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Advocacy Tip: CANS Assessment

The Child and Adolescent Needs and Strengths Assessment

The purpose of the CANS is to accurately represent the shared vision of the child/youth serving system—children, adolescents, and families. The goal of the CANS is to bring together all perspectives and create a shared vision As such, completion of the CANS is accomplished in order to allow for the effective communication of this shared vision for use at all levels of the system. It is a way to document or measure what the youth, caregiver and team are communicating about the strengths, needs, identified action items and strategies to address those action items. The CANS is well liked by youth and families, providers and other partners in the services system because it is easy to understand and does not necessarily require scoring in order to be meaningful to a child and family.

How CANS Works

The way the CANS works is that each item suggests different pathways for service planning. There are four levels of each item designed to translate into the following action levels (separate for needs and strengths):

The action levels for Need items are:

0 - Indicates no need for action

1 - Indicates a need for watchful waiting to see whether action is needed or prevention planning (i.e., flag it for later review to see if any circumstances change)

2 - Indicates a need for action

3 - Indicates the need for either immediate or intensive action

The action levels for Strengths items are:

0 - Indicates a centerpiece strength. The focus of a strength-based plan of care

1 - Indicates a useful strength, which can be included in a strength-based plan of care

2 - Indicates an identified strength, which could be developed to become useful

3 - Indicates no strength has been identified in this area

Even though each section has a numerical rating, the assessment is designed to give a profile or picture of the needs and strengths of the child and family. It is not designed to "add up" all of the "scores" of the dimensions for an overall score rating. The CANS should be reviewed and updated with the client/family a minimum of every six months or more frequently if clinically indicated, to measure progress and revise the treatment plans. Additional reasons to review/update the CANS include changes in environment or client/family functioning.

Key Characteristics of the CANS Assessment

1. It is an item level tool. Items are included because they might have direct impact on the service planning process.

2.  Each item uses a 4- level rating system. The levels of each item are designed to translate immediately into action levels. There are different action implications for needs and strengths.

3. Rating should describe the child/youth, not the child/ youth in services. All ratings are done with an understanding that a service context might be masking a need. Rate the need, not the fact that the service is masking it.

4. Always consider cultural and developmental contexts before 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 child/youth’s developmental and/or chronological age depending on the item.

5. It is about the ‘what’, not about the ‘why’. Although several items have some cause and effect thinking, most of the CANS is entirely descriptive. For example, school attendance is a need whether the youth is truant or expelled. It doesn’t matter why the youth has missed school.

6. A 30-day window is used for ratings in order to make sure assessments stay “fresh” and relevant to the child/youth’s present circumstances. However, the action levels can be used to over-ride the 30-day rating period.


  1. True or False: The CANS assessment includes both a child’s strengths and needs.
  2. Name one key characteristic of the CANS assessment
  3. How often should a CANS assessment be reviewed or updated? 

To receive 1 hour worth of training credit, read the above article and submit answers to the accompanying training questions to Leticia Hernandez at

Advocacy Tip: CANS Assessment