An Introduction to ASQ®-3

Why Screen?

• To detect delays early
• To improve child outcomes
• To encourage parent involvement and education
• Because screening is recommended by major educational and medical organizations, including:
  • American Academy of Pediatrics
  • Head Start
  • Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT), Medicaid’s child health program

What Is ASQ-3?

• The third edition of a widely used developmental screening tool.
• A series of illustrated parent- or caregiver-completed questionnaires.

What Is ASQ-3?

• Used to accurately identify children who may be at risk for developmental delays.
• Designed to encourage parent involvement and education.
• Low-cost, reliable, and rigorously tested.
• Also offers online questionnaire completion and online data management systems.

How Was ASQ-3 Developed?

• ASQ initiated in 1980 at the University of Oregon.
• Authors reviewed other standardized tests and studied the literature extensively to design a better tool for screening.
• ASQ skills were selected because they are easily observed or elicited by parents at home.
• First edition published in June 1995.
• ASQ-3 published in June 2009.

Why Choose ASQ-3?

• Proven accurate by new research—highly reliable and valid.
• "Anytime" screening—expanded administration windows so the intervals are seamless from 1 through 66 months.
• Fast and easy scoring.
• Educates families and is parent-friendly.
• Strengths-based—it’s easy to share results and talk about a child’s development.

Screen with ASQ-3 in 3 Simple Steps

• Step 1: Try the items/Answer the questions—Parents can easily try activities with their child—3 simple responses: Yes, Sometimes, or Not Yet.
• Step 2: Score the questionnaire—Professionals score in just 2−3 minutes.
• Step 3: Get the results—Copy the child’s scores to the Information Summary page—Interpret results and determine follow-up.

Step 1: Try the items

• Parents complete the items of the questionnaire alone, or a professional can help guide the parent through completion if there are literacy or language learning problems.
• Most parents can complete a questionnaire in 10−15 minutes.
• Be sure the correct age interval is being used.

Step 2: Score the questionnaire

• Professionals score the questionnaires with a simple 0, 5, and 10 point scoring system.
• Scores from the 5 areas are transferred to the Information Summary page.
• Scoring can be completed in 1−3 minutes.

Step 3: Get the results

• Review the child’s scores and compare to standardized cutoffs on the Information Summary page.
• Interpret results.
• Determine follow-up actions, if needed.

ASQ-3 Product Features

The ASQ-3 Age Intervals

21 Questionnaire intervals:

• 2, 4, 6, 8, 9, 10, 12, 14, 16, 18, 20, 22, 24 months (spaced 2 months apart)
• 27, 30, 33, 36 months (spaced 3 months apart)
• 42, 48, 54, 60 months (spaced 6 months apart)
• Corrected date of birth used for children born more than 3 weeks premature for up to 2 years of age.
• ASQ-3 Age Calculator (www.agesandstages.com/age-calculator/) helps select the correct interval.

Elements of ASQ-3: Areas & Questions

• 5 developmental areas (Communication, Gross Motor, Fine Motor, Problem Solving, Personal-Social)
• 6 questions in each area.
• Questions are in hierarchical order.
• Questions #5 and #6 are average skills for children of that age interval.
• Response options: Yes, Sometimes, Not Yet.
• Written at a 4- to 5-grade reading level.

Elements of ASQ-3: Overall Section

• This is an un-scored section.
• Looks at the quality of skills (e.g., speech).
• Example: “Does your baby use both hands equally well?” - “No” response indicates possible cerebral palsy. Important to follow up.
• Example: “Concerns about vision?” - “Yes” response could mean a possible vision problem. Important to follow up.
• Parent concerns are very predictive.
• Any concerns or questionable responses require follow-up.

Elements of ASQ-3: Information Summary

• Each ASQ-3 interval has its own unique summary sheet.
• “Window of administration” at the top.
• Each summary sheet has the following sections:
  • Child/family information
  • Bar graph with cutoffs and total scores
  • Section for recording overall responses
  • Section for noting follow-up action to be taken
  • Optional section: Individual item responses (records the responses for all items in one small box, eliminating the need to look back at the pages of the questionnaire for answers to individual items)

Scoring ASQ-3

• Yes = 10 points, Sometimes = 5 points, Not Yet = 0 points.
• Transfer scores to the Information Summary page.
• Compare the child’s score in each area to cutoff scores; cutoff scores based on empirical research.
  • Scores falling in the area without shading indicate the child is developing typically.
  • Scores falling in the gray area mean the child should be monitored and another screening may be desirable in a few months (1 -2 SD below the mean).
  • Scores falling in the dark shaded area mean the child may be at risk for developmental delays and should be referred for further assessment (2 SD below mean).

Validity and Reliability

• New standardization – based on 18,572 questionnaires for 15,138 children (an exceptionally large standardization sample).
• The sample mirrors the demographic mix of the U.S. population and includes underserved populations and children of all socioeconomic statuses.
• The strong technical data improved even further with the 3rd edition—Reliability:
  • Test-retest: 0.92 (excellent).
  • Inter-rater: 0.93 (excellent).
• Validity: 0.82 to 0.88 (excellent).
• Sensitivity: 0.86 (excellent).
• Specificity: 0.85 (excellent).

ASQ-3 and Children with Autism

• Children with autism were included in the normative sample.
• ASQ-3 reliably picks up delays associated with autism and identifies children who should receive further evaluation.
• Relevant items – Overall questions elicit parent concerns.
  • Sample Overall questions:
    • Do you have any concerns about your child’s behavior?
    • Does anything about your child worry you? If yes, explain.

ASQ-3 Product Family

ASQ®-3 Starter Kit

• Includes the User’s Guide, Set of Questionnaires, Quick Start Guide, with Spanish and English Questionnaires.
• Price: US $295.00

ASQ®-3 User’s Guide

• Complete how-to instructions, strategies for a wide variety of settings, Technical Report, Intervention Activities.
• Price: US $55.00

ASQ®-3 Questionnaires

• Sturdy, user-friendly box with handle, Questionnaires on paper and CD-ROM in one convenient package.
• Price: US $240.00 (Spanish/English)

Additional Translations

• Questionnaires on CD-ROM, Supplemental materials.
• Price: Arabic, Chinese, French, Vietnamese US $175.00 each.

ASQ®-3 Quick Start Guide

• 4-page laminated guide—durable, easy to use.
• Price: English, Spanish, French US $30.00 each.

ASQ®-3 Learning Activities

• More than 400 fun and effective activities to share with parents.
• Price: English, Spanish US $49.95 each.

ASQ Training DVDs

• ASQ-3 Scoring and Referral: $49.95 | 2009 | 25 minutes.
• The Ages & Stages Questionnaires on a Home Visit: $49.95 | 2007 | 20 minutes.

ASQ®-3 Materials Kit

• Convenient access to items needed for ASQ-3 screenings.
• Price: US $325.00.

ASQ® Online

• Web-based management and questionnaire completion system; available 24/7.
• Automated scoring for accuracy and efficient reporting to help analyze progress.

ASQ Pro & ASQ Enterprise

• ASQ Pro account for single-site programs.
• ASQ Enterprise account for multi-site programs.

ASQ® Family Access

• Online completion for parents via a secure, customizable URL, mobile-optimized.

Brookes On Location Training

• Virtual and in-person seminars from ASQ-3 experts. Seminars for all levels of users.

ASQ-3 & ASQ:SE-2 Training of Trainers Institute

• Held virtually multiple times a year, 3-day training from ASQ-3 experts.