What is the CASI?
The CASI is an evidenced-based, computerized assessment instrument for children and adolescents referred to group homes or residential treatment facilities developed by Paul A. Sunseri, Psy.D. The CASI is designed to identify children at risk for multiple residential placements so that they may be provided with targeted services in order to stabilize them early in care.

Additionally, the CASI is used as part of a psychological assessment battery for the purpose of developing a comprehensive, effective treatment plan. It is the only clinical assessment instrument specifically designed for children in residential care.

All of the information provided by the CASI is based on extensive research on children in residential treatment programs (10,000+ children and their families).

Why use an evidenced-based instrument?
A substantial number of children and adolescents are unstable in care and subsequently experience multiple placements. The frequency of placement failure ranges from 30-50%, depending on the population served (age, referral source, etc) and the level of care of the residential program. One-third of clients ages 12 and older terminate treatment by runaway alone. Children with more serious behavior problems and behaviors that lead to multiple placements often go unrecognized when they first enter the residential care system. By identifying these children upon entry, agencies can elect to implement additional or more focused services with the goal of stabilizing the child in care.

What are the potential benefits of a research-based assessment?
The federal government has recognized the importance of reducing multiple placements among foster children. Outcomes and accountability standards have established no more than two placements within a year as beneficial to a child's well-being. In fact, research has shown that placement failure worsens a child's behavioral functioning across time.

Reducing multiple placements benefits county placing agencies as well. Residential care is extremely costly, and stabilizing a child early in care potentially avoids the expenditure of scare county resources on placement settings that are likely to offer little or no benefit. Conversely, children at low risk for multiple placements need not be placed into excessively restrictive and more expensive settings.

How does the CASI actually work?
Important information is entered into the software with each child referred for placement. The information required to generate a Narrative Report is readily available on just about every child at the time of referral. This process is also not time-consuming; CASI users have found that in most cases, an adequate assessment can be conducted in about 30-45 minutes by anyone reasonably familiar with the child and his or her family. The computer will then generate an 10-12 page Narrative Report that summarizes the data and provides a wealth of useful information. Please see the Online Demo for more details and a copy of a sample Narrative Report.

What information does the CASI provide?

• It compares the severity of the child’s behaviors to the typical or average child in residential care. The CASI Behavior Scales tell you whether the referred child’s problems in the areas of Aggression, Noncompliance, Other Externalizing/ Conduct Problems, Sexualized Behavior, Self-Harm, and Total Problems are more serious, less serious, or about the same as the average child in care. The Behavior Scales are normed on over 1200 children in residential care. Each scale is empirically validated and therefore meaningful in a practical sense. For example, as scores on the Aggression Scale increase, so does the probability of requiring physical restraint or seclusion and how often these interventions are likely to be used. As scores on the Other Externalizing Scale increase, so does the probability of running away and the frequency of running away, and so on.



• The CASI automatically calculates a Family Functioning Index and its corresponding Family Functioning Level (low, intermediate, and high). As you might guess, numerous measures of treatment outcome and placement stability are highly associated with the level of family functioning.



• The CASI identifies the likely presence and frequency of three serious treatment interfering behaviors exhibited during placement: the need for psychiatric hospitalization, physical restraints or seclusions, and running away. These behaviors have been shown through research to be predictable even if the child has no history of the behaviors prior to admission.



• Using decision algorithms, the CASI considers all of the above information and provides a statement of Degree of Risk for Placement Disruption in which the child is reliably identified as either Low, Moderate, or High risk for multiple placements.

Finally, based on the conclusions in the Narrative Report, treatment approaches with empirical support are identified that would be most helpful with respect to stabilizing the child in care. Treatment recommendations are an optional component of the Narrative Report, i.e., they may be included or omitted at the user's discretion.

How can we become more familiar with the CASI?
For more information, please contact us and we will gladly answer any questions you might have.

We will also gladly provide you with a copy of the User's Guide and Technical Manual for the Child and Adolescent Screening Inventory for Residential Care, which fully describes the development and psychometric properties of the instrument.

New! The Foster Care Version of the CASI

Click here to learn about the CASI-FC, designed to reduce multiple placements among children placed in foster care.