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, child care, early education, adult mental health and substance abuse services, 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, and a 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?

  • Assists providers in creating comprehensive, culturally sensitive, strength-based, individualized, and coordinated service/treatment plans for infants, toddlers, and children ages 0-5 years.
  • Can be used with young children with mental health challenges as well as those with medical and developmental co-occurring disorders.
  • Supports active participation by child and family.
  • Can be used as a metric to monitor progress in treatment.
  • Assists in assessment of program effectiveness at a systems level.
  • Provides a common language for diverse providers.

What doesn't the ECSII do?

  • It does not provide a 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 uses the ECSII?

  • Licensed mental health providers, others working in child serving agencies, including early childhood educators, 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 ECSII?

Online ECSII trainings will be available for purchase through AACAP's online store by the end of Summer 2019.
For information on in-person ECSII trainings, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org