What is the CASII?

The Child and Adolescent Service Intensity Instrument (CASII) is a standardized assessment tool that provides a determination of the appropriate level of service intensity needed by a child or adolescent and his or her family. It is unique in its capacity to determine a service intensity need, guide treatment planning, and monitor treatment outcome in all clinical and community-based settings.

The CASII is developmentally informed and developed on the foundation of a System of Care approach -- embracing individualized service planning, supporting the use of intensive care coordination or wraparound planning teams, and providing a broad service array. The CASII recognizes that the use of home and community-based services and natural supports can provide increased service intensity instead of relying just on “bricks and mortar” to achieve higher levels of service intensity.

The CASII is applicable to children living in a variety of settings including those within a community with their parents or extended family, those in foster care, and to children in institutional settings. The CASII assesses the service intensity needs of children and adolescents presenting with psychiatric, substance use, medical and/or developmental concerns. It incorporates holistic information on the child within the context of his/her family and community by assessing service intensity needed across 6 Dimensions including:

  • Risk of Harm
  • Functional Status
  • Co-Occurring Conditions
  • Recovery Environment
  • Resilience/Response to Services
  • Involvement in Services

The CASII links the results of a clinical assessment with a defined level of service intensity using a clinically derived and empirically tested algorithm. It is user-friendly, culturally informed, and supports active participation by child and family. The CASII can be used at all stages of intervention and is designed for use in all child-serving systems, including behavioral health, physical health, education, child welfare, juvenile justice, substance use, and developmental to facilitate integrated attention to the child’s needs. It is independent of diagnosis, promotes effective communication between providers and systems, and informs clinicians’ engagement with the child, family, and community.

What does the CASII do?

  • It assists providers in creating comprehensive, strength-based, individualized, and coordinated service/treatment plans for children 6-18 years of age.
  • It can be used to evaluate children and adolescents presenting with mental health challenges as well as those with medical, substance use, and developmental co-occurring disorders.
  • It supports active participation by child and family.
  • It can be used as a metric to measure and monitor progress in treatment.
  • It can help assess the effectiveness of a program or intervention at a systems level.
  • It provides a common language different providers to address the needs of a child and their family.

What doesn't the CASII do?

  • It does not provide a clinical diagnosis for a child or family.
  • It does not prescribe a specific plan or setting.
  • It does not replace a comprehensive clinical evaluation or judgement.

Who can benefit from use of the CASII?

  • Licensed primary and mental health care providers
  • Child welfare programs
  • Developmental disability treatment programs
  • Juvenile justice systems
  • Insurance benefit administrators
  • Policy makers and advocates in child serving agencies
  • Service coordinators and wraparound planning teams

How do I get trained on the use of the CASII?

In Person CASII Trainings:

In person CASII trainings (ideal for groups of 20 or more who would like instruction in a more traditional classroom setting) are conducted over one day and take place at whichever location your agency provides.  Training costs vary depending on the type of organization being trained and the number of trainees.  In order to keep classroom sizes small and facilitate learning, one trainer is used for each group of 20 trainees.  There is an additional cost for manuals for in person trainings which average to $30 per person plus 15% shipping and handling.  
 
Online CASII Trainings:

Online CASII trainings (ideal for individuals, smaller groups, larger scale trainings, or those who need a course refresher) are offered through AACAP’s learning management systems, Pathways.  This online option consists of five e-learning modules leading to the development of skills necessary to determine CASII composite scores, attribute service intensity levels, and create personalized service treatment plans.  The estimated time to complete all online activities is approximately 6 hours and the purchase of a manual is optional.  

By the end of the modules course learners will be able to:

  • Understand the Systems of Care philosophy which serves as the foundation for the CASII.
  • Explain why the CASII is useful in determining appropriate supports and services.
  • Determine the correct anchor points for each CASII dimension and compute a composite score.
  • Describe service intensity levels for each CASII dimension.
  • Use the CASII to create a service plan based on wraparound service plan concepts as well as any other team-based treatment planning processes.

To access online CASII trainings visit AACAP's online store. Please note that purchases are non-transferable and all modules must be completed by the owner of the account. 
 
For more detailed information on training options or to obtain a quote for an in person CASII training, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org.

 

CASII REFERENCES

Daleiden, E. L. (2004). Child status measurement: Operating characteristics of the CALOCUS and CAFAS. Honolulu, HI: State of Hawaii Department of Health Child and Adolescent Mental Health Division.

Daleiden, E. L., & Chorpita, B. F. (2005). From data to wisdom: quality improvement strategies supporting large-scale implementation of evidence-based services. Child and Adolescent Psychiatric Clinics of North America, 14(2), 329-349. https://doi.org/10.1016/j.chc.2004.11.002

Daleiden, E. L., Pang, D., Roberts, D., Slavin, L. A., & Pestle, S. L. (2010). Intensive Home Based Services Within a Comprehensive System of Care for Youth. Journal of Child and Family Studies, 19(3), 318-325. https://doi.org/10.1007/s10826-009-9300-z

Fallon, T., Pumariega, A., Sowers, W., Klaehn, R., Huffine, C., Vaughan, T., . . . Grimes, K. (2006). A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity. Journal of Child and Family Studies, 15(2), 140-152. https://doi.org/10.1007/s10826-005-9012-y

Greenwood, P. (2014). Connecticut and Hawaii: Early Starters With Quite Different Results. In Evidence-Based Practice in Juvenile Justice: Progress, Challenges, and Opportunities (pp. 13-26). New York, NY: Springer New York.

Henderson, L., Wasser, C., & Wasser, T. E. (2018). Using the Child and Adolescent Service Intensity Instrument (CASII) as an Outcome Measure. Journal of Clinical Outcomes Management, 25(4).

Illinois Department of Children & Family Services. (2017). Annual Progress & Services Report (APSR).

Minnesota Department of Human Services Children’s Mental Health Division (2008). Outcome Measures Pilot: SDQ and CASII - Report for Minnesota Mental Health Action Group (MMHAG).

Nakamura, B. J., Daleiden, E. L., & Mueller, C. W. (2007). Validity of Treatment Target Progress Ratings as Indicators of Youth Improvement. Journal of Child and Family Studies, 16(5), 729-741. https://doi.org/10.1007/s10826-006-9119-9

Ono, Y., Pumariega, A., Yamamoto, A., Yoshida, K., Nakayama, H., Nakanishi, D., . . . Millsaps, U. (2009). CASII Development in Japan. Paper presented at the 56th Annual Meeting of the American Academy of Child and Adolescent Psychiatry, Honolulu, HI. New Research Poster

Pumariega, A.J., French, W., Millsaps, U, Moser, M., & Wade, P. (2019). Service intensity/level of care determination in a child welfare population. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-019-01393-w

Pumariega, A., Millsaps, U., Moser, M., & Wade, P. (2014). Matching Intervention to Need in Juvenile Justice: The CASII Level of Care Determination. Adolescent Psychiatry, 4(4), 305-313.

Pumariega, A., Wade, P., Millsaps, U., Moser, M., & Clark, T. (2006). The Use of a Level of Care Measure in a Child Welfare Population. Paper presented at the 18th Annual Research Conference: A System of Care for Children's Mental Health: Expanding the Research Base, Florida Mental Health Institute - Tampa, FL.