Originally developed for acquired brain injury, the CANS remains one of the most useful supplementary tools in NDIS FCAs for high-support participants.
What Is the CANS?
The Care and Needs Scale was developed at the University of Sydney specifically for adults with acquired brain injury. It is an 8-level ordinal scale that captures the intensity of supervision, prompting and physical support a person requires across a typical 24-hour period. Levels range from CANS 1 (no support required) through to CANS 8 (24-hour care with two attendants).
When to Use the CANS in an NDIS FCA
We use the CANS in FCAs for participants with ABI, severe intellectual disability, complex behaviour, late-stage neurodegenerative conditions and dual diagnosis. It is particularly powerful in SIL assessments because the level numbers translate cleanly into ratio recommendations (CANS 5–6 typically maps to 1:1, CANS 7–8 typically maps to 2:1 or active overnight).
CANS Levels — Quick Reference
- —CANS 1 — No support required
- —CANS 2 — Supports available but rarely used
- —CANS 3 — Supports for a few hours per week
- —CANS 4 — Supports for part of every day
- —CANS 5 — Supports for most of the day but able to be alone at night
- —CANS 6 — Supports for most of the day and contactable supports at night
- —CANS 7 — 24-hour support including active overnight
- —CANS 8 — 24-hour 2:1 support including active overnight
Limitations and Cautions
The CANS was not developed for psychosocial disability, paediatric populations or episodic conditions, and should be used alongside — not instead of — domain-by-domain functional assessment. It is a complement to the NDIS functional domains, not a substitute.
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