Your ASQ Questions Answered
Here are answers to the 10 questions our users most often ask us about the ASQ screening system.
- How often should ASQ-3 and ASQ:SE-2 be completed for a child?
- When you rescreen a child, what is the best timeframe for the rescreening? Should you use the same questionnaire or move to the next age interval?
- What languages are available for ASQ-3 and ASQ:SE-2?
- If a child is already getting early intervention or other services, do the ASQ-3 or ASQ:SE-2 still need to be administered?
- Can ASQ questionnaires be completed electronically?
- What is the ASQ keycode? How do I use it?
- How do I integrate ASQ-3 and ASQ:SE-2 with my office’s electronic health record?
- Several ASQ-3 intervals include an item related to gender and whether the child identifies their gender correctly. Some parents have concerns about this item, and some say that they find it to be insensitive to the transgender community. How should we handle this issue?
- I have heard that parents are good reporters of their child’s development. Can you share more information about this research?
- Can ASQ-3 be used as an autism screener?
Looking for an answer to a question that’s not listed? Head over to our Knowledge Base where you’ll find answers to many more questions.
The ASQ is a flexible system and it allows programs to choose the frequency of screening based on what works best with your program’s goals and capabilities. We do recommend that programs screen on a regular basis from 1 month to 6 years, rather than just once, considering the rapid social-emotional and developmental changes that occur in children.
Parents also have different needs at different stages of a child’s development. For example, some parents are very comfortable and at ease about parenting infants but begin to feel challenged when their child becomes a toddler and strives for independence. In addition, any change in children’s homes, schools, or health status may greatly affect their development.
For children birth to 24 months, screening with ASQ-3 every 4–6 months is adequate. If a delay is suspected, programs should rescreen in 2–3 months. For children 2–3 years, every 6 months is adequate unless a delay is suspected. Using each age interval of ASQ:SE-2 is a reasonable monitoring schedule. Programs with fewer resources may choose specific intervals for their monitoring efforts.
2. When you rescreen a child, what is the best timeframe for the rescreening? Should you use the same questionnaire or move to the next age interval?
The ASQ is a flexible system and it allows programs to choose the frequency of screening based on what works best with your program’s goals and capabilities. In general, the developers recommend rescreening a child who scored in the monitoring zone (gray area) in 2–3 months. This allows the child to practice skills, especially those where lack of opportunity may have had an impact.
When rescreening, the questionnaire interval used depends upon the age of child and the interval’s administration window. You should use the age-appropriate questionnaire when rescreening. You may decide to rescreen with the same questionnaire if the child remains in the age window and, if the child scores in the typical area for that interval, rescreen again in 4–6 months with the next age interval. The most important thing is to follow up consistently if children score in the referral area or if there are concerns.
ASQ-3 questionnaires are available in English, Arabic, Chinese, French, Spanish, and Vietnamese. ASQ-3 is also available in Hmong and Somali in the Patient Tools, Inc. system.
ASQ:SE-2 questionnaires are available in English, Arabic, French, and Spanish. The first edition of ASQ:SE is also available in Hmong and Somali in the Patient Tools, Inc. system.
4. If a child is already getting early intervention or other services, do the ASQ-3 or ASQ:SE-2 still need to be administered?
ASQ-3 was designed to identify children with delays. If a child has been previously identified with a delay or disability, it not recommended that professionals continue administering questionnaires to the child. Parents of these children may be discouraged when completing questionnaires because their child can do only a few of the skills targeted. If you are interested in figuring out where a child is within a domain that may not be affected by the delay (for instance, gross motor skills on a child with language delays), selected domains on ASQ-3 could be completed.
The ASQ:SE-2 can be completed by parents of all children, however, as a measure of behavior and social-emotional skills. But, it’s important to note that children with disabilities often score above the ASQ:SE-2 cutoff points (suggesting areas of concern), so professionals may opt to use the screener to provide a profile of children’s strengths and competencies but not to compare the child’s profile with normative cutoff scores.
Yes, programs interested in offering parents the option to complete questionnaires online can subscribe to ASQ Family Access. Programs set up a secure, customizable webpage and share the link with parents. Then, parents can complete questionnaires via mobile phones, tablets, or computers. Completed questionnaires are scored and saved in the ASQ Online system, making the screening process easier than ever! Learn more about ASQ Online here.
