Assistive technology (AT) prescription under the NDIS is a clinical reasoning process, not a product transaction. Occupational therapists and speech pathologists assess the person, their environment and their goals; trial options; recommend the least-complex AT that meets the need; and plan for set-up, training and review. Getting this sequence right matters because poorly matched AT is frequently abandoned — one foundational study found 29.3% of devices were completely abandoned, often because the user's opinion was not considered ().
Key takeaways
- AT is any device or system that helps a person do something they otherwise could not, or do it more safely or independently — from a simple grip to a powered wheelchair or a speech-generating device.
- The NDIS describes AT by complexity, from basic, low-risk items through to specialised and complex AT that needs a suitably qualified assessor.
- The clinical task is to recommend the least-complex effective option and to evidence why it is reasonable and necessary for the participant's goals.
- Abandonment is common and largely preventable; matching the person to the technology and trialling before purchase are the strongest safeguards ().
- Speech-generating devices and other communication AT sit within the broader AAC framework and require a speech pathologist's input ().
What counts as assistive technology under the NDIS?
Assistive technology spans an enormous range, from low-cost everyday aids to highly engineered, individually configured equipment. The NDIS organises AT by complexity and risk rather than by product type, which is what determines how much assessment and evidence is required before it can be funded.
In practice, clinicians work across a spectrum:
- Basic, low-risk AT — readily available, low-cost items that a person can identify and use safely with little or no support (for example, simple daily-living aids).
- Standard AT — low-to-medium cost and risk, typically available off the shelf, sometimes needing minor adjustment or straightforward training.
- Specialised AT — higher cost and risk, often sourced from a specialist supplier and configured to the individual.
- Complex AT — custom-made or substantially modified, and frequently linked with other supports and equipment.
The principle that runs through all of it is proportionality: the more complex, costly or risky the AT, the more clinical assessment and justification is expected. Basic items can usually be obtained without a formal assessor report, whereas specialised and complex AT requires input from a suitably qualified AT assessor. (Because NDIS thresholds and operational rules are periodically updated, clinicians should confirm current cost bands and evidence requirements directly with the NDIA at the time of prescription.)
What does an evidence-based AT assessment involve?
A defensible AT assessment is structured and goal-led. It answers a clear question: what is the participant trying to do, and what is the least-complex AT that will help them do it safely and durably?
1. Clarify the functional goal
Start from the participant's own goals and the specific tasks and environments involved — getting dressed independently, communicating wants and needs, moving safely around the home, participating at school or work. AT recommendations should trace directly back to these goals.
2. Assess the person and the environment
Consider the person's strengths, abilities and preferences, and the physical and social environment in which the AT will be used. This is where occupational therapists contribute detailed task and environment analysis, and speech pathologists contribute communication assessment. Communication AT in particular should be selected within the AAC framework, weighing aided options such as speech-generating devices against the individual's motor, sensory and language profile ().
3. Trial before you recommend
Trialling is the single most important step for preventing wasted funding and abandonment. A trial confirms that the device works for this person in their setting, surfaces training needs, and tests whether a simpler option would suffice. The evidence on abandonment makes the case plainly: devices were most often abandoned when the user's opinion was not considered in selection and when performance did not meet expectations ().
4. Recommend the least-complex effective option
Where two options meet the need, the less complex, lower-risk and lower-cost choice is generally preferred. Over-prescription is a real risk: more sophisticated AT is not automatically better and can introduce training burden, maintenance demands and a higher chance of disuse.
5. Document why it is reasonable and necessary
The written recommendation should connect the AT to the participant's goals, set out the functional benefit, explain why alternatives were not selected, and describe set-up, training and review. This is the evidence the NDIA relies on, and the discipline that protects the participant from receiving equipment that does not fit.
How do clinicians avoid AT abandonment?
Abandonment is the failure mode that quietly undermines AT programs. The classic data point — 29.3% of devices completely abandoned — is sobering, but the same study identified why, which tells clinicians where to intervene ().
The throughline is participant involvement. AT that the person helped choose, trialled, and was trained to use — and that is reviewed as their needs change — is far more likely to be used. Our builds trialling and training into every AT recommendation for this reason.
Where speech pathology and OT intersect on AT
Many participants need both perspectives. An occupational therapist may lead on mobility, seating, daily-living and home-based AT, while a speech pathologist leads on communication AT such as speech-generating devices and other AAC. The two disciplines coordinate on shared considerations — positioning for device access, sensory factors, and consistent use across home, school and community. Treating communication AT as part of the broader AAC system, rather than as an isolated gadget, keeps the focus on function ().
Evidence at a glance
For current NDIS AT complexity levels, cost bands and evidence requirements, clinicians should confirm details directly with the National Disability Insurance Agency, as operational rules are periodically updated.
Frequently asked questions
What is assistive technology under the NDIS?
It is any device or system that helps a participant complete a task they otherwise could not, or do it more safely or independently. The NDIS classifies AT by complexity and risk — from basic, low-risk items to specialised and complex AT — which determines how much assessment is required.
When is an AT assessor or report required?
Basic, low-risk AT can generally be obtained without a formal assessor report, while specialised and complex AT requires input from a suitably qualified AT assessor. Because thresholds change, confirm current requirements with the NDIA before prescribing.
How do clinicians stop expensive AT from being abandoned?
By involving the participant in selection, trialling the device in the real environment before purchase, providing training, and scheduling review. Abandonment is strongly linked to ignoring user opinion and poor real-world performance ().
Why recommend the least-complex option when a higher-tech device exists?
More complex AT is not automatically more effective and can add training and maintenance burden and raise the risk of disuse. Where a simpler option meets the goal safely, it is usually the better and more proportionate recommendation.
Do OTs and speech pathologists both assess AT?
Yes, often together. Occupational therapists typically lead on mobility, daily-living and home AT; speech pathologists lead on communication AT and AAC. Coordinated assessment keeps the focus on the participant's goals across all their environments. Our and speech pathologists work together on combined AT needs.
If you are supporting a participant who may benefit from assistive technology, . Speak with Align Network's speech pathology and occupational therapy team.
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