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Changes to NDIS funding

Danielle Watkins

Every year in June, families and clinicians who rely on the National Disability Insurance Scheme (NDIS) wait for an announcement from the government to find out what the next 12 months are likely to look like. Each year, The NDIA uses a mix of market data, research, and (apparently) public and industry engagement to inform changes to pricing arrangements and price limits through its Annual Pricing Review. This tells the disability sector what the government will pay, under the NDIS, for a long list of services.

As a clinician and a business owner, this annual announcement impacts what fees I will charge for my services over the next 12 months. I now no longer wait for it with any hope, but with dread. For the past 6 years the therapy cap has remained the same at $193.99 per hour, despite sky rocketing costs in all of our business overheads. This June, our worst fears were realised. The price guide showed a reduction in the amount the scheme will pay for clinical services. I am grateful that the hourly rate for speech pathologists has not dropped. I feel for my colleagues in physiotherapy, podiatry, and dietetics who have had their hourly rate decreased. What has dropped for speech pathology is the amount that the NDIS will pay for travel. They are now only going to pay 50% of the hourly rate for the therapist to travel to the client. Interestingly, the NDIS website states that they are “Increasing the price limits for psychologists, nurses and other supports based on how much wages and the cost of living have gone up.” – apparently this does not apply to most other clinicians.

There is a lot that could be said about these decisions, but I will stick to the facts:

  1. NDIS will pay for $193.99 per hour of service for speech pathology.
  2. NDIS will pay for $86.79 per hour of service for an Allied Health Assistant.
  3. NDIS will pay for 50% of the above rate for a therapist to travel to the appointment location. This was previously 100%. The new rates are:
    1. $97 per hour for a speech pathologist
    2. $43.40 per hour for an Allied Health Assistant
  4. NDIS will pay for $1 per km of provider travel.

For a number of complex reasons, Talking Fish Therapies has made the decision to NOT change its prices. We will continue to charge the following:

Speech Pathologist:

  • $387.98 for assessment and report
  • $193.99 for 1 hour therapy session (45 minutes face to face, 15 minutes admin)
  • $193.99 for support letters/application forms
  • $1.00 per km travelled for mobile therapy; and $193.99 per hour travelled for mobile therapy

Allied Health Assistant:

  • $87.79 for 1 hour therapy session (45 minutes face to face, 15 minutes admin)
  • $1.00 per km travelled for mobile therapy; and $87.79 per hour travelled for mobile therapy

We will be simplifying and clarifying how we charge for travel. From 1 July 2025, we will record the travel time and kilometers travelled to your appointment and include these in our invoice, as per the above fees. If your therapist needs to return to their office after your appointment, we will include that time and those kilometers as well. If there is more than one client seen at that location, the travel fee will be equally divided between those clients.

For example, if your therapist travels 30 minutes and 30km to a school and sees 3 clients at that school. The travel charge will be:

  • $193.99 x 0.5 hours = $97. A ⅓ share of this fee = $32.01
  • $1 x 30kms = $30. A ⅓ share of this fee = $9.90
  • $32.01 (time) + $9.90 (kms) = $41.91 (total travel fee)

Please be aware that travel fees often vary depending on the number of clients available at any given location on any given day. Where the therapist is travelling from can also change, so you will likely see different travel fees on different days. Any shared travel expenses will show on invoices as a discount.

We thank you for your kind understanding at this time as we make these complex and difficult billing changes. We understand that some families will be impacted and others will not. If you have any concerns about these changes that we are being forced to make, I encourage you to contact your local MP to let them know how the changes to the NDIS are impacting your family. You can find a list of who represents you on the Parliament of Australia website.

How we work

Talking Fish Therapies Hybrid Speech Therapy

Danielle Watkins

The hybrid speech therapy program is a way of combining the expertise of our Certified Practicing Speech Pathologists (CPSPs) and the availability of our Allied Health Assistants (AHAs).

We want to provide quality speech therapy to more children in our community. Our Speech Pathologists do not currently have enough time to see all the children that need our help but we still want to do as much as we can.

1. A Certified Practising Speech Pathologist (CPSP) assesses your child and writes a report.

2. Together with the family, the CPSP writes a therapy plan with clear goals for everyone to work towards.

3. An Allied Health Assistant (AHA) is instructed on how to provide the therapy to achieve these goals.

4. The AHA works regularly with the child and meets with the CPSP to make sure the therapy is going well.

5. The CPSP has an appointment with the child and family once per school term to support the child, family, and the AHA to continue working towards their goals.

This program is not appropriate for all children, please speak to your speech pathologist about whether your child is eligible for this program. 

All our Allied Health Assistants have been chosen as suitable for this role for a variety of reasons, many are speech pathology students who are working towards being Certified Practising Speech Pathologists themselves.

