Introducing the interRAI 0-3 tool

What is interRAI?

interRAI is an international collaborative that aims to promote evidence-informed clinical practice. interRAI assessments have multiple applications, such as care planning, quality indicators, and resource allocation. Previous assessments have focused on children and youth (4-18 years of age), adults and seniors.
interRAI 0-3 Instrument

With the development of the interRAI 0-3 assessment that focuses on children from 0 to 47 months of age, the interRAI suite will be available across the lifespan. The interRAI 0-3 is a new, innovative approach to intervention that, in part, will attempt to interrupt the poverty cycle at multiple levels. Specifically, Low Birth Weight (LBW) is a primary indicator of children’s health that places young children at an increased likelihood of adverse life outcomes that can persist through the lifespan. Compared to normal-birth-weight infants, there is a disproportional number of LBW infants who demonstrate chronic developmental, behavioural, socio-emotional, and psychological difficulties and overall poor childhood health (Cheadle & Goosby, 2010; Lund et al., 2012; Scott et al., 2012). In addition to targeting young children of LBW, we will intervene to reduce the poverty rates of vulnerable children in a high-risk, low socio-economic community with the ultimate intent of reducing long-term unemployment. To date, there is no systematic, coordinated delivery of mental health screening, assessment and treatment for such young children.

We intend to evaluate the interRAI 0-3, an innovative approach to assessment and treatment that will fill existing gaps by offering a holistic system to identify child and family needs, so that individualized, evidence-based care planning interventions can be employed in a timely, effective manner. This inventive, integrated system comprehensively assesses medical, developmental, social, family and psychiatric problems with best practice treatment. Through a multi-modal, community-driven approach to treatment, several areas of risk and protection are targeted to circumvent poverty and demonstrate improved outcomes.

The assessment lasts 60-90 minutes and identifies risk factors across 19 domains (i.e., childcare, medications, and feeding and sleeping). The responses are then used to trigger one or more of the 17 Collaborative Action Plans (CAPs) based on by algorithms within the interRAI 0-3 assessment software. CAPs are evidence-based guidelines for areas of high need established thorough literature review and expert opinion. The extent of need is also measured through scales whereby a scale of zero denotes a normal situation and higher-scores reflect greater severity. The interRAI 0-3 tool uses a “state of the art” software program to support scoring and uptake of these CAPs. CAPs available within the interRAI 0-3 assessment tool include:

  • Attachment
  • Physical Activity
  • Problematic Eating
  • Gross and Fine Motor
  • Emotional Regulation
  • Caregiver Distress
  • Sensory Issues
  • Communication
  • Dressing
  • Social Engagement
  • Toilet Training Readiness
  • Caregiver Informal Support
  • Sleep Management
  • Nutritional Intake
  • Parenting
  • Transitions Planning
  • Traumatic Life Events

Project Overview
Participants of interRAI 0-3 will be young children aged 0-47 months, and their families who are accessing services at selected agencies in Ontario.


The goals include the following:

  1. improve identification of developmental, behavioural and emotional problems in young children;
  2. enhance evidence-informed care planning; and
  3. facilitate access to early intervention and individualized, tailored treatment based on the needs of the child and the family.

With respect to relevance for the partner agency, this project is designed to support early detection of high-risk young children to improve triaging, prioritizing and optimal outcome for the clients served within their agencies. This will also facilitate capacity building through improved evidence-informed practice, mental health literacy and knowledge translation regarding early signs and symptoms of mental health and/or developmental issues in young children. Additionally, high quality data will enhance the ability to utilize data driven decision making to foster outcome measurement for agencies.


Thanks for sharing this Sarah.

Are other groups able to access the assessment? Can it be used in a non-clinical setting as well? Just curious how agencies and other not for profits may be able to integrate this to support their work in early childhood development.

Are there a list of indicators available for us to see around each of the domains?