Appendix 6241.25: Definitions of Person Characteristics for CPS
CPS October 2023
This appendix defines the Person Characteristics that are available in IMPACT.
Per 6241.25 Person Characteristics in IMPACT, the caseworker must review and, when necessary, update the child’s Person Characteristics every time the Child’s Plan of Service (CPOS) is developed or reviewed.
Any characteristics that are checked for parent or caretaker or as Suspected or Diagnosed for children must also be documented in detail in the case file, including the Application for Placement, if placement is being sought.
Instructions and Use
AFCARS Disability
AFCARS is the Adoption and Foster Care Analysis and Reporting System. Detailed information can be found on the Children’s Bureau’s Adoption and Foster Care Analysis and Reporting System (AFCARS) web page. DFPS and Community-Based Care staff can also find more information on the DFPS Safety Net in the AFCARS IMPACT Reference Guide.
Answer “Yes” if any AFCARS disability characteristic applies. Characteristics for AFCARS purposes are marked with the conditionally required indicator that appears next to the Begin date. The indicator looks like a green vertical line with two short horizontal lines crossing through it.
For AFCARS disability characteristics, the disability must match the AFCARS definition in order to be checked as “Diagnosed.” Note that not every characteristic that can be marked as “Diagnosed” is an AFCARS disability. For example, a child can be diagnosed with enuresis (involuntary urination) or encopresis (uncontrolled bowel movements), but these, by themselves, would not result in the child being disabled, per AFCARS guidelines.
Begin and End Dates
Begin Dates
When a characteristic is checked as “Suspected,” IMPACT pre-fills the date into the Begin field on the right-hand side of the screen for that characteristic. If necessary, change the Begin date to match when the characteristic was first suspected.
Example: If on February 13, 2023, the caseworker receives feedback from the child’s therapist that during the previous therapy session, six days earlier, the therapist thinks that the child might have autism spectrum disorder (ASD) and should be referred for an autism evaluation or screening, the caseworker changes the Begin date to 2/7/2023, even if they are marking Autism as Suspected on 2/13/2023.
When a characteristic is checked as “Diagnosed,” the Begin date becomes a conditionally required field and must be filled in to Save the page. If that same characteristic was suspected first, the Suspected box becomes grayed out, and the Begin date that applied to that characteristic is cleared. The Begin date for any diagnosed characteristic is the date it was actually diagnosed – not the date that DFPS learns of the diagnosis.
Example: A child is removed and placed in DFPS conservatorship on 4/10/2023. The child was diagnosed with Post-Traumatic Stress Disorder (PTSD) during a psychological evaluation that occurred on 11/5/2022. The caseworker checks the Diagnosed box for Post-Traumatic Stress Syndrome and enters a Begin date of 11/5/2022.
End Dates
When a characteristic is suspected but gets ruled out, uncheck the Suspected box. Enter the correct “End” date for the date that the suspicion officially ended (IMPACT will pre-fill with the day’s date automatically, but that date may not be accurate if the caseworker is reviewing Person Characteristics two weeks after the suspicion officially ended or was unfounded).
Example: The caseworker believes the child may be engaging in self-harm (self-abuse) based on statements that a sibling made. However, after evaluation or further investigation, self-harm is found to not to be happening. The caseworker enters an end date for self-abuse for the day on which the self-harm was found not to be confirmed.
Example 2: A youth takes a home pregnancy test and believes she may be pregnant. After going to the doctor, it is confirmed that the home pregnancy test result was a false positive, and the youth is not pregnant. The caseworker unchecks the Suspected box for Pregnant-current and enters the date that the medical exam ruled out pregnancy.
When a characteristic that is diagnosed no longer applies, uncheck the Diagnosed checkbox and enter an end date for the date that the diagnosis was ruled out or changed.
Example: The child is in an accident, becomes temporarily paralyzed, and is diagnosed with a physical disability. Later, the paralysis goes away, and the child no longer has a physical disability after being cleared by a doctor. The Diagnosed checkbox must be unchecked and an End date is entered for when the doctor declared the child no longer had a physical disability.
Example 2: A youth in conservatorship who is pregnant gives birth. Uncheck the Diagnosed box for Pregnant-current and enter an end date that matches the baby’s birthday. In this example, the caseworker also checks the Suspected box for Youth Parent (which, in this case, means confirmed, rather than something believed but not known), and enters the baby’s birthday for the begin date.
