Tips for working with families in your screening program

Begin by explaining the purpose of screening and describing the ASQ system. This explanation may occur in person, over the phone, in a printed document, or in a letter mailed to the parent completing the questionnaires for the first time.

Share the What Is ASQ-3? or ¿Qué es ASQ-3? (BROKEN LINK) handout with parents.

ASQ is designed to illustrate a child’s strengths as well as needs. Completing the questionnaires and learning how to use the results should be a positive experience that respects and reinforces the parents’ vital role in their child’s development. Some parents, however, may feel uncomfortable about participating in a screening program for various reasons, including the fear that their child may be labeled as below normal.

Sample language when introducing ASQ:

• “The ASQ is a screening tool that provides a quick check of your child’s development.”
• “Your answers will show your child’s strengths and any areas in which your child may need more help or practice.”
• “The information you provide will be helpful in determining whether your child needs further assessment.”

Acknowledge that the parents know their child best and that their unique knowledge of the child’s interests, behaviors, and interactions in various settings is key to developing a comprehensive picture of the child’s development.

Provide opportunities at every step for parents to ask questions and receive answers to their satisfaction.

Provide the questionnaires in the family’s home language when possible or ensure an interpreter is available. Be cognizant of different communication styles. Sensitively seek clarification of family interests, traditions, and values, but respect the parents’ preferences if they don’t seem comfortable with providing information or with greater involvement.

To the extent your resources allow, schedule the screening at a location and time that is convenient and comfortable for the family. When possible, offer flexibility with regard to where and how they complete the questionnaires: in face-to-face interviews, online, over the phone, at home, or in the office or school. As necessary, provide individualized assistance and support, which may range from being available to answer questions, to reading the items, to assisting parents in eliciting and interpreting their children’s responses.

Go over “Important Points to Remember”:

• “Try each activity with your child before marking a response.”
• “Making completing this questionnaire a game that is fun for you and your child.”
• “Make sure your child is rested and fed.”

Describe briefly the developmental areas of the questionnaires (“The questions in each area go from easier to more difficult.”), the questionnaire items (“Your child may be able to do some, but not all, of the items.”), and the Overall section (“The Overall section asks questions about your child’s overall development and about any concerns you may have about your child’s development.”).

Once you have scored the questionnaires, share screening results in a strengths-based and family-friendly format. Highlight the child’s strengths in addition to areas for further support, and allow for any questions or discussion. Parents should be informed in person, over the telephone, or through mail or email that their child’s development seems typical. Follow-up screening should be scheduled for a child whose score falls in the monitoring zone.

When sharing results:

• Provide screening information as quickly as possible.
• Assure parents that the conversation is confidential.
• Remind parents that screening only indicates the need for further assessment and does not diagnose a child.
• Review the results, emphasizing the child’s strengths.
• Avoid terms such as fail, normal, or abnormal.
• Use language such as well above cutoffs, close to cutoffs, and below cutoffs when explaining a child’s scores.
• Discuss information that may have affected scores (opportunity, health history, cultural or environmental factors).
• Listen to parents’ perceptions of their child and be open to new ideas and viewpoints.
• Discuss parent concerns and provide specific, nonjudgmental examples of your concerns.
• Emphasize parents’ current skills and resources.

If parents are interested, provide information about community resources and referral options.

Sharing results that identify a child as needing further assessment can be an extremely sensitive conversation. Carefully prepare for these discussions and conduct them with compassion and empathy.

The setting for the conversation should be private, and it should take place at a time that is convenient for the family. Consider cultural practices (Should other family members be invited to the meeting?) and language issues (Is an interpreter needed?).

Provide parents with ideas for fun games and activities to support the child’s needs and interests.

Try these sample learning activities (in English or Spanish) from ASQ-3™ Learning Activities or ASQ-3™ Actividades de aprendizaje