 14 above, the Applicant seeks:
   1. Allied Health Professional Supports

An additional 1 hour per week to fund exercise physiology in addition to the 2 hours per week that the Applicant can use flexibly but is currently using to fund weekly speech and occupational therapy. Making a total of 3 hours per week.

An additional 10 hours per week to fund an ABA therapy assistant, Level 2 to provide 1:1 ABA therapy in addition to the 12 hours per week currently funded. Plus, an additional 3 hours per week for an ABA Specialist to supervise the Therapy Assistant Level 2, oversee goals, progression and plan, skill building sessions with family, case consultation, assessments and report writing. Making a total of 25 hours per week.

$3,560 to pay for the items recommended by Ms Saha, the Applicant's former Occupational Therapist.

• Invoices from Brain and Body Health Pty Ltd (22.01.2025- 02.08.2025).
• Invoices from Rainbow Club (31.03.2025 -17.06.2025).
• Invoices from Karen Rodriguez, Speech Pathologist (12.02.2025-30.07.2025).

The Applicant requests that the funding amount for support coordination remain the same but that funding should be changed to self or plan managed. This funding is currently agency managed.[59]

As stated above the Applicant does not seek any ongoing funding for Behaviour Support which is currently provided for in his current SOPS.

1. The Tribunal commences consideration of the issues in dispute by making some general observations in relation to the NDIS. The NDIS is designed to provide participants with supports that are reasonable and necessary to ameliorate their substantially reduced functional capacity to undertake the tasks and actions of daily living in specified areas of life. In this respect, it is a scheme that operates in relation to objectively ascertained functional need in specified areas of life, not subjective want at large.[60]
2. With respect to the provision and funding of supports, a participant's (and in this case a participant includes the participant's parents) choice and control is not unconstrained. It operates subject to the 'reasonable and necessary' considerations set out in s 34(1) and its related rules. By operation of s 34(1)(c) a participant is not free to select a form of support that is more expensive than an alternative that would meet their functional needs just as well. Participant choice and control operates subject to what is reasonable and necessary by way of support. A participant does not dictate what is reasonable and necessary. That is so, notwithstanding the fact that, by operation of s 34(1)(a), the participant's goals and aspirations are a relevant consideration in determining what support is reasonable and necessary.[61] Further, the role of informal support in the ongoing support of participants must be recognised and respected in the provision and funding of supports as the principles contained in ss 4(e) and 31 (c) and (ca) of the NDIS Act make it clear.[62]
3. With respect to allied health professional supports, the Tribunal notes that since the Applicant was 19 months old until he was 3 years and 5 months old, he has received treatment from at least 14 health specialists including, 4 occupational therapists, 3 ABA therapists, 3 speech pathologists, 1 paediatrician, 1 exercise physiologist, 1 audiologist and his general practitioner. As can be seen from the Tribunal's summary of the evidence before it,none of the health specialists who provided evidence in this case are in complete agreement as to what ongoing supports are reasonable and necessary for the Applicant to address his impairments. The Tribunal also notes that there is significant divergence in the published and referred literature with respect to the appropriate amount of early intervention therapy for children with ASD and GDD such as the Applicant.

1. The Applicant's mother would like the Applicant to:
   • Start dressing and undressing independently and start brushing his teeth independently.
   • Build communication skills and start communicating verbally his needs and wants.
   • Increase his concentration skills and understand concepts to complete tasks independently and in the correct way.
   • Develop his strength, balance and coordination so he can participate in age-appropriate physical activities and start walking independently.
   • Better recognise and understand others and their feelings.[63]

These goals have not been updated since the Applicant's original plan was made dated 8 April 2024.[64] The evidence indicates that the Applicant has made at least some progress towards achieving these goals. When a new plan is made, new goals will need to be set.

