What is CANS?
The Child and Adolescent Needs and Strengths (CANS) assessment is a comprehensive trauma-informed behavioral health evaluation and communication tool. It is intended to prevent duplicate assessments by multiple parties, decrease unnecessary psychological testing, aid in identifying placement and treatment needs, and inform case planning decisions. CANS assessments help decision-making, drive service planning, facilitate quality improvement, and allow for outcomes monitoring.
DFPS uses CANS to gather information about the strengths and needs of a child to plan for services that will help the child and family reach their goals.
The Texas version of CANS was developed for children in DFPS conservatorship. A credentialed, CANS-certified STAR Health clinician administers the assessment. Assessments for children placed in the Region 3B Community-Based Care catchment area can be administered by a CANS-certified provider affiliated with the child placing agency.
Who receives a CANS Assessment?
All youth in DFPS conservatorship ages 3-17 years old who entered DFPS care on or after September 1, 2016, are eligible to receive a CANS.
Why do we need CANS?
To put it simply, the CANS assessment provides all those involved in a child’s care a thorough understanding of a child’s behavioral health needs and makes recommendations for the supports and services. In conjunction with a Texas Health Steps medical checkup, we can see a full picture of a child’s strengths and needs to create the best plan of service.
Six Key Components of CANS
- The CANS rating items were chosen because they are each relevant to service planning.
An item exists because it might lead down a unique pathway regarding decision-making.
- Each item uses a 4-level rating system.
These levels are designed to translate immediately into action levels. Different action levels exist for needs and strengths. For a description of these action levels, please see below.
- Rating should describe the youth, not the youth in services.
If an intervention is present that is masking a need, but must stay in place, this should be factored into the rating consideration and would result in a rating of an “actionable” need.
- Culture and development should be considered prior to establishing the action levels.
Cultural sensitivity involves considering whether cultural factors are influencing the expression of needs and strengths. Ratings should be completed considering the youth’s developmental and/or chronological age depending on the item. In other words, delinquency is not relevant for a young child, but would be for an older youth. Alternatively, school achievement should be considered within the framework of expectations based on the youth’s developmental age.
- The ratings are generally "agnostic as to etiology."
Specific ratings window (e.g. 30 days) can be over-ridden based on action levels.
- Specific ratings window (e.g. 30 days) can be over-ridden based on action levels.
A 30-day window is used for ratings in order to make sure assessments stay “fresh” and relevant to the youth’s present circumstances. However, if there is good reason, the action levels can be used to override the 30-day rating period. During the initial assessment, the rating is based on the presenting needs that can be outside of the 30-day rating period. Additionally, if the presenting problem or the behavior occurred before 30 days and is still a focus of treatment, this behavior would be rated outside of the 30-day window.
The Legislature passed Senate Bill 125 in May 2015, requiring DFPS to conduct a developmentally appropriate assessment, including trauma screening and interviews with individuals who know the child's needs, no later than the 45th day after a child enters state care. CPS requires a CANS by a child’s 30th day in care to allow the assessment information to be included in a child’s plan of service. Before the passage of this legislation, DFPS worked with internal and external stakeholders to identify the most appropriate, trauma-informed assessment to meet the needs of children in care. After much research and evaluation, the workgroup selected the CANS assessment developed by the John Praed Foundation as the best choice to serve our children and families.