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. To access online ECSII trainings visit AACAP's online store.

What is the Early Childhood Service Intensity Instrument (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. This instrument 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 ECSII 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 ECSII used?
The ECSII 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, 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 ECSII is applicable to children in a variety of settings including those living with their parents or extended family, those in foster care, and institutional settings.


What does the ECSII measure?
The ECSII incorporates holistic information on the child within the context of their family and community by assessing service intensity needed across 6 Domains:
  • Degree of Safety
  • Child-Caregiver Relationships
  • Caregiving Environment
  • Functional/Developmental Status
  • Impact of the Child’s Condition
  • Services Profile Fit

In what ways can the ECSII help my organization?

  • 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 which can be used by different providers to address the needs of a child and their family.

What are the limitations of the ECSII?
  • 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 ECSII now?
  • Licensed primary and mental health care providers
  • Child welfare programs
  • Developmental disability treatment programs
  • Early childhood educators
  • Insurance utilization management administrators
  • Policy makers and advocates in child serving agencies
  • State agencies administering Medicaid funds
  • Managed care organizations

What types of ECSII training options are offered?
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 online training includes an accessible version of the ECSII manual.

What are the learning objectives of ECSII training?
  • 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.

How do I purchase ECSII training?
 To access online ECSII trainings visit AACAP's online store. Please note that purchases 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 and to obtain a quote for an in person ECSII training, please contact AACAP's Clinical Practice Program Manager at clinical@aacap.org .