Child and Adolescent Service Intensity Instrument

The AACAP's Work Group on Community Systems of Care developed the Child and Adolescent Service Intensity Instrument (CASII). The CASII (formerly called CALOCUS) is a tool to determine the appropriate level of care placement for a child or adolescent. The CASII links a clinical assessment with standardized "levels of care" and has a method for matching the two. The method consists of quantifying the clinical severity and service needs on six dimensions (eight ratings) that are standardized using anchor points. The ratings are quantified in order to convey information easily, but also provide a spectrum along which a child/adolescent may lie on any given dimension. This allows for a broad range of users to employ the CASII.

This can be done for any child/adolescent in any setting regardless of diagnosis or the system with which the child is involved. The instrument also considers three distinct types of disorders: psychiatric disorders, substance use disorders, or developmental disorders (including autism and mental retardation), and has the ability to integrate these as overlapping clinical issues. Once the dimensional ratings are done, the scores are combined to generate a level of care recommendation. This integration of multiple dimensions is the essence of the CASII instrument. It is this that guides the user to an appropriate CASII level of care assignment.

CASII One-Page Overview

Background information and Initial Data Analysis


Video presentation on the CASII by Geoff Gentry, Ph.D., recorded at Clarity Child Guidance Center in Texas:

For more information about the ECSII or to arrange a training, please call the Clinical Practice Program Manager at 202-587-9671 or email