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What you need to know about living or communicating with a person with Aphasia

You may have heard about aphasia before, or you are only just learning about it because your loved one has been diagnosed with it. 

Aphasia is a language disorder that occurs when there is some type of damage to the brain; this could be due to head trauma, stroke, dementia for example. Aphasia results in difficulties in understanding what someone is saying, speaking, reading, and writing. The severity and type of difficulties will depend on the size and location of the brain damage. 

You can read more in our previous blog ‘What is Aphasia?’. 

Living with aphasia is very difficult – can you imagine how frustrating it would be to be able to form full sentences in your mind and only be able to get a word or two out. Or you can recall lots of stories and memories about your loved ones but have trouble saying their names. 

That is the reality for people living with aphasia. With this in mind – the two most important things for living or communicating with someone with aphasia is to exercise patience and empathy. 

It is important to remember. 

• Aphasia is not a reflection of a person’s intelligence; there is a difference between not being able to provide an answer and not knowing an answer. You may need to ask if they have an answer and just can’t get it across.
  
  
• A person with aphasia (or anyone for that matter) might need a different approach to get the same result. If you are working with someone with aphasia you might need to assist them in finding an easier way for them to perform a task.
  
  
• When a person with aphasia is talking – listen patiently, the speaker may have difficulty finding the words or they may stumble, this is okay – be patient. Focus on what the person says, not what they haven’t been able to say.
  
  
• Simple is best – keep distractions and noise to a minimum. Use adult language but keep it simple and concise. Break down lengthy instructions. Use gestures, pictures, or other means to help support your communication.
  
  
• Just because a person with aphasia may have difficulties, does not mean they should avoid all communication. Keep the person involved. Involve them as much as you can with decision making but avoid burdening them with day-to-day details.
  
  
• Not everyone with aphasia is the same, just like every human – they are individuals with their own needs and wishes, so support will differ. 

Tips for communicating with someone with Aphasia

• Make sure that you have their attention before you start talking. This may include getting them to face you and getting their eye contact.
  
  
• Minimise background noise where possible e.g. Turn the TV down, move to a quieter room.
  
  
• Pay attention to the person’s body language and gestures they use.
  
  
• Keep your voice at a normal level unless I ask otherwise.
  
  
• Keep communication simple but don’t ‘talk down to them.
   
• Use short sentences. Repeat keywords if needed.
  
  
• Slow down.
  
  
• Give them time to listen, process and respond. This is likely to take a little longer than usual, but do not try and finish sentences for them.
  
  
• Try using different modalities of communication – drawings, gestures, writing, facial expressions. It may be easier to understand than words at times.
  
  
• Ask them to try another way e.g. drawing, pointing, or writing if they are having trouble.
  
  
• Ask ‘yes’ or ‘no’ questions.
  
  
• Let them make a mistake – this is okay.
  
  
• Let them try to do things for themselves. They may need multiple attempts, help when asked. 

Practice kindness – and reach out for support where needed. Your speech pathologist is here to help you and your loved one navigate through this tricky time. 

There are some fantastic resources out there – here are some below. 

• https://www.aphasia.org/ 
• https://aphasia.org.au/ 
• https://tactustherapy.com/ 

   

Why get siblings involved in therapy?

Siblings can often feel left out or jealous when one child is off going to appointments and has “special activities” they complete at home with their parents.  

Allowing siblings to join in with home practice and therapy, where appropriate, can help your children feel included and valued. Siblings can make the best practice partners for a child with speech and language difficulties. 

They can be an extra player in a game or a great model for language or social skills.  

A sibling can share in their brother or sister’s speech and language goals. For example, they can show them the flashcards for their speech sounds, give them a model to follow for language or simply help by playing in their reward games. 

They can also help to model turn-taking and many other social skills.

How to get a sibling involved in therapy

1. Make sure your child’s siblings don’t “take over” the session. Have some alternative activities for them. Explain Turn-taking to each child. Make it fun.  You could have a talking stick and when a child has the stick it is their turn to talk.
   
   
2. Make sure they are not too distracting. Assign roles. Give each child a specific role in the game or practice.
   
   
3. Create an environment of encouragement and support. Make sure your kids use kind words. Help their sibling by giving them phrase they can say to encourage them. For example, “I really like your /s/ sound”.
   
