<p>CHILD AND ADOLESCENT NEEDS AND STRENGTHS (CANS) © COMPREHENSIVE PROFILE (AGES 5-17) Please  appropriate use: Initial Reassessment Date: M M D D Y Y Transition/Discharge m m d d y y M F Child’s Name DOB Gender</p><p>LIFE FUNCTIONING RATING CAREGIVER NEEDS 0 = No evidence of problem - 1 = History - Watchful 2 = Moderate need 3 = Severe need - 0 = No evidence 1 = Some needs LIFE DOMAIN FUNCTIONING 2 = Moderate needs 3 = Severe needs 0 1 2 3 CAREGIVER NEEDS Family     0 1 2 3 Living Situation     Physical     Sleep     Mental Health     Social Development     Substance Use     Recreation     Developmental     Developmental *1     Safety     Communication     CHILD BEHAVIORAL/EMOTIONAL NEEDS     Judgment 1 = History, sub- threshold, 0 = No evidence Acculturation     watch/prevent Job Functioning     3 = Causing severe/dangerous 2 = Causing problems Legal     problems Medical *2     CHILD BEHAVIORAL/EMOTIONAL Physical Health     NEEDS Sexuality *3     Psychosis     Daily Functioning     Impulse/Hyperactivity     Independent Living(Age 14-21)     Depression     School Behavior     Anxiety     School Achievement     Oppositional     School Attendance     Conduct     CHILD STRENGTHS RATING Adjustment to Trauma *4     0 = Strength 1 = Useful Anger Control     2 = Identified 3 = Not yet identified Substance Use *5     CHILD STRENGTHS CHILD RISK RATING 0 1 2 3 Family     0 = No evidence 1 = History, watch/prevent Interpersonal     2 = Recent act 3 = Acute, act immediately Optimism     CHILD RISK BEHAVIORS Educational     0 1 2 3 Vocational     Suicide Risk     Talents/interests     Self-Mutilation     Spiritual/Religious     Others Self Harm     Community Life     Danger to Others *6     Relationship Permanence     Sexual Aggression *7     Child Involvement with Care     Runaway *8     Natural Supports     Delinquency *9     ACCULTURATION RATING Judgment     0 = No evidence 1 = Minimal needs Fire Setting *10     2 = Moderate needs 3 = Significant needs Social Behavior     ACCULTURATION 0 1 2 3 Language     Modules (*) Identity     1 - Developmental Module Ritual     2 - Medical CAREGIVER STRENGTHS RATING 3 - Sexuality 0 = Strength 1 = Some need 2 = Moderate need 3 = Severe need 4 - Trauma CAREGIVER STRENGTHS 5 - Substance Use Disorder 0 1 2 3 6 - Violence Supervision     7 - Sexual Abuse Behavior Involvement     Knowledge     8 - Runaway Organization     9 - Juvenile Justice     Social Resources 10 - Fire Setting Residential Stability    </p><p>November 2013 revised Copyright 1999 Praed Foundation Page 1 of 2 Modules Bullying     Frustration management     DEVELOPMENTAL NEEDS MODULE(DD) Hostility     0 1 2 3 Paranoid Thinking     Cognitive     Secondary gains from anger     Developmental     Violent thinking     Communication     Resiliency Factors Self-Care / Daily Living     Aware of violence potential     SEXUALITY MODULE Response to consequences     Sex-related Problems Commitment to self-control     0 1 2 3 Treatment involvement     Promiscuity     Masturbation     SAB- SEXUALLY AGGRESSIVE BEHAVIOR Reactive sexual behavior     0 1 2 3 Knowledge of sex     Relationship     Choice of relationships     Physical force/threat     Sexual identity     Planning     Sexual deviance Age Differential     Voyeurism     Type of sex act     Frotteurism     Exhibitionism     Response to accusation     Fetishism     Temporal consistency     Pedophilia     History of sexual behavior     Sexual masochism     Sexual sadism     Severity of sexual abuse     Transvestic fetishism     Prior treatment     SUBSTANCE USE MODULE (SUD) RUNAWAY 0 1 2 3 0 1 2 3 Severity of Use     Duration of Use     Frequency of running     Stage of Recovery     Consistency of destination     Peer Influences     Planning     Parental Influences     Safety of destination     Environmental Influences     TRAUMA MODULE Involvement in illegal acts     Characteristic of the trauma experiences Likelihood of return on own     0 1 2 3 Involvement of others     Sexual Abuse*     Physical Abuse     Realistic expectations     Emotional Abuse     Planning     Medical Trauma     JJ-JUVENILE JUSTICE Natural Disaster     Witness to Family Violence     0 1 2 3 Witness to Community Violence     Seriousness     Witness/Victim-Criminal Acts     History     If Sexual Abuse >0, complete the following Planning     Emotional closeness to perpetrator     Community safety     Frequency     Peer Influences     Duration     Parental Influences     Force     Environmental Influences     Reaction to disclosure     FS- FIRE SETTING Adjustment Affect Regulation     0 1 2 3 Intrusions     Seriousness     Attachment     History     Disclosure     Time Before Treatment     Planning     VIOLENCE MODULE Use of Accelerants     Historical Risk Factors 0 1 2 3 Intention to harm     History of physical abuse     Community safety     History of violence         Witness to domestic violence     Response to accusation Witness Environmental violence     Remorse     Likelihood to future fires    </p><p>Emotional/Behavioral Risks 0 1 2 3 November 2013 revised Copyright 1999 Praed Foundation Page 2 of 2</p>