Quick Answer: How Do OTs Assess and Prescribe Assistive Technology?
What is assistive technology (AT)? Assistive technology is any item, equipment, software, or product system used to maintain, increase, or improve the functional capabilities of a person with disability. Under the NDIS, AT ranges from low-cost aids like shower chairs and dressing sticks through to high-cost items like powered wheelchairs, communication devices, and home automation systems.
What is an AT assessment? An AT assessment is a clinical evaluation conducted by a qualified occupational therapist that identifies a participant’s functional needs, determines which assistive technology would address those needs, and produces a written report and recommendation for NDIS funding purposes.
Who conducts AT assessments? Occupational therapists are the primary allied health professionals who assess and prescribe assistive technology under the NDIS. For some AT categories, other allied health professionals (physiotherapists, speech pathologists) may also be involved.
What does the NDIS fund? The NDIS funds AT that is reasonable and necessary — directly related to a participant’s disability, represents value for money, and is likely to be effective. AT is funded across four risk and complexity categories: low cost/low risk, low cost/high risk, high cost/low risk, and high cost/high risk.
Where? Rebound Health occupational therapists conduct AT assessments in Frenchs Forest on Sydney’s Northern Beaches, serving NDIS participants across Dee Why, Brookvale, Warriewood, Narrabeen, Mona Vale, and surrounds.
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Introduction: The Right Equipment Changes Everything
The right piece of equipment at the right time can be genuinely life-changing.
A shower chair that allows someone to bathe independently after a stroke. A powered wheelchair that gives a person with degenerative disease the freedom to move through their community. A communication device that gives a non-speaking person their voice. A smart home system that allows someone with limited mobility to control their environment without assistance.
Assistive technology is not about making do with less — it is about enabling people to do more. And under the NDIS, accessing the right AT starts with one thing: a thorough, evidence-based occupational therapy assessment.
At Rebound Health in Frenchs Forest, our occupational therapists assess and prescribe assistive technology for NDIS participants across Sydney’s Northern Beaches — from low-cost daily living aids through to complex, high-cost equipment requiring comprehensive clinical reports.
This post explains exactly how the AT assessment process works, what the NDIS funds, and how to access AT that genuinely matches your functional needs.
What Is Assistive Technology Under the NDIS?
The NDIS defines assistive technology broadly — any equipment, device, software, or system that helps a person with disability to perform tasks they would otherwise struggle to complete, or to complete them more safely and independently.
AT under the NDIS spans an enormous range:
Daily Living and Self-Care AT
- Shower chairs, bath boards, and bath lifts
- Commodes and raised toilet seats
- Grab rails and bathroom safety equipment
- Dressing aids — sock aids, button hooks, long-handled shoehorns
- Adaptive kitchen equipment — dycem mats, rocker knives, one-handed cutting boards
- Continence aids and management products
Mobility AT
- Manual wheelchairs — standard, lightweight, and custom-moulded
- Powered wheelchairs and power-assist devices
- Scooters and mobility vehicles
- Walking frames, crutches, and walking sticks
- Stair lifts and platform lifts
- Vehicle modifications for driving or passenger transport
Seating and Positioning AT
- Custom seating systems and pressure care cushions
- Postural support devices
- Specialised beds and bed positioning equipment
- Standing frames and tilt tables
Communication AT (AAC)
- Speech generating devices (SGDs)
- Low-tech communication boards and books
- Symbol-based communication systems
- Eye-gaze technology
- Voice output communication aids
Home Modification AT
- Electronic door openers and intercoms
- Home automation and environmental control systems
- Ceiling hoists and tracking systems
- Ramps and threshold modifications
- Smart home devices — voice-activated controls, automated lighting
Sensory and Cognitive AT
- Noise-cancelling headphones and sensory tools
- Visual support materials and systems
- Memory aids — electronic organisers, reminder devices
- Screen readers and magnification software
- Braille displays and tactile interfaces
Workplace and Education AT
- Ergonomic workstation equipment
- Voice-to-text and dictation software
- Adapted keyboards, mice, and input devices
- Screen readers and accessibility software
- Task management apps and cognitive support tools
The NDIS AT Funding Framework: Risk and Complexity Categories
The NDIS categorises AT across two dimensions — cost and risk — creating four funding tiers that determine the level of assessment and evidence required:
Low Cost, Low Risk AT
Items under $1,500 that carry minimal risk if incorrectly used — such as basic daily living aids, simple dressing equipment, and standard bathroom safety items.
These can often be purchased directly from the participant’s NDIS Core Supports budget without a formal OT report, though an OT assessment is still recommended to ensure the right item is selected.
Low Cost, High Risk AT
Lower cost items that carry significant risk if incorrectly prescribed or used — such as specific continence products, some splints and orthoses, or cushions for participants with pressure injury risk.
An OT assessment and recommendation is required to ensure safe and appropriate prescription.
