Understanding the CANS
(Child and Adolescent Needs and Strengths) Tool
These images explain the Child and Adolescent Needs and Strengths (CANS) tool used in Idaho’s Youth Empowerment Services (YES) system of care — what it is, how it works, and how families and youth fit into the process. Each card below is shown with its full text. They were initially published on our Facebook page.
What is a CANS?
The Child and Adolescent Needs and Strengths (CANS) is a communications tool that helps families tell their stories in a way that is used to identify unmet needs and areas of strength for the child and their unique family system.
Why Does Idaho Use the CANS Tool?
The Child Adolescent Needs and Strengths tool was identified in the Jeff D. Settlement Agreement as the functional assessment tool to be used in Idaho. It is actually used in all 50 states and ensures a solid foundation for treatment planning as well as an ongoing assessment for measuring outcomes.
How Is a CANS Completed?
The Child Adolescent Needs and Strengths is an informational tool that is used to gather and interpret information. It is about what is going on with the youth and family, not why it is happening. CANS items are not asked as individual questions, but used as conversation starters which helps youth and families feel comfortable and supported.
What Else Could a CANS Tell Us?
In addition to identifying strengths and needs a CANS is used to capture information about the youth’s ability to function within their family and community. It is also used to determine if a youth has a functional impairment and create meaningful care plans to support the youth and family.
What Are Predictive Strengths?
In the CANS framework, there are six key “predictive strengths”, also called PC FIRE, that are strongly linked to better outcomes for youth. When youth develop four or more of these strengths, they experience about a 60% reduction in needs. That’s compared to just 31% for youth who don’t have these strengths in place. The six key strengths are: peer influences, coping skills, family, interpersonal skills, resilience, and educational setting.
Let's Look at Rater Considerations
When completing a Child and Adolescent Needs and Strengths (CANS) tool the following questions should be considered:
Is this need impacting the child’s functioning?
How urgent is action required for this need?
Are you focused on describing the need or strength, and not the underlying cause?
What services are already in place for the youth and family?
The CANS Is Not an Assessment
The Child and Adolescent Needs and Strengths (CANS) tool is not something a child “passes” or “fails.” It is a communication and planning tool used to organize information about a child or youth’s strengths, needs, functioning, and goals. It helps teams create a shared understanding of what is going well and where support may be needed. Additionally, the CANS is used to help determine whether a child has a Serious Emotional Disturbance (SED).
Parents and Youth Are Experts
Families and youth are critical members of the assessment process. The Child and Adolescent Needs and Strengths (CANS) tool is designed to include the perspectives of caregivers and youth because they know the child best. Information shared by families directly influences ratings, treatment planning, and service recommendations.
Strengths Matter Just as Much as Needs
The Child and Adolescent Needs and Strengths (CANS) tool does not focus only on problems or challenges. It also identifies strengths, interests, talents, relationships, cultural connections, and coping skills. These strengths are important because they help guide treatment and build resilience.
Higher Ratings Do Not Mean “Bad Parenting” or a “Bad Kid”
The Child and Adolescent Needs and Strengths (CANS) tool ratings are used to identify areas where support or action may be needed. A higher rating simply means that a need may require immediate attention or intervention. It is not a judgment about the child, youth, or family.
The CANS Helps Determine the Right Level of Care
Information from the Child and Adolescent Needs and Strengths (CANS) tool helps providers and systems understand what level of support may be appropriate. This can include outpatient therapy, skill-building services, family support, crisis services, or other behavioral health interventions. The goal is to match services to actual needs.
The CANS Should Reflect Current Needs and Functioning
The Child and Adolescent Needs and Strengths (CANS) tool is intended to describe how the child or youth is functioning right now, not define them permanently. Because children grow and circumstances change, the CANS is updated over time to reflect progress, new strengths, or changing needs.
The CANS Process Should Be Collaborative
Families and youth should be invited to participate in conversations about ratings, goals, and treatment planning. Parents and youth can ask questions, provide examples, clarify information, and share concerns if something does not feel accurate.
Culture, Identity, and Family Context Matter
The Child and Adolescent Needs and Strengths (CANS) is designed to consider the child and family within their cultural, community, and family context. Providers should take into account language, traditions, lived experiences, developmental differences, and family values when completing the assessment.
The CANS Can Help Track Progress Over Time
Because the assessment is completed periodically, it can help show growth and improvement over time. Families may see changes in areas such as emotional regulation, school functioning, daily living skills, relationships, or behavioral health symptoms. This can help celebrate progress and guide next steps.
Understanding the CANS Helps Families Advocate More Effectively
When families and youth understand the purpose of the Child and Adolescent Needs and Strengths (CANS), they are often more comfortable participating in meetings and decision-making. Knowledge about the process can increase trust, improve communication with providers, and empower families to advocate for services, supports, and goals that truly meet their needs.