Cerebral Palsy and the NDIS
Cerebral palsy is a group of permanent movement disorders caused by damage to the developing brain, typically occurring before, during, or shortly after birth. CP affects muscle tone, movement, coordination, and posture. The severity varies enormously — from mild limitations affecting one limb to severe quadriplegia affecting all four limbs, trunk, and often speech and swallowing.
Under the NDIS Act 2013 (Section 24), cerebral palsy is a permanent disability that meets the disability criterion. Most people diagnosed with CP will be eligible for the NDIS, though the level of funding depends on the severity of functional impacts and the supports required.
The GMFCS classification system
The Gross Motor Function Classification System (GMFCS) is the standard tool used to describe motor function in people with CP. Understanding GMFCS levels helps providers plan appropriate supports and documentation:
| GMFCS Level | Mobility | Typical NDIS Support Needs |
|---|---|---|
| Level I | Walks without limitations | Therapy supports (physio, OT), minor assistive devices, capacity building |
| Level II | Walks with limitations, may use hand-held mobility device | Therapy, walking aids, some personal care assistance, community access support |
| Level III | Walks using hand-held mobility device indoors, wheelchair for longer distances | Manual wheelchair, increased personal care, home modifications, therapy, community access |
| Level IV | Self-mobility with limitations, transported in wheelchair or uses powered wheelchair | Powered wheelchair, significant personal care, SIL potential, high intensity supports, home modifications, SDA potential |
| Level V | Transported in wheelchair, severely limited self-mobility | Full personal care, powered wheelchair with specialised seating, 24/7 SIL, SDA (High Physical Support), high intensity supports, PEG feeding, complex positioning |
NDIS Funding Categories for CP Supports
Participants with cerebral palsy typically access supports across all three NDIS funding categories. The range and value of supports depends on the participant's GMFCS level and individual functional profile.
Core Supports
- Assistance with daily life — personal care (showering, dressing, toileting, meal preparation), domestic assistance, SIL
- Transport — wheelchair-accessible transport, support worker accompanying the participant, taxi transport
- Consumables — continence aids, nutritional supplements (for PEG-fed participants), everyday assistive devices
- Community participation — support workers accompanying participants to community activities, sport, recreation
Capacity Building Supports
- Improved daily living — occupational therapy for daily living skills, physiotherapy for mobility and strength, speech pathology for communication and swallowing
- Improved health and wellbeing — exercise physiology, hydrotherapy, dietetics
- Improved learning — educational support, transition planning for school to adult services
- Support coordination — essential for participants with complex needs who access multiple services
Capital Supports
- Assistive technology — wheelchairs (manual and powered), standing frames, communication devices, seating systems, splints and orthotics, environmental control units
- Home modifications — ramps, widened doorways, accessible bathrooms, ceiling hoists, stair lifts, kitchen modifications
- Vehicle modifications — wheelchair-accessible vehicles, wheelchair hoists, hand controls for driving
- Specialist Disability Accommodation — purpose-built or modified housing for participants with extreme functional impairment
Assistive Technology for Cerebral Palsy
Assistive technology (AT) is often the most significant capital investment in a CP participant's NDIS plan. Providers who supply, maintain, or support the use of assistive technology need to understand the NDIS AT framework.
AT categories and approval pathways
| AT Category | Cost Threshold | Assessment Required | Examples for CP |
|---|---|---|---|
| Low-cost AT | Under $1,500 | No formal assessment — can be self-purchased from Core or Capacity Building budgets | Adapted utensils, non-slip matting, simple switch devices, bath seats |
| Mid-cost AT | $1,500 – $15,000 | Assessment by a qualified therapist (OT, physiotherapist, speech pathologist) | Manual wheelchairs, standing frames, basic AAC devices, shower commodes |
| High-cost / complex AT | Over $15,000 | Comprehensive AT assessment, quotes from multiple suppliers, NDIA approval | Powered wheelchairs, custom moulded seating, eye-gaze communication systems, ceiling hoists, vehicle modifications |
If you provide support to participants who use complex assistive technology, your staff must be trained in the correct use and maintenance of that equipment. Auditors will check that staff competency is documented in your training register. This includes wheelchair operation, hoist transfers, AAC device setup, and pressure-relieving equipment management. The SIL Rescue Kit includes a Training Register template for tracking these competencies.
Specialist Disability Accommodation Eligibility
Specialist Disability Accommodation (SDA) is specialist housing for NDIS participants with extreme functional impairment or very high support needs. Many participants with severe cerebral palsy (GMFCS Level IV and V) are eligible for SDA.
