All instructions are in the word doc. please answer all the questions.
Microsoft Word - NCTSN CANS Comp Manual_formatted This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), US Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. Child and Adolescent Needs and Strengths (CANS) Manual The NCTSN CANS Comprehensive – Trauma Version A Comprehensive Information Integration Tool for Children and Adolescents Exposed to Traumatic Events August 2011 2 Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS comprehensive Version: August 2011 Primary Developers Cassandra Kisiel, Ph.D. John S. Lyons, Ph.D. Margaret Blaustein, Ph.D. Tracy Fehrenbach, Ph.D. Gene Griffin, JD, Ph.D Jamie Germain, Ph.D. Glenn Saxe, M.D. Heidi Ellis, Ph.D. Acknowledgements A large number of individuals have collaborated in the development of the National Child Traumatic Stress Network (NCTSN) CANS-Comprehensive. Along with the CANS versions for developmental disabilities, juvenile justice, and child welfare, this information integration tool is designed to support individual case planning and the planning and evaluation of service systems. The trauma domains on the CANS were developed in collaboration with Cassandra Kisiel, Ph.D., Glenn Saxe, M.D., Margaret Blaustein, Ph.D, and Heidi Ellis, Ph.D. within the National Child Traumatic Stress Network in 2002 and have been incorporated across several versions of the CANS. The NCTSN CANS- Comprehensive is an open domain tool for use in service delivery systems that address the mental health of children, adolescents and their families. The copyright is held by the Praed Foundation to ensure that it remains free to use. For more information about alternative versions of the CANS to use please contact John Lyons. For more information on the NCTSN CANS Comprehensive – Trauma tool contact, Cassandra Kisiel. Please Note: Training and certification is required for the ethical and reliable use of the CANS Contact for further information: Cassandra Kisiel, Ph.D. Center for Child Trauma Assessment and Service Planning Mental Health Services and Policy Program Northwestern University Feinberg School of Medicine Chicago, Illinois 60611 Phone: (312) 503-0459
[email protected] The National Child Traumatic Stress Network 3 www.NCTSN.org Recommended Citation Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe, G., Ellis,H., Praed Foundation, & National Child Traumatic Stress Network. (2010). Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS Comprehensive – Trauma Version: A comprehensive information integration tool for children and adolescents exposed to traumatic events. Chicago, IL: Praed Foundation/Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress. About the National Child Traumatic Stress Network Established by Congress in 2000, the National Child Traumatic Stress Network (NCTSN) brings a singular and comprehensive focus to childhood trauma. NCTSN’s collaboration of frontline providers, researchers, and families is committed to raising the standard of care while increasing access to services. Combining knowledge of child development, expertise in the full range of child traumatic experiences, and dedication to evidence-based practices, the NCTSN changes the course of children’s lives by changing the course of their care. About the Praed Foundation Founded in 1999, the Praed Foundation seeks to support transformational activities in human services, with a special emphasis on improving the lives of children and families. The Foundation has a variety of projects that supports its mission including managing flexible funding for youth with mental health needs in the juvenile justice system. The primary work of the Foundation is in support of a mass collaboration of individuals who seek to use evidence-based assessments as an approach to working together to maintain the focus of human service enterprise on the people they serve. 4 Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS comprehensive Version: August 2011 Table of Contents Primary CANS Domains: Exposure to Potentially Traumatic/Adverse Childhood Experiences 6 Symptoms Related to Traumatic/Adverse Childhood Experiences 11 Child Strengths 16 Life Domain Functioning 20 Acculturation 26 Child Behavioral/Emotional Needs 28 Child Risk Behaviors 34 Caregiver Needs and Strengths 39 Optional CANS Domains: If you choose not to rate these optional domains, please leave those sections of the scoring sheet blank Ratings of Children Five Years Old and Younger 45 Transition to Adulthood 49 CANS Scoring Sheet Scoring Sheet for the NCTSN CANS Comprehensive 55 NOTE: For additional details or if you have specific questions on any of the items listed in this manual, please consult the CANS Comprehensive Glossary for further information. The National Child Traumatic Stress Network 5 www.NCTSN.org CANS Action Levels The way the CANS works is that each item suggests different pathways for service or treatment planning. There are four levels of each item with anchored definitions; however, these definitions are designed to translate into the following action levels (separate for needs and strengths): For Potentially Traumatic / Adverse Childhood Experiences Domain: 0- No evidence of any trauma of this type 1- A single incident or trauma occurred or suspicion exists of this type of trauma 2- Multiple