The CALOCUS-CASII is a result of the merger between the Child and Adolescent Service Intensity Instrument (CASII) and the Child and Adolescent Level of Care Utilization System (CALOCUS). 
For the most up to date information and frequently asked questions please visit the CALOCUS-CASII Website at calocus-casii.org. To access online CALOCUS-CASII trainings visit AACAP's online store.

What is the Child and Adolescent Level of Care/Service Intensity Utilization System (CALOCUS-CASII)?
The Child and Adolescent Level of Care/Service Intensity Utilization System (CALOCUS-CASII) is a standardized tool used to determine the intensity of services needed for children and adolescents from ages 6-18 years.  This instrument is developmentally informed and has been created on the foundation of a System of Care approach -- embracing family-driven, youth-guided care that includes individualized strength-based and culturally sensitive service planning, supporting the use of intensive care coordination or wraparound planning teams when indicated, and providing a broad service array that includes natural supports as well as clinical services. The CALOCUS-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” or other out of home placement to achieve higher levels of service intensity.


How is the CALOCUS-CASII used?
The CALOCUS-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 the child and family. The instrument 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 is designed for those providing care for populations with developmental disabilities. It is independent of diagnosis, promotes effective communication between providers and systems, and supports providers’ engagement with the child, family, and community.

The CALOCUS-CASII is applicable to children and adolescents in a variety of settings including those living with their parents or extended family, those in foster care, and in institutional settings. This instrument assesses the service intensity needs of children and adolescents presenting with psychiatric, substance use, medical and/or developmental concerns.

What does the CALOCUS-CASII measure?
 The CALOCUS-CASII incorporates holistic information on the child within the context of their family and community by assessing service intensity needed across 6 Dimensions:

  • Risk of Harm
  • Functional Status
  • Co-Occurrence of Conditions: Developmental, Medical, Substance Use, and Psychiatric
  • Recovery Environment
  • Resilience and Response to Services
  • Engagement in Services

In what ways can the CALOCUS-CASII help my organization?
  • It assists providers in creating comprehensive, strength-based, individualized, and coordinated service/treatment plans for children and adolescents 6-18 years of age.
  • It can be used to assist in the evaluation of 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.
  • It can help assess the effectiveness of a program or intervention at a systems level.
  • It provides a common language for persons served, providers and payers to use.

What are the limitations of the CALOCUS-CASII?
  • 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 is using the CALOCUS-CASII now?
  • Licensed primary care and mental health care providers
  • Service coordinators and wraparound planning teams
  • Child welfare agencies
  • Developmental disability programs
  • Juvenile justice systems
  • Insurance utilization management administrators
  • Policy makers and advocates in child serving agencies
  • State agencies administering Medicaid funds
  • Managed care organizations

What types of CALOCUS-CASII training options are offered?
In Person CALOCUS-CASII Trainings:

In person CALOCUS-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 whatever location your agency provides, or by zoom.  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 $30 per person plus 15% shipping and handling.

Online CALOCUS-CASII Trainings:

Online CALOCUS-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 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 online training includes an accessible version of the CALOCUS-CASII manual.

What are the learning objectives of CALOCUS-CASII training?
  • Understand the Systems of Care philosophy that serves as the foundation for the CALOCUS-CASII.
  • Explain why the CALOCUS-CASII is useful in determining appropriate supports and services.
  • Determine the correct anchor points for each CALOCUS-CASII dimension and compute a composite score.
  • Describe service intensity levels for each CALOCUS-CASII dimension.
  • Use the CALOCUS-CASII to create a service plan based on a System of Care approach to service planning.

How do I purchase CALOCUS-CASII training?
To access online CALOCUS-CASII trainings visit AACAP's online store. Please note that purchases to online modules are non-transferable.  Each trainee must create their own account profile and be the same person completing the training.

For more details and/or to obtain a quote for in person trainings, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org.

CALOCUS-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, Mental Health Institute - Tampa, FL.