The NCTSN CANS provides a comprehensive assessment of the type and severity of clinical and psychosocial factors that may impact treatment decisions and outcomes. Notably, it includes domains measuring exposure to potentially traumatic experiences and levels of traumatic stress symptoms, as well as assessing for strengths. The NCTSN CANS can be used either as a prospective assessment tool during treatment planning or as a retrospective assessment tool to review existing information (e.g., chart reviews) for quality assurance monitoring or system planning. Items can be coded or completed by mental health personnel, child welfare workers, parents, family advocates, probation officers, teachers, research staff, and other groups of laypeople.
The NCTSN CANS is part of the Child and Adolescent Needs and Strengths (CANS) series of decision support tools designed to support individual case planning and the planning and evaluation of service systems. Different versions of the CANS are tailored to the needs of specific youth populations (see altered versions).
Overview
NCTSN CANS/ CANS Trauma Version
Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe, G., Ellis, H., Praed Foundation, & National Child Traumatic Stress Network. (2011). Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS Comprehensive – Trauma Version: A comprehensive information integration tool for children and adolescents exposed to traumatic events. Chicago, IL: Praed Foundation/Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
Cassandra Kisiel, Ph.D., Center for Child Trauma Assessment and Service Planning, Mental Health Services & Policy Program, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611. c-kisiel@northwestern.edu or Nicole Maj, B.S.: n-maj@northwestern.edu
Administration
There are four levels of each item with anchored definitions; however, these definitions are designed to translate into the following action levels (separate for needs and strengths):
In general the rating for scales is as follows.
• 0=no evidence and/or no need for action
• 1=mild degree and/or need for watchful waiting to see if action is needed
• 2=moderate degree and/or need for action
• 3=severe or profound degree and/or need for immediate or intensive action
• U=unknown but indicates a need for more information
| Domains | Scale | Sample Items |
|---|---|---|
Training
Parallel or Alternate Forms
There are multiple versions of the CANS, which are available from http://www.buddinpraed.org/. The different versions are tailored to the needs of specific
populations of youth.
1. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-MH): An Information Integration Tool for Children and Adolescents with Mental Health Needs
2. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-CW): An Information Integration Tool for Children and Adolescents with Child Welfare Involvement
3. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-0 to 4): An Information
Integration Tool for Early Development
4. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-DD): An Information Integration Tool for Children and Adolescents with Developmental Disabilities and Their Families
5. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-JJ): An Information Integration Tool for At-Risk and Delinquent Children and Adolescents
6. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-SD): An Information Integration Tool for Children and Adolescents with Issues of Sexual Development
7. CHILD & ADOLESCENT NEEDS AND STRENGTHS-TRAUMA EXPOSURE AND
ADAPTATION VERSION (CANS-TEA): An Information Integration Tool for Children and
Adolescents Exposed to Traumatic Events
Psychometrics
Pilot Sample of 128 youth from an ethnically diverse, urban clinical setting (82 males, 46 females with an average age of 11.98 years). The most common trauma experience were traumatic grief/separation, followed by physical abuse and community violence).
| Type: | Rating | Statistics | Overall Scale |
|---|---|---|---|
| Internal consistency | Cronbach's alpha | 0.94 | |
| Traumatic Stress Symptoms Domain | 0.78 | ||
| Child Strengths | 0.98 |
Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner (Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston, NJ: Civic Research Institute
In development
| Validity Type | Not known | Not found | Nonclincal Samples | Clinical Samples | Diverse Samples |
|---|---|---|---|---|---|
| Convergent/Concurrent | Yes | ||||
| Discriminant | Yes | ||||
| Sensitive to Change | Yes | ||||
| Intervention Effects | Yes | ||||
| Longitudinal/Maturation Effects | Yes | ||||
| Sensitive to Theoretically Distinct Groups | Yes | ||||
| Factorial Validity | Yes |
Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner (Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston, NJ: Civic Research Institute
| Not Known | Not Found | Nonclinical Samples | Clinical Samples | Diverse Samples | |
|---|---|---|---|---|---|
| Predictive Validity: | |||||
| Postdictive Validity: |
In development
Population Information
The items for CANS-Trauma version were developed and refined in conjunction with trauma-focused, mental health settings and populations and child welfare settings.
Pros & Cons/References
1. Potentially traumatic/adverse childhood experiences and traumatic stress symptoms are included in the measure, along with psychosocial, behavioral, emotional and daily life functioning factors.
2. The CANS is a great tool for facilitating the exchange of information about patients
because it provides a common language regarding an array of important areas of
symptomatology and functioning.
3. Item anchors are relevant to clinical decision-making.
4. Information provided can be closely linked to treatment planning.
5. The item incorporates a solid focus on strengths, consistent with strength-based
treatment planning guidelines.
6. The measure makes conceptual sense to clinicians.
7. The measure incorporates strengths, which can be used to reinforce and guide strengths-based interventions.
While certain psychometric properties have been established, there currently are few published articles examining the psychometrics of the CANS Trauma or NCTSN CANS. These statistics are being updated and publications are in process.
The reference for the manual is:
Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe,
G., Ellis, H., Praed Foundation, & National Child Traumatic Stress Network. (2011). Child and
adolescent needs and strengths (CANS) manual: The NCTSN CANS Comprehensive – Trauma
Version: A comprehensive information integration tool for children and adolescents exposed to
traumatic events. Chicago, IL: Praed Foundation/Los Angeles, CA & Durham, NC: National
Center for Child Traumatic Stress.
Other references:
Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with
traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner
(Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston,
NJ: Civic Research Institute
Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H., & Saxe, G. (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. Emotional and Behavioral Disorders in Youth, Winter 2009, 13-19.
Kisiel, C.L., Fehrenbach, T., Small, L., Lyons, J. (2009) Assessment of complex trauma
exposure, responses and service needs among children and adolescents in child welfare. Journal of Child and Adolescent Trauma, 2, 143-160.
The author provided feedback, which was integrated into the review.