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5. Show your child how a zipper on a coat moves up and down, and say, “See, this goes up and down.”. Put the zipper to the middle, and ask your child to move the zipper down. Return the zipper to the middle, and ask your child to move the zipper up.
Please provide the following information. Use black or blue ink only and print legibly when completing this form. Date ASQ completed: Child’s information. Child’s first name: Child’s date of birth: Person filling out questionnaire. First name: Middle initial:
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.”.
Count as “yes”. 3. After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line.
This CD-ROM contains 1) your End User License Agreement, 2) printable ASQ-3 PDFs, 3) infor- mation about ASQ, 4) information about the authors, 5) training information, and 6) order forms. The ASQ-3 PDFs are organized as a single comprehensive set and also within six individual folders
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.
5. 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.”.
