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Family and Children's
Resource Program

Vol. 19, No. 1
December 2013

Specialized Assessments Commonly Used in NC Child Welfare Practice

Child welfare agencies often turn to specialized assessments to gather information they need to understand and meet the needs of children and families. Following are just a few examples of the ones used in North Carolina.

Developmental Assessments
When young children have been maltreated it is important to assess their development. In North Carolina this is done for children under age 3 through a referral to their local Children's Developmental Services Agency (CDSA). These agencies employ professionals specially trained to conduct and interpret developmental assessments. CDSAs also provide early intervention and other developmental services for eligible children.

NC's Child Service Coordination Program also provides developmental assessments. This family-centered program serves children ages 0-5 with a developmental delay, a disability, a chronic illness, or an emotional or social disorder. For more information call 919/707-5600.

Domestic Violence
The challenge in providing child protective services in domestic violence situations is to keep the children safe without penalizing the non-offending parent/adult victim and without escalating the violent behavior of the alleged perpetrator of domestic violence. To help CPS workers and their agencies meet this challenge, the NC Division of Social Services implemented a child welfare policy and makes available the following assessment tools, which can be used to guide child welfare practice in cases involving domestic violence:

  • Children's Domestic Violence Assessment Tool
  • Non-Offending Parent/Adult Victim DV Assessment Tool
  • DV Perpetrator Assessment Tool

To access the policy and these tools, consult North Carolina's child welfare policy manual:

Functional Assessments
Functional assessments are often used by private child-placing agencies and mental health professionals to understand children's needs when they are placed in out-of-home care, and to measure the extent to which their level of functioning improves while they are in care. Examples of functional assessments include:

Child & Adolescent Needs and Strengths-Mental Health (CANS-MH)
Primary uses: (a) decision support regarding service intensity and residential placement, (b) quality assurance for the provider agency, and (c) outcomes monitoring. Different versions are available for mental health, developmental disabilities, juvenile justice, and child welfare populations.

Assesses functioning in these areas: (1) problem presentation; (2) risk behaviors; (3) functioning; (4) care intensity and organization; (5) caregiver capacity; (6) strengths. Designed to provide a profile of the needs and strengths of the child. CANS-MH is structured to facilitate individual service planning and case management. There are other versions of the CANS; several incorporate trauma items.

Child & Adolescent Level of Care Utilization System (CALOCUS)
Primary uses: (a) quantifying the clinical severity and service needs of children with psychiatric disorders, substance use disorders, and developmental disorders with emphasis on initial placement decisions; (b) determining the level and intensity of services needed.

Assesses functioning in these areas: (1) risk of harm; (2) functional status; (3) co-morbidity; (4) recovery environment (environmental stressors, environmental supports); (5) resiliency and treatment history; (6) acceptance and engagement (child/adolescent, parent/caregiver).

Composite scores are used with a decision tree to determine an appropriate level of care/placement.

Child & Adolescent Functional Assessment Scale (CAFAS)
Primary uses: (a) tracking clinical outcomes for individual children; (b) assigning children to appropriate levels of treatment, service, or care; (c) documentation for assisting in case management activities and the development of treatment plans; (d) program evaluation. Designed for ages 5 to 19. A companion instrument, the PECFAS, is designed for children age 3-7.

Assesses functioning in these areas: (1) school/work role performance; (2) home role performance; (3) community role performance; (4) behavior toward others; (5) moods/emotions; (6) self-harmful behavior; (7) substance use; (8) thinking.
Behavioral descriptors are provided to assist in assigning an impairment level in each of the domains. Impairment is rated on a four-point scale from "Minimal or No Impairment" to "Severe Impairment." Total scores are obtained from a simple sum of scores for all eight domains.

Physical Exams / Evaluations
Medical assessments can reveal the full extent of neglect and abuse; they frequently uncover infections, internal injuries, motor skill issues, skin conditions, untreated fractures, immunization deficiencies, and a variety of other issues. Medical exams can also help by assuring the child and the child's caregivers that, even though abuse has occurred, the child will recover physically (CWIG, 1993).

References for this and other articles in this issue