An NDIS speech pathology assessment is a comprehensive evaluation for participants seeking support for communication or swallowing difficulties. This guide is for NDIS participants, parents, carers, and support coordinators seeking to understand the assessment process. Understanding the assessment is crucial because it provides the evidence needed for NDIS planning and funding, ensuring that supports are tailored to individual needs and meet the “reasonable and necessary” criteria for approval.
Introduction to Speech Pathology
Speech pathology is a specialised area within health sciences dedicated to helping people overcome communication and swallowing difficulties. Speech pathologists, also known as speech therapists, are highly trained allied health professionals who assess, diagnose, and treat a wide range of challenges related to speech, language, voice, fluency, and swallowing. Using evidence-based practice, these healthcare professionals deliver high-quality services tailored to each individual’s needs, whether the goal is clearer speech, improved understanding, or safer swallowing.
In Australia, speech pathologists are eligible to work across diverse settings, including hospitals, community health centres, private practices, schools, and aged care facilities. They play a vital role in supporting people of all ages—from children developing language skills to older adults managing swallowing disorders. As part of a multidisciplinary team, speech pathologists often collaborate with other allied health professionals, such as occupational therapists and psychologists, to provide holistic care that addresses the full range of a person’s needs.
Speech pathology services are essential for improving quality of life, supporting participation in the community, and enabling people to achieve their goals. Whether working with children, adults, or the elderly, speech pathologists in Australia are committed to delivering evidence-based, person-centred care that makes a real difference in everyday life.
Next, we’ll look at how speech pathology assessments are structured within the NDIS.
What a Speech Pathology Assessment Is (in NDIS Terms)
In the NDIS, Speech Pathology is a therapy support that can help with communication and swallowing disability support needs, including spoken, non-spoken and signed communication, and the use of symbols and augmentative and alternative communication methods. NDIS supports include a range of services and assistance funded by the scheme to help participants achieve their goals and improve their quality of life.
A good assessment does two jobs at once:
- It clarifies the communication and/or swallowing profile (what is happening, where, and why it is hard).
- It links findings to functional outcomes and NDIS goals, so supports are more likely to be considered reasonable and necessary.
The NDIS model allocates funding to an individual, allowing them to purchase goods and services from registered providers who deliver supports tailored to their needs. Participants can use the NDIS Provider Finder to locate registered providers for their assessments and ensure their assessment meets NDIS requirements.
Key Components and Steps of an NDIS Speech Pathology Assessment
Key components of an NDIS speech pathology assessment include:
- Case history collection: This involves gathering extensive background information including medical history, developmental milestones, and previous therapy experiences.
- Observation: Observation involves seeing how participants communicate and interact in various daily life settings such as home, school, or clinic.
- Standardised and informal testing: These tests evaluate receptive and expressive language, speech production, social communication, literacy, and swallowing management.
- Goal setting: Goal setting in the assessment involves establishing SMART goals (Specific, Measurable, Achievable, Relevant, and Time-bound) for therapy, often in collaboration with the participant and their support network.
- Report generation: The assessment concludes with a detailed report outlining assessment findings, current skill levels, and recommendations for therapy and equipment.
This structured process ensures that the assessment is thorough, evidence-based, and directly linked to NDIS planning and funding requirements.
Transitioning from the general overview, let’s explore what specific areas a speech therapist examines during an assessment.
What a Speech Therapist Looks at in an Assessment
Key Areas Assessed
Speech pathologists conduct comprehensive assessments, often working in collaboration with other professionals as part of a multidisciplinary approach. What is assessed depends on age, goals, and presenting needs, but a comprehensive Speech Pathology assessment commonly considers:
- Communication (understanding and expression): This includes receptive language (understanding), expressive language (putting thoughts into words), and broader communication skills.
- Speech clarity and intelligibility: This includes speech sound production (articulation and phonology) and whether others can reliably understand the person in day-to-day situations.