1. The Tribunal accepts that the Applicant has the impairments referred to at paragraph 25 above and that the supports requested are necessary to address the needs of the Applicant arising from those impairments in relation to which he meets the disability requirements. The Tribunal is also satisfied that the supports in issue will assist the Applicant pursue his goals referred to above and that they will assist the Applicant to undertake activities, so as to facilitate his social and economic participation. Accordingly, ss 34(1)(aa), (a) and (b) are satisfied.
2. The Tribunal will now consider each of the issues referred to in paragraph 57 above.
   1. Allied Health Professional Supports
3. The Applicant is currently funded for two hours per week of allied health therapy, this amounts to 53 hours over 6 months in his current plan.[65] This can be use flexibly for allied health professionals. He currently sees a speech pathologist and an occupational therapist. The Applicant seeks a further one hour of funding per week to enable him to see an exercise physiologist.
4. The Tribunal heard evidence from the Applicant's current speech pathologist, Ms Rodriguez. She sees him during school terms (approximately 40 weeks per year) for one hour per week. She said she has developed a good rapport with the Applicant and she has developed strategies to manage his emotional dysregulation. She gave evidence that the Applicant has made progress with her, since she commenced seeing him when he was 1 year and 9 months old until the date of hearing when he was 3 years and 9 months old. He has gone from being non-verbal to verbal. The Tribunal observes that it is not clear from the evidence how much of this would be attributable to the Applicant's speech therapy as opposed to the Applicant's intrinsic natural development over 2 years. Ms Rodriguez says that the Applicant has ongoing problems with receptive and expressive language. She recommends that he continue to see her on a weekly basis during school terms (40 weeks per year). The Respondent accepts and the Tribunal agrees that ongoing speech therapy is a reasonable and necessary support for the Applicant.
5. The evidence in relation to the benefits the Applicant may be receiving from occupational therapy is unclear. Ms S gave evidence that the Applicant is currently receiving occupational therapy from a therapist named Chelsea at Brain and Body Health for 1 hour per week. Ms S said that over the last 4 months the Applicant's occupational therapy has focused on his feet, and as a result he can now jump and his foot is not twisted. There is no evidence from the Applicant's current occupational therapist in relation to the Applicant's goals, progress and future needs. Ms Ventouris (occupational therapist) had three face to face sessions with the Applicant in March 2024. At that time, she recommended weekly sessions of occupational therapy to support the Applicant's:
   • Learning and development of appropriate play skills.
   • Overall self-care skills, including feeding, dressing and toileting.
   • Parents to enable them to implement appropriate evidence based home regulation strategies.[66]

The Tribunal accepts that occupational therapy to address these impairments is reasonable and necessary but it does not accept that he necessarily requires weekly sessions of occupational therapy for 52 weeks per year and 4 hours of NDIS report management.

