S8E05 - Assessing Need Or Navigating Policy? The Reality of OT Practice in the NDIS

When assessment tools and NDIS policy don’t line up

As NDIS reforms gather pace, OTs are being pulled in two directions at once. On one side, we’re being told to simplify, reduce “extra” evidence and focus on structured assessment pathways. On the other, the tools we’re expected to use still rely on clinical reasoning, collateral information and transparent justification to be considered valid.

That tension is not theoretical. It’s playing out in everyday report writing, accreditation processes and plan reviews across the country.

The I-CAN reality check many clinicians aren’t expecting

The first reality is the clear expectation that conclusions are supported by explicit reasoning – particularly around frequency and intensity of support. It’s not enough to state what is required; the rationale must be transparent, functionally linked and grounded in everyday impact.

The second is the requirement to reference and integrate other sources of evidence – including relevant professional reports, clinical documentation and collateral information. This reflects sound clinical practice and strengthens the integrity of the assessment.

What’s interesting is not that these elements are required – they absolutely should be in a valid and reliable assessment framework. The question is what happens if the tool is later used within a planning system that does not consistently allow for, consider or weight external evidence in the same way.

This isn’t a criticism of I-CAN. It’s a reflection on alignment. If a tool’s validity depends on multi-source evidence and clinical reasoning, then any system using that tool needs to preserve those same inputs to maintain its integrity.

Preparing for support needs assessments without losing OT rigour

With support needs assessments expected to play a larger role in planning, OTs cannot afford to let their clinical standards slip.

Structured tools do not replace professional reasoning. They require it.

Reports still need to clearly connect assessment findings to functional participation. Frequency and intensity must be justified in terms of real-world support needs, not abstract scoring. Recommendations must logically flow from evidence that has been interpreted, not just presented.

This is the moment to simplify templates, not inflate them. Clarity, consistency and defensible reasoning will carry more weight than volume.

Standardised assessments are being used, but not always in a clinically sound way

The conversation around standardised assessments has become increasingly polarised. Some clinicians feel pressure to include more tools to “prove” their case. Others are pulling back, concerned that raw scores will be misread or used in isolation.

The problem isn’t the tools themselves. It’s how they are being used.

Reports overloaded with eight or nine standardised measures rarely add clarity. They often overwhelm the reader and increase the risk of inconsistency. At the same time, simply listing scores without interpretation leaves critical gaps.

A balanced approach works best. Use a small number of well-chosen measures. Provide a concise, plain-language interpretation. Then embed that meaning within the broader functional narrative. A short, well-written paragraph can often achieve more than pages of technical explanation.

Why attaching full assessment forms can backfire

Including full assessment printouts or item-level responses might feel protective, but it can create unintended consequences.

Standardised tools are designed to be interpreted as complete measures, not as isolated questions. When item responses are visible, there is a risk that someone without appropriate training may focus on a single answer and draw inaccurate conclusions.

A safer approach is to include summary scores and your functional interpretation, then clearly link those findings to observed performance and reported impact. If a result does not align with your broader evidence, it is better to explain the discre