- Social communication: Social communication (pragmatics) can include turn-taking, reading cues, staying on topic, and using language appropriately in different contexts.
- Voice and fluency: Voice quality and fluency (including stuttering) are also part of the areas that may be assessed depending on needs.
- Literacy related skills (when relevant): Literacy may be assessed depending on age and presenting difficulties, including reading, writing, spelling, and phonological awareness.
- Feeding and swallowing (dysphagia) when relevant: Swallowing and mealtime assessments often involve a case history, a physical examination of the mouth and throat muscles, and observation of eating and swallowing with different foods and fluids. The NDIS also explicitly recognises swallowing as an area Speech Pathology supports can address.
If swallowing safety is a concern (coughing with meals, choking, recurrent chest infections, significant weight loss), this is a priority area to address quickly with the right clinical pathway.
Now that you know what is assessed, let’s look at how the assessment is usually conducted.
How the Assessment Is Usually Done
Assessment Methods
Most assessments combine several inputs so the Speech Therapist can see the full picture. Assessments may involve input from family members and students (if relevant), and can be conducted in-person, online, or a combination of both.
Case History and Functional Interview
A comprehensive case history is collected, including presenting difficulties, medical history, and prior therapy. Interviews during the assessment discuss medical history, developmental milestones, daily routines, and specific concerns of the participant.
Observation in Real Communication Moments
Observation involves seeing how the person communicates with familiar people, in new situations, during play, during learning tasks, or during mealtimes, depending on the referral focus.
Standardised Tools and Informal Measures
Speech Therapists use a range of standardized assessment tools for formal assessment when comprehensive and detailed information is required. Standardized and informal testing evaluate receptive and expressive language, speech production, social communication, literacy, and swallowing management.
Environmental Scan
For many NDIS participants, the environment is part of the barrier. Noise, time pressure, sensory load, unfamiliar partners, device access, and routines can change outcomes.
Augmentative and Alternative Communication (AAC) Consideration (When Speech Is Not Reliable)
The NDIS recognises that Speech Therapists can support the use of symbols and Assistive Technology (AT), including augmentative and alternative communication methods. If AAC is relevant, the assessment may consider:
- What the person needs to communicate day-to-day
- What access method works (touch, switch, eye gaze, partner-assisted scanning)
- What system fits the person and their settings (home, school, community)
- Training needs for communication partners
Session Structure
Assessment length varies widely based on complexity. Speech Pathology Australia indicates that assessments may take 30 to 60 minutes on average, with some assessments taking over an hour and sometimes up to 3 hour sessions, and multiple sessions may be required.
A common structure looks like this:
- Session 1:
- Goal and referral clarification
- Case history
- Initial observation and screening
- Plan for any additional assessment (including AAC trial needs if relevant)
- Session 2 (if needed):
- Deeper testing (standardised tools, language samples, literacy measures)
- Functional tasks (school, community, vocational context)
- Caregiver and teacher input where appropriate
- Session 3 (if needed):
- AAC trials and comparison (if relevant)
- Swallow and mealtime observation in the most relevant setting
- Consolidation of recommendations and next-step planning
With the assessment process outlined, let’s summarise the full journey from start to finish.
Summary of the NDIS Speech Pathology Assessment Process
The NDIS speech pathology assessment process is designed to be thorough and participant-centred. Key components include:
- Case history collection: Gathering extensive background information, such as medical history, developmental milestones, and previous therapy experiences.
- Observation: Observing how the participant communicates and interacts in various daily life settings (home, school, clinic).
- Standardised and informal testing: Using formal and informal tools to evaluate receptive and expressive language, speech production, social communication, literacy, and swallowing management.
- Goal setting: Collaboratively establishing SMART goals (Specific, Measurable, Achievable, Relevant, and Time-bound) for therapy, tailored to the participant’s needs.