1. Ms Saha (occupational therapist) has not provided therapy to the Applicant for over 1 year. She recommended the procurement of the consumable items referred to in the table at paragraph 10 above. She also recommended the Applicant's parents attend courses or workshops to assist them to manage the Applicant's challenges. This evidence is not current and does not relate to current occupational therapy that the Applicant is receiving. The Tribunal does not accept that funding for these consumables is reasonable and necessary.
2. Ms Ventouris says in her report dated 10 April 2024 that she supports the recommendation for weekly sensorimotor therapy to develop the Applicant's gross motor skills and social skills as per the separate sensorimotor therapy report.[67] The Applicant relies upon this aspect of Ms Ventouris' report to support his request for an additional 1 hour per week for exercise physiology plus an additional 4 hours for reports. The Tribunal has no evidence about the need for exercise physiology or sensorimotor therapy. The separate sensorimotor therapy report referred to comprises a list of sensorimotor sessions that the Applicant underwent with Ms Michelle Bauser between 15 April and 16 December 2024. The report refers contains the Applicant's 'occupational performance priorities.' It contains notes prepared by Ms Ventouris with respect to the Applicant's behaviour/performance during her 3 sessions with him in March 2024. Input from Ms Bauser is limited to the Applicant's background history obtained in April 2024. It contains no other information with respect to any progress made during the sensorimotor sessions or any future recommendations with respect to them or exercise physiology.
3. Ms Ventouris also supported the recommendation for weekly sensorimotor therapy, but as stated, there is no such recommendation by the sensorimotor therapist or an exercise physiologist in relation to this.
4. The Respondent submits that the evidence does not address how the requested support of exercise physiology for 1 hour per week plus 4 hours for report management, interacts with the requested funding for other therapies and that in the absence of any evidence from any relevant expert in this field, the Tribunal would not find additional funding for this support to be reasonable and necessary.[68] The Tribunal accepts that contention.
5. The Applicant currently has funding for 53 hours over 6 months for capacity building supports for improved daily living skills. The Applicant can use that funding flexibly. The evidence is that he currently uses that funding for speech and occupational therapy. The Tribunal finds that additional and separate funding for more therapy such as exercise physiology is not value for money per s 34(1)(c), nor is it effective and beneficial per s 34(1)(d) having regard to the current funding available to the Applicant and the lack of evidence to support any additional funding for exercise physiology. As the criteria in s 34(1) are cumulative, it is not necessary for the Tribunal to consider whether the further criteria under ss 34(1)(e) and (f) are met in relation to allied health support.
   1. ABA Therapy
6. The Applicant is currently funded for an ABA Therapy Assistant Level 2, 12 hours per week for 6 months. This amounts to 312 hours over 6 months in his current plan.[69] According to Ms S, this ABA therapy is currently being provided by Ms Bejil for a total of 4 hours per week, 2 hours between 8:30 and 10:30 am on a Tuesday at home and 2 hours at childcare on a Friday. The Tribunal understands that the Applicant is receiving some support from Ms Khullar to assist the Applicant integrate into childcare, but this is being paid for from the funding provided by the Respondent in his current plan for Behaviour Support.
7. The question of how much funding ABA therapy should be provided by the Respondent to the Applicant is vexed.
   • Ms Higgins recommends funding for 25 hours per week by a therapy assistant, Level 2 and 12 hours per month from a specialist consultant.
   • Ms Khullar recommends funding for 4 hours per week to enable her to provide behaviour support training to the therapy assistant, Level 2 and the Applicant's parents.
   • Ms Rieder recommends funding for a program supervisor to provide 6 hours per week behaviour therapy and 20 hours per year for program updates, developmental assessment, family support, multi-disciplinary consultations and reports and 6 hours per week for a therapy assistant, Level 1.
   • Dr Tannous recommends funding for 4 sessions per week of ABA therapy.
   • Ms Bejil recommends funding of at least 6 hours per week to enable her to provide ABA therapy.
   • Dr Pincus recommends 8-12 hours per week of ABA therapy.
8. The Applicant contends that his request for 25 hours per week for an ABA assistant and for 12 hours per month for an ABA supervisor as well as 6 hours per year for NDIS reports[70] is based soundly on the recommendations of his treating clinicians, in all instances speaking within the ambit of their expertise.[71] As can be seen from the above summary, not all of the clinicians that have treated the Applicant recommend the number of hours requested by the Applicant for ABA/EIBI funding. Only Ms Higgins makes that recommendation based on her assessment of the Applicant in June-August 2024. Whilst the Tribunal accepts that Ms Rieder states in her report that "Research has shown that EIBI with 20-40 hours per week is often recommended for young children with ASD", she did not go on to make that recommendation for this Applicant. Similarly, Ms Bejil refers to evidence that recommends "that a child with ASD receive 15-25 hours of therapy support", she does not go on to make that recommendation for this Applicant.
9. The Applicant refers to the following statement from the National Research Council (2001) Educating Children with Autism.[72], which states at page 6:

The committee recommends that educational services begin as soon as a child is suspected of having an autistic spectrum disorder. Those services should include a minimum of 25 hours a week, 12 months a year, in which the child is engaged in systematically planned and developmentally appropriate educational activity toward identified objectives.[73]

