Developmental Questionnaire

Watching a child grow and develop is very exciting for a parent. A child’s development is important for parents and caregivers to follow but sometimes knowing what is or isn’t a concern can be difficult. That is why Help Me Grow offers a developmental questionnaire designed to help parents and caregivers follow and understand their child’s development.

 

What are the Ages and Stages Questionnaire-3 and Ages and Stages Questionnaire Social-Emotional?
The Ages and Stages Questionnaire–3 (ASQ3) and Ages and Stages Questionnaire Social-Emotional (ASQ:SE) are great tools to help parents discover their child’s strengths and uncover any potential areas of concern. They are tested, valid and reliable instruments used by many health care providers to teach parents about typical child development and help better identify any parent concerns. Parents can use the results of the ASQ-3 and ASQ:SE to help talk with pediatricians, teachers or other professionals if they have concerns about their child’s development. To learn more about developmental warning signs, please click here.

 

The ASQ3 assesses the five major areas of development: gross motor, fine motor, communication, problem solving, and social-emotional development and is available for parents of children ages one month through 5 1/2 years.

 

The ASQ:SE is a screening tool that is designed to identify children who may be at risk for social or emotional difficulties. The ASQ:SE was developed to monitor a child’s development in the behavioral areas of self-regulation, compliance, communication, adaptive, autonomy, affect and interaction with people. The ASQ:SE can be used to aid in identifying young children who may benefit from further evaluation and/or prevention interventions to improve their social competence, emotional competence, or both. The ASQ:SE is available for parents of children ages three months through 5 1/2 years.

 

We highly recommend that if you choose to complete the ASQ:SE for your child, that you complete the ASQ3 as well.

 

What Does Help Me Grow do with the ASQ3?
After you (the parent or caregiver) have completed the questionnaire and returned it to Help Me Grow, a member of our team will contact you with your results. If after receiving the results, you have questions or feel that your child or family needs extra support, a knowledgeable Help Me Grow team member will help you connect to resources or information. With your permission, we can also send your child’s ASQ3 and ASQ:SE results to your health care provider or any other agency that is working with your family.

 

What do I have to do?
It’s simple! We provide the questionnaire in one of two ways:
Online

 

Please click the appropriate box below to fill out an online ASQ3 or ASQ:SE questionnaire. You will have an option to print the questionnaire after you click the link. Once you have completed and submitted the online form, a Help Me Grow WNY team member will contact you regarding the results.

Take ASQ3 Online

Take ASQ:SE Online

Mail
Please sign up here to receive a hard copy of the ASQ3 or ASQ:SE in the mail.Please return your completed questionnaire to:
Help Me Grow WNY
C/O 2-1-1 WNY
1170 Main Street
Buffalo, NY, 14209
Once we receive your completed questionnaire, we will contact you with your child’s results.