- Report generation: Producing a detailed report that outlines assessment findings, current skill levels, and recommendations for therapy and equipment.
This process ensures that the assessment provides the essential evidence the NDIA needs to determine and approve “reasonable and necessary” funding and to support the development of a targeted therapy plan.
Next, we’ll discuss why the assessment matters for your NDIS plan and how it impacts funding and support decisions.
Why the Assessment Matters for Your NDIS Plan
A strong assessment can change the trajectory of a plan because it converts “we think support is needed” into evidence linked to function and goals. The assessment report provides essential evidence the NDIA needs to determine and approve “reasonable and necessary” NDIS funding.
1) It links support to reasonable and necessary criteria
The NDIS funds supports that are related to disability, represent value for money, are likely to be effective, and take into account other supports available.
2) It strengthens planning reports and plan review evidence
The NDIA notes that reports for plan reassessment should explain the therapy approach and provide evidence of outcomes achieved and progress made toward goals.
This is where Speech Pathology assessments matter. They establish the baseline, then progress can be measured against it.
3) It supports Assistive Technology (including AAC) requests when needed
For assistive technology, the NDIA requires sufficient evidence to decide what is reasonable and necessary, and provides guidance for preparing evidence and using templates for some AT. If AAC is part of the plan, the assessment and report often become the backbone of the request.
With an understanding of why the assessment is so important, let’s look at what a good NDIS-ready report should include.
What a Good Speech Pathology Report Should Include (NDIS-Ready)
Borrowing from NDIA reassessment expectations, a strong report usually makes it easy to see:
- The participant’s goals and the functional impact day-to-day
- What was assessed and what the findings mean functionally
- What has been tried already and what worked or did not work
- Measurable outcomes to track (baseline measures and targets)
- Recommended frequency and focus of supports, linked to goals
- If relevant, AAC and AT recommendations with evidence of suitability and expected benefit
A well-structured report ensures that all stakeholders, including the NDIA, have the information needed to make informed decisions about funding and supports.
Now, let’s review how to prepare for your assessment to get the best possible outcome.
Practical Checklist: How to Prepare for a Speech Pathology Assessment
To get the best outcome from the first session, prepare:
- Your NDIS goals and the one or two you want Speech Pathology to support
- The top 3 daily situations that break down (home, school, community, work)
- Any previous Speech Pathology reports, school reports, or specialist letters
- A short note on what helps, what makes it worse, and what triggers overwhelm
- If AAC is relevant: what has been tried (apps, boards, devices), and what did not fit
- If swallowing is relevant: typical foods, mealtime routines, coughing or choking patterns, fatigue impact
With your preparation complete, you’ll be ready to make the most of your assessment session.
Practical Examples (What “Why It Matters” Looks Like)
Example 1: A Child Who Struggles to Follow Instructions at School
The assessment shows receptive language needs, identifies the classroom contexts where it breaks down, and recommends strategies and supports that reduce load and improve participation. Outcomes might include improved ability to follow multi-step instructions and reduced classroom distress.
Example 2: A Teen Who Avoids Social Situations
The assessment identifies social communication and pragmatic language needs and builds a program for real-world confidence, including structured practice, role play, and gradual exposure, with progress measures that show participation gains.
Example 3: An Adult with Unreliable Speech
The assessment identifies when speech is not functional, trials AAC options, and supports an AT request with evidence of functional need and expected outcomes, linked to NDIS goals and reasonable and necessary criteria.
These examples show how a thorough assessment can directly inform practical supports and positive outcomes.
NDIS Quality and Safeguards
The National Disability Insurance Scheme (NDIS) Quality and Safeguards Commission plays a crucial role in ensuring that disability services across Australia are safe, effective, and of the highest quality. As an independent regulator, the commission oversees NDIS providers and works to protect the rights and wellbeing of all NDIS participants. This includes setting clear standards for service delivery, monitoring compliance, and responding to any concerns about the quality or safety of supports.
