Key Points

  • Intellectual disability qualifies for NDIS based on functional impact; children under 9 access the Early Childhood Approach; most people with moderate to profound intellectual disability are approved
  • Supported decision-making is a right, not a preference; NDIS plans should be built around the person’s expressed goals and preferences, with support to understand options rather than decisions made for them
  • Core Supports fund current daily living assistance; Capacity Building funds therapies and programs that build independence over time; a balanced plan includes both
  • Behaviour support is essential when behaviours of concern are present; the Positive Behaviour Support Plan should identify unmet needs driving the behaviour, not primarily focus on eliminating the behaviour
  • Speech pathology and AAC are often underutilised for adults with intellectual disability; communication support should continue throughout adult life, not only in childhood
  • Community participation supports cover both community access (support worker assistance) and structured programs that build social and practical skills

Intellectual Disability and the NDIS

Intellectual disability is characterised by significant limitations in intellectual functioning (typically IQ below 70) and adaptive behaviour, manifesting during the developmental period (before age 18). It is one of the most common primary disability categories in the NDIS, with intellectual disability participants representing a significant proportion of the total NDIS population.

Intellectual disability ranges from mild (many people live independently with limited support) through moderate and severe to profound (requiring comprehensive support with all daily activities). Support needs, provider types, and plan structures vary enormously across this range.

The NDIS’s person-centred framework is particularly important for intellectual disability, as it reframes the support relationship away from doing things for the person toward supporting the person to live the life they choose. Supported decision-making is central to this.

NDIS Eligibility

For children under 9, the Early Childhood Approach provides access to support without a formal NDIS access decision in many cases. Early Childhood Partners coordinate supports and may facilitate a formal access request for ongoing NDIS planning.

For people over 9, a formal NDIS access request requires:

  • A psychologist’s assessment documenting intellectual disability (IQ and adaptive behaviour measures)
  • Evidence of functional impact on daily living
  • Evidence that mainstream supports are insufficient

For adults, the I-CAN assessment tool (introduced from September 2025 for participants over 16) assesses functional capacity across six domains and informs plan funding and support types. Families should ensure assessors communicate in accessible formats and allow adequate time for the person to participate.

Supported Decision-Making

Supported decision-making is one of the most important principles in intellectual disability support and is frequently misunderstood or underimplemented.

What it means in practice:

  • The person is asked what they want, given accessible information to make an informed choice, and their expressed preference is respected
  • Supporters help the person understand options using their preferred communication format (pictures, simple language, familiar examples)
  • The person’s decision stands even if supporters disagree, unless there is a legal reason to override it (guardianship or administration orders from a state tribunal)
  • Decisions are made with the person, not for them

What it does not mean:

  • Leaving the person to make decisions without adequate information or support
  • Accepting an expressed preference as final without checking understanding
  • Overriding the person’s choice because a family member or support coordinator thinks they know better

The Australian Government funded specific supported decision-making programs through 2026 and 2027 to assist people with intellectual disability in financial decision-making. Support coordinators should be familiar with supported decision-making principles and implement them in NDIS planning processes.

The Provider Team

Support Coordinator

A support coordinator navigates the NDIS plan, connects the person with appropriate providers, monitors service delivery, and advocates for the person’s rights and goals. For intellectual disability, the support coordinator should:

  • Understand intellectual disability and its functional implications
  • Use accessible communication with the participant
  • Implement supported decision-making in all provider selection processes
  • Coordinate the broader team (OT, speech pathologist, behaviour support, support workers) and ensure they are communicating

Support Workers

Support workers provide direct assistance with personal care, domestic tasks, community access, and social participation. For intellectual disability, support workers should have:

  • Training in intellectual disability support
  • Familiarity with the person’s communication system (AAC if applicable)
  • Knowledge of the person’s Positive Behaviour Support Plan if one is in place
  • Skills in supported decision-making and choice presentation

Consistency of support workers is particularly important for many people with intellectual disability; frequent changes in personnel are destabilising and require repeated adjustment to new communication styles and routines.

Occupational Therapist

An OT for intellectual disability addresses:

  • Daily living skills training: Teaching self-care, domestic, and community skills using task analysis, visual prompts, and graduated independence approaches
  • Assistive technology: Prescribing AAC devices, visual schedules, adapted equipment
  • Home and school environment assessment: Identifying modifications that support independence and safety
  • Functional capacity assessment: For NDIS applications and plan reviews
  • Sensory processing: OTs with sensory processing expertise address sensory difficulties that are common in intellectual disability

OTs working with people with intellectual disability must use adapted communication: plain language, visual supports, adequate processing time, and a paced approach to therapy sessions.

Speech Pathologist

Communication support is often the most underutilised area of allied health for adults with intellectual disability. Many adults received speech pathology in childhood and it was discontinued, but communication goals evolve throughout life: workplace communication, assertiveness, community access, digital communication, and health literacy are important adult communication goals.

Speech pathology for intellectual disability covers:

  • AAC: Assessing, prescribing, and training in augmentative and alternative communication
  • Social communication: Conversation skills, turn-taking, topic maintenance, and assertiveness
  • Functional communication: Using communication in real community contexts (shops, public transport, medical appointments)
  • Health literacy: Understanding health information, consent, and rights

All team members and family carers should be trained in and consistently use the person’s AAC system.

Psychologist

Psychology for intellectual disability addresses:

  • Mental health: Anxiety, depression, grief, and trauma are underdiagnosed in intellectual disability because presentations may differ from those in the general population
  • Therapeutic approaches: Adapted CBT and other evidence-based approaches modified for intellectual disability are available
  • Behaviour understanding: Some psychologists also provide behaviour support; the role should be clarified

Behaviour Support Practitioner

Behaviour support is required when behaviours of concern (behaviours that cause harm or significantly limit participation) are present. For intellectual disability, common drivers include:

  • Communication barriers: The person cannot express a need verbally and behaviour is the communication
  • Sensory discomfort: Unaddressed sensory needs drive avoidance or seeking behaviours
  • Mental health conditions: Anxiety, depression, and PTSD present differently in intellectual disability
  • Inadequate choice and control: Environments with limited choice and autonomy increase the frequency of behaviours of concern

A Positive Behaviour Support Plan (PBSP) addresses these drivers. It should be a living document reviewed regularly as the person’s needs and environment change.

Community Participation and Employment

Community Participation

Community access funding (Core Supports) allows a support worker to accompany the person to community activities, recreation, social groups, and cultural events aligned with their interests and goals. The support worker’s role is to facilitate participation, not to substitute for it.

Capacity Building can fund structured community participation programs that also build skills: social skills groups, community education, volunteering programs, and similar initiatives.

Supported Employment

Adults with intellectual disability have the right to work. Supported employment programs provide:

  • Job coaching and workplace support
  • Job matching (aligning role demands to the person’s skills and interests)
  • Employer awareness and relationship building
  • Graduated hours and ongoing support

NDIS funds employment supports through Capacity Building. The separate Disability Employment Services (DES) system, funded by the Department of Employment, provides ongoing job coaching for people in open employment.

Evidence consistently shows that people with intellectual disability succeed in competitive employment when support is well matched. The assumption that intellectual disability precludes employment is not supported by evidence.

Key Resources

Finding Intellectual Disability Support Providers

Carevo connects people with intellectual disability to support coordinators, OTs, speech pathologists, behaviour support practitioners, and NDIS-registered community participation providers across Australia.

Find an intellectual disability support provider through Carevo