   
4. Make sure you don’t include siblings if your child is having a “bad” day.

 Fun ways to involve a sibling

• Play “Simon Says”
  
  
• Singsong together and take turns having each child do the actions.
  
  
• Read books together and ask each child questions (depending on each child’s level).
  
  
• Play turn-taking games.
  
  
• Do a scavenger hunt. Have siblings take turns giving each other clues where items are hidden.
  
  
• Create a fun recipe or craft together, while practising their speech and language targets and practising target speech sounds between each step.

Siblings can learn to become helpers to make therapy a more enjoyable experience for the whole family.  Well, thought through activities can let both siblings feel appreciated and special.

Parents can create an atmosphere where everyone feels included and speech practice is a positive family activity for all.

What are everyday routines and why should I incorporate my speech and language goals?

Everyday routines are things you typically do each day. This is as simple as getting dressed in the morning, getting breakfast ready, weeding the garden, playing, or folding the washing. 

The biggest advantage of including your own or your child’s speech therapy goals in daily tasks is that you don’t have to set time aside to get it done. It can decrease refusal in children, or the demand on adults to find time in an already busy schedule. 

Practice outside of your speech pathology appointments is important for most therapies. Your therapist will provide more information about how much practice is helpful based on your individual goals. 

Doing your own or your child’s therapy goals during daily activities helps to improve how quickly you reach that goal and how well you apply the new skill to various situations. There’s lots of research showing how ‘natural practice’ is the most meaningful.

What are some examples?

 

There are lots of ways to incorporate speech therapy goals into daily activities. Here are just a few examples of how you can transform routines into an opportunity to build speech and language.

Folding the laundry

• Vocabulary: Sort items of clothing into sizes (big, medium, and small). This can help with learning new concepts.
  
  
• Word relationships: put clothes into piles depending on what body part they are put on (e.g. pants and shorts go together because they both go over your legs).
  
  
• Find items that have your speech sound. For example, if you are working on the /s/ sound describe all the socks that are in the washing (spotty socks, green socks, long socks).
  
  
• Understanding sentences: ask your child/communication partner to find items based on descriptions. For example, “can you find something red that goes on your feet?”

Breakfast time

• Order of events/retell: Practice saying what you will do, or what you have done in the correct order. This is important for procedures, giving instructions, and also telling people about things you have done.
  
  
• Asking for items: You can help your child/communication partner to practice asking for items. This helps with building sentences, social requests, and learning items.
  
  
• Themes for sounds: Plan a breakfast which has a few of your child’s/your speech sounds. For example, /b/ – bread, banana, butter, bowl, bag.

Grocery shopping

• Language memory: practice how many items you can remember from your list without checking. First talk about each of the items (e.g. pear – “it’s a fruit, it’s green”), say the list out loud, then see how many things you/your child can remember.
  
  
• Speech sounds: help your child/communication partner to notice items that have their speech sound. This can help bring their attention to their goal, without the pressure of saying it.
  
  
• Recreate the experience at home: once you go to the shops, help your child to use the language they have heard by playing ‘shops’ in your own home. 

In the backyard 

• Descriptions: play eye spy to help build describing words. For example, I spy something that is tall and green.
  
  
• Following instructions: Give your child/communication partner an instruction based on their language goals. For example ‘on’/‘under’. “Put the pot on the table. Put the shovel under the tree.”

These are great ideas, but how can I plan it?

The first step is to make sure you understand your child’s/you own goals. Your speech pathologist can help you plan out activities based on your specific therapy. 

They will help you determine what you are trying the achieve, the level of difficulty to aim for, how to change the activity if it’s too easy or too hard, and what activities will work best. 

You can help your therapist by using open communication about what you feel is achievable and your daily activities. 

The importance of vocal hygiene when working, learning or participating in Telehealth sessions from home

Now more than ever, we are utilising technology to communicate. Thousands of Australian workers are working from home and communicating with their coworkers via video and voice calls. Children, too, are learning from home and connecting with their teachers via video calls.

Even our doctor and specialist appointments are over the phone.

With this in mind, it is not uncommon for you to experience discomfort in your voice. 

This is where “vocal hygiene” comes into play.  Just as you would have a shower to get clean, it is equally important to care for your voice.  Vocal hygiene includes hydration, breathing, voice production and changing daily habits or behaviours.

