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 six key dimensions: Risk of Harm, Functional Status, Co-Occurring Conditions, Recovery Environment, Resilience/Response to Services, and 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?

  • Assists providers in creating comprehensive, strength-based, individualized, and coordinated service/treatment plans for children 6-18 years of age.
  • Can be used on populations with mental health challenges including those with medical, substance use, and developmental co-occurring disorders.
  • Supports active participation by child and family.
  • Can be used as a measurable outcome indicator for any provided treatment and/or intervention.
  • Assists in assessment of program effectiveness at a systems level.
  • Provides a common language for diverse providers.

What doesn't the CASII do?

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

Who uses the CASII?

  • Licensed mental health providers, care coordinators, insurance benefit administrators, and policy makers in child serving agencies.
  • Service coordinators and wraparound planning teams.

How do I find more information on training in the CASII?

For online CASII trainings, please visit AACAP's online store. Once purchased, users will have access through Pathways, AACAP's learning portal.
For information on in-person CASII trainings, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org.

CASII/ECSII 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.