Assessment of the complex effects of trauma across child serving settings: Measurement properties of the CANS-Trauma Comprehensive

This study examined the measurement properties of the Child and Adolescent Needs and Strengths-Trauma Comprehensive Version (CANS-Trauma). This comprehensive, trauma-focused, and strengths-based assessment strategy is designed to assess the complex needs of traumatized children and adolescents across child-serving settings and support the treatment/service delivery process. The current study assessed 257 children and adolescents from three mental health agencies across the country that were partners in the National Child Traumatic Stress Network (NCTSN). Internal consistency and inter-rater reliability, convergent and discriminant validity, and scale properties of the CANS-Trauma were examined. Overall, measurement properties of the CANS-Trauma showed promising results. Internal consistency varied from marginally acceptable to excellent across most domain scores (α = 0.62-0.90); the traumatic stress symptoms domain demonstrated very good internal consistency (α = 0.82). Inter-rater reliability for the CANS-Trauma was good overall, while the traumatic stress symptoms domain had marginally acceptable reliability. There was evidence for convergent validity with more limited evidence for discriminant validity, based on the association between domains on the CANS-Trauma and subscales of the Trauma Symptom Checklist for Children-Alternate (TSCC-A) and the Child Behavioral Checklist for Children (CBCL). Rasch modeling analyses indicated that the CANS-Trauma had good scale properties overall, including item fit within each of the domains. These preliminary results also suggested that the various mental health and trauma symptom domains on the CANS-Trauma were more sensitive to populations with significant trauma symptoms and mental health difficulties compared to populations with lower to moderate difficulties in these areas. Implications of these findings are discussed in terms of the utility of a comprehensive, trauma-informed assessment strategy in practice settings.