Abstract
The Child and Adolescent Functional Assessment Scale (CAFAS) is a multidimensional measure of impairment that assesses the extent of interference in day-to-day functioning secondary to emotional, behavioral, or substance use problems. Respondents were 984 youths, aged 5 to 17, who were referred for mental health services. They were assessed at intake and at 6 and 12 months postintake with a battery of measures administered by evaluation staff who were independent of treatment. Utilization indicators included restrictiveness of care, total cost, number of bed days, and total number of days of service received. The CAFAS total score at intake was a significant predictor of service utilization and cost determined at 6 and 12 months postintake. The CAFAS score was also the best predictor when compared with other measures of psychopathology. Only the CAFAS and presence of conduct disorder contributed to the prediction of service utilization and cost at 12 months.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Federal Register, May 20, 1993, pp. 29422–29425.
Hodges K, Gust J: Measures of impairment for children and adolescents.Journal of Mental Health Adminsitration 1995; 22:403–413.
Diagnostic and Statistical Manual of Mental Disorders. (Third ed., rev.). Washington, DC: American Psychiatric Association, 1987.
Eisen SV, Griffin M, Sederer LI, et al.: The impact of preadmission approval and continued stay review on hospital stay and outcome among children and adolescents.Journal of Mental Health Administration 1995; 22(3):270–277.
Hodges K: Child and Adolescent Functional Assessment Scale. Unpublished manuscript, Department of Psychology, Eastern Michigan University, Ypsilanti, 1990.
Breda CS: Methodological issues in evaluating mental health outcomes of a children's mental health managed care demonstration.Journal of Mental Health Administration 1996; 23(1):40–50.
Hodges K: The Child and Adolescent Functional Assessment Scale Self Training Manual. Unpublished manuscript, Department of Psychology, Eastern Michigan University, Ypsilanti, 1990.
Hodges K: Child Assessment Schedule. Unpublished manuscript, Department of Psychology, Eastern Michigan University, Ypsilanti, 1990 (Rev. ed.).
Hodges K: Child Assessment Schedule-Parent Form. Unpublished manuscript, Department of Psychology, Eastern Michigan University, Ypsilanti, 1990 (Rev. ed.).
Hodges K, Kline J, Stern L, et al.: The development of a child assessment interview for research and clinical use.Journal of Abnormal Child Psychology 1982; 10:173–189.
Achenbach TM:Manual Checklist/4-18 and 1991 Profile. Burlington: University of Vermont Department of Psychiatry, 1991.
Brannan AM, Heflinger CA, Bickman L: The Burden of Care Questionnaire: Measuring the Impact on the Family of Living with a Child with Serious Emotional Problems. Unpublished manuscript, Center for Mental Health Policy, Vanderbilt University, Nashville, TN, 1995.
Hodges K: Manual for the Child Assessment Schedule. Unpublished manuscript, Department of Psychology, Eastern Michigan University, Ypsilanti, 1990 (Rev. ed.).
Hodges K: Structured interviews for assessing children.Journal of Child Psychology and Psychiatry 1993; 34: 49–68.
Summerfelt WT, Foster EM, Saunders RC: Mental heath services utilization in a children's mental health managed care demonstration.Journal of Mental Health Administration 1996; 23(1):80–91.
Foster EM, Summerfelt WT, Saunders RC: The costs of mental health services under the Fort Bragg demonstration.Journal of Mental Health Administration 1996; 23(1):92–106.
Kazdin AE:Conduct Disorders in Childhood and Adolescence. Newbury Park, CA: Sage, 1987.
Loeber R: Antisocial behavior: More enduring than changeable?Journal of the American Academy of Child and Adolescent Psychiatry 1991; 30(3):393–397.
Schonfeld IS, Shaffer D, O’Connor P, et al.: Conduct disorder and cognitive functioning: Testing three causal hypotheses.Child Development 1988; 59:993–1007.
Borduin CM, Mann BJ, Cone LT, et al.: Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence.Journal of Consulting and Clinical Psychology 1995; 63(4):569–578.
Henggeler SW, Schoenwald SK, Pickrel SG: Multisystemic therapy: Bridging the gap between university- and community-based treatment.Journal of Consulting and Clinical Psychology 1995; 63(5):709–717.
Kazdin AE, Bass D, Siegel T, et al.: Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior.Journal of Consulting and Clinical Psychology 1989; 57(4):522–535.
Burns BJ, Thompson JW, Goldman HH: Initial treatment decisions by level of care for youth in the CHAMPUS Tidewater demonstration.Administration and Policy in Mental Helath 1993; 20(4):231–246.
Barkley RA, Anastopoulos AD, Guevremont DC, et al.: Adolescents with ADHD: Patterns of behavioral adjustment, academic functioning, and treatment utilization.Journal of the American Academy of Child and Adolescent Psychiatry 1991: 30(5):752–761.
Burns BJ, Santos AB: Assertive community treatment: An update of randomized trials.Psychiatric Services 1995; 46(7):669–675.
Hodges K: Measures for Assessing Impairment in Children and Adolescents. Paper presented at a 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, May 1994.
Hodges VK, Wong MM: Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale (CAFAS).Journal of Child and Family Studies 1996; 5(4):445–467.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hodges, K., Wong, M.M. Use of the Child and Adolescent Functional Assessment Scale to predict service utilization and cost. The Journal of Mental Health Administration 24, 278–290 (1997). https://doi.org/10.1007/BF02832662
Issue Date:
DOI: https://doi.org/10.1007/BF02832662