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The HEADS-ED was developed by integrating concepts from the HEADS mnemonic (Cohen et al., 1991) and the communimetric Child Assessment of Needs & Strengths (CANS) based measure (Lyons, 2009).

There are two versions of the HEADS-ED:
The HEADS-ED Under 6, which is for use with infants and children from birth up to their 6th birthday, and
The HEADS-ED Over 6, for use with children, adolescents, and youth from ages 6 to 21 years.
Each of these tools include 7 domains, incorporated into the acronym HEADS-ED

The HEADS-ED Under 6
Home & Caregivers
Eating & Sleeping
Activities & Peers
Development, speech/language/motor
Emotions, behaviours
Discharge or Current Resources
The HEADS-ED Over 6
Education & Employment
Activities & peers
Drugs & alcohol
Emotions, behaviours, thought disturbance
Discharge or current resources

Clinician using tablet to interview a 10 year old

These psychosocial items are used to classify the level of intervention required by the patient in each domain:

0 - No action needed
1 - Needs action but not immediate / moderate functional impairment
2 - Needs immediate action / severe functional impairment
A score of 0, 1, or 2 is assigned for each psychosocial variable and these scores are summed to obtain a total score. A higher overall score on this screening tool, particularly in any domains with a score of 2, indicates a greater need for more intensive or immediate MHA services.
For the HEADS-ED Over 6, in the Emergency Department, a total score of greater than or equal to 8 and/or a suicidality score of 2 recommends a need for a psychiatric consultation and/or admission.  

For the HEADS-ED Under 6, a score of 6 or higher recommends priority consultation with a specialized provider for more immediate or intensive service.