HD FS 340
S. Hegland
Ages & Stages Questionnaire Assignment
Timeline: by
Tuesday, November 19
Task
Find a family; bring child’s birthdate and age to class to sign up for
ASQ form
Thursday, November 21
Pick up ASQ form
Tuesday, December 2
NO CLASS (use for completing home visit)
Thursday, December 12
Completed observation assignment due
N.B.: No practica (except for make- ups) week of December 9
Contact a family, and arrange to complete an Ages & Stages Questionnaire (ASQ) for a child
who is between the ages of 4 and 36 months of age; note the child’s age and birthdate. On
November 19, in class, you need to inform me of the birthdate of the child. On November 21 I
will provide you with a copy of the appropriate form of the ASQ for the child yo u have selected.
Collect this information carefully; there are 15 different forms for the ASQ for children at 4,6, 8,
10, 12, 14, 16, 18, 20, 22, 24, 27, 30, 33, or 36 months of age. The forms are only valid for
children from one month before to one month after the designated age. If possible, arrange to
complete the questionnaire during a visit to the child’s home, where s/he and the parent will feel
most comfortable. If necessary, however, you could complete the questionnaire with the parent at
a location such as a child care center, child care home, or church nursery. Under no
circumstances can you complete the questionnaire without the parent present.
When you discuss the ASQ with the parent, be sure to include the following points:
1. Explain that child must be
• rested,
• fed, and
• ready to play
2. Explain questionnaires designed to determine what child can and cannot do. Be sure they
understand that the child will probably NOT be able to do all the activities targeted.
3. Emphasize importance of trying each activity with the child
4. Explain the 3 possible answers for most answers: yes, sometimes, no.
5. Clarify how to answer questions about activities child did earlier but no longer does, or
does infrequently (e.g., crawling = yes)
6. Emphasize name of instructor, agency, address, phone and e- mail for possible contact
(see letter).
Follow these steps and decisions in using the ASQ Questionnaire on a home visit.
1. Obtain consent from the parent(s) to participate in the observation experience. Be sure to
obtain written consent during the home visit; without written parental consent, you will
receive an F for the assignment, because I cannot grade it!
2. Telephone and schedule a home visit date and time (within one week). Leave your phone
number in case they need to reach you to reschedule. It may be helpful to telephone the
night before to remind the parent.
3. Typically you would mail the age-appropriate questionnaire to the child’s home two
weeks before the visit. Use the questionnaire appropriate for the child. Questionnaires can
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be completed up to 1 month before and after the child’s corresponding chronological age,
creating a 2-month “window” for the use of each questionnaire. If the child’s age falls
outside of the 2- month “window” at the time of the home visit, give the parents the
previous age interval questionnaire to complete.
4. Assemble appropriate types and materials needed to complete the questionnaire. A
complete list of materials is found at the end of this assignment. Review your
questionnaire carefully to know what toys and materials to bring.
5. Determine whether the parents are capable or reading and comprehending the
questionnaire.
a. for parents who are unable to read or otherwise unable to complete the questionnaire
(e.g., as a result of mental illness, developmental disability, or a language difference)
• the home visitor may read the items on the questionnaire
• the home visitor may demonstrate for parents how to elicit the questionnaire items
b. For parents who are able to read and comprehend the questionnaire:
• Parents can read and administer the questionnaire with the home visitor’s
assistance.
• The home visitor may demonstrate how to elicit the behaviors required for
questionnaire completion
6. To describe the questionnaire, the home visitor can give the following informatio n:
• Description of the ASQ as a tool parents can use to check their child’s development.
• Clarification of the home visitor’s role (i.e., to read and demonstrate how to elicit
desired behavior).
• Ideas for involving family members, including siblings, in the elicitation of behaviors
described on the questionnaires.
7. Begin the questionnaire by completing the second page (i.e., demographic information).
In response to “Who is completing the questionnaire?” the home visitor’s name should be
entered.
8. Explain the scoring system.
• Yes indicates the child is performing the behavior.
• Sometimes indicates the child is just beginning to perform the behavior (i.e., it is an
emerging skill).
• Not yet indicates the child is not yet performing the behavior.
9. Introduce each area of development on the questionnaire.
• Communication items focus on language skills—both what the child understands and
what he or she can say.
• Gross motor items focus on large muscle movement and coordination.