Child Investigation
Characteristics in this section are only entered during the investigation phase of a case. Once a child is placed in DFPS conservatorship, the Child Investigation section must not be used; instead, enter or transfer characteristics to the Child Placement section of the Person Characteristics.
Child Placement
Characteristics in this section are only entered after a child enters DFPS conservatorship and is in DFPS conservatorship. If a child was not removed, the Child Placement section must not be used.
Diagnosed
Check the Diagnosed box for certain characteristics when the characteristic has been diagnosed by a medical or mental health professional.
For example, this happens after visits with doctors, psychologists, or after the results of medical or mental health testing or screening (that is, a psychological exam or blood work).
Note: The Child and Adolescent Needs and Strengths (CANS) assessment is not a diagnostic test. Results from the CANS for diagnoseable conditions (such as autism spectrum disorder, developmental delay, mood disorder, etc.) can be checked as “Suspected,” if they have not been otherwise diagnosed yet. Although the CANS is administered by a clinician, it is not intended to diagnose the child. For purpose and information regarding the CANS, see CPS Handbook, 6431 Child and Adolescent Needs and Strengths (CANS) Assessment and Family Strengths and Needs Assessment (FSNA) and the 3 in 30 Resource Guide.
No Characteristics
If no characteristics are suspected or diagnosed, check the No Characteristics Applicable checkbox in the “No Characteristics” section.
Note: This will be uncommon for a child in DFPS conservatorship.
Parent/Caretaker
Characteristics in this section only display for adults and must only be checked for parents, legal guardians, or caregivers of a child. They can apply to any stage of service and are not limited to investigations. The characteristics are checkbox only and do not have Suspected, Diagnosed, Begin or End dates associated with them.
Suspected
This checkbox represents either a suspicion of a diagnosable condition or a suspicion or confirmation of a non-diagnosable condition.
Being previously adopted, having a history of animal cruelty, or receiving Medically Dependent Children Program (MDCP) or Community Living Assistance and Support Services (CLASS) Medicaid waiver services are examples of characteristics that cannot be diagnosed (because they are not diagnoseable conditions), but can be suspected or confirmed, nonetheless.
Example: If the “Suspected” box for “Previously Adopted” box is checked, this indicates one of two things: It is suspected that the child was previously adopted, or the child’s previous adoption was confirmed (Note: Confirmations of previous adoptions are documented in the Child’s Plan of Service).
Definitions
The following conditions, marked with an asterisk ( *), qualify a youth for a three-day medical exam upon entering conservatorship.
*ADD/ADHD
A neurobehavioral disorder of attention deficit/hyperactivity disorder (ADHD) or attention deficit disorder (ADD—the AFCARS definition). Symptoms can include inattention, hyperactivity, impulsivity, irritability, or difficulty managing emotions.
Note: ADD is the outdated term for what is now called ADHD. There are different types of ADHD depending on the person’s symptoms.
*Alcohol Abuse (compulsive use or need)
A pattern of alcohol use leading to significant impairment in functioning. For diagnosis, a person has demonstrated at least one of the following within the past 12 months:
- Recurrent use of alcohol resulting in a failure to fulfill major obligations at work, school, or home.
- Recurrent use of alcohol in situations that are physically hazardous (such as driving while intoxicated).
- Continued use of alcohol despite significant social or interpersonal problems caused by its use.
Animal Cruelty Hx
The child has a history (hx) of causing harm to animals. This refers to any animals, even if the animals were not pets.
Assaultive Behavior
The child engages in (confirmed) or is believed to engage in (suspected) behavior that causes or tries to cause physical harm and aggression toward others. Aggression and assaultive behavior can be:
- Verbal
- Against property
- Non-suicidal self-harm
- Physical against others
This includes, but is not limited to, the following aggression against others:
- Punching
- Kicking
- Biting
- Throwing things at others
If the behaviors displayed only harm the child and are not intended to harm others, then do not use Assaultive Behavior; use Self Abuse instead.
*Autism
A brain development disorder that impairs social interaction and communication and causes restricted and repetitive behavior, all starting before the person is three years old. Diagnoses include autism, Asperger’s syndrome and pervasive developmental disorder, not otherwise specified.
Note: Autism is now referred to as autism spectrum disorder (ASD).
Behavioral Problem (including adjudicated or not, running away, and so on)
Any known or suspected behavioral problem.
Note: This characteristic can only be checked during an investigation, prior to the child’s removal.
*Bipolar
A brain disorder that causes changes in a person's mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks. These episodes are categorized as manic/hypomanic or depressive.
