Utilization of early therapeutic supports by autistic preschoolers in Australia: A cross-sectional study following implementation of the National Disability Insurance Scheme.
NDIS doubled the therapy choices for autistic preschoolers, yet poor or remote families still get fewer visits.
01Research in Context
What this study did
Pye et al. (2024) asked 1,053 Australian parents of autistic preschoolers what therapies their child used after the NDIS started. They used an online survey and checked if family income, location, or child need changed the number of services.
The team counted how many kids got speech, OT, psychology, or other supports. They also looked at how long families waited and how much they paid out of pocket.
What they found
Most kids now use two different therapies at once. Speech, OT, and psychology are the top three picks. Families with higher incomes and those living in cities access more services than those in poor or remote areas.
Kids with greater support needs do get more hours, but even they average only 2.3 services. Children in very remote zones are half as likely to see any therapist at all.
How this fits with other research
Salomone et al. (2016) saw the same postcode lottery in Europe: where you live, not how severe your autism is, decides if you get help. Katherine’s 2024 numbers show the NDIS widened the menu but did not erase the gap.
Byiers et al. (2025) scoping review of Dutch services also finds guidelines exist yet uptake is patchy. Together the three papers say the same story across continents: policy opens the door, but money and geography still decide who walks through.
Delgado-Lobete et al. (2019) in Canada used the same survey style and likewise found smooth services in cities versus long waits in rural towns. The pattern repeats: rich cities win, poor or remote families wait.
Why it matters
If you write NDIS plans, ask for travel funding or telehealth hours when the family lives outside major cities. Track service counts on your intake form and flag any child with zero therapy—then link them to a local provider or telehealth before gaps widen. One extra phone call can stop rural kids from falling behind their city peers.
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02At a glance
03Original abstract
There are many types of support for young autistic children and their families, but service use in this population is not well understood. In this study, primary caregivers of autistic preschoolers were surveyed (n = 95) and a selection were then interviewed (n = 19) to understand how early, therapeutic supports were accessed by families in Australia following the establishment of a National Disability Insurance Scheme (NDIS). This article presents the quantitative data from surveys and interviews. Families usually accessed at least two types of support. The most accessed supports were occupational therapy, speech pathology and psychology, with 43% of the sample accessing some other form of support. Multiple linear regression indicated that children's higher level of support need, living in less remote or less socio-economically disadvantaged areas, and high household income were associated with higher numbers of supports accessed. Services tended to follow an individual, clinic-based model and little use of alternative service delivery was reported. The findings indicate that Australian families are accessing a wider range of support types than before the NDIS and children with more substantial autism-related support needs are likely to access a greater number of types of supports. Socio-economic inequities continue to exist and should be addressed.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3255