The Ages & Stages Questionnaire, or ASQ, is simply one of the best tools available for developmental screenings of children from birth to age 5. It has been in development for about 40 years and tested by tens of thousands of participants.
You can purchase questionnaires, or it is now available as a free* online screening tool at https://osp.uoregon.edu/home/checkDevelopment. A parent may complete it by themselves, or it can be done with a professional. (Parent educator, social worker, child care worker, physician…)
Completing the questionnaire
First, you choose the correct questionnaire for the child’s age: they’re in two month increments for the first two years (2 months, 4 months…. 24 months), then every 3 months (27, 30, 33, 36), then every 6 months (42, 48, 54, 60).
The parent fills out the questionnaire. It asks six questions in each of five realms of child development: communication (what child understands and what they can say), gross motor (running, climbing, throwing), fine motor (hand and finger coordination), problem solving, personal-social (self-help skills and interactions with others).
The form asks simple questions, like “If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, ‘What is this?’ does your child correctly name at least one picture?” The parent answers the questions yes, sometimes, or not yet. They are encouraged to try things out with their child as they go through the questionnaire, so they can see what their child’s abilities are for sure.
There is an additional optional questionnaire called ASQ:SE which assesses social-emotional development, such as autonomy, compliance (ability to follow directions), adaptive functioning (sleeping, eating, toileting), self-regulation, emotional affect, interaction (ability or willingness to respond to others), social communication.
Results (and how they’re calculated)
With the online questionnaire, the parent receives a report which lists which categories their child is “on schedule” with, where they should “monitor” and if there are any categories where the child is “not on schedule.”
To give professionals a little more insight into the calculations that lead to these categorizations: The results are scored 10 points for every yes, 5 for sometimes, 0 for not yet, so a maximum of 60 points per category. On the written test, you would then tally it on a table similar to this:
If the child scored as we would expect for a child of this age (on the example above, this would be a score of 40 or higher on problem-solving, shown in the white/un-shaded area of that row), then the child’s development appears to be on schedule. If they scored close to the cut-off (in the gray area, shown as 35 or 40 points on the personal-social row), that would be something to monitor. If they score below the cut-off (a unique number for each category of each questionnaire), then further assessment by a professional is recommended.
This is a screening tool, not a diagnostic tool. If all looks well for the child (all scores are in the white area or the online tool says “on schedule”) then we can be assured that they are likely well on track. If they’re in the gray area / “monitor”, then we ask more questions to figure out why. If there’s a good explanation, then the score probably is not a cause for worry, but you could recommend adding activities to build the child’s skills in those areas and re-screening in a few months. If they’re in the black area / “not on schedule” consider referrals to more resources. The Oregon website offers this helpful ASQ Review Guide to help you determine next steps.
These videos for providers offer more information about how to use the ASQ with parents.
It’s most effective when this tool is used as the beginning of a conversation with parents. After completing the tool, what do they see as their child’s strengths? Do they have any concerns about their child’s development? Did the screening reduce those concerns (they discovered the child is actually on track) or increase them (child is shown as monitor or not on schedule)? What are some next steps they can do to help their child’s development?
On my post for parents about how to complete the ASQ, you can see how I talk with parents about interpreting their results – whether to worry, how to seek help, etc.
* The screening is free for parents. Since I know the ASQ is a product that is sold, and is fairly pricey, I wanted to be sure I wasn’t violating copyright by promoting use of the online tool. The website is for the Oregon Screening project, so I have looked for legal terms on the site to see whether they limit its use to Oregon residents or in any other way, and all I have found is “This site is open to all parents of children ages 1 month up to 72 months.”
The screening is also available free at Easter Seals: www.easterseals.com/mtffc/asq/. I prefer the Oregon screening project, because Easter Seals asks for all of the family’s contact information and will add them to their mailing list.