1. The Tribunal notes that all of the health professionals who gave evidence supported play based therapy as appropriate educational activity for the Applicant. As indicated above, the Respondent's Early Childhood Approach Guideline states that, "Best practice recognises children learn and develop in everyday settings. This includes their own home, and other places, such as childcare, playgroup or preschool, where they play with family or friends." A key aspect of this is that it is important to build the capacity of families and important people in a child's life to support their learning and development. The Tribunal observes that best practice supports play with appropriate supervision from family and friends as an appropriate educational activity that would not require an ABA therapy assistant or supervisor to be with the Applicant during that time.
2. The Tribunal accepts that there are a number of published papers that the Applicant relies upon that conclude that greater total hours and longer duration of interventions were predictive of stronger post-intervention outcomes. Equally, Dr Pincus refers to published research that does not support the assertion that intervention effects increase with increasing amounts of intervention.[74]
3. Dr Pincus also refers to the "Position Statement on Therapies and Interventions" by Reframing Autism which was updated in July 2022. This is a group of adults who are on the spectrum; several of them have had early intensive intervention through ABA therapy as children. That group rejects the use of any therapy or intervention which are intensive in nature, or which utilise the system of rewards and punishments to modify autistic behaviours in autistic individuals to act and perform non-autistically. The group notes that while compliance might superficially seem like a reasonable goal for children, conditioning already vulnerable autistic individuals to be unquestioningly compliant puts them at an even greater increased risk for emotional, physical and sexual abuse.[75]
4. The Applicant contends that this position statement is not peer reviewed and it is a view from one section of the deeply divided autism community.[76] The Applicant makes the point that the diversity of the autism spectrum and the range of therapies and supports needed has long been recognised by experts in the field. The Tribunal agrees with this submission and accepts that the range and diversity of people on the autism spectrum is enormous and accordingly the type of therapy and the number of hours required cannot be standardised for all children diagnosed with autism.
5. The Applicant's request for increased funding for ABA therapy is based on the premise that more intensive therapy for the Applicant will improve his skills. The Tribunal is not satisfied on the evidence that more hours of intensive therapy for the Applicant will lead to a better outcome for him. As stated, Ms Higgins is the only professional who recommends the number of ABA therapy hours requested by the Applicant. The balance of the professionals recommend less hours, ranging between 4 and 12 hours. When taking in context the Respondent's current funding of 12 hours per week of a therapy assistant, Level 2 is at the higher end of the range recommended, by the majority of professionals.
6. The Respondent submits that if the Applicant was funded for all of the supports he seeks that would amount to 28-31 hours of formal interventions per week. As at the date of hearing he was 3 years and 5 months old. As stated by Dr Pincus, a 5-year-old neurotypical child only attends school for 30 hours per week and the academic lessons are placed in the first couple of hours of the day with much of the time in the afternoon devoted to more leisure based activities.[77]
7. The Respondent urges caution with respect to approving funding for formal intervention for the Applicant of between 28 and 31 hours per week. Dr Pincus described this as an enormous number of therapy hours for a child of the Applicant's age. Such intensive therapy restricts of the Applicant to have leisure time and do activities that he enjoys doing; it could result in the Applicant becoming therapist-dependent; it could be neurodiverse affirming and it could be traumatic for the Applicant noting the comments about the Applicant being distressed during therapy which may indicate his lack of consent to participate. Taking all of this into account, Dr Pincus still supports a trial of ABA therapy for the Applicant of between 8-12 hours per week.
8. Having regard to the evidence and the therapy schedule proposed by Ms Higgins, the Tribunal considers that the therapy requested could be accommodated apart from 1 hour of exercise physiology on a Saturday morning (for the reasons outlined above) and the 2 hours of ABA therapy recommended for each afternoon between 2:30 and 5pm, 7 days per week.
9. The Respondent contends that the evidence does not:
   • Address how fewer hours or less intensive supports would not achieve the goals identified in Ms Higgins' report.
   • Establish that the recommended hours for ABA/EIBI are value for money s 34(1)(c) or more beneficial and effective than a less intensive approach with speech and occupational therapists, or in some combination with those therapies s 34(1)(d).
10. The Tribunal does not accept the evidence that the Applicant requires 25 hours per week with an ABA assistant plus 12 hours per month with an ABA supervisor plus 6 hours per year for NDIS report writing. The Tribunal rejects the evidence that intervention at this level is required to achieve improved outcomes as compared to 8-12 hours per week of ABA therapy. The Tribunal does not accept that the evidence supports a finding that higher therapy hours for the Applicant will provide him with better outcomes. The Tribunal forms the view that the program of intervention recommended by Ms Higgins is not value for money and as a consequence the Tribunal finds that s 34(1)(c) is not satisfied. Based on the current research literature and the expert opinions that recommend between 4 and 12 hours of ABA therapy, the Tribunal is not satisfied that the program of intervention recommended by Ms Higgins is effective and beneficial or that it represents current good practice, especially taking into account the other therapies that the Applicant is receiving, which would amount to up to 31 hours of intensive therapy per week. Accordingly, the Tribunal finds that 34(1)(d) is not satisfied.