These therapy sessions are currently being offered at our clinic in Officer.

Your CPSP appointments will be one-off appointments once per term. 

Your regular appointments with your AHA are available Tuesdays, Wednesdays, Thursdays, and Saturdays.

About speech pathology

How to get from ‘New Grad’ to ‘CPSP’

Danielle Watkins

You have just finished your speech pathology degree – congratulations!

If you want to work in private practice, you will need to join Speech Pathology Australia and register for Provisional Certification so that your clients will be eligible for rebates and funding under Medicare and National Disability Insurance Scheme (NDIS), among other funding schemes. Once you have your certification, you can use the postnominals ‘CPSP’ which stands for Certified Practicing Speech Pathologist.

Speech Pathology Australia has lots of information about the requirements for certification and here at Talking Fish we have read it thoroughly and created a plan to get our new graduate speech pathologists up to standard and feeling confident within their first three months of working with us. From there, it is simply practice, practice, practice (and follow your professional development plan)!

Week 1: Orientation

  • we start with the usual paperwork, getting familiar with resources and technology
  • 2 clients per day, there will likely be time to observe other therapists with their clients throughout the week as well
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end. Everyone at Talking Fish does a ‘Weekly Wrap-Up’ to summarise their achievements and learnings for the week.

Week 2: Planning

  • this week we create a professional development plan. Everyone at Talking Fish Therapies has one of these and we regularly refer back to them
  • begin the Speech Pathology Australia Ethics module. This is one of the requirements for certification
  • 2 clients per day plus observation of other clinicians
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end

Week 3: Ethics

  • complete the SPA ethics module. This is a 6 hour module so we allow 2 weeks for it to be completed
  • 3 clients per day plus observation if time allows
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end

by the end of this week you will have completed one of the requirements for certification: completion of the ethics training.

Week 4: Cultural learning

  • a Speech Pathology Australia module on Aboriginal and Torres Strait Islander culture is required this week. This is not a requirement for your initial certification but it is very important to the Talking Fish team so we have included it here, early in the new graduate program
  • 3 clients per day plus observation if time allows
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end

Week 5: Evidence Based Practice

  • Speech Pathology Australia’s Evidence Based Practice module 1
  • 3 clients per day plus observation if time allows
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end

Week 6: Evidence Based Practice

  • Speech Pathology Australia’s Evidence Based Practice module 2
  • 3 clients per day plus observation if time allows
  • formal meetings with supervisor on Monday and Friday to get ready for the week and to debrief at the end

by the end of this week you will have completed two more requirements for certification: completion of EBP training and 12 hours of individual supervision

Week 7-12: Practice, practice, practice

  • 4 clients per day
  • weekly formal meetings with your supervisor to continue to improve your practice

by the end of this period you will have completed the final requirement for certification: 200 speech pathology practice hours

From here, everyone’s journey is different. At Talking Fish Therapies we recommend training in DIR Floortime early in your career but this may not be appropriate for everyone, depending on their caseload. This is why a well thought out Professional Development Plan is important and should be referred to often.

If you would like to join us for your new grad year and beyond we would love to hear from you!

Language

Developmental Language Disorder

Sally Rush

Developmental Language Disorder 

Developmental language disorder (DLD) is a communication disorder classified as persistent difficulties understanding and/or using language. People with DLD do not typically have any other diagnoses to explain their language difficulties (such as Autism Spectrum Disorder). This means that DLD often goes unnoticed in the classroom and students can go years without receiving the appropriate help.

Characteristics

Diagnosis

  • Ongoing difficulties with the use and understanding of language (vocabulary, grammar, idea generation, following instructions etc.) that does not resolve after 5 years of age.
  • Social communication challenges impacted by difficulties understanding spoken language and self-expression.
  • Word finding difficulties and difficulty learning new words.
  • Difficulty following instructions. 
  • Difficulties comprehending spoken or written language. This impacts reading comprehension and people with DLD often receive a diagnosis of Dyslexia. 
  • Disengaging with academic content due to a reduced ability to participate and access curriculums. 
  • Difficulties with written language and expression. This may impact the ability to generate diary entries, creative stories or essays. 
  • DLD diagnosis is completed by a team of healthcare professionals. Specifically, psychologists, educational specialists, and Speech Pathologists. 
  • Assessments may involve: Cognitive assessment, educational assessment, standardised language assessment. 

Supports

  • Children with DLD will require support and modifications to access their school curriculum. This may include extended assessment times, 1:1 examinations with a support person, visual representations of words in the form of a mind-map, or having word lists sent home in advance to allow pre-teaching of concepts.
  • Children with DLD have many strengths. It is crucial that children with DLD are taught and encouraged to complete their work in a method that works for them. For example, rather than a diary entry, children may be encouraged to verbally recite their entry and have the teacher write it for them, or write their story in a visual mind-map format to allow them to clearly express their thoughts.
  • Speech pathologists can support individuals with DLD to increase their ability to communicate and understand various aspects of language. Therapy may be targeted to specific interests or goals that the individual might have around their language abilities (comprehension, vocabulary etc.).