• Fine motor items focus on small muscle movement and coordination.
• Problem solving items focus on the child’s play with toys.
• Personal-social items focus on the child’s interactions with toys and other children.
10. Administer the questionnaire
a. If necessary, read each item
b. Paraphrase items as needed for parents who seem to need clarification.
c. When appropriate, rephrase questions in terms of the family’s values or cultural
orientation.
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d. Comment on the child’s accomplishments whenever possible. Praise the child
directly. Highlight the parents’ strengths and reinforce positive parent-child
interactions.
e. Adapt materials used for questionnaire items to the family’s culture and values (e.g.,
some cultures do not use mirrors).
f. For items the parents cannot answer with certainty, have them try to elicit the
behaviors while the home visitor is present.
g. If the child is uncooperative and the parents are unsure whether the child can perform
a behavior, the home visitor can call parents in a week or so, thereby giving the
parents more time to try the item.
11. Complete the Overall section, paying close attention to the parents’ concerns.
a. Offer suggestions and resources when appropriate
b. Encourage dialogue about the child’s development and parenting issues.
12. Score the questionnaire.
a. The home visitor can do the scoring or show the parents how to do the scoring.
b. Compare the child’s area scores with the cutoff scores indicated on the Information
Summary Sheet.
c. Review the questionnaire for unanswered items. If all items are answered, proceed to
Step 2. If any questions were left unanswered, ask the parent to score unanswered
questions.
d. Correct items marked not yet if more advanced items are scored yes.
e. Score each item on the questionnaire using the following values:
• Yes = 10 points
• Sometimes = 5 points
• Not yet = 0 points
f. Check your total of points in each area.
g. Plot the area totals on the bar graph provided on the Information Summary Sheet.
h. Note any area score(s) falling in the shaded portion of the bar graph. The child may
require further assessment in these areas.
i. Read the responses in the Overall section carefully. Contact the parents for
clarification if the answers suggest potential problems. Transfer the yes and no
responses, along with the comments when they are relevant, to the top area of the
Information Summary Sheet.
j. If your analysis leads to the conclusion that additional assessment is desired, it is
important not to alarm parents but to emphasize that the score indicates only that
further evaluation or follow- up may be in order. Emphasize that you are a student,
not qualified to make conclusions about the child’s developmental progress. If
parents are concerned, refer them to their child’s physician and to their local AEA
(unless they live in Des Moines). A map and a directory of all the AEA’s in Iowa can
be found at http://www.state.ia.us/educate/aea/index.html. Parents in Des Moines can
contact the Des Moines Public Schools ECSE office (515-242-8213) for additional
observation and assessment.
13. Discuss the results with the parents.
a. Explain the area scores.
b. Using the bar graph on the Information Summary Sheet, show the parents where the
child’s scores fall in relation to the cutoff scores.
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c. Encourage dialogue with the parents about the child’s development.
d. Discuss referral options if necessary (see below).
14. Offer intervention activity suggestions appropriate for the child’s current and upcoming
questionnaire age interval.
a. Describe some of the activities with the parents.
b. Encourage the parents to place the activities in an accessible place (e.g., on
refrigerator door).
15. Thank the parent for helping you learn to observe the development of young children.
Summarizing the home visit:
Be sure all parts of the ASQ are completed. Type an evaluation of the observation experience.
Address each of the following points:
1. Describe two anecdotes* that each describe the (observable) behavior of the parent and
child involved in one item on the ASQ involved in the activity. (*behavioral description
of a situation, child behavior, adult behavior, outcome).
2. Upon reflection, how do you think the ASQ experience went?
3. Upon reflection, what did you do that contributed to the ASQ experience success?
4. Upon reflection, what would you do differently if you did this ASQ experience again?
5. Upon reflection, what would you plan next for this child and the parent?
On December 12, turn in:
1. The completed ASQ, including the Information Summary (be SURE to accurately
calculate the child’s exact age in months and days).
2. The parent’s written permission
3. Your evaluation
Grading Criteria
Component
Completed
ASQ
Accurately
completed
ASQ
Information
Summary,
Objectively
recorded
anecdotes
Thoughtful
summary
Grammar &
Spelling
Total*
Your
My
Points assessment assessment
5
5
5
5
5
25
Unless the written parent permission is included, the grade is 0 (F).
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