This article is featured in The Guardian and is republished with permission.
The head of Australia’s peak body of psychologists and disability experts have warned the NDIS’s new assessment tool hasn’t been tested on a variety of disability types – including diverse autistic needs – which may lead to “tragedies” occurring, if more research is not conducted.
The National Disability Insurance Agency (NDIA) announced in September it had procured the Instrument for the Classification and Assessment of Support Needs (I-CAN) to be used as the basis for determining support plans for NDIS participants.
The I-CAN tool, developed by the Centre for Disability Studies, takes the form of a three-hour semi-structured interview. The answers are fed into a computer program that produces a budget of supports for NDIS participants.
It will be rolled out from mid-2026, in a “staged” fashion, as part of a major overhaul to the way that NDIS support plans are determined.
The NDIA called the tool the “gold standard of available, validated needs assessment tools. It has been developed over more than 20 years in the Australian context and tested through multiple research studies across a range of disability groups”.
The president of the Australian Psychological Society, Dr Kelly Gough, which represents more than 25,000 psychologists across Australia, said there were strengths to the I-CAN tool, but was concerned about the way the tool had been “validated” – tested and shown to produce consistent results.
Gough was also alarmed that the NDIA was planning to have people conduct the support needs assessment using the I-CAN tool who had no allied health background. The NDIA has said that while it will look to recruit assessors with allied health backgrounds, this will not be a requirement.
“All of those studies and all that validation has been done with people who were allied health professionals of one kind or the other – psychologists or physios or OTs,” he said.
“We don’t have any published evidence that I’m aware of that it’s an effective or a valid tool if it’s done by people who don’t have all that other knowledge and background.”
A spokesperson for the NDIA said: “The Support Needs Assessment will be conducted by trained, appropriately skilled assessors.”
Gough added that APS members had also raised concerns that the I-CAN is “not particularly good at understanding the sorts of requirements and support needs for people in [some disability] categories” including those with acquired brain injury and psychosocial conditions.
Gough warned that if the I-CAN were to be implemented broadly without further research and validation, there could be consequences.
“What will probably happen is that there will just be terrible outcomes for six months or a year and complaints … and people talking to the government and the ombudsman and whatever else and maybe a couple of tragedies and then something will get fixed.”
The president of the Institute of Clinical Psychologists, Dr Marjorie Collins, shared Gough’s concern that the I-CAN has not be validated for use with a wide range of disability groups.
“The I-CAN has not been tested on very many populations at all,” she said, adding to roll it out to all adult NDIS participants without further testing would be “reprehensible”.
She said that it had only been “validated on a couple of populations, one of them being people with intellectual disability”, and that for that group, the research shows the tool is reliable.
“Maybe it’s really great for people with an intellectual disability, but who knows if it’s going to be picking up what you’re wanting it to be picking up with people with an acquired brain injury or somebody with autism or somebody with psychosocial disability, for example.
“Because they are very different populations and the I-CAN has not, as yet, had any publications looking at whether it validly measures disability in those populations.
Helen Dickinson, professor of public service research at the University of New South Wales, said the I-CAN also needed to be tested to check: “does it work for people with different intersectional characteristics, so people from culturally and linguistically diverse backgrounds, people from First Nations backgrounds”.
Jenny Karavolos, co-chair at the Australian Autism Alliance, said there were elements of the I-CAN that were “welcome”, including that it was based on the World Health Organization’s International Classification of Functioning, Disability and Health and that the tool was not “stand-alone” but would be used alongside a questionnaire about people’s personal and environmental circumstances.
However, she said her organisation had not endorsed the use of the I-CAN because “we haven’t found any studies that show it can reliably capture the diversity of autistic support needs.”
“They need to do the pilot testing against a large, diverse autistic sample,” she said.
Karolovos also called for clarity about how the “staged” rollout would work, saying, that when the NDIS first launched there was a feeling that “we’re designing the plane while we’re flying it”.
“That’s the situation we’re all trying to avoid,” she said. “It’ll cost more in the long run, people fall apart, it will cost everyone, society, more. So can we spend the time and get the testing right?”
A spokesperson for the NDIA said that the tool would be rolled out over the next five years and that the NDIA will use the I-CAN “as the starting point for developing a tailored tool for the NDIS’ specific needs”.
The spokesperson said the I-CAN tool is “appropriate for use across all disability types” and “has been extensively researched and tested in a range of real-world disability settings.”
“We are continuing to consult with participants, families, carers and the broader disability community to make sure that the Support Needs Assessment will work for all participants, including different disability types, people in remote areas, First Nations participants and people from culturally and linguistically diverse backgrounds.”