What is the ECSII?

The Early Childhood Service Intensity Instrument (ECSII) is a standardized tool used to determine the intensity of services needed for infants, toddlers, and children from ages 0-5 years. The ECSII is used by providers involved in the care of young children with emotional, behavioral, and/or developmental needs including those children and families experiencing environmental stressors that may put them at risk for such problems. The instrument provides guidance for providers and families seeking services from a variety of agencies and providers including child welfare, mental health, primary and specialty health care, and other community-based supports. The ECSII provides a common language for these diverse individuals and offers guidance in selecting specific services at the appropriate intensity for the young child.

The ECSII is based on the concept of Service Intensity as opposed to traditionally defined “level of care”. Traditionally, level of care has implied the need for facility-based programs to achieve higher levels of service intensity. The ECSII emphasizes intensive home and community-based services to provide higher intensity when needed. Service intensity involves multiple factors, including not only the frequency and quantity of services, but also the extent to which multiple providers or agencies are involved and the level of care coordination required.

The ECSII is based on the System of Care approach that embraces a family-driven and child-centered model of care that integrates and coordinates efforts of different agencies in the least restrictive setting that is clinically appropriate. The instrument guides the user to assess service intensity needs across 6 Domains including:

  • Degree of Safety
  • Child-Caregiver Relationships
  • Caregiving Environment
  • Functional/Developmental Status
  • Impact of the Child’s Condition
  • Services Profile Fit

The ECSII uses an algorithm that integrates the service intensity needs for each of the six domains into a single Service Intensity score. Using the ECSII, different providers and agencies can collaborate with families and each other to provide services at specific levels of Service Intensity that are individualized while still considering the priorities and strengths of the family. Though the ECSII is diagnosis independent and non-prescriptive regarding which specific services are needed, it does provide information and guidance for effective service planning.

What does the ECSII do?

  • It assists providers in creating comprehensive, culturally sensitive, strength-based, individualized, and coordinated service/treatment plans for infants, toddlers, and children ages 0-5 years.
  • It can be used to evaluate children presenting with mental health challenges as well as those with medical 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.
  • Assists in assessment of program effectiveness at a systems level.
  • 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 ECSII 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 ECSII?

  • Licensed primary and mental health care providers
  • Child welfare programs
  • Developmental disability treatment programs
  • Early childhood educators
  • 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 ECSII?

In Person ECSII Trainings:

In person ECSII trainings (ideal for groups of 20 or more who would like instruction in a more traditional classroom setting) are conducted over a day and a half (1.5 days) 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 ECSII Trainings:

Online ECSII 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 ECSII 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 ECSII.
  • Explain why the ECSII is useful in determining appropriate supports and services.
  • Determine the correct anchor points for each ECSII domain and compute a composite score.
  • Describe service intensity levels for each ECSII domain.
  • Use the ECSII to create a service plan based on wraparound service plan concepts as well as any other team-based treatment planning processes.

To access online ECSII 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 and to obtain a quote for an in person ECSII training, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org .