High Cost, Low Risk AT
Items over $1,500 that carry relatively lower functional risk — such as standard powered wheelchairs for experienced users, or certain communication devices.
A formal OT assessment report is required for NDIS funding approval.
High Cost, High Risk AT
Complex, expensive items where inappropriate prescription or use carries significant safety risk — custom-moulded seating systems, complex powered wheelchairs, ceiling hoists, complex AAC devices, and home automation systems.
These require a comprehensive AT assessment report from a suitably qualified OT, often involving trial of the equipment, and may require a quote from an approved AT supplier.
What Does an OT AT Assessment Involve?
An AT assessment is not simply a product recommendation. It is a systematic clinical process that evaluates the person, their environment, their goals, and the technology — and produces evidence that justifies NDIS funding on the basis of functional need.
Step 1: Occupational Profile and Goal Setting
The assessment begins with understanding the person — their disability, their daily life, their functional goals, and the specific tasks where AT may assist. Key questions include:
- What activities is the person currently unable to perform, or performing unsafely?
- What are the person’s goals for independence and participation?
- What environments does the person need to function in — home, community, workplace, school?
- What AT has been trialled previously, and what was the outcome?
- What is the person’s capacity to learn to use new technology?
- What are the carer and family’s practical considerations?
Step 2: Functional Assessment
The OT assesses the person’s current functional capacity across the domains relevant to the AT under consideration:
- Physical capacity — strength, range of motion, grip, endurance, coordination, balance
- Cognitive capacity — memory, attention, problem solving, learning new skills
- Sensory capacity — vision, hearing, tactile awareness
- Communication — receptive and expressive language, literacy
- Postural and seating needs — particularly for mobility and seating AT
Step 3: Environmental Assessment
AT does not exist in isolation — it must work in the person’s real environments. Our OTs assess:
- Home environment — doorway widths, floor surfaces, bathroom dimensions, bedroom layout, access points
- Community environments — vehicle access, public building accessibility, transport compatibility
- Workplace or school — desk height, layout, technology infrastructure
- Carer capacity — can the support network safely maintain, charge, and troubleshoot the AT?
Step 4: AT Identification and Trial
Based on the assessment findings, the OT identifies one or more AT options that could address the identified functional needs. Where possible — and particularly for high-cost or high-risk AT — a trial of the equipment is arranged before finalising the recommendation.
AT trials may involve:
- Borrowing equipment from an AT supplier or AT library
- Visiting an AT showroom or demonstration centre
- Trialling AT in the person’s home or relevant environment
- Testing multiple options to identify the best fit
Trial informs the final recommendation and provides evidence that the AT is effective and appropriate for that specific person.
Step 5: AT Assessment Report
The OT produces a written AT assessment report for submission to the NDIS. A high-quality AT report includes:
- Summary of the participant’s disability and functional impairment
- Functional assessment findings — what the person can and cannot do, and why
- Goals that the AT will support
- Description of the AT recommended, including make, model, and supplier where relevant
- Clinical justification — why this AT is the most appropriate solution for this person
- Evidence from trial (if conducted)
- Value for money consideration — why the AT is reasonable and necessary
- Supplier quote (for high-cost AT)
- Any training or support required for safe AT use
The quality of this report directly affects whether the NDIS approves the funding. A well-written, clinically robust AT report is one of the most important documents in a participant’s NDIS journey.
Step 6: Implementation, Training, and Review
Funding approval is not the end of the OT’s role. Effective AT implementation requires:
- Delivery and setup — ensuring the AT arrives correctly configured for the individual
- Training — the participant, their family, and their support workers in safe and effective AT use
- Environmental integration — ensuring the AT works in all relevant environments
- Review — monitoring AT effectiveness over time and adjusting recommendations as the person’s needs change
Common AT Scenarios Our OTs Address
Scenario 1: Post-Stroke Bathroom Independence
A participant recovering from stroke has right-sided weakness and is unable to safely shower or bathe independently. Their OT assesses balance, upper limb function, and bathroom layout — recommending a combination of a shower chair, grab rails, handheld shower head, and a long-handled bath brush. The OT writes a low-cost AT report for NDIS Core Supports, and trains the participant and their support worker in safe use.
Scenario 2: Powered Wheelchair for Progressive Neurological Condition
A participant with progressive MS is no longer able to self-propel a manual wheelchair for functional distances. Their OT conducts a comprehensive powered mobility assessment — evaluating driving capacity, cognitive function, vision, seating needs, and home/community environments. Following a trial of multiple powered chair options, the OT produces a high-cost AT report with supplier quote for NDIS Capital Supports funding.
Scenario 3: AAC Device for Non-Speaking Autistic Child
A seven-year-old autistic child is minimally verbal. Their OT — working alongside a speech pathologist — conducts an AAC assessment evaluating the child’s communication profile, symbolic understanding, motor access, and sensory considerations. The team recommends a specific speech generating device with a symbol-based interface, producing a high-cost AT report and arranging a funded trial period before final prescription.
