Abstract
We investigated the relationship between scores on the Child and Adolescent Functional Assessment Scale (CAFAS) and several indicators of functioning assessed in the national evaluation of the demonstration grants funded by the Center for Mental Health Services System of Care Initiative. The sample included 3187 youths, ranging in age from 4 to 23, with serious emotional disturbance (SED) who were evaluated at intake. At 6 month post-intake, 873 of these youths were re-evaluated. As predicted, higher CAFAS scores were associated with previous psychiatric hospitalization, more serious psychiatric diagnoses, and more restrictive living arrangements. Youths in residential inpatient settings were significantly more impaired than youths living in their own home or in regular foster care. Below average school performance, poor attendance, and contact with law enforcement personnel were also associated with greater impairment. Youth's total CAFAS scores decreased significantly from intake to 6 months. These results indicate that the CAFAS is a measure of functioning which has both statistical and clinical significance.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Achenbach, T. M. (1991). Manual Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
Doucette-Gates, A., Hodges, K., & Liao, Q. (1998, March). Using the CAFAS: Examining child outcomes and service use patterns. The 11th Annual Research Conference: A System of Care for Children's Mental Health: Expanding the Research Base, Tampa, FL.
Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.
Federal Register (1993, May 20). pp. 29422–29425.
Friedman, R. M., Katz-Leavy, J. W., Manderscheid, R. W., & Sondheimer, D. L. (1996). Prevalence of serious emotional disturbance among children and adolescents. In R. W. Manderscheid & M. A. Sonnenschein (Eds.), Mental Health, United States, 1996 (pp. 71–89). Washington, DC: U.S. Government Print Office.
Hersch, P. (1997, February). Implementing eligibility determination process for children's mental health services in Massachusetts: Characteristics of youth—the first six months. In C. J. Liberton, K. Kutash, & R. M. Friedman (Eds.), 10th annual research conference proceedings: A system of care for children's mental health: Expanding the research base (pp. 377–382). Tampa, FL: Research & Training Center for Children's Mental Health.
Hodges, K. (1994a). Child and Adolescent Functional Assessment Scale. Ypsilanti, MI: Eastern Michigan University, Department of Psychology.
Hodges, K. (1994b). The Child and Adolescent Functional Assessment Scale Self-Training Manual. Ypsilanti, MI: Eastern Michigan University, Department of Psychology.
Hodges, K. (1994c, May). Measures for assessing impairment in children and adolescents. Paper presented at the meeting sponsored by the Center for Mental Health Services on the Development of Standardized Methodology for Estimates of the Incidence and Prevalence of Serious Emotional Disturbance Among Children and Adolescents, Bethesda, MD.
Hodges, K. (1995, March). Psychometric study of a telephone interview for the CAFAS using an expanded version of the scale. The 8th annual research conference: A system of care for children's mental health: Expanding the research base, Tampa, FL.
Hodges, K. (1996). CAFAS Manual for Training Coordinators, Clinical Administrators and Data Managers. Ypsilanti, MI: Eastern Michigan University, Department of Psychology.
Hodges, K. (In press). Child and Adolescent Functional Assessment Scale (CAFAS). In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcome assessment (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.
Hodges, K., & Gust, J. (1995). Measures of impairment for children and adolescents. Journal of Mental Health Administration, 22, 403–413.
Hodges, K., Warren, B., & Wotring, J. (1998, March). The development of criteria for determining levels of care for SED youth based on empirical data. The 11th annual research conference: A system of care for children's mental health: Expanding the research base, Tampa, FL.
Hodges, K., & Wong, M. M. (1996). Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale. Journal of Child and Family Studies, 5, 445–467.
Hodges, K., & Wong, M. M. (1997). Use of the Child and Adolescent Functional Assessment Scale to predict service utilization and cost. Journal of Mental Health Administration, 24, 278–290.
Hodges, K., Wong, M., & Latessa, M. (1998). Use of the Child and Adolescent Functional Assessment Scale (CAFAS) as an outcome measure in clinical settings. Journal of Behavioral Health Services & Research, 25, 326–337.
Lemoine, R. L., & McDermott, B. E. (1997, February). Assessing levels and profiles of service need using the CAFAS. In C. J. Liberton, K. Kutash, & R. M. Friedman (Eds.), 10th annual research conference proceedings: A system of care for children's mental health: Expanding the research base (pp. 371–376). Tampa, FL: Research & Training Center for Children's Mental Health.
Pernice, F., Gust, J., & Hodges, K. (1997, February). A structured interview for collecting objective clinical data. In C. J. Liberton, K. Kutash, & R. M. Friedman (Eds.), 10th annual research conference proceedings: A system of care for children's mental health: Expanding the research base (pp. 471–476). Tampa, FL: Research & Training Center for Children's Mental Health.
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, J. P., Fisher, P., Bird, H., & Alusahlia, S. (1983). A Children's Global Assessment Scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.
Stroul, B. A., & Friedman, R. M. (1994). A system of care for children and youth with severe emotional disturbances (rev. ed.). Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.
Stroul, B., McCormack, M., & Zaro, S. (1996). Measuring outcomes in systems of care. In B. Stroul (Ed.), Children's mental health: Creating systems of care in a changing society (pp. 313–336). Baltimore, MD: Paul H. Brooks Publishing Company.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hodges, K., Doucette-Gates, A. & Liao, Q. The Relationship Between the Child and Adolescent Functional Assessment Scale (CAFAS) and Indicators of Functioning. Journal of Child and Family Studies 8, 109–122 (1999). https://doi.org/10.1023/A:1022902812761
Issue Date:
DOI: https://doi.org/10.1023/A:1022902812761