11. The Tribunal does accept that the evidence establishes that ABA therapy with a qualified ABA therapist, Level 2 would be or would likely to be beneficial to the Applicant for up to 10 hours per week, 2 hours per day. This allows for 2 hours of ABA therapy 5 days per week in the morning as suggested by Ms Higgins in her proposed therapy schedule. The Respondent has already allowed sufficient funding to cover this. However, Ms Higgins also recommends in that proposed therapy schedule that the Applicant undergo further ABA training for an additional 2 hours per day 7 days per week. For the reasons stated the Tribunal determines these additional hours are not value for money and that these additional hours are not effective and beneficial and do not represent current good practice.
12. Ms Higgins further recommends that the Applicant be funded for 12 hours per month of Supervision/Behavioural Consultation to oversee goals, progression, treatment planning and family skill building sessions.[78]
13. The Applicant submits that the Respondent put funding for PBS in the Applicant's revised plan in August 2024. This was not requested by the Applicant and the Applicant does not want that funding. He wants funding for ABA not PBS. The evidence is that Ms Bejil is trained in ABA therapy and provides that therapy to the Applicant, but Ms Khullar is a Behaviour Support Practitioner and is not trained in ABA therapy. She is paid for out of the Behaviour Support funding. The Tribunal understands that the Applicant would prefer to use a trained ABA specialist, such as Ms Higgins. The Tribunal considers that to be reasonable and this should be funded in lieu of funding for Behaviour Support. The Tribunal accepts that it is reasonable to have a senior ABA therapist work with the therapy assistant, Level 2 to write reports, oversee goals, progression, treatment planning and to conduct family skill building sessions. The Tribunal considers that 2 hours per week for a senior ABA specialist is reasonable and necessary in addition to the 10 hours per week for an ABA therapy assistant, Level 2. This amounts to a total of 12 hours per week for ABA therapy, 10 hours for a therapy assistant, Level 2 and 2 hours for a senior ABA specialist. Based on the evidence the Tribunal considers this level of ABA therapy from 2 therapists working together with the Applicant and his parents is value for money, effective and beneficial and represents current good practice. Accordingly, both ss 34(1)(c) and (d) are satisfied.
14. With respect to the further criteria under ss 34(1)(e) and (f), the Tribunal finds that this level of funding for ABA therapy takes into account what is reasonable to expect families, carers, informal networks and the community to provide. The Tribunal is also satisfied that ABA therapy is a NDIS support.
    1. Consumables
15. At the hearing, no evidence was given in relation to the consumable items requested by the Applicant as recommended by Ms Saha, the Applicant's former occupational therapist, whom he has not seen for over one year. In Ms Saha's report dated 14 October 2024 she recommends the procurement of the stated consumable items for the Applicant to use at home to extend the benefits of his therapy sessions, engage him outside of the clinic, allow for more consistent practice and help reinforce the skills they were developing in therapy. These consumables are connected to the therapy that the Applicant was engaging in directly with Ms Saha.
16. Dr Pincus does not support the funding of any of these consumable items. He believes there would need to be a more thoroughly formed case from the current occupational therapist before such items could be considered.[79] The Tribunal agrees.
17. The Respondent submits and the Tribunal agrees that there is no evidence that these consumables are currently reasonable and necessary for the Applicant.
    1. Invoices
18. The Applicant put before the Tribunal 3 bundles of invoices from:
    • Brain and Body Health Pty Ltd (22.01.2025 - 02.08.2025);
    • Rainbow Club (31.03.2025 - 16.06.2025); and
    • Karen Rodriguez, Speech Pathologist (12.02.2025 - 30.07.2025).
19. The Applicant gave no evidence in relation to any of those invoices. Some of the invoices from Brain and Body Health Pty Ltd relate to functional neurological therapy which was not an issue in dispute in this application. There are invoices from 24 March 2025 until 2 August 2025 relating to occupational therapy. During this period the Applicant had funding for this type of therapy in the sum of $20,369.04.[80] There is no evidence that allows the Tribunal to make a finding that the therapy to which those invoices relate was reasonable and necessary over and above the amount the Applicant was already funded for in that period. If that the Applicant claims that funding was insufficient, the Tribunal has no evidence upon which to base this finding. The invoices from the Rainbow Club relate to swimming sessions. This was not an issue in dispute in this application. There are invoices from 12 February 2025 until 30 July 2025 relating to speech pathology. During this period the Applicant had funding for this type of therapy in the sum of $20,369.04.[81] There is no evidence that allows the Tribunal to make a finding that the therapy to which those invoices relate was reasonable and necessary over and above the amount the Applicant was already funded for in that period. If that the Applicant claims that funding was insufficient, the Tribunal has no evidence upon which to base this finding.
20. The Tribunal finds that there is no evidence to allow it to conclude that the invoices relating to therapy received by the Applicant during the period of his second SOPS (between 30 August 2024 and 5 August 2025, when his current SOPS came into effect) were reasonable and necessary.
    1. Support Coordination
21. In the Applicant's current SOPS in his plan, he has funding for Support Coordination, and that funding is accepted by the Respondent. The Applicant wants this funding to be self-managed as opposed to agency managed. There is no evidence before the Tribunal that would allow it to make any finding as to whether the way in which this funding is managed should be changed. Accordingly, the Tribunal makes no finding in relation to this and this funding component will remain agency managed as it is currently.

