NDIS Allied Health Reports: What Support Coordinators Need to Know

When a participant keeps forgetting routines, struggles with multi-step tasks or finds it hard to learn new skills, the support team often needs to know why. A neuropsychological assessment can help answer that question.

Clinical neuropsychology examines the relationship between brain function, cognition, behaviour and everyday functioning. A neuropsychological assessment provides detailed information about areas such as attention, memory, learning, language, processing speed, executive functioning and problem-solving, and explains how these affect a person's daily life.

For NDIS participants, neuropsychology is most useful when there is a specific cognitive question that matters to the person's function or support planning. This guide explains when a referral may be appropriate, what the assessment involves, how it differs from psychology and Occupational Therapy, and how Support Coordinators can write a clear referral question.

When might an NDIS participant need neuropsychology?

Neuropsychology may be relevant where cognitive functioning is a major part of the participant's disability-related needs and the support team needs more detailed information than a general functional assessment can provide.

This can occur with acquired brain injury, traumatic brain injury, stroke, neurological conditions, intellectual disability or other conditions affecting cognition, depending on the individual referral question.

Signs that a neuropsychological assessment may help include when a participant:

• has difficulty retaining new information or routines, even with repeated support

• struggles to plan, start or complete multi-step tasks

• shows a change in thinking skills after an injury, illness or neurological event

• is not progressing as expected in therapy and the reason is unclear

• needs a clearer picture of their cognitive strengths and difficulties before support planning or a major transition

What can a neuropsychological assessment help clarify?

A neuropsychological assessment may help clarify:

• cognitive strengths as well as difficulties

• how cognition affects everyday function at home, at work, in study or in the community

• strategies for supporting learning or decision-making

• the impact of executive dysfunction, such as difficulties with planning, organisation, initiation or self-monitoring

• considerations for rehabilitation, support or environmental modification

Understanding strengths matters as much as identifying difficulties. Recommendations work best when they build on the abilities a participant already has.

What happens during a neuropsychological assessment?

The process commonly includes:

1. Clinical interview: discussing the participant's concerns, history, goals and daily functioning, often with family or carers involved with consent.

2. Review of history and records: looking at relevant medical, developmental, educational and therapy information.

3. Standardised cognitive testing: completing structured tasks that measure areas such as memory, attention, language and problem-solving.

4. Interpretation: comparing results with expected performance and considering how they relate to the person's everyday function.

5. Reporting and feedback: providing a written report with findings and practical recommendations, and explaining the results.

The exact assessment is tailored to the referral question and the participant. Testing can be demanding, so the practitioner considers factors such as fatigue, communication, sensory needs and the person's capacity to participate. Sessions may be split across more than one appointment, and breaks can be built in. Many standardised tests need to be completed face to face, although some parts of the process may be suitable for telehealth.

Learn more about CARED's neuropsychological assessment service.

Neuropsychology vs psychology

Psychology and neuropsychology are related but not identical.

• Psychology may focus on emotional, behavioural and psychosocial functioning, and on therapeutic intervention to build skills such as coping and emotional regulation.

• Neuropsychology provides specialised assessment of cognitive functioning and its relationship to the brain and behaviour.

A participant may need one, the other or both, depending on the clinical questions. For example, neuropsychological findings about memory or attention can help a psychologist adapt therapy so it suits the way the participant learns best. Read more about CARED's Psychology service, or see our guide to psychology vs Positive Behaviour Support if behaviours of concern are part of the picture.

Neuropsychology vs Occupational Therapy

Occupational Therapy (OT) looks at everyday occupational performance and functional participation. Neuropsychology can provide a deeper analysis of the cognitive processes that may be driving functional difficulties.

For example, an Occupational Therapist may identify that a participant cannot manage appointments independently. A neuropsychological assessment may help clarify whether memory, attention, planning, initiation or another cognitive process is contributing to that difficulty. The two disciplines often work well together: neuropsychology explains the "why", and OT helps put practical strategies and supports in place.

What about a Functional Capacity Assessment?

A Functional Capacity Assessment (FCA), usually completed by an Occupational Therapist, describes what a person can and cannot do across everyday areas of life and the supports they need. A neuropsychological assessment focuses more closely on the cognitive processes underneath those functional difficulties. Some participants benefit from both. For more detail, see our complete guide to NDIS Functional Capacity Assessments.

How can findings inform NDIS supports?

Where relevant, findings can provide evidence about disability-related cognitive and functional needs and inform practical recommendations. Recommendations may relate to:

• environmental supports, such as visual schedules or simplified routines

• compensatory strategies, such as reminders, checklists or technology

• the type and level of assistance a participant may need

• therapy priorities and the way therapy is delivered

• the need for input from other disciplines

The NDIA explains what makes useful supporting evidence from health professionals, including recent information from an appropriate professional that describes how impairments affect different areas of a person's life.

As with other clinical reports, a neuropsychological assessment provides evidence. It does not determine the participant's NDIS funding outcome, which is decided by the NDIA. If a plan review or reassessment is coming up, read how allied health services can help you prepare for an NDIS plan review.

When should a Support Coordinator refer?

Refer when there is a specific cognitive question that matters to the participant's function or support planning.

"Please assess cognition" is broad. "We need to understand why the participant cannot retain new routines or safely manage multi-step tasks" gives the neuropsychologist a much clearer clinical question.

A strong referral usually includes:

• The functional concern: what the participant is finding difficult in daily life, with specific examples.

• The question to answer: what the team needs to understand, and why.

• Relevant history: diagnoses, injuries, previous assessments and current supports.

• How the findings will be used: for example, to guide support planning, therapy, a living arrangement decision or evidence for a plan review.

• Practical considerations: communication needs, fatigue, sensory needs or anything else that may affect testing.

Next step

Every participant's needs are different, and this article is general information rather than individual clinical or NDIS advice. If you are unsure whether neuropsychology, psychology, OT or a Functional Capacity Assessment is the right starting point, CARED can help triage the referral question.

Refer for neuropsychology or ask CARED whether neuropsychology is the right assessment pathway, or contact our team to talk it through.