About the CAFAS Measure

CAFAS in Ontario is funded by the Ministry of Child and Youth Services  to train clinicians to be reliable raters of the CAFAS, and to support the implementation and use of the CAFAS in the province's network of children's mental health agencies and hospital clinics.

The Child and Adolescent Functional Assessment Scale (CAFAS) is used to assess the degree of functional impairment in children and adolescents with emotional, behavioural, or substance use problems. Clinical psychologist Dr. Kay Hodges developed the CAFAS.

The CAFAS is a clinician-rated tool that can be used in clinical and research setting to assess clinical progress or outcome. In Ontario, CAFAS is being used to examine treatment outcomes for all children ages 6 years to 17 years who receive mental health services in a participating community-based children's mental health centre (Ontario Ministry of Child and Youth Services) or hospital-based children's mental health clinic (Ontario Ministry of Health and Long-Term Care).

Rating a client on the CAFAS scale takes approximately 10 minutes. The CAFAS contains a menu of behaviourally anchored descriptions from which the rater chooses those that best describe the client. No specific interview or questionnaire needs to be administered to the client. The clinician rates the client based on his or her knowledge of the client's functioning. Multiple sources of information can be used.

The CAFAS is organized into eight scales for rating the child: School/Work, Home, Community, Behavior Towards Others, Moods/Emotions, Self-Harmful Behaviour, Substance Use, and Thinking. A total score is derived for which there are general interpretive guidelines. Two optional scales are provided for rating the client's caregiver(s) on their ability to provide for the client's material needs and social support needs.

The CAFAS can be rated on a paper scoring form or by using the CAFAS software program. In Ontario, all participating agencies are required to use the CAFAS software version and to collect the Ontario Common Data Set.

A background in mental health and demonstration of inter-rater reliability are required in order to rate the CAFAS.Reliability training for clinicians across the province is ongoing. Procedures for reliability training of new clinicians in Ontario are described in section entitled Becoming A Reliable Rater.

Reliability and validity data have primarily been generated by two large-scale evaluation studies: (1) The Fort Bragg Evaluation Project (Lambert & Guthrie, 1996) and (2) the national evaluation of the service grants funded by the U.S. Centre for Mental Health Services Branck of Substance Abuse and Mental Health Services Administration of the Department of Public Health and Human Services (Breda, 1996; Summerfelt, Foster, & Saunders, 1996). For further information about validity and reliabilty, and research using the CAFAS, please refer to the Online Bibiography.