Scenario 4: Smart Home System for High-Level Spinal Cord Injury
A participant with C4 quadriplegia is unable to independently operate light switches, door locks, or appliances. Their OT conducts an environmental control assessment and recommends an integrated smart home system with voice activation and switch access. The OT coordinates with an AT supplier and home modification builder to ensure seamless installation, and produces a high-cost, high-risk AT report for NDIS Capital Supports.
Scenario 5: Workplace AT for Adult with ADHD
A participant with ADHD is struggling to manage the cognitive demands of an open-plan office environment. Their OT conducts a workplace assessment and recommends a combination of noise-cancelling headphones, dictation software, a task management app, and an ergonomic workstation setup. The lower-cost items are funded through NDIS Capacity Building — Finding and Keeping a Job, with the OT providing a written workplace modification letter to the employer.
What Makes a Good AT Assessment Report?
Not all AT reports are equal — and the quality of the report directly affects NDIS funding outcomes. Our OTs write AT reports that are:
Functionally grounded — the link between the participant’s functional impairment and the recommended AT is explicit and evidence-based, not assumed.
Goal-aligned — the AT is clearly connected to the participant’s NDIS goals, using NDIS language and framework.
Specific — make, model, supplier, and cost are specified where relevant, with a clear rationale for why this specific item (not a generic category) is recommended.
Trialled where possible — evidence from a trial period significantly strengthens the funding case.
Reasonable and necessary — the report explicitly addresses the NDIS’s “reasonable and necessary” criteria, including value for money and appropriateness.
Supported by functional assessment data — standardised assessment findings, functional observations, and clinical reasoning are documented, not just described in general terms.
NDIS Funding Pathways for AT
AT is funded across multiple NDIS budget categories depending on the type and cost of the item:
- Core Supports — Consumables — low-cost, low-risk daily living AT and continence products
- Capital Supports — Assistive Technology — higher-cost AT items requiring formal assessment and approval
- Capacity Building — Improved Daily Living — OT AT assessment and report writing
- Capacity Building — Finding and Keeping a Job — workplace AT assessment and prescription
- Capital Supports — Home Modifications — AT that forms part of a broader home modification
Understanding which budget category applies to your AT needs is part of what our OTs help participants and support coordinators navigate.
Frequently Asked Questions
Do I need an OT assessment for all NDIS assistive technology?
Not for all AT — low-cost, low-risk items can sometimes be purchased directly from Core Supports. However, an OT assessment is strongly recommended even for low-cost AT, because choosing the wrong item wastes NDIS funding and may not address the functional need. For anything above $1,500, or for AT with safety implications, a formal OT assessment and report is required.
How long does an AT assessment take?
This depends significantly on the complexity of the AT. A straightforward daily living aid assessment may be completed in a single one-to-two hour appointment. A complex powered mobility or AAC assessment may involve multiple sessions, a trial period, and several weeks of report writing and supplier engagement.
Can I choose my own AT, or does the OT decide?
AT prescription is always a collaborative process. The OT brings clinical expertise about what will be safe and effective; the participant brings knowledge of their own life, preferences, and goals. The best AT outcomes emerge from genuine partnership between the participant, their OT, and often their family or carers.
What happens if the NDIS rejects my AT funding request?
If an AT funding request is rejected, there is a review and appeals process. A well-written, clinically robust OT AT report significantly reduces the likelihood of rejection. If a rejection does occur, our OTs can provide additional evidence, clarify clinical reasoning, or support the review process.
Can an OT assess AT for my child at school?
Yes. OT can assess and prescribe AT for use in school environments — including seating and positioning, writing and communication AT, sensory tools, and environmental modifications. School-based AT assessment may involve liaison with teachers and school staff (with parental consent) to ensure the AT is appropriate for the school environment.
My plan doesn’t have AT funding. What can I do?
If your current NDIS plan does not include AT funding, an OT assessment report can be used to support a plan review request — providing clinical evidence that AT is a reasonable and necessary support for your disability. Our OTs are experienced in writing reports that support successful plan reviews.
Access Expert AT Assessment at Rebound Health Frenchs Forest
Whether you need a simple daily living aid or a complex, high-cost AT solution — the right starting point is always a thorough occupational therapy assessment by a clinician who understands both your functional needs and the NDIS funding framework.
At Rebound Health Frenchs Forest, our OTs provide expert AT assessment and prescription for NDIS participants across Sydney’s Northern Beaches — from initial assessment through to implementation, training, and review.
📍 Rebound Health | Frenchs Forest, Northern Beaches, Sydney
📞 9907 6023
🌐 www.reboundhealth.com.au
Rebound Health is a specialist allied health practice on Sydney’s Northern Beaches offering occupational therapy, exercise physiology, and dietetics. We support NDIS participants, children, adults, and families across Frenchs Forest, Brookvale, Warriewood, Dee Why, Narrabeen, Mona Vale, and surrounding suburbs.