Communication and Capacity Assessment: Documentation for Disability Support

Why Communication and Capacity Documentation Matters

Many NDIS participants have communication disabilities. This doesn't mean they can't make decisions — it means we need to support them to communicate their preferences and understand information.

Documentation must reflect the participant's actual communication abilities and what support they need to make informed choices, not assumptions about their capacity.

Communication Assessment Documentation

Document the participant's communication profile:

• Verbal communication: Can they speak? How clearly? How much can they understand?
• Non-verbal communication: Do they use gestures, facial expressions, eye gaze, pointing?
• AAC systems: Do they use picture boards, communication devices, or apps?
• Literacy: Can they read and write? What level?
• Best communication times: When are they most communicative? (e.g., one-on-one vs. group settings)
• Support strategies: What helps them communicate? (slow speech, visual supports, familiar person)

Capacity Assessment and Documentation

Capacity is decision-specific — someone might have capacity for some decisions but need support for others.

Document:

• The specific decision: (e.g., "choice of activities for Friday" vs. "financial decision about NDIS funds")
• Information provided: What did you explain? In what format? (verbal, pictures, simple language, AAC device)
• Understanding: Did the participant understand the options and consequences? How do you know?
• Expression of preference: How did they communicate their choice?
• Consistency: Do their choices align with their stated values and preferences?

Supported Decision-Making Documentation

Even if someone has limited capacity, they can usually make decisions with support. Document the support you provided:

• Who was involved in supporting the decision? (family, advocate, support worker)
• What role did each person play?
• How was information presented to the participant?
• How did you ensure the participant's preference was the deciding factor (not the supporter's preference)?

This article was written by AccuNote's Communication & Capacity Team, which helps providers support autonomy and informed consent for participants with communication disabilities.