NDIS I-CAN v6 and Cerebral Palsy

A practical guide for participants, families, and supporters

Disclaimer: This article reflects publicly available information about the NDIS I-CAN v6 assessment framework as at June 2026. It does not constitute professional disability support, medical, or legal advice. For personalised guidance, contact the NDIA on 1800 800 110, your Support Coordinator, or a disability advocacy organisation.

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Cerebral palsy is Australia's most common physical disability, affecting approximately 1 in 700 births and more than 34,000 Australians. It is among the most common conditions represented in the NDIS — and it is also one of the most diverse.

Cerebral palsy affects movement and posture as a result of damage to the developing brain. But "cerebral palsy" is not a single experience. It spans mild hemiplegia — affecting one side, with many people living and working independently — to quadriplegia with significant motor, communication, and cognitive impacts. Between these extremes are hundreds of thousands of individual presentations.

The I-CAN v6 assessment does not ask "do you have cerebral palsy?" It asks "what do you need support with in daily life?" This is the right question. It also means that preparation matters enormously — because a generic description of cerebral palsy is far less useful than a specific, accurate account of your daily functional life.

This guide explains what to document, domain by domain.

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Three Under-Documented Impacts of Cerebral Palsy

Before working through the domains, three impacts of CP are frequently under-documented in NDIS assessments and deserve specific attention.

1. Fatigue

Many people with cerebral palsy experience significant fatigue that is disproportionate to what others might expect. Managing movement with CP requires substantially greater energy expenditure than typical movement — a person with hemiplegic CP may use two to three times the energy of someone without CP to perform the same walking task. Over a full day, this energy cost accumulates into genuine, limiting fatigue.

In adulthood, this fatigue often becomes more significant. Many adults with CP describe a point in their thirties or forties where activity tolerance reduced meaningfully, affecting work capacity, community participation, and daily functioning.

Document fatigue specifically: what activities trigger significant fatigue, how severe it becomes, how long recovery takes, and what tasks are impossible when fatigue is present.

2. Pain

Pain — particularly musculoskeletal pain from spasticity, joint stress, and the effort of sustained movement — is common in CP and tends to increase with age. It is a legitimate functional support need that is often overlooked in NDIS assessments because it is invisible and assumed to be "just part of the condition."

Document pain: its location, typical severity, frequency, what activities trigger or worsen it, and how it limits daily function.

3. Ageing with CP

As noted above, the functional consequences of CP often increase with age even though CP itself is non-progressive. If your functional capacity has changed in recent years — if you are experiencing more fatigue, more pain, or reduced capacity to perform tasks you previously managed — document this change specifically and note when it began. This trajectory is relevant to assessing future support needs.

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Domain-by-Domain Guidance

Self Care

What to document: Physical assistance required for bathing, dressing, toileting, grooming, and eating; any adaptive equipment in use and what it enables; how long self-care tasks take with and without support; fatigue impact of morning self-care on the rest of the day.

Example: "Morning personal care takes approximately 90 minutes with support worker assistance. Showering requires a shower chair and hand-held shower head; support worker assists with lower limbs and hair. Dressing requires assistance with lower limbs and fastening — buttons and zippers are not manageable independently. After the morning routine, there is a significant fatigue cost that limits what can be managed in the first part of the day."

General Tasks and Demands

CP can affect the ability to manage daily routines, medication, and safety — particularly for those with more significant physical impairment or co-occurring cognitive features.

What to document: Whether daily routines (including complex care routines involving equipment, positioning, or medications) can be managed independently or require prompting and support; ability to manage medications reliably (particularly where CP affects hand function or memory); any safety concerns in daily life related to the physical nature of CP (fall risk during routine tasks, inability to respond to emergencies, etc.).

Domestic Life

Fine motor limitations, fatigue, and mobility constraints from CP frequently affect the ability to manage a household.

What to document: Ability to shop for groceries (physical access to shops, ability to handle money and carry items); ability to cook safely (handling hot items with limited grip or reduced hand function, fatigue while standing at the stove); ability to manage cleaning and laundry (physical demands, fatigue cost); what adapted equipment or support is used; which domestic tasks cannot be done independently and the consequences if support is unavailable.