The NDIS Quality and Safeguards Commission collaborates with healthcare professionals, disability services, and other government agencies to develop robust frameworks that prevent abuse, neglect, and exploitation. Through ongoing education, training, and support, the commission empowers NDIS providers and their workers to deliver services that respect participant choice, dignity, and independence.
For NDIS participants and their families, the commission’s work means greater confidence in the quality of supports received. By prioritising safety, transparency, and continuous improvement, the NDIS Quality and Safeguards Commission helps ensure that every person accessing disability services can do so in a supportive environment that upholds their rights and promotes their wellbeing.
Let’s now look at who can refer for an assessment and what information is needed.
Referrers
Who to refer:
NDIS participants, parents and carers, Support Coordinators, GPs, Paediatricians, schools, SIL providers, and community teams where communication and/or swallowing impacts daily function, safety, learning, work, or community participation.
What to include in the referral:
- Participant details and NDIS number
- Plan dates and funding type (self-managed, plan-managed, NDIA-managed)
- Current goals and the functional impact day-to-day
- Communication concerns (what is hard, where, and with who)
- Any swallowing concerns and key risks (if relevant)
- Previous reports and what has been trialled
- Preferred service setting (clinic, home, school, telehealth)
- Consent and key contacts (parent, carer, Support Coordinator, school)
With a clear referral, the assessment process can begin smoothly.
FAQs
Do I need an assessment to get Speech Pathology in my NDIS plan?
The NDIA states that when you ask for therapy supports to be included in your plan, you need to provide an assessment or report from your therapist, and sometimes the NDIA will request further assessment and reporting.
How long does a Speech Pathology assessment take?
Speech Pathology Australia notes 30 to 60 minutes on average, with some assessments over an hour, and in some cases up to 3 hour sessions may be required.
What does a Speech Therapist assess for NDIS participants?
Common areas can include receptive language, expressive language, speech sound production, voice, fluency, social communication, literacy, feeding, and swallowing, depending on age and presenting needs.
Can Speech Pathology assessments support AAC funding requests?
Yes. The NDIA requires sufficient evidence for assistive technology decisions, and Speech Pathology can be part of the evidence and recommendation process where communication AT is needed.
Why do reports matter for plan reviews?
The NDIA advises that reassessment reports should explain the therapy approach and provide evidence of outcomes and progress toward goals, which helps decisions about reasonable and necessary supports.
Is swallowing support part of Speech Pathology under the NDIS?
Yes. NDIS therapy supports guidance includes Speech Pathology for communication and swallowing disability support needs.
What makes an assessment “NDIS-aligned”?
It links findings to functional capacity and participation goals, includes evidence of what is likely to be effective, and supports reasonable and necessary decision-making.
How Bloom Healthcare Can Help
Bloom Healthcare’s Speech Pathology team provides practical, goal-led assessments that focus on real-world communication and swallowing outcomes. Our university-trained allied health professionals work with individuals of all ages, from children with disabilities to adults with acquired communication problems, developing personalised treatment plans to improve communication and swallowing abilities. Our team treats speech and swallowing disorders using evidence-based techniques, including exercises and modifications to food textures, and collaborates closely with occupational therapy and other healthcare professionals to ensure comprehensive support.
Bloom Healthcare’s speech pathologists contribute to the field through ongoing research, teaching, and the development of new courses, advancing innovation and best practice in speech therapy. Our clinicians have experience working in private practice, regional Victoria, and with a diverse range of client groups, including those with mental health needs, intellectual disability, and cerebral palsy. Ongoing sessions with our team can enhance communication skills, improve self-confidence, and reduce feelings of frustration and social isolation, leading to a better overall quality of life for individuals with disabilities.
Bloom Speech Therapists can help translate findings into an NDIS-ready plan, including progress measures, reporting for plan reviews, and support for AAC and other Assistive Technology evidence when relevant.