Resources

For more information, you can head to:

Speech

Childhood Apraxia of Speech Awareness Month

Sally Rush

May 14th is Childhood Apraxia of Speech awareness month! The month is not commonly recognised in Australia, but we wanted to write a piece about it to raise awareness for the disorder. 

What is Childhood Apraxia of Speech? 

Childhood Apraxia of Speech (CAS), or dyspraxia, is a rare neurological motor speech sound disorder that disrupts the planning and programming of accurate speech sounds. Just like we use our brain to make a cup of tea or ride a bike, we need our brain to tell our facial muscles (jaw, lips and tongue) how to move to make the correct sounds. Children with CAS know what they want to say, but are not able to accurately coordinate the muscles of their mouths to make the sounds they want. Children can vary from having mild to severe speech sound difficulties. These difficulties can impact children’s ability to engage in activities and participate in group activities due to their difficulties being understood by their peers.

Importantly, children with CAS are just like any other child. They like the same foods, the same iPad apps, and they all like to laugh and have fun. They just need some extra support and time to get their message across 💙

What does CAS sound like? 

Children with CAS experience varied degrees of difficulty producing accurate speech sounds.

The three main features seen in the speech of children with CAS are:

  1. Inconsistent speech errors. 

This occurs because children with CAS may not have a plan to make a sound, so it is different each time they make it. This means that they might make different mistakes for the same word. For example; producing the word ‘bike’, three different ways in a matter of minutes (‘ike’, ‘bi’, ‘bibe’). 

  1. Disrupted transitions between sounds and syllables. 

This means that the child’s speech may sound choppy or disjointed because they are experiencing difficulty moving onto the next part of their word or sentence. Children with CAS may speak slower than other children because they require more effort to get their message across. For example, ‘bay.. bee’ for baby. 

  1. Inappropriate prosody. 

Prosody refers to the volume, rhythm, intonation, and stress of speech. Children with CAS may speak without changing their intonation (monotone), or stress the wrong parts of speech (speak loudly at the incorrect time) because this is an extra layer of speech that needs to be planned. 

What therapy is there for children with CAS? 

Evidence shows that CAS requires frequent, intensive therapy to see the best results in children (twice weekly therapy). Therapy for CAS is slightly different from therapy that targets other speech sound disorders. Therapy for CAS often requires repeated attempts to produce the correct sound so the child can learn the correct motor plan. Therapists will assist children in producing sounds, syllables, and words correctly depending on their difficulties.

Available therapies can be found here: https://childapraxiatreatment.org/treatment-methods/ 

Children with CAS can also benefit from augmentative and alternative communication (AAC) such as speech generating devices or sign language to help them get their message across. 

If you have any questions about CAS, feel free to get in touch with us at Talking Fish. 

More information can also be found at this website:

Speech

The relationship between learning how to read and spell, and your child’s speech sounds

Sally Rush
  • Did you know that there are 44 speech sounds in the English language that combine to make thousands of words, using only 26 letters?!
  • These sounds are called phonemes. The letters or groups of letters that we use to represent these speech sounds are called graphemes. Understanding the relationship between graphemes and how that can be matched to phonemes is essential for our children when learning to read.
https://www.readingdoctor.com.au/phonemes-graphemes-letters-word-burger
  • Our children need a full set of sounds (44), to decode the relationship between letters, and their sounds.
  • For some children, learning, understanding and using the correct speech sounds in conversation is challenging. For example, saying ‘pish’ instead fish.

They might not be able to map sounds to the corresponding letter, as they cannot produce the sound, or do not understand how the sound is used in words. For example, I can produce the ‘k’ sound, but say ‘tat’ instead of cat.

  • Some children may require additional support from a speech pathologist to support their ability to produce or understand certain sounds. This will improve their sounds in conversation, and their ability to decode letter-sound relationships.

TIP:

  • When teaching your child the alphabet, teach them the letter sounds (phonemes) that the letters names make.

HELPFUL WEBSITES:

How we work

COVID 19 operations

Danielle Watkins

It’s a difficult time for everyone at the moment. Whilst allied health services such as speech pathology are eligible to still operate in person, Talking Fish Therapies has made the decision to operate completely via telehealth. Telehealth comes in many different forms, so we will be speaking to our families about what will work best for them during this time.

 

We are also working on some innovative solutions to get around some of the difficulties we are facing. Keep an eye out for updates on these!

 

Stay safe everyone, keep in touch, and please don’t hesitate to reach out if you need any assistance.