Communication

CP affects communication in some but not all presentations. The impact is most significant in dysarthric CP (motor speech disorder) and in presentations with cognitive or language co-occurrences.

What to document:

• If speech is affected: intelligibility in familiar vs unfamiliar settings; speech fatigue (voice quality deteriorating after sustained speech); use of AAC
• If cognitive/language processing is affected: describe how
• If communication is unaffected: a brief note confirming this is appropriate

Mobility

This is typically a central domain for CP participants.

What to document:

• Mobility aids in use (walker, wheelchair — manual or power — crutches)
• Walking distance and terrain limitations (flat surfaces only, distance before pain or fatigue)
• Transfer ability — from chair to standing, in and out of vehicles
• Community mobility — what environments are accessible, what are not
• Progression — has mobility capacity changed in recent years?
• The "cost" of mobility — what can no longer be managed after a demanding mobility day?

Interpersonal Interactions & Relationships

CP itself does not typically affect social cognition, but it can affect social participation and relationships through communication barriers, physical access limitations, and fatigue.

What to document: Any communication-related barriers to social interaction; physical access barriers to social settings; the impact of fatigue on social capacity.

Learning & Applying Knowledge

What to document: For children, supports required at school. For adults, any educational history shaped by CP; current learning context and supports needed.

Life Long Learning

Many people with CP have vocational goals or career aspirations that physical barriers, fatigue, and accessibility challenges make difficult to pursue.

What to document: Employment or vocational goals; the physical access, fatigue, and assistive technology requirements that CP creates for any workplace; what adjustments or support would enable meaningful employment or skills development; whether the person has previously attempted employment and what happened.

Mental & Emotional Health

The mental health challenges associated with CP are often under-recognised. Living with a physical disability that affects visibility, communication, and independence carries a significant psychological burden, and rates of depression and anxiety are higher in people with CP than in the general population.

What to document: Any mental health conditions; the emotional impact of managing CP's physical demands and social visibility; whether mental health support is in place and accessible; how mental health affects functioning in daily life.

Community, Social & Civic Life

What to document: Actual current community participation; physical access barriers; fatigue barriers; transport needs and what transport is currently available; what participation requires in terms of support.

Domestic Life

See the General Tasks and Demands section above, which now covers shopping, cooking, cleaning, and household tasks as they relate to CP.

What to document: Specific domestic tasks that cannot be managed independently due to fine motor limitations, fatigue, or mobility; what adapted equipment is in use; support required for each task area.

Behaviours of Concern

For most CP participants, this domain will have minimal relevance. Note any exceptions.

Physical Health

CP involves ongoing physical health management that is often substantial and complex — spasticity, pain, epilepsy, orthopaedic conditions, and medication management are all common.

What to document: Physical health conditions present (spasticity management, epilepsy, chronic pain, orthopaedic conditions); medications and their management; the frequency and complexity of physiotherapy, occupational therapy, and specialist appointments; how physical health management affects daily life and what support it requires.

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Equipment, Assistive Technology, and Home Modifications

CP participants often rely on a significant range of assistive technology and home modifications — powered wheelchairs, communication devices, shower chairs, hoists, modified vehicles, home access modifications, and more.

Two things are important to document about equipment:

1. What the equipment enables you to do. This demonstrates why it is reasonable and necessary, and helps the assessor understand your functional capacity in context.

2. What you still cannot do even with current equipment. There is often a gap between what current AT enables and what full participation would require. This gap is relevant to future plan funding, particularly for equipment upgrades.

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Getting Allied Health Reports Right

For CP participants, occupational therapy and physiotherapy reports are among the most important supporting documents. Ensure these reports:

• Describe functional capacity in daily-life terms across I-CAN domain areas (not just rehabilitation targets)
• Include information about fatigue and pain as functional impacts
• Note any ageing-related changes to functional capacity
• Address equipment needs and the functional justification for each item

If existing reports are primarily focused on rehabilitation goals or equipment specifications without functional context, ask your OT or physiotherapist for a supplementary functional summary specifically for the NDIS assessment.

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Sources: Cerebral Palsy Alliance, NDIA — Support needs assessment framework, NDIS Amendment (Getting the NDIS Back on Track No. 1) Act 2024, Disability Advocacy Network Australia (DANA)