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Child and Adolescent Needs and Strengths (CANS) Assessment

Child and Adolescent Needs and Strengths (CANS) Assessment


OPWDD uses the CANS as the person-centered, consensus-based functional needs assessment for people with developmental disabilities ages 17 and younger and their families. The CANS assessment tool is designed to give a profile of the specific current needs and strengths of the child/adolescent and caregiver(s). The CANS will provide important information to the child’s/adolescent’s Care Manager (CM)/Qualified Disabilities Professional (QIDP)/those responsible for maintaining the care plan to assist with the person-centered care plan.

The CANS Process

The CANS is a 3-part process, conducted annually by a certified CANS assessor, designed to provide the story of a child/adolescent’s life. This process includes: 

  • Review of supporting documentation (medical evaluations, clinical assessments, Individualized Educational Plan (IEP), Life Plan, and other care plans, etc.)
  • Interview with the child’s/adolescent’s caregiver(s)
  • Interview/observation with the child/adolescent
    • NOTE: While it is best practice to include an observation and/or interview of the child/adolescent, in some instances, it may be contraindicated or determined unnecessary.

There is a portion of the CANS that focuses on the caregiver’s strengths and needs. OPWDD understands that it is important for the caregiver(s) to share their story to help understand what strengths are present, as well as supports the caregiver(s) may utilize or need to care for the child/adolescent. This information will help the CM/QIDP/those responsible for maintaining the care plan have a better understanding of what types of services may best fit with the child/adolescent and their support system. Each caregiver perspective is equally valid, and building consensus through collaboration supports more accurate assessments and stronger plans. This section of the assessment is completed, regardless of the support needs of the caregiver(s).


Involvement of those responsible for maintaining the child’s/adolescent’s care plan 

Care Managers (CM)/Qualified Disabilities Professionals (QIDP)/those responsible for maintaining the care plan may be interviewed by the CANS assessor. In some instances, especially if the child/adolescent only receives minimal services, the CM/QIDP/those responsible for maintaining the care plan may be one of the only resources for information for the child/adolescent and would need to be interviewed by the assessor. The caregiver and child/adolescent also have the option to request the CM be present during their discussion with the CANS assessor, but it is not required for the CM/QIDP/those responsible for maintaining the care plan to be present during the interview(s). The CANS assessor relies upon the CM/QIDP/those responsible for maintaining the care plan to identify the child/adolescent/caregiver(s) and support the assessor in coordinating interviews, as needed. The CM/QIDP/those responsible for maintaining the care plan ensure that the CANS assessor has access to all supporting documentation for review, prior to the CANS interview(s).

Once CANS is Completed

After the CANS has been completed by the CANS assessor, it is electronically transferred within 48 hours to the person's record in the OPWDD computer system, CHOICES. The CM/QIDP/those responsible for maintaining the care plan will review the CANS report summary with the caregiver(s) and child/adolescent, as well as additional support providers (i.e., residential provider), as appropriate and within 30 days of availability. At this time, the caregiver/child/adolescent and other supports may provide any other information they would like included in the child’s/adolescent’s care plan.

CANS Summary

The CANS Summary, also referred to as the Strengths and Needs Report, will be used to create the care plan. This provides the CM/QIDP/those responsible for maintaining the care plan with information about the child/adolescent’s needs, strengths, interests, and available and current natural supports. Details provided in the Strengths and Needs Report will help the CM/QIDP/those responsible for maintaining the care plan to expand on information already known about the child/adolescent or identify areas that require further exploration or assessment for the ongoing development of the care plan.

The CANS Guidance document was developed to assist with the discussion and use of the Strengths and Needs Report.

CANS Participation

State laws and regulations require that an assessment chosen by OPWDD must be used to review and record a person’s strengths and needs, as a condition of receiving OPWDD services.  OPWDD uses the CANS to conduct these required assessments for individuals 17 years old or younger. The CANS is a tool that is very effective at helping OPWDD to learn more about the strengths and needs of children/adolescents with intellectual and/or developmental disabilities. The CANS will provide important information to the CM/QIDP/those responsible for maintaining the care plan to assist with care planning and connecting the child/adolescent/caregiver(s) with appropriate services. The caregiver must participate in the CANS assessment for children/adolescents newly eligible for OPWDD services. For those children/adolescents who are currently receiving services, if the primary caregiver does not participate, the assessment may be completed by interview of others who support the child/adolescent and documentation review.