In this article, we explore vocal hygiene strategies to help you care for your voice at home.

How can talking on the phone affect my voice?

Talking on the phone or via video is taxing on your voice. You may notice your voice is more tired than usual or your throat is tight, and your voice is hoarse or even starts to ache. 

If you talk for long periods without drinking water, you might notice an increased sensation of dryness or irritation in your throat. This is why vocal hygiene is absolutely essential on a daily basis.

What vocal hygiene strategies can I use to help my voice?

• Drink plenty of water.  If you absolutely hate water, then try adding some flavouring such as cordial or water infusers. Alternatively, you could add different fruit directly to your water (lemon, cucumber, and mint).
• Avoid smoking and dry, dusty environments.
  
• Ensure any reflux is managed effectively.
  
• If you use an inhaler, use a spacer and then rinse and gargle after using
  
• Avoid mouthwash, alcohol and lollies that contain menthol.
  
• Get enough rest.
• Use diaphragmatic breathing. See previous blog (What is diaphragmatic breathing?)

Strategies for good vocal hygiene

• Warm-up your vocal cords: produce an ‘mmm’ sound, and say ‘oo’ using a comfortable pitch, then glide up and down in pitch.
  
• Have a glass or bottle of water near you. Continue to sip water during the call can help to reduce dryness or mucus.
  
• Set up in a quiet space and ask your other telehealth participants to find a quiet space, with a good signal so they can hear.  This can lower the risk of you straining your voice to be heard.
  
• Use headphones.
  
• Set your monitor at a comfortable height.  This is to avoid twisting your neck or hunching over as this might affect your breathing and voice box function.
  
• Prepare images or videos to share to rest your voice.

What can I do after a phone or online meeting?

• Enable time for your voice to recover e.g. schedule time to complete admin between sessions.
  
• Drink plenty of water

Vocal hygiene is not always useful as a stand-alone treatment for voice disorders. If you or your child are having any voice difficulties, speech pathology assessment and intervention is recommended.  

If you have any concerns regarding your vocal hygiene please do not hesitate to call Harrison Speech Pathology on (02) 4953 6128 regarding your concerns. 

All our therapists are trained and experienced in implementing therapy targeting voice issues.

 

How to support students who have a language impairment with home schooling

Why do kids with language impairment need more support?

Children with language impairment can have specific difficulties learning language form (sounds, grammar), content (meanings), and use (intended meaning). These difficulties can impact their ability to understand and/or use spoken/written language. 

Learning at the same level as their peers can be challenging for them. They struggle daily in school tasks that require speaking, listening, reading, and/or writing. 

Language impairment can also affect a child’s ability to communicate and interact with those around them causing frustration and isolation. With the recent need for parents to home-school during lockdowns, your child may need extra support and strategies to help them achieve classroom expectations.

How can I help my child with language impairment during home-schooling?

 

1. Make sure there are no distractions. Turn off the tv/music and make sure the space is free of clutter and siblings if too distracting. Before giving an instruction, make sure you have their full attention and have eye contact.
   
   
2. Make a brief visual schedule so that they know how long each activity is and when breaks come. Ensure frequent breaks for physical activity or snack breaks.
   
   
3. Use visuals, gestures, and real objects that relate to your child’s experience. For example, if your child was learning about something like ‘gravity’, you could play a ball game throwing ball up/down, or jump on the trampoline. If your child loves drawing, have them draw a picture around the topic. Play games where you can ‘brainstorm’ words in a category.
   
   
4. Slow down the rate at which you provide information. ‘Chunk’ information into smaller parts and wait between each part to make sure your child understands. Give them lots of time to respond to questions and comments.
   
   
5. Rephrase complex language into language that is easier for them to understand.
   
   
6. For new words/topics that your child does not know, repeat the information, and give them examples or show pictures/videos. Encourage them to retell so you can check their understanding of the new vocabulary.
   
   
7. Encourage your child to ask for clarification. Let them know that it is good to ask questions and ask for clarification. Let them know a specific phrase that they can say e.g. “I’m not sure” or “I don’t understand” or “Can you explain that in a different way?”
   
   
8. Explain things even if they appear obvious e.g. “I’m going to read you a story. It is important to look at me and the book when I’m reading. It is important to think about what I am saying”.
   
   
9. Try not to use sarcasm, indirect requests, idioms, or ambiguities, which may be confusing for a child with language impairment.

