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I-CAN - Instrument for the Classification and Assessment of Support Needs

The Centre for Disability Studies (CDS), in conjunction with The University of Sydney and the Royal Rehabilitation Centre Sydney, worked collaboratively over several years to develop an instrument to assess and classify the support needs of adults with diverse disabilities in residential and respite settings. Interest in the instrument has also led to it's use in Day Programs, Mental Health and Rehabilitation settings, with some researchers trialling applications within chronic disease management, and transition to employment and education. A number of organisations and government departments have participated in this research and as a result, a revised instrument was developed called I-CAN: Instrument to assess and classify the support needs of people with disability. A technical report detailing findings of earlier stages of research has been published by CDS (Llewellyn, Parmenter, Chan, Riches & Hindmarsh, 2005), with several presentations and publications authored focusing on the more recent findings (eg. Arnold et al., 2009a; Riches et al., 2009a; 2009b) and further publications being authored.

The I-CAN uses both the AAIDD (Luckasson et al., 2002) and ICF (WHO, 2001) conceptualisation of disability and identifies the areas in which support is needed by adults with disabilities (aged 16 years and up) in the current and/or a future environment. Support areas comprise health and well being and activities and participation in daily life. Each item within the domains is rated according to the frequency and level of the support required. The I-CAN balances support needs both important to and support important for a person, with a focus on the person's long term dreams and goals. Support is conceptualised as a means to engagement, empowerment, inclusion and a life of quality.

I-CAN domains

Unlike other assessment instruments, the I-CAN is designed to be used across disability types and levels of impairment. It emphasises support needed rather than deficits or skill, and is completed by a team of people who know the individual well enough to provide accurate information. The team is led by a trained facilitator and team members consist of the person with disability and key people involved in that person's life on a regular or daily basis, such as family members, advocate, guardian, key worker and relevant staff.

The benefits of using the I-CAN include immediate access to a state of the art assessment system that identifies individual support needs across domains in health and well being, and activities of daily living. It provides an efficient way to record individual assessments over time, with frequency and level data collated to determine individual support needs within and across the various domains. These domain totals can then be graphed, with each individual profile showing intensity of support required in various domains in the current and/or potential environment.

There is also opportunity to undertake additional concurrent ratings of support in cases where episodic conditions exist that significantly affect support needed, or where a change in circumstances or environment is occurring. Re-assessments that are completed at various times can be compared with one another, enabling increases and decreases in support need to be identified for planning purposes. Graphs can also be created to see scores for groups of individuals, e.g. according to age group, disability type or specific conditions such as epilepsy or dementia etc.

With such a classification system, it is intended that more appropriate, effective and efficient planning, resource allocation and supports delivery may be implemented.

Both the online and pen and paper versions are available for immediate use. Facilitators receive an administration pack that includes a hardcopy manual and laminated coding scales to guide users easily through the assessment process. If not completed online, the pen and paper interview forms can be sent back to CDS for data entry.

An earlier computerised version based on a Filemaker Pro data base was field tested in 2006, and this version is now superceded by a web-based version that provides organisations with even greater flexibility and utility for planning and funding purposes. The web-based version allows data to be entered immediately during the assessment process (or at a later time). Once data are entered, a written psychological report is generated that identifies and summarises the individual's support needs within and across relevant domains. This information does not necessarily replace the Individual or Person-Centred Planning process, but it can be used to inform, guide and improve the quality of this process. The new web based version is being further developed at CDS with additional features continually being added.

Data available to date strongly suggests that domain scores can be assigned to support bands (Arnold et al., 2009b) for purposes such as individual funding etc, with further work on-going. Alternate Cost Estimation tools have been developed which allow for cost prediction based upon actual specialist service requirements, award rates and organisational on-costs. CDS continually seeks feedback from all stakeholders to further develop the I-CAN, with suggestions incorporated into ongoing iterations of the tool.

The current pricing can be found here

Costs comprise
  • training of facilitators
  • use of the instrument
  • online data analysis
  • optional data entry services
  • optional additional data analysis or clinical services

For additional information contact:
Samuel Arnold sam.arnold@sydney.edu.au or
Vivienne Riches vivienne.riches@sydney.edu.au
Alternately send an email to theteam@i-can.org.au

Telephone +61-2-9036-3600


Prof. Patricia O'Brien
Director and Professor
Centre for Disability Studies


References

Arnold, S. R. C., Riches, V. C., Parmenter, T. R. & Stancliffe, R. J. (2009a). The I-CAN: Using E-Health to get People the Support they Need. Electronic Journal of Health Informatics, 4(1), e4.

Arnold, S. R. C., Riches, V. C., Parmenter, T. R. & Stancliffe, R. J. (2009b). I-CAN: Support Needed for Inclusion and Empowerment. Presented at the International Association for the Scientific Study of Intellectual Disabilities (IASSID) 2nd Asia Pacific Regional Congress, Singapore, 24-27th June.

Llewellyn, G., Parmenter, T. R. P., Chan, J., Riches, V. C., & Hindmarsh, G. (2005). I-CAN: Instrument to classify support needs of people with disability. Sydney: The Faculty of Health Sciences, University of Sydney.

Luckasson, R., Borthwick-Duffy, S., Buntix, W. H. E., Coulter, D. L., Craig, E. M., Reeve, A., Schalock, R. L., Snell, M. E., Spitalnik, D. M., Spreat, S. & Tasse, M. (2002). Mental Retardation: Definition, Classification and Systems of Supports (10th Ed). Washington, DC: American Association on Mental Retardation.

Riches, V. C., Parmenter, T. R., Llewellyn, G., Hindmarsh, G. & Chan, J. (2009a). I-CAN: A new instrument to classify support needs for people with disability: Part I. Journal of Applied Research in Intellectual Disability, 22, 326-339.

Riches, V. C., Parmenter, T. R., Llewellyn, G., Hindmarsh, G. & Chan, J. (2009b). The reliability, validity and practical utility of measuring supports using the I-CAN instrument: Part II. Journal of Applied Research in Intellectual Disability, 22, 340-353.

World Health Organization (2001). The International Classification of Functioning, Disability and Health (ICF). Geneva: Author.




Reports and Presentations
Our award winning presentation at HISA HIC 08
Presentation at IASSID Asia-Pacific Regional Congress Singapore 09
Linkage Project Technical Report 2005
2006 I-CAN Presentation prior to version 4
Additional documents also available on the CDS website


Get in touch with theteam@i-can.org.au or contact CDS

I-CAN do it!