A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity |
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| Authors: | Theodore Fallon Jr. M.D. M.P.H. Andres Pumariega M.D. Wesley Sowers M.D. Robert Klaehn M.D. Charles Huffine M.D. Thomas Vaughan Jr. M.D. Nancy Winters M.D. Mark Chenven M.D. Larry Marx M.D. Albert Zachik M.D. William Heffron M.D. Katherine Grimes M.D. M.P.H. |
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| Affiliation: | (1) Psychoanalytic Center of Philadelphia, Philadelphia, PA, USA;(2) Child and Adolescent Psychiatry, East Tennessee State University, Johnson City, TN, USA;(3) Allegheny County Office of Behavioral Health, Pittsburgh, PA, USA;(4) Maricopa Integrated Health System, Phoenix, AZ, USA;(5) Department of Psychiatry, University of Washington, Seattle, WA, USA;(6) Behavioral Health, Children's Hospital of Birmingham, Birmingham, AL, USA;(7) Psychiatry, Oregon Health Sciences University, Portland, OR, USA;(8) Clinical Operations, Vista Hill Foundation, San Diego, CA, USA;(9) Director of Child and Adolescent Services, Maryland Department of Mental Health, Baltimore, MD, USA;(10) Department of Psychiatry, University of Kentucky, Louisville, KY, USA;(11) Department of Psychiatry, Harvard Medical School, Boston, MA, USA;(12) P.O. Box 81, Chester Springs, PA 19425, USA |
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| Abstract: | The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASII) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demonstrates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASII demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale. |
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| Keywords: | The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrumen intensity of services for children and adolescents level of care |
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