*Child Sexual Aggression
Sexually aggressive behavior occurs when a child takes advantage of another person in a sexual way through seduction, coercion, or force.
- Seduction: The use of charm, manipulation, promises, gifts, and flattery to induce a person to engage in sexual behavior.
- Coercion: The exploitation of authority or the use of bribes, threats, threats of force, or intimidation to gain cooperation or compliance.
- Force: Threat or use of physical or emotional harm towards a person, or someone or something a person cares about.
See CPS Handbook, 6419 Working with Children Who Are Sexually Aggressive, Have Sexual Behavior Problems, or Are Victims of Sexual Abuse.
*Conduct Disorder
Severe behaviors that violate the rights of others or societal norms. Behaviors may involve aggression towards others, animals, or destruction of property, all of which could result in legal consequences.
*Depression
A medical illness that causes changes in the following:
- Mood
- Energy
- Appetite
- Sleep
- Engagement in normal activities
- Suicidal thoughts
Depression is frequently associated with feelings of sadness and sometimes anxiety. It causes feelings of sadness or a loss of interest in activities a person usually enjoys, and it can lead to a variety of emotional and physical problems and can decrease one’s ability to function at work and at home.
*Developmental Delay
A development delay is when a child lags behind his or her peers in one or more of the following areas:
- Speech.
- Gross physical motor skills.
- Fine motor skills like writing, putting on clothes, using utensils, and others.
- Social skills.
- Problem solving.
*Developmental Disability
A group of conditions causing impairment to physical, learning, language, or behavioral functioning. These conditions result in a severe, chronic disability that is likely to continue indefinitely.
*Down Syndrome
Down syndrome is a condition in which a person has an extra chromosome. A medical term for having an extra copy of a chromosome is “trisomy.” Down syndrome is also referred to as Trisomy 21.
*Drug Abuse (compulsive use or need)
For a pattern of drug use (other than alcohol use) leading to significant impairment in functioning, a person must demonstrate at least one of the following within the past 12 months:
- Recurrent use resulting in a failure to fulfill major obligations at work, school, or home.
- Recurrent use in situations that are physically hazardous (such as driving under the influence).
- Continued use despite significant social or interpersonal problems caused by the drug use.
*Eating Disorder
Behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorders, pica (nonfood or non-nutritious food) and rumination (regurgitation) disorder.
Emotionally Disturbed
An obvious or suspected mental health condition that has not yet been diagnosed by a mental health professional. These are behaviors that are outside of age-appropriate behaviors. Behaviors include, but are not limited to:
- Hyperactivity – short attention span, impulsivity
- Aggression – Acting out or fighting,
- Self-injurious behavior – physically harming one’s body
- Withdrawal – Not interacting socially, excessive fear or anxiety
- Immaturity – Inappropriate crying, tantrums, poor coping skills
- Learning difficulties – academically performing below grade level
Emotionally Disturbed – DSM
A group of diagnosed conditions that have a serious negative impact on a child's educational or functional performance and experience. Diagnoses include conduct disorders, anxiety disorders, obsessive-compulsive disorders, eating disorders, bipolar disorders, depressions, and psychotic disorders. This does not include neurodevelopmental disorders, substance use disorders, autism spectrum disorders, intellectual disabilities, personality disorders, or learning disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook used by health care professionals as a guide to the diagnosis of mental disorders.
*Enuresis and encopresis
Enuresis and encopresis are elimination disorders characterized by difficulties with toileting behaviors. Enuresis is the inappropriate elimination of urine. Encopresis is the inappropriate elimination of feces.
*Failure to Thrive
Failure to Thrive (FTT) describes an infant or child who does not gain weight at the expected rate. Children are diagnosed with failure to thrive when their weight or rate of weight gain is significantly below that of other children of similar age and sex.
Financial Problem
A parent or caretaker cannot provide for a child’s basic needs due to a lack of financial resources.
Note: This is a parent or caretaker only characteristic.
Fire Setting Hx
Fire setting is a complex pattern of behavior in which a child or adolescent starts fires, either accidentally or intentionally. Factors in classifying fire setting include intentionality, damage caused, frequency, and interest in fire versus actually starting fires.
Note: “Hx” stands for “history.”
Gang Activity or Affiliation
Any criminal activity that is conducted as part of an organized youth gang. It includes any criminal activity that is done in concert with other gang members or done alone, if it is to fulfill gang purposes.
*Hearing Impaired
Any degree of hearing loss, from mild to profound, including those who are deaf and those who are hard of hearing.