The ASQ keycode is a unique number that comes with each type of ASQ-3 or ASQ:SE-2 questionnaires and learning activities books. The keycode is provided on a sticker affixed to each product. You’ll need this keycode to access online questionnaires and learning activity sheets after you purchase a subscription to ASQ Pro or ASQ Enterprise.
Once your ASQ Online subscription is activated, the keycode can be entered into the system. The keycode is entered within the Program Details section and can be entered by the account administrator or the program administrator.
There are various options for integrating ASQ-3 and/or ASQ:SE-2 questionnaire results with an office’s electronic health record, ranging from scanning completed questionnaires to automated data transfer with ASQ Online. Read more about data integration options.
8. Several ASQ-3 intervals include an item related to gender and whether the child identifies their gender correctly. Some parents have concerns about this item, and some say that they find it to be insensitive to the transgender community. How should we handle this issue?
This is an important issue. We agree that the questions related to gender are potentially hurtful to families and children, and we apologize. In the past, gender was considered a hallmark of development but now there exists a much more nuanced and sophisticated view of all that is involved with gender. We consider this item to be dated and have omitted it as we begin work on the next edition of ASQ.
As you use ASQ-3, you may find it best to omit the item related to gender and calculate an adjusted score for the Personal-Social area.
For your reference, items related to gender appear on ASQ-3 in the Personal-Social area on the 36 month, 42 month, 48 month, 54 month, and 60 month questionnaires.
9. I have heard that parents are good reporters of their child’s development. Can you share more information about this research?
Research has indeed shown that parents—regardless of socioeconomic status, location, or well-being—give accurate information about their child’s development (Rydz et al., 2005; Squires et al., 1998). Parent report is most accurate if questions are straight-forward and ask about their child’s current, observable behaviors. While there are some parents, such as those with substance abuse issues or severe mental health problems, that may not provide accurate information, most parents can accurately answer simple questions about their child’s current repertoire of behaviors.
Because parents (and other primary caregivers) have expert knowledge about their child’s abilities and skills, parental involvement in developmental screening important. Several research studies have shown that parents’ observations and report of their children’s development are predictive of developmental delays. Studies published in Topics in Early Childhood Special Education have shown that parents as observers are effective identifiers of children with delays (Diamond, 1993) and that use of parent-completed questionnaires was an accurate way to monitor children’s development (Bricker & Squires, 1989). Furthermore, studies by Frances Glascoe and colleagues (Glascoe, 1997; Glascoe & Dworkin, 1995) showed that parental concerns about language, fine motor, cognitive, and emotional-behavioral development are highly predictive of actual problems. These studies establish parent-report tools, like ASQ-3 and ASQ:SE-2, as an accurate method of developmental screening. In addition, parent-completed tools are time- and cost-efficient, and they help educate parents about typical child development.
For more detailed information about parent reporting of children’s developmental skills, the following articles are helpful:
- Bricker, D., & Squires, J. (1989). The effectiveness of parental screening of at risk infants: The infant monitoring questionnaires. Topics in Early Childhood Special Education, 9(3), 67–85.
- Diamond, K. (1993). The role of parents’ observations and concerns in screening for developmental delays in young children. Topics in Early Childhood Special Education, 13(1), 68-81.
- Glascoe, F.P. (1997). Parents’ concerns about children’s development: Prescreening technique or screening test? Pediatrics, 99, 522–528.
- Glascoe, F.P., & Dworkin, P. (1995). The role of parents in the detection of developmental and behavioral problems. Pediatrics, 95(6), 829–836.
- Rydz, D., Shevell, M.I., Majnemer, A., & Oskoui, M. (2005). Developmental screening. Journal of Child Neurology, 20(1), 4–21.
- Squires, J., Potter, L., Bricker, D., & Lamorey, S. (1998). Parent-completed developmental questionnaires: Effectiveness with low and middle income parents. Early Childhood Research Quarterly, 13(2), 345-354.
ASQ-3 is not an autism screener. However, ASQ-3 reliably picks up delays associated with autism and identifies children who should receive further evaluation. Questions on behavior and communication in the Overall section also elicit parent concerns that may point to autism. Children with autism were included in the normative sample for ASQ-3.