SDA design categories relevant to CP
- High Physical Support — the most common SDA category for participants with CP. Includes ceiling hoists, accessible bathrooms, wider corridors and doorways, assistive technology integration, and structural provisions for powered wheelchairs
- Fully Accessible — designed for participants who can direct their own care but need a fully wheelchair-accessible home. Suitable for some GMFCS Level III-IV participants
- Robust — designed for participants with complex behaviours that require a resilient built environment. Less common for CP unless the participant has co-occurring behavioural needs
High Intensity Daily Activities for CP
Many participants with cerebral palsy require high intensity daily personal activities — clinical care tasks that go beyond standard personal care. Providers delivering these supports need registration under registration group 0104 and must comply with the High Intensity Daily Personal Activities supplementary module.
Common high intensity supports for CP
- PEG feeding — enteral nutrition for participants with swallowing difficulties (dysphagia) resulting from CP
- Seizure management — approximately 30-50% of people with CP also have epilepsy; rescue medication administration and post-seizure care
- Complex positioning and transfers — hoist transfers, manual handling requiring specific techniques, pressure area management
- Respiratory support — chest physiotherapy, suctioning, oxygen therapy for participants with respiratory complications
- Bowel management programs — for participants with neurogenic bowel dysfunction
- Subcutaneous injections — e.g., baclofen pump management
SIL Registration Deadline: 1 July 2026
If you provide SIL for participants with CP, you need audit-ready policies. The SIL Rescue Kit has 65 documents mapped to every NDIS Practice Standards Core Module outcome.
Get the SIL Rescue Kit — $297Therapy Supports: Physio, OT, and Speech
Therapeutic supports are a lifelong component of care for most people with cerebral palsy. The NDIS funds allied health services that address the functional impacts of CP and work toward the participant's NDIS plan goals.
Physiotherapy for CP
Physiotherapy for participants with CP focuses on maintaining and improving mobility, strength, flexibility, and cardiorespiratory fitness. Common interventions include stretching programs (to manage muscle contractures), strength training, gait training, hydrotherapy, and post-surgical rehabilitation (e.g., after orthopaedic surgery for contracture release). Progress notes should document specific measurements where possible — range of motion, functional mobility scores, timed mobility tasks, and pain levels.
Occupational therapy for CP
Occupational therapy addresses the participant's ability to perform daily activities independently. For CP, OT commonly covers upper limb function (fine motor skills, grip strength, hand function), adaptive equipment prescription and training, home modification assessments, wheelchair and seating assessments, sensory processing support, and daily living skills training. OTs also play a key role in prescribing assistive technology.
Speech pathology for CP
Speech pathology for CP may address communication (speech intelligibility, AAC systems, social communication) and swallowing (dysphagia management, mealtime management plans, PEG feeding oversight). Progress notes for speech pathology should document communication outcomes using functional terms — what the participant was able to communicate, using which method, and how this compares to previous sessions.
Progress Notes for Physical Disability
Progress notes for participants with cerebral palsy must capture physical support accurately, document equipment use, and link all activities to NDIS plan goals. The NDISCompliant Notes Rewriter can help support workers format their shift notes into compliant, audit-ready documentation.
What to include in every progress note
- Date, time, duration, and location of the support session
- The NDIS plan goal being addressed
- Physical supports provided (transfers, positioning, personal care tasks) with specific methods used
- Equipment used (wheelchair type, hoist, standing frame, AAC device, splints)
- Any changes in the participant's physical presentation (increased tone, pain, skin integrity concerns)
- The participant's engagement and communication during the session
- Any clinical care tasks completed (PEG feed, medication administration, seizure care)
- Staff actions and clinical reasoning for any decisions made
Documenting transfers and positioning
| Poor Documentation | Compliant Documentation |
|---|---|
| "Helped with shower" | "Completed two-person hoist transfer from bed to shower chair at 07:15 using ceiling hoist and large sling. Sarah tolerated the transfer well, maintaining a neutral head position throughout. Showered with full assistance — staff washed hair, body, and applied moisturiser to pressure areas. No skin breakdown observed on sacrum or heels. Transferred back to wheelchair at 07:45." |
| "Had physio exercises" | "Completed prescribed stretching program (hamstrings, hip flexors, adductors — 3 repetitions, 30 seconds each). Jason reported discomfort during left hamstring stretch (3/10 pain). Stretch was modified to reduce intensity. Standing frame session: 20 minutes in standing frame with trunk support. Goal 1: Maintain standing tolerance of 30 minutes by December." |
Important: This article provides general guidance about NDIS compliance requirements. It is not legal or professional advice. Requirements may change as the NDIS Commission updates its policies and Practice Standards. Always verify current requirements with the NDIS Quality and Safeguards Commission or a registered NDIS consultant before making compliance decisions.