*HIV Positive or AIDS
A person who has tested positive for HIV (human immunodeficiency virus) antibodies or been diagnosed with AIDS (acquired immunodeficiency syndrome), or is suspected to have HIV or AIDS.
*Infant Alcohol Addiction, Prenatal Exposure to Alcohol, Fetal Alcohol Syndrome or Effect
The child has been identified as prenatally exposed to alcohol. This is known as Fetal Alcohol Spectrum Disorder (FASD) and may be diagnosed as Fetal Alcohol Syndrome, Alcohol-Related Neurodevelopmental Disorder, Alcohol-Related Birth Defects, or Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure. This exposure can result in physical effects, developmental or cognitive effects, and behavioral effects.
*Infant Drug Addiction and Prenatal Drug Exposure
The child has been identified as prenatally exposed to drugs.
*Inhalant Abuse
A type of substance abuse that involves breathing in or sniffing household products for the purpose of intoxication.
*Intellectual and Developmental Disability
An intellectual or developmental disability, also called IDD, includes many severe, chronic conditions that are due to mental or physical impairments.
Intellectual disability involves problems with general mental abilities that affect functioning in two areas such as intellectual functioning (for example, learning, problem solving, judgment) and adaptive functioning (activities of daily life such as communication and independent living).
Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas.
Learning Disabled
A person having a neurodevelopmental condition affecting intellectual processes, educational attainment, and the acquisition of skills needed for independent living and social functioning. Examples could include dyslexia, dysgraphia, ADHD, and intellectual disability.
Limited English Proficiency
A person with limited ability to read, write, speak, or understand English. This characteristic is often abbreviated as LEP.
Medicaid Waiver: Receiving HCS Services
A person who is receiving Home and Community-Based Services (HCS) from the Health and Human Services Commission (HHSC). This can be confirmed by the regional developmental disability specialist. The Placement tab in IMPACT reflects non-DFPS paid and HCS living arrangements, if placement occurs during the DFPS case.
*Medicaid Waiver: Receiving MDCP or CLASS
A person who is receiving Medically Dependent Children Program (MDCP) services or Community Living Assistance and Support Services (CLASS) from HHSC. This can be confirmed by the regional developmental disability specialist.
Medicaid Waiver: Waiting List
A person who is on an interest list (waiting for services) for any of the HHSC waiver programs. This can be confirmed by the regional developmental disability specialist. Examples of these programs are:
- Medically Dependent Children Program (MDCP)
- Community Living Assistance and Support Services (CLASS)
- Deaf Blind Multiple Disabilities (DBMD)
- Home and Community-Based Services (HCS)
*Medically Complex
Medically complex is a term used when a child with more than one chronic medical condition requires ongoing, specialized care. These conditions would be present for at least one year, require ongoing attention, or could limit functioning. The conditions may also require high health care needs or utilization and often require the use of medical technology. The medical condition can vary from a rare illness to premature birth, and even incidents involving some sort of physical trauma. These conditions are typically functionally limiting and, in some cases, life-threatening.
*Medically Fragile
The serious, ongoing illness or chronic condition that has lasted or is anticipated to last at least 12 or more months, or has required at least one month of hospitalization, and that requires daily, ongoing medical treatments and monitoring by appropriately trained personnel. which may include parents or other family members. It requires the routine use of a medical device or assistive technology to compensate for the loss of body functioning. The child lives with on ongoing threat to his or her wellbeing. Examples include ventilator dependence, gastronomy tube dependence, congestive heart failure, apnea monitoring, or dialysis.
Military Dependent (legal dependent of individual on active duty in the U.S. Armed Services)
A person who is a spouse or a child of a person in the military.
Military Member on Active Duty in the U.S. Armed Services
A person who is on active duty in any branch of the U.S. military.
Note: This is a parent or caretaker only characteristic.
*Mobility Impaired
Someone who has a broad range of disabilities that limit functions of moving in any of the limbs or in fine motor ability. They often require adaptive equipment or assistance with mobility. Examples include a person who uses a wheelchair or demonstrates an unsteady gait or difficulty walking.
*Mood Disorder
A mental health class that health professionals use broadly to describe all types of depression, anxiety, and mania or bipolar disorders.
*Oppositional Defiant Disorder
A disorder in children and adolescents who are referred to mental health providers for behavioral issues. Individuals with this disorder experience varying levels of dysfunction secondary to oppositionality, vindictiveness, arguments, and aggression.
