Global Developmental Delay (GDD) is a term used to describe children who exhibit significant delays in multiple areas of development. While this diagnosis is crucial for Early Childhood Early Intervention (ECEI), it is not considered age-appropriate after the age of 6 for the National Disability Insurance Scheme (NDIS). Here’s why:
Understanding Global Developmental Delay
According to DSM-5, the Global Developmental Delay diagnosis is set aside for children under the age of 5 when an alternative diagnosis cannot be evidenced and the child is unable to participate in formal diagnostic assessments.
Often a diagnosis of GDD is given to children who show delays in achieving developmental milestones in areas such as motor skills, speech and language, cognitive abilities, and social interactions. This diagnosis allows for early intervention, which is essential for addressing developmental issues as early as possible. This is the intent of an early intervention approach, it is designed to build capacity and reduce functional impact. It can also be a first step on the path to a more accurate and defined diagnosis.
Age-Appropriate Diagnoses
As children grow older, their developmental progress can be more accurately assessed. By the age of 6, children are expected to have reached certain developmental milestones that can be measured more precisely using formalised assessments. At this stage, a more specific diagnosis, such as an intellectual disability or a specific learning disorder, becomes necessary and age appropriate.
NDIS Eligibility Criteria
The NDIS has specific eligibility criteria that must be met for continued support. For children under 6, GDD is recognized under the Early Childhood, Early Intervention requirements. However, after the age of 6, the NDIS requires a diagnosis that reflects a permanent and significant disability. This shift ensures that the support provided is appropriate and targeted to the child’s long-term needs.
Many children do benefit from and meet the eligibility criteria for the early intervention approach, however this does not guarantee becoming a full participant of the scheme. One of the primary foundations of the NDIS is that with appropriate early intervention many children will not require NDIS supports later in life and will graduate from the NDIS.
NDIS Eligibility Criteria
- Accuracy of Diagnosis: By age 6, developmental assessments are more reliable, allowing for a more accurate diagnosis. This helps in identifying the designed to age appropriate at a key point in time.
- Focus on Permanent Disabilities: The NDIS aims to support individuals with permanent and significant disabilities. GDD is a temporary diagnosis used until the age of 6 when a more specific diagnosis can be identified. After age of 6, the focus shifts to long-term conditions that require ongoing support. If eligibility is still required due to function impact this can be evidenced through more appropriate diagnostic tools at later developmental stages.
- Resource Allocation: Ensuring that NDIS resources are allocated to those with permanent disabilities who have severe and profound support needs helps maintain the sustainability of the NDIS and the confidence of the Australia taxpayer who meet the costs of the NDIS. This approach ensures that support is available for those who need it most. A GDD diagnosis becomes inappropriate from an NDIS perspective once a more age appropriate diagnosis could be obtained. Lack of a more age permanent disability could not be met.
- Dignity of risk. Another design principles of the NDIS it that it assumes capacity until there is evidence to the contrary. The legal decision maker not the NDIS takes the risk of not having an updated diagnosis and evidence of functional impact.
Conclusion
The transition from a diagnosis of Global Developmental Delay to a more specific age-appropriate diagnosis from the age of 6 is a crucial step in ensuring that children receive the most appropriate and effective support for their disability. This change aligns with the NDIS’s commitment to providing targeted assistance to individuals with permanent and significant disabilities, will help ensure financial sustainability and assist children through an Early Childhood Early Intervention approach who would not meet full scheme eligibility requirements. When children graduate from the NDIS it is a great accomplishment and shows their functional impact does not require lifelong NDIS supports.
The system is only as good as the information it is provided and if a child’s diagnosis or evidence base is not appropriate that is not the responsibility of the NDIS, that is the responsibility of the legal decision maker and from the NDIS perspective, is part of the dignity of risk. Unfortunately, one of the results of the eligibility reassessment process is that some children will be exited that should not have been. It will be expected that this will ultimately be picked up through mainstream systems and evidence gathered to retest eligibility. This is the dignity of risk of individualised, person-centred supports.
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