Fun ways to support kids with language impairment

• Play a Pictionary-style game where you have to draw a topic item.
  
  
• Make up songs/tunes to rehearse new word meanings or information.
  
  
• Play charades using topic information.
  
  
• Watch YouTube videos on the topic.
  
  
• Create a “new words” book with definitions and drawn/printed pictures.
  
  
• Make a ‘mind-map for a topic with words and/or pictures. Make it colourful and creative. 

Remember that your child needs patience and understanding to learn in the different world of home-schooling. They will be out of their routine and missing the daily social interactions with their friends. 

Remember that you are a parent, not a teacher. Just do the best you can to support them during this time. Keep in mind that they have different learning and language skills, and try to keep their learning fun!

Why is play important? 

Play is the key ingredient to children’s learning. It creates moments of learning for children through connection together. 

Children’s communication is driven by the development of joint attention in which children are able to engage in interactions with others through directed attention to an object of interest or toy. These toys or objects become the foundation to build meaningful communication. 

When your child is playing, they’re gaining experiences that give them lots to think and communicate about. They also have the chance to learn new words!

How do I play with purpose?

When you’re planning a purposeful play session, think about how your child naturally plays. It is important to recognise the stage of play your child engages in so that you can get alongside them and play at your child’s level. 

Helping them get the most out of play means that you have to learn to follow their lead. Then, you can join in at their level and build on their language and skills in a more meaningful way. In doing this, they’ll want to play longer, giving them even more chances to learn.

Small changes in your normal routines and everyday interactions can increase opportunities for speech and language development in your child. It is important to identify or establish some enjoyable routines and interactions in your day to begin playing with purpose and create a context for language modelling or therapy targets. 

Then, you can use your child’s favourite play activities to support their language goals and encourage them to pretend and use their imagination. 

What does purposeful play look like?

 

A successful, purposeful play activity should involve you and your child interacting and having fun. Once your child is taking the first turn and you are able to take turns back and forth, they are ready to learn. 

Here are some helpful tips to play with purpose:

1. When you are playing with your child, it is helpful to get down on their level, face to face. Make sure you have the toy/s you plan to use beside you and observe what your child is doing.
   
   
2. Wait to see what they are doing and how they choose to interact and play with the toy.
   
   
3. Listen to what they say or communicate. Think about what sounds or words they are already using.
   
   
4. Get alongside them and repeat (imitate) your child’s actions with the toys. Join in the play by getting your own toys, using fun sounds and words, using pretend play (if your child is ready). You want to aim to repeat a gesture alongside a word or phrase at least 3-5 times during an interaction.
   
   
5. Offer opportunities for them to imitate you or cue them to take a turn by waiting. Be sure to match what you say to what’s happening so that your child can associate the words or gestures to the activity.
   
   
6. Use short, grammatical sentences to help them learn new words and word combinations. For example, you could say, “Let’s throw the ball!”, “Throw the ball”, “I’m going to throw the ball”. Your child may say, “throw” or “ball” but will begin to develop their ability to speak in longer sentences.
   
   
7. Pause often to give your child a chance to take a turn. If they need prompting, you could ask questions (but not too many) or give a visual helper or gesture.
   
   
8. Finally, add language to the interaction by modelling your child’s turn or expanding their message. It is important to model language at or just above your child’s level but remembering to say less, emphasise key words or targets, speaking slowly, and showing them what to do or how to say it.

And don’t forget: Keep the play fun and keep the play going!

If you or your child experience communication difficulties, please do not hesitate to call Harrison Speech Pathology and speak directly to one of our trained therapists.

 

Changes in routine can be stressful for both children and adults with Autism.

Routines provide a feeling of safety because they are predictable. The level of change that causes distress for individuals with Autism is different for each person.

Here, we share some insight into potentially triggering routine changes and provide recommendations on how to support your loved one.

What are some potentially stressful routine changes?

• Having a different support worker
• Changes in weather and temperature 
• New clothing or shoes
• Someone different picking up from school or day program
• Having visitors at home
• Visiting someone else at their home
• Changing activities
• Unexpected occurrences (like a fire alarm going off)
• Doing things in a different order (like eating dinner before having a shower when it is usually having a shower first)
• Not being able to finish an activity (like watching the end of a movie, finishing a game)
• Going to a new place
• Having a new teacher or therapist
• Being introduced to new foods
• Not being able to go somewhere New plates, cutlery, drink bottle
• New toiletries (like toothbrushes, brushes, soaps)
• A new member of the family (like a pet or baby)
• Changes to the environment (like moving furniture around)

How can I support an individual with Autism when this occurs?

