Child and Adolescent Service Intensity Instrument Development in Japan

Abstract

Abstract Objectives: Level of Care (LOC) determination is an important process of care planning for emotionally disturbed children and adolescents. As a tool of LOC determination, the Child and Adolescent Service Intensity Instrument (CASII) has been developed and tried to extend the usage out of the United States. As part of that effort, the CASII is currently being evaluated for its psychometric property in Japan. Methods: The CASII has been translated into Japanese, and then, 23 child psychiatrists and 70 nonpsychiatrist professionals who completed CASII training rated 7 vignettes to test inter-rater reliability. External validity was being evaluated by comparing the CASII ratings of 163 participants aged 6–17 against the Child Behavior Checklist (CBCL)/Youth Self-Report (YSR) and Child Global Assessment Scale (CGAS). Results: Inter-rater reliability among psychiatrists showed intra-class correlation coefficients ranging from 0.63 to 0.91 and those by nonpsychiatrists from 0.42 to 0.80. Cronbach's alpha was higher than 0.97 for both psychiatrists and nonpsychiatrists. The CASII ratings and LOC determination for 145 participants were significantly correlated with the Actual LOC and ratings of CBCL/YSR and CGAS except for the Internalizing Problem scores. There was no significant difference between LOC Recommended and Actual LOC. Conclusions: The Japanese version of the CASII showed fairly good inter-rater reliability and validity to use in the practice of mental health as well as child welfare in Japan.