NCTSN CANS Comprehensive - Trauma Version ('CANS Trauma')

Submitted by mholliday on Mon, 10/29/2012 - 13:05

Overview

Acronym: 
NCTSN CANS/ CANS Trauma Version
Author(s): 
Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe, G., Ellis, H., Praed Foundation, & National Child Traumatic Stress Network.
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. (2011). 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. 

 

Obtain(Email/Website): 

Cassandra Kisiel, Ph.D., Center for Child Trauma Assessment and Service Planning, Mental Health Services & Policy Program, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611. c-kisiel@northwestern.edu or Nicole Maj, B.S.: n-maj@northwestern.edu

Cost: 
Free
Copyrighted: 
Yes
Measure Description: 

The NCTSN CANS provides a comprehensive assessment of the type and severity of clinical and psychosocial factors that may impact treatment decisions and outcomes. Notably, it includes domains measuring exposure to potentially traumatic experiences and levels of traumatic stress symptoms, as well as assessing for strengths. The NCTSN CANS can be used either as a prospective assessment tool during treatment planning or as a retrospective assessment tool to review existing information (e.g., chart reviews) for quality assurance monitoring or system planning. Items can be coded or completed by mental health personnel, child welfare workers, parents, family advocates, probation officers, teachers, research staff, and other groups of laypeople.

The NCTSN CANS is part of the Child and Adolescent Needs and Strengths (CANS) series of decision support tools designed to support individual case planning and the planning and evaluation of service systems. Different versions of the CANS are tailored to the needs of specific youth populations (see altered versions).
 

Domain(s) Assessed : 
Trauma Exposure/Reminders
Traumatic Stress
Grief/Loss
Anxiety/Mood (Internalizing Symptoms)
Externalizing Symptoms
Relationships & Attachment
Psychosocial Functioning
Cognition & Development
Health
Parenting
Parent, Caregiver, Family Mental Health & Functioning
Age Range: 
0-18
Measure Type: 
Screening
Other Measure Type: 
general assessment
# of Items: 
110
Measure Format: 
Other
Other Measure Format: 
The NCTSN CANS is an information integration tool and can be completed by clinician rating by integrating information from multiple sources, in a semi-structured interview format, via chart review, or other methods.
Average Time to Complete (min): 
15-45
Reporter Type: 
Clinician
Average Time to Score (min): 
15-45
Periodicity: 
The CANS is typically completed every 6 months.
Response Format: 

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):

In general the rating for scales is as follows.

•    0=no evidence and/or no need for action

•    1=mild degree and/or need for watchful waiting to see if action is needed

•    2=moderate degree and/or need for action

•    3=severe or profound degree and/or need for immediate or intensive action

•    U=unknown but indicates a need for more information
 

Materials Needed: 
Paper/Pencil
Sample Item(s): 

Domains: Traumatic/Adverse Childhood Experiences; Traumatic Stress Symptoms; Child Strengths; Life Domain Functioning; Acculturation; Child Behavioral/Emotional Needs; Child Risk Behaviors; Ratings of Children 5 Years & Younger (optional); Transition to Adulthood (optional); Caregiver(s) Needs & Strengths

Information Provided: 
Clinician Friendly Output
For Specific Populations: 
Complex Trauma

Training

Administration Training: 
Manual/Video

Parallel/Alternate Forms

Parallel Form: 
No
Alternate Form: 
No
Different Age Forms: 
Yes
Altered Version Forms: 
Yes
Describe Alternative Forms: 

There are multiple versions of the CANS, which are available from http://www.buddinpraed.org/. The different versions are tailored to the needs of specific
populations of youth.

1. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-MH): An Information Integration Tool for Children and Adolescents with Mental Health Needs
2. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-CW): An Information Integration Tool for Children and Adolescents with Child Welfare Involvement
3. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-0 to 4): An Information
Integration Tool for Early Development
4. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-DD): An Information Integration Tool for Children and Adolescents with Developmental Disabilities and Their Families
5. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-JJ): An Information Integration Tool for At-Risk and Delinquent Children and Adolescents
6. CHILD & ADOLESCENT NEEDS AND STRENGTHS (CANS-SD): An Information Integration Tool for Children and Adolescents with Issues of Sexual Development
7. CHILD & ADOLESCENT NEEDS AND STRENGTHS-TRAUMA EXPOSURE AND
ADAPTATION VERSION (CANS-TEA): An Information Integration Tool for Children and
Adolescents Exposed to Traumatic Events
 

Psychometrics

Norms : 
Clinical Populations
Notes on Psychometric Norms: 

Pilot Sample of 128 youth from an ethnically diverse, urban clinical setting (82 males, 46 females with an average age of 11.98 years).   The most common trauma experience were traumatic grief/separation, followed by physical abuse and community violence). 


 

Reliability: 
Type:RatingStatisticsOverall Scale
Internal consistency Cronbach's alpha0.94
Traumatic Stress Symptoms Domain0.78
Child Strengths0.98
References for Reliability: 

Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner (Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston, NJ: Civic Research Institute

Content Validity Evaluated: 
Yes
References for Content Validity: 

In development

Construct Validity Evaluated: 
Yes
Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/ConcurrentYes
DiscriminantYes
Sensitive to ChangeYes
Intervention EffectsYes
Longitudinal/Maturation EffectsYes
Sensitive to Theoretically Distinct GroupsYes
Factorial ValidityYes
References for Construct Validity: 

Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner (Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston, NJ: Civic Research Institute

Criterion Validity Evaluated: 
Yes
Criterion Validity: 
Not KnownNot FoundNonclinical SamplesClinical SamplesDiverse Samples
Predictive Validity:
Postdictive Validity:
References for Criterion Validity: 

In development

Population Information

Population Used For Measure Development: 

The items for CANS-Trauma version were developed and refined in conjunction with trauma-focused, mental health settings and populations and child welfare settings.

Measure has demonstrated evidence of reliability and validity in which populations?: 
Physical Abuse
Sexual Abuse
Medical Trauma
Witness Death
Natural Disaster
Domestic Violence
Community Violence
Traumatic Loss (Death)
Kidnapping/Hostage
Neglect
Accidents
Assault
Imprisonment
Immigration Related Trauma
Terrorism

Pros & Cons/References

Pros: 

1.  Potentially traumatic/adverse childhood experiences and traumatic stress symptoms are included in the measure, along with psychosocial, behavioral, emotional and daily life functioning factors.
2. The CANS is a great tool for facilitating the exchange of information about patients
because it provides a common language regarding an array of important areas of
symptomatology and functioning.
3. Item anchors are relevant to clinical decision-making.
4. Information provided can be closely linked to treatment planning.
5. The item incorporates a solid focus on strengths, consistent with strength-based
treatment planning guidelines.
6. The measure makes conceptual sense to clinicians.
7. The measure incorporates strengths, which can be used to reinforce and guide strengths-based interventions.
 

Cons: 

While certain psychometric properties have been established, there currently are few published articles examining the psychometrics of the CANS Trauma or NCTSN CANS.  These statistics are being updated and publications are in process.

Author Comments : 

The author provided feedback, which was integrated into the review.

References: 

The reference for the manual is:

Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe,
G., Ellis, H., Praed Foundation, & National Child Traumatic Stress Network. (2011). 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. 

Other references:

Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H. Saxe, G., (2009). Treating children with
traumatic experiences: Understanding and assessing needs and strengths. In J.S. Lyons, D.A. Weiner
(Eds.),Behavioral Health Care: Assessment, Service Planning and Total Clinical Outcomes. Kingston,
NJ: Civic Research Institute

Kisiel, C.L., Blaustein, M., Fogler, J., Ellis, H., & Saxe, G. (2009). Treating children with traumatic experiences: Understanding and assessing needs and strengths. Emotional and Behavioral Disorders in Youth, Winter 2009, 13-19.

Kisiel, C.L., Fehrenbach, T., Small, L., Lyons, J. (2009) Assessment of complex trauma
exposure, responses and service needs among children and adolescents in child welfare.  Journal of Child and Adolescent Trauma, 2, 143-160.
 

Developer of Review: 
Liz Torgersen, B.A., Cassandra Kisiel, Ph.D.
Last Updated: 
Mon, 10/29/2012
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