Government is committed to ensuring that children with disabilities and their families who need early intervention, therapy and respite services can access that support in a timely way.
An Assessment of Need is a specific assessment process carried out by the HSE under the Disability Act 2005, to determine whether a child has a disability as defined within the Act. If it is determined that they do, assessments are arranged to identify the health and education needs of the person with a disability and the services required to meet those needs. It is important to note that children do not require an Assessment of Need to access health services.
Demand for Assessments of Need has increased significantly in recent years, reflecting both the increase in population and the number of families exploring all options to access services for their child. Unfortunately, this demand is outpacing the capacity of the system to respond, with the result that there were 20,209 applications overdue for completion nationwide at the end of 2025, according to the most recently available HSE data.
On a positive note, there has been continued improvement in the number of completed AON reports, with 5,939 reports completed in 2025. This is a 43% increase nationally compared to the number completed in 2024. Additionally, since June 2024, 7,700 clinical assessments have been commissioned privately through the AON Targeted Waitlist Initiative to support the delivery of AON reports at a cost of €27.8 million. Funding of €20 million has been provided this year for the AON Targeted Waitlist Initiative. It is expected that some 6,000 clinical assessments will be delivered this year, with a specific focus on autism spectrum disorder at a fixed cost of €2,900 per assessment.
Separately, the Government continues to work with the HSE on a range of legislative and non-legislative improvements to the Assessment of Need process. This is to ensure the needs of children are identified as early as possible and to improve the delivery of assessment reports to families.
Most children and young people with disabilities can have their needs met through mainstream services. However, children and young people with complex needs may require access to health and social care supports and services delivered by Children’s Disability Network Teams (CDNTs). It is important to note that a diagnosis is not required to access a CDNT.
Whilst recognising that there is more to do, real progress has been made in reducing the CDNT waiting list. HSE preliminary data indicates that the national CDNT waiting list has reduced by 48%, from 16,522 children awaiting an initial contact in 2023, to 8,648 children at the end of February 2026.
Preliminary data for February 2026 reports that Children’s Disability Network Teams are providing services and supports nationally for 45,141 children, and strategies and supports for waitlisted children with urgent needs, where staffing resources allow.
This Government recognises that delays faced by families are unacceptable and there has been intensive work by this Department and the HSE to address this.
The Government has provided funding for additional posts to enhance the capacity of CDNTs and shorten the waiting times in recent years, with further investment in both Budgets 2025 and 2026 to fund additional therapy posts and clinical trainee places.
Progress is being made on the recruitment of staff to CDNTs, with the HSE reporting a 28% increase in staffing levels nationwide from October 2023 to October 2025. This equates to an additional 448 Whole-Time Equivalents (WTE), including an additional 321 Health and Social Care Professionals (HSCPs).
To continue this growth, the HSE is driving intensive domestic and international recruitment efforts and will undertake a variety of workforce initiatives to support sustained growth of CDNTs and the wider disability service.
A dedicated Disability Workforce Strategy will be developed by the HSE in 2026, to meet growing service demands and address recruitment and retention challenges across specialist disability services, including CDNTs. The Strategy will be developed as a distinct and visible strand within the new HSE Resourcing Strategy 2026-2029, detailing specific actions for Disability services while remaining fully aligned with national workforce reform
In addition, placements on CDNTs will continue to be expanded, alongside a continued expansion in the number of places in higher education, to develop the pipeline of future therapists.
The Programme for Government commits to doubling the number of college places for speech and language therapists, physiotherapists, occupational therapists, dietitians, psychologists and social workers. This expansion will provide up to 461 additional student places by 2028, with the majority commenced in 2025.
In 2026, the HSE will develop targeted retention actions and innovative recruitment campaigns to address persistent vacancies and optimise recruitment across all service providers, ensuring the workforce reaches its funded level.
As set out in the HSE’s 2026 National Service Plan (NSP), Budget 2026 has provided an additional €25m for investment in Respite Services. This funding will provide a range of new respite initiatives nationally. The NSP states that 500 more children and adults with a disability are expected to receive respite sessions in both centre based and alternative settings within their community. This represents a 7% increase on 2025 figures. 2026 funding will also allow for 10,000 additional respite bed nights nationally, including high support placements (a 6% increase on 2025) along with 25,000 additional day sessions through for adults and children including after-school, weekend, and holiday programmes (a 6% increase on 2025).
HSE Disability Services recognises the importance of support during transition between child and adult services. CDNTs work with families to prepare for this change through Individual Family Support Planning, which includes goal setting, skills development, and referral to appropriate adult services. Transition planning is recognised as a gradual process that supports young people and families to prepare for adulthood and lifelong wellbeing.
Many young people who access clinical inputs from CDNTs may also be in receipt of other Paediatric clinical input and may appropriately be referred towards adult Primary Care teams or other adult clinical care services as they move towards adulthood. The Central Referrals Office in each Integrated Health Area assists in ensuring referrals are directed to the appropriate service.
The HSE Day Opportunities Team works closely with CDNTs to support transfer to HSE funded adult day services where this is the appropriate pathway.
Referrals for transition planning may be made from age 16 and families are invited to information sessions to meet local service providers, including those offering rehabilitative training.
It is recognised that demand for registered residential, respite and personal assistant services continue to increase due to demographic change, increased life expectancy and the evolving and increasingly complex needs of people with disabilities.
The Department, alongside the HSE, is continuing to work to increase provision in order to assist those who are most vulnerable in our society, and who urgently require services.