1. Behaviour Support
2. The Applicant submitted that the Respondent put funding for Behaviour Support (PBS) in the Applicant's revised plan in August 2024. The Respondent is content to leave that funding in the Applicant's plan. The Applicant submits that this funding was not requested nor does he want it. He wants funding for ABA not PBS. The Tribunal considers that ABA funding for a senior ABA therapist, 2 hours per week and for a therapy assistant, Level 2, 10 hours per week is reasonable and necessary. The Applicant wishes to focus on ABA therapy and he does not request further funding for behaviour support. Accordingly, the Tribunal finds that in the Applicant's case additional funding for behaviour support is not value for money nor is it likely to be effective and beneficial. It should no longer be included in the Applicant's SOPS.

1. Pursuant to s 105 of the ART Act the decision under review made on 6 August 2025 is set aside and remitted to the Respondent for reconsideration within 14 days in accordance with a direction that the following supports are reasonable and necessary supports that are to be included in the Applicant's SOPS:
   • 106 hours per annum for early childhood intervention - other early childhood professionals.
   • 520 hours per annum for early childhood intervention ABA therapy assistant, Level 2.
   • 104 hours per annum for early childhood intervention ABA supervisor/specialist.
2. Pursuant to s 101(a) of the ART Act the application for review insofar as it concerns the internal review decision dated 7 August 2024 and the decision to approve a Statement of Participant Supports dated 30 August 2024 is dismissed on the basis that it is now lacking in substance.
3. The Applicant's SOPS is not to include funding for consumables or capital equipment and funding for support coordination is to remain at the same level as the current SOPS and will remain agency managed.

[9] Drake v Minister for Immigration and Ethnic Affairs [1979] AATA 179; [1979] 24 ALR 577 at 589.

[10] Shi v Migration Agent's Registration Authority [2008] HCA 31; (2008) 235 CLR 286 at [45] - [46].

[11] National Disability Insurance Agency v Davis [2022] FCA 1002 at [60].

[12] Beezley v Repatriation Commission [2015] FCAFC 165 (2015); 150 ALD 11 at [68]; HPSC and National Disability Insurance Agency [2021] AATA 727 at [85].

[14] Re Drake and Minister for Immigration and Ethnic Affairs (No 2) [1979] AATA 179; (1979) 2 ALD 634.

[60] Sayadi and National Disability Insurance Agency [2025] ARTA 1217 at [81].

[72] Committee on Educational Interventions for Children with Autism. Catherine Lord and James P McGee, eds. Division of Behavioural and Social Sciences and Education,