incidents or a moderate degree of trauma of this type 3- Repeated and severe incidents of trauma of this type. For Needs Domains – Symptoms Related to Trauma/Adverse Experiences, Life Domain Functioning, Acculturation, Child Behavioral/Emotional Needs, Child Risk Behavior, Children Five and Younger, Transition to Adulthood, Caregiver Domain: 0- No evidence of a need /no need for action 1- Watchful waiting /prevention/mild need 2- Action needed/moderate need 3- Immediate -- Intensive action /severe need For Strength Domain: 0- Centerpiece strength 1- Useful Strength 2- Strength has been identified in this area but it must be built 3- No strength is identified in this area /no information NOTE: The majority of items on the CANS should be rated in the context of what is normative for a child’s age/developmental stage. 6 Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS comprehensive Version: August 2011 Exposure to Potentially Traumatic/Adverse Childhood Experiences Domain These ratings are made based on LIFETIME exposure of trauma or adverse childhood experiences. For this domain, the following categories and action levels are used: 0 = a dimension where there is no evidence of any trauma of this type. 1 = a dimension where a single incident of trauma occurred or suspicion exists of this trauma type. 2 = a dimension where the child has experienced multiple incidents or moderate degree of this trauma type. 3 = a dimension which describes repeated and severe incidents of trauma with medical / physical consequences. 1. SEXUAL ABUSE – This rating describes the child’s experience of sexual abuse. 0 There is no evidence that child has experienced sexual abuse. 1 There is a suspicion that the child has experienced sexual abuse with some degree of evidence or the child has experienced “mild” sexual abuse including but not limited to direct exposure to sexually explicit materials. Evidence for suspicion of sexual abuse could include evidence of sexually reactive behavior as well as exposure to a sexualized environment or Internet predation. Children who have experienced secondary sexual abuse (e.g. witnessing sexual abuse, having a sibling sexually abused) also would be rated here. 2 Child has experienced one or a couple of incidents of sexual abuse that were not chronic or severe. This might include a child who has experienced molestation without penetration on a single occasion. 3 Child has experienced severe or chronic sexual abuse with multiple episodes or lasting over an extended period of time. This abuse may have involved penetration, multiple perpetrators, and/or associated physical injury. The National Child Traumatic Stress Network 7 www.NCTSN.org 2. PHYSICAL ABUSE - This rating describes the child’s experience of physical abuse. 0 There is no evidence that child has experienced physical abuse. 1 There is a suspicion that child has experienced physical abuse but no confirming evidence. Spanking without physical harm or threat of harm also qualifies. 2 Child has experienced a moderate level of physical abuse and/or repeated forms of physical punishment (e.g. hitting, punching). 3 Child has experienced severe and repeated physical abuse with intent to do harm and that causes sufficient physical harm requiring hospital treatment. 3. EMOTIONAL ABUSE - This rating describes the degree of severity of emotional abuse, including verbal and nonverbal forms. This item includes both “emotional abuse,” which would include psychological maltreatment such as insults or humiliation towards a child and “emotional neglect” defined as the denial of emotional attention and/or support from caregivers. 0 There is no evidence that child has experienced emotional abuse. 1 Child has experienced mild emotional abuse. For instance, child may experience some insults or is occasionally referred to in a derogatory manner by caregivers. 2 Child has experienced moderate degree of emotional abuse. For instance, child may be consistently denied emotional attention from caregivers, insulted or humiliated on an ongoing basis, or intentionally isolated from others. 3 Child has experienced significant or severe emotional abuse over an extended period of time (at least one year). For instance, child is completely ignored by caregivers, or threatened/terrorized by others. 4. NEGLECT - This rating describes the severity of neglect an individual has experienced. Neglect can refer to a lack of food, shelter or supervision (physical neglect) or a lack of access to needed medical care (medical neglect) or failure to receive academic instruction (educational neglect). 0 There is no evidence that child has experienced neglect. 1 Child has experienced minor or occasional neglect. Child may have been left at home alone for a short period of time with no adult supervision or there may be occasional failure to provide adequate supervision of child. 2 Child has experienced a moderate level of neglect. Child may have been left home alone overnight or there may be occasional failure to provide adequate food, shelter, or clothing with corrective action. 3 Child has experienced a severe level of neglect including multiple and/or prolonged absences by adults, without minimal supervision, and failure to provide basic necessities of life on a regular basis. 8 Child and adolescent needs and strengths (CANS) manual: