Attachment 2 - Matrix KIPP

ATTACHMENT 2: KIPP MATRIX
Instrument	Instrument Description	Frequency	Target Population	Annual Number of Respondents	Annual Burden Hours	Research Question
Family Assessment Battery	(1) Families are videotaped and experts rate them on dimensions such as problem solving, planning a fun activity, teaching, monitoring, and parenting processes; (2) parent-informant items assess social skills, problem behaviors, and academic competence of children and youth.	Completed twice: baseline for all cases and again when parents have completed the PMTO curriculum (6 months in most cases) or at 6 months for control cases	Children age 3-16 with serious emotional disturbance and their parents	300 families	930 (including completion of Caregiver Initial Info Form	Do children age 3-16 in foster care who meet criteria for SED achieve more timely and stable permanence if their families receive early, intensive home-based parent management training compared to children in foster care whose families receive usual services?
North Carolina Family Assessment Scale (NCFAS)	Used by caseworkers to assess and rate family functioning (problems and strengths) in the domains of Environment, Parental Capabilities, Family Interactions, Family Safety, Child Well-being, Caregiver/Child Ambivalence, Social and Community Life, Self-Sufficiency, Family Health, and Readiness for Reunification. It is used at intake and again at case closure and the change score (the difference between the Intake and Closure ratings) indicates the amount of change achieved during the service period.			45 caseworkers respond for an average of 7 study cases each	945
Child and Adolescent Functional Assessment Scale (CAFAS)/ Preschool and Early Childhood Functional Assessment Scale (PECFAS)	Used to assess the day-to-day functioning (impairments and strengths) of children ages 5-19 in the domains of School/Work Role Performance, Home Role Performance, Community Role Performance, Behavior Toward Others, Moods/Emotions, Self-Harmful Behavior, Substance Use, Thinking, and Risk Behaviors. The PECFAS is a version used for younger children. The assessor completes the scale based on information collected during a typical clinical assessment.