Types of CANS Assessments

An initial assessment is the person’s first CANS assessment completed by OPWDD.

routine reassessment is the standard reassessment that occurs at least one year after either the initial assessment or last OPWDD CANS assessment. A CANS is repeated every year, or more often if needed, to keep the information up to date.

Significant Change in Condition (SCIC) reassessment is conducted when a significant improvement or decline in a person’s behavior, medical condition or functioning has occurred since the last assessment and before the scheduled reassessment. Some SCIC reassessment qualifying events include:

  • Accidents or events resulting in serious personal injury
  • Major medical events or prolonged illness
  • Major psychiatric events resulting in extended inpatient psychiatric hospitalization
  • Significant improvement in behavior or physical functioning that may be related to an improvement in an acute medical condition, recovery from prolonged illness or stabilization resulting from psychiatric and/or medical intervention

SCIC reassessment qualifying events will not typically be resolved without intervention by staff/supports. These events usually impact more than one area of the person’s health or behavioral status and require professional review or revision of the person’s care plan. They often result in a newly identified need for reduced or enhanced support to maintain health and safety. If a person/caregiver believes that they/the person has had a Significant Change in Condition, they should contact their Care Manager or Qualified Intellectual Disabilities Professional to share information, supporting documentation, and to discuss any additional needs, including the need for a CANS reassessment.

CANS Coding and Obtaining Consensus

Each CANS item uses a 4-level rating system based on the child’s identified strengths and where actions are needed to support the child. Different ratings exist for needs and strengths. Ratings should describe the child/adolescent, not the child/adolescent 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.  The item ratings translate directly into action levels which support a comprehensive understanding of the story of the child/adolescent/caregiver.

Within the Strengths and Needs Report, an example is displayed for each item rating. The example provided is not comprehensive and may not reflect the story of the child/adolescent/caregiver. The takeaways are the action levels, which are relevant to care planning. They may suggest the needs to be included in the care plan and how urgently they require attention, as well as assist with understanding strengths to build upon through the plan of care.   The assessor guides the conversation with the child/adolescent/caregiver(s), and other supports and uses their training to help identify appropriate rating of items in the CANS, provide education/interpretation for assessment language as needed, and engage the supports in a conversation to reach consensus.

Questions About CANS

Once this review has been completed, if there are questions and concerns that have not been resolved, the CM/QIDP/those responsible for maintaining the care plan must submit the following via secure email server to [email protected].

  • Form to Request a Review of Information in CANS Summary (CAS/CANS Request for Review Form)
  • The note/documentation of the CANS summary discussion and review with at least the person and primary supports (actively involved family/Legal Guardian and residential supports, as applicable) written by the CM/QIDP/those responsible for maintaining the care plan.
    • Note/documentation MUST be attached to the email and capture details of the review, including newly learned information, need for any follow-up, and how this information is addressed in the Life Plan. 
    • Include specific item(s) that have been identified as questions and/or concerns. 
    • Document the context and details around why the team feels the items are of concern.
    • Add any additional information that may be an important consideration in the review of the person's CANS.

Please note, once the above information is submitted, we will reach back out to you with a list of the documents reviewed by the assessor. We will need the CM/QIDP/those responsible for maintaining the care plan to provide those documents, at that time.

OPWDD will follow up with the CM/QIDP/those responsible for maintaining the care plan and/or person/primary supports, as appropriate, to provide a response to the questions/concerns, which may include additional guidance and/or action.

If the person or family has any additional questions or concerns, they may call 1-518-473-7484 for further support.

CANS Assessment Request Guidance

Guidance for Care Managers on how to request a CAS or CANS Assessment for someone they support is available on the Care Managers page under the Provider section of the website.