Case Study - Child with Learning Difficulties

This page contains information on Speech, Language and Communication Disorders and Speech Pathology Services - Case Study - Child with learning difficulties

Page last updated: 13 December 2017

My four year old son has learning difficulties. Last year my doctor diagnosed my son with Autism Spectrum Disorder. He receives help at kindergarten from a support teacher. The teacher has suggested that the assistance of a speech pathologist would be helpful to develop his speech and communication skills. I am not sure I can afford speech pathology along with the other support my son needs and would like to find out what support there is for him.

How do I find a speech pathologist?

Speech Pathology Australia is a national organisation that represents and supports Speech Pathologists. You can find information about speech pathology and speech pathology services from their website.

What services are available?

Helping Children with Autism Medicare items

The Australian Department of Health funds Medicare items through the Helping Children with Autism programme. This programme provides services through the Medicare Benefits Schedule for the early diagnosis and treatment of children with autism or any other pervasive developmental disorder to access a consultant paediatrician or psychiatrist. Medicare rebates may also be claimed for speech pathology services that are provided following a referral from a specialist through the Helping Children with Autism programme.

Under the Helping Children with Autism programme, your child can be referred by a consultant paediatrician or psychiatrist for the following allied health services:

  • up to four diagnostic / assessment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists to assist the referring practitioner with diagnosis or to contribute to your child’s treatment and management plan (for a child under 13 years of age).
  • up to twenty treatment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists (for a child under 15 years of age, providing a treatment and management plan is in place before their 13th birthday).

Children can access the autism Medicare services providing they have not already accessed services under the Better Start for Children with a Disability program and providing they meet the requirements of each Medicare service.

Further information can be found on the Helping Children with Autism program page.

For inquiries about eligibility, claiming, fees and rebates, call the Department of Human Services (Medicare): patient inquiries 132 011; provider inquiries 132 150.

Helping Children with Autism program

Through the Helping Children with Autism program, administered by the Department of Social Services, early intervention funding is available for families of children diagnosed with Autism Spectrum Disorder (ASD), who are registered with an Autism Advisor prior to their sixth birthday. Autism Advisors can be contacted through the state and territory Autism Associations.

The Helping Children with Autism program funding is transitioning to the National Disability Insurance Scheme (NDIS). Some areas have already been closed to new registrations and others will close as the NDIS is rolled out. New registrations for the Helping Children with Autism program in NDIS sites, close one month after an NDIS Early Childhood Partner becomes operational in the site.

Families of children registered with the Helping Children with Autism program have access to early intervention funding of up to $12,000 (to a maximum of $6,000 per financial year) until the child turns seven years of age, or has exhausted all their funding, or has an NDIS plan in place, whichever comes first.

Early intervention funding is aimed at increasing access to early intervention services, including speech pathology. A component of the early intervention funding can be used by families to access critical resources to support therapy in the home environment.

To assist with additional challenges faced by some families living in outer regional and remote areas, eligible children may be able to access a further $2,000 payment to help the family access early intervention services or training, respite and other resources. The state and territory Autism Advisor can advise families on eligibility for the Access payment.

To support access to information and services for families with a child with ASD, a website with specific information on effective therapies and location information is available on the Raising Children website.

National Disability Insurance Scheme

The National Disability Insurance Scheme supports people with a permanent and significant disability that affects their ability to take part in everyday activities. The National Disability Insurance Scheme works to assist you to identify supports you need to live your life. These supports may help you achieve goals in many aspects of your life, including independence, involvement in your community, education, employment, health and wellbeing.

The National Disability Insurance Scheme gives you choice and control over how, when and where your supports are provided, and gives you certainty that you will receive the support you need. It also focuses on early intervention where getting early supports can reduce the impact of disability on you or your child.

Can I access the National Disability Insurance Scheme?

You need to meet the following requirements:

  • have a permanent and significant disability that affects your ability to take part in everyday activities;
  • be aged less than 65 when you first access the scheme;
  • be an Australian citizen, a permanent resident or a New Zealand citizen who holds a Protected Special Category Visa;
  • live in a trial site location (during the trial).

Use the NDIS Access Checklist to find out if you might be able to receive assistance from the National Disability Insurance Scheme and the next steps.

Further information can be found at the NDIS website:

Contact us
Call: 1800 800 110, 8am to 5pm Monday to Friday
For people with hearing or speech loss
TTY 1800 555 677
Speak and listen 1800 555 727

Chronic Disease Management allied health services

The Chronic Disease Management Medicare items in the Medicare Benefits Schedule enable general practitioners to plan and coordinate your health care if you have a chronic or terminal medical condition. General practitioners are able to use Medicare items for general practitioner-managed care planning and/or team-assisted care planning, depending on your health needs. It is important to note that referral for allied health services, which includes speech pathology, under a Chronic Disease Management plan for eligible patients is based on your general practitioner’s clinical assessment of your needs.

Once appropriate Chronic Disease Management items are in place, you can be referred by your general practitioner for up to five Medicare rebateable allied health services each calendar year.

Eligible allied health services are: speech pathology; Aboriginal health work; audiology; diabetes education; chiropractic; dietetics; exercise physiology; mental health work; occupational therapy; osteopathy; physiotherapy; podiatry; and psychology.

It is important to be aware that the Australian Government has no authority to control the amount doctors and health professionals actually charge for their services, and they are free to set their own fees. Where their fee exceeds the applicable Medicare rebate for that service, the patient is responsible for the out-of-pocket costs. Patients and carers are encouraged to speak to their medical practitioners regarding the payment of fees or the possibility of bulk billing. Medical practitioners are encouraged to consider the personal circumstances of their patients when determining the fees they charge, and many do so.

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