*Other Behavior Problem
Use this characteristic for any behavior problem that is not specifically listed on the Person Characteristics page. If a specific characteristic covers the child’s behavior problem such as drug use, abuse, or enuresis (involuntary urination), then mark that specific characteristic and do not use Other Behavior Problem.
*Other Medical Problem That Requires Special Medical Care (such as chronic illness, diagnosis of HIV or AIDS)
Use this characteristic for any medical problem that is not specifically listed on the Person Characteristics page. If a specific characteristic covers the child’s medical problem (such as medically complex, HIV or AIDS), then mark that specific characteristic and do not use Other Medical Problem.
*Physically Disabled
A person who has a condition that substantially impairs one or more basic physical activities, such as walking, climbing stairs, reaching, lifting, or carrying. This can be caused by a physical deformity, long-term implications of injury or illness, or disease such as cerebral palsy, spina bifida, multiple sclerosis, or muscular dystrophy.
*Post-Traumatic Stress Syndrome
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event, series of events, or set of circumstances.
*Pregnant-Current
A youth who has a confirmed pregnancy by a medical professional.
Note: Be sure to set an End date when the child or youth gives birth, or if the pregnancy does not come to term for any reason (for example, a miscarriage).
Previously Adopted
Child experienced a prior legal adoption before the current out-of-home care episode. Include any public, private, or independent adoption in the United States or adoption in another country and tribal customary adoptions.
Note: Confirmations of any and all previous adoptions are documented in the Child’s Plan of Service.
*Psychotic Disorder
A group of serious illnesses that affect the mind. These disorders involve hearing things that other people cannot hear or seeing things that other people cannot see. These sensory inputs may be benign or may instruct the person to do certain things.
Public Assistance (AFDC, Medicaid, SSI, Food Stamps, and so on)
Use this characteristic if the parent, legal guardian, or caregiver is on the Temporary Assistance for Needy Families (TANF) program (formerly called Aid to Families with Children (ADFC), Medicaid, Supplemental Security Income (SSI), Supplemental Nutrition Assistance Program (SNAP – formerly called food stamps), or another type of public assistance.
Note: This is a parent or caretaker only characteristic.
*Reactive Attachment Disorder
A condition where a child doesn't form healthy emotional bonds with his or her caretakers (parental figures), often because of emotional neglect or abuse at an early age.
Runaway
The child left, without authorization, the home or facility where the child is residing.
See 6460 When a Child or Youth Is Missing from DFPS Conservatorship, its subitems, and applicable resource guides.
Note: Set an End date when the child is recovered.
*Self-Abuse
A behavior that causes damage or harm to oneself. This is referred to as non-suicidal self-harm.
*Sexual Behavior Problem
A sexual behavior problem is when a child exhibits sexual activities or actions that are outside the range of those which are developmentally appropriate. A sexual behavior problem is different than sexually aggressive behavior/child sexual aggression.
Sexually Transmitted Disease
Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections that are passed from one person to another through sexual contact. The contact is usually by vaginal, oral, or anal sex. But sometimes they can spread through other intimate physical contact. This is because some STDs, like herpes and human papillomavirus (HPV), are spread by skin-to-skin contact.
Sibling Group
The child is part of a sibling group. Any or all of the siblings do not have to be in DFPS conservatorship for this characteristic to be marked. Siblings include any type of relation – full siblings, half siblings, adoptive siblings, or step-siblings.
*Speech Disabled
A person who has a communication disorder, is unable to speak, or uses a device to speak.
*Spina Bifida
A birth defect that occurs when the spine and spinal cord don't form properly.
*Terminal Illness
An illness or condition that cannot be cured and is likely to lead to someone's death. It's sometimes called a life-limiting illness.
Terminated International Adoption
A child who was involved in an international adoption who enters DFPS conservatorship as a result of the court terminating parental rights, or the parents relinquishing their rights to the child.
3-day Exam Qualification
Note that any characteristic marked with an asterisk (*) qualifies the youth for a 3-day medical exam upon entering conservatorship.
*Traumatic Brain Injury
Injury that is caused by a forceful bump, blow, or jolt to the head or body, or from an object that pierces the skull and enters the brain. The injury can cause short-term or permanent problems with normal brain functioning such as how a person thinks, understands, moves, communicates or acts.
Tribal Member
A member of a federally recognized tribe or is eligible for membership in a tribe and the biological child of a tribal member.
*Visually Impaired
A person who is blind or has impaired vision which impacts daily functioning.
Youth Parent
A youth of any age who has a child of his or her own. The youth parent’s child does not have to be in DFPS conservatorship for this characteristic to be marked.