• Communicate the change in advance if possible. Being warned about incoming change will assist the person to manage the situation more easily.
  Try social stories. This involves a short story with pictures that explains the change. They are usually from the perspective of the person with Autism (for example “I will go to the dentist”).

  These can be read before, during and after the change to support the person to understand and adapt to it because they know what to expect. Social stories may be on paper or a person’s device (for example iPad, Proloquo2go, Lamp).

• Explain the change with visuals like drawings, pictographs or photos. They can be made into any size and are handed to an individual step by step to prepare them during the routine.
  Create a schedule. This could be as simple as “first” and “then” or plan the individual’s day in advance. Their schedule might include visuals but could be handwritten — it depends on the individual’s capacity to understand the text.
  
• Offer short and simple explanations. It is important to give information in short bursts to allow the person to process and understand without overwhelming them. For example “the pool is closed today, so we are staying home”. 
• Set a variety of timers to help the person transition between activities or steps in their routine. Visual timers include sand timers and gel timers. Auditory timers include alarms on a device, ringing a bell or an alarm clock. Have extra time to spare. Some individuals may require additional time to process and complete routines when a change has been implemented. Reward flexibility. Individuals with Autism have increased difficulty when routines are changed, therefore it is important to praise their flexibility when they are able to be supported through the change. 
  
• Use people in their lives. Many people with Autism have a support team (for example teachers, therapists, family members). Utilise each person on the team to support the individual through routine changes. For example, each person uses the prepared visuals/schedule/social stories to ensure consistency and repetition of the upcoming change to routine. 
  
• Use sensory supports. Sensory supports can assist when an individual becomes dysregulated during the routine change. For example, fidget toys, weighted blankets, movement breaks, music, objects to squeeze, headphones. Each individual with Autism has different sensory preferences so it is important to determine these prior to offering something during a change in routine. 

Include your Speech Pathologist in the changes

If your loved one has a Speech Pathologist, be sure to include them when any routine changes occur. Your Speech Pathologist can help provide routine consistency through regularly scheduled sessions.

For more information about scheduling sessions, contact our team on (02) 4953 6128 today.

 

 

Your environment has drastically changed again over the past few weeks – and telehealth is now the primary option for speech sessions for the time being. 

This may bring up several feelings – both good and bad, but let’s go back to basics and set yourself up for success whilst we navigate this together. 

Telehealth is a very effective treatment option when you’re prepared, so here are some tips to help you get the most out of your Telehealth speech pathology sessions at home. 

Making the most of your Telehealth speech pathology session

• Talk to your speech pathologist beforehand about what to expect from your Telehealth speech pathology session and what is involved. This is also a good time to ask any questions so that your speech pathologist can walk you through any issues.
• Think about your home routine, and the goals you have been working towards – the great thing about telehealth is that it can give your speech pathologist a great insight into your home routines. You may want to use this to your advantage and incorporate your home routines into the session to create functional learning opportunities. This could mean getting the family involved, where they previously might not have been able to. Siblings can be very helpful therapy assistants!
• Think about the set up – what are your or your child’s abilities and needs? Is there a comfortable chair? Do they need a fidget cushion or toy? Will they need room for a movement break? You might even have some toys that are motivating and would be a great addition to the session.
• Record the session! This is a great opportunity (with the speech pathologists’ consent) to record some of the session which might be useful to show other family members to help use strategies at home.

Explaining Telehealth to your child or teenager

It is also useful to take some time to explain telehealth to your child or teenager, so that they feel ready to participate – especially if they are new to telehealth, or routine changes have been causing anxiety.

The most important thing here is to let them know who they are seeing and why – and it may also be useful to explain why they are seeing them through a screen.

Explain that you will still be working together but using different games, and that they might even be able to show their speech pathologist their favourite games, toys or pets.

If your child is especially anxious you could set up your own test call so they can feel familiar with the set up. You may need to set up a sign or similar so that other family members do not intrude.

