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There are 21 ASQ-3 questionnaires for use with children from 1 month to 5½ years old (one questionnaire for each age range). Here are the five important areas of development that each questionnaire looks at: Communication: Your child’s language skills, both what your child understands and what he or she can say.
2. Ask your child to draw a picture of a person on a blank sheet of paper. You may ask your child, “Draw a picture of a girl or a boy.”. If your child draws a person with head, body, arms, and legs, mark “yes.”. If your child draws a person with only three parts (head, body, arms, or legs), mark “sometimes.”.
Use black or blue ink only and print legibly when completing this form. Date ASQ completed: Child’s information. Child’s first name: Middle initial: Child’s last name: If child was born 3 or more weeks prematurely, # of. Child’s gender: Male. Female.
Use black or blue ink only and print legibly when completing this form. Date ASQ completed: Child’s information. Child’s first name: Middle initial: Child’s last name: If child was born 3 or more weeks prematurely, # of. Child’s gender: Male. Female.
Count as “yes”. 1. After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your Count as “not yet” child scribbles back and forth.) 2.
Count as “yes”. 1. After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? Count as “not yet”.
01. Start by downloading or obtaining a copy of the ages and stages questionnaire. 02. Read the instructions carefully to understand the purpose, format, and scoring of the questionnaire. 03. Gather the necessary materials such as a pen or pencil and a quiet, comfortable space to complete the questionnaire. 04.