Reassure your child about their privacy, this might be using strategies such as playing music outside their room or other family members going for a walk during your child’s Telehealth speech pathology session. Encourage your child to stay focused and approach telehealth in the same way they would in person. You may need to help them mute social media, and make sure they have had something to eat beforehand.

You can let your speech pathologist know if telehealth therapy isn’t working well for you. This way they can try some other strategies or come up with a new plan with you. Remember we are here to work with you to meet you and your families’ goals.

Book a Telehealth speech pathology session with Harrison Speech Pathology today.

So, your child is having trouble communicating and your local speech pathologist has mentioned AAC devices to help make things easier. You might be worried this will stop their natural speech development, but this is a common misconception and a BIG MYTH.

AAC devices and systems can be a powerful tool to help your child communicate more effectively. In this blog, we delve deeper into AAC devices and clear the air around the value of their use.

What is AAC?

If this is the first time you’ve heard about AAC, it’s natural to be curious or sceptical about these devices. AAC stands for augmentative alternative communication and it is used to express thoughts, needs, wants, and ideas in children and adults who have severe speech problems.

We all have AAC – for example, when we make facial expressions or gestures, use symbols or pictures, and write things down. However, this is not possible for some children and adults.

AAC devices like picture communication boards and electronic devices can help people express themselves, increase social interaction, and improve their self worth.

Does AAC have an impact on speech development?

It might come as a surprise, but evidence suggests AAC does not stop speech development. In fact, there is evidence to suggest it does the opposite – it has a positive impact on speech and language development (Millar, Light & Schlosser, 2006; Blischak, Lombardino & Dyson, 2003).

AAC users incorporate other ways to communicate including AAC devices, systems, gestures, and sounds. Sometimes, they will even use speech if they can’t communicate what they want to because speech is the most efficient and effective way to communicate.

Your child will use what works best to get what they need quickly – this may be through a variety of means. In speech pathology, we call this multimodal communication. Use of speech can sometimes be frustrating for kids who are struggling to communicate verbally, which is why speech is often more successful when it is supported by AAC devices.

In other words, if speech is unclear, the AAC device can be used to provide clarification. This makes for a more positive communicative experience for everyone involved.

Don’t shy away from AAC devices

AAC has so many benefits for your child’s development –  but most importantly, it is our hope as speech pathologists that everyone is able to express themselves successfully and we will always support your child in doing so – whatever that looks like for them. 

AAC is a powerful tool. If you want to learn more, have a chat with your local speech pathologist next time you see them. At Harrison Speech Pathology, we specialise in children’s speech pathology and social skill development, so we can help find an AAC system suited to your child.

Contact the team at Harrison Speech Pathology for more information on AAC devices and their benefits!

Image: Mouse4All | Unsplash

The National Disability Insurance Scheme provides funding and support for people living with a disability. Each eligible person will receive an individualised funding plan based on their functional needs and goals they wish to achieve.

What is the difference between NDIS and NDIA?

The NDIS is a national system that provides support to those living with a disability. The NDIA is the government agency that implements and manages the NDIS to ensure continued support for each individual.

How is my funding managed?

There are three different ways that your NDIS funding can be managed.

• Agency (NDIA)-managed: Providers claim each individual session from your plan and NDIA pays the provider.
• Plan-managed: A plan manager will pay providers for you and also assist you in keeping track of your funds.
• Self-managed: You are the manager of your own funds and pay providers directly and NDIA will then reimburse you.

Can I claim speech pathology sessions through my NDIS funding?

Yes. You can definitely claim speech pathology assessment and intervention using your NDIS funding.

How long do plans go for?

Plan lengths can range in time. Majority of plans will be for 12 months with the goals within each individual plan being reviewed every 12 months. This is to ensure individual goals are kept up to date as the participant progresses and their functional needs change and develop.

What happens when my plan is expiring?

When your plan end date is coming up providers such as Speech Pathologists will be required to complete an updated assessment and progress report for NDIA to review prior to providing a participant with a new plan.

How do I start speech pathology sessions with my funding?

If you would like to access speech pathology assessment and intervention using your funding, give Harrison Speech Pathology a call. We will assist you in booking in an initial assessment and provide you with recommendations for ongoing therapy sessions to make the best use of your NDIA funding.

If you require any further information, please refer to the NDIS website directly or give us a call to discuss your questions.