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Survey

ICR 201407-0925-005 · OMB 0925-0593 · Object 49036101.

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application/vnd.openxmlformats-officedocument.wordprocessingml.document
Survey
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2013-11-01
2026-10-19
complete

Extracted Text


14M Ages & Stages-3 (ASQ-3™) SAQ

Event Category:
Time-Based
Event:
12M
Administration:
N/A
Instrument Target:
Child
Instrument Respondent:
Primary Caregiver
Domain:
Neuro-Psychosocial
Document Category:
Scored Assessment
Mode (for this instrument*):
In-Person, PAPI; Phone, PAPI
OMB Approved Modes:
In-Person, PAPI; Phone, PAPI
Method:
Self-Administered
Estimated Administration Time:
13 minutes
Multiple Child/Sibling Considerations:
Per Child
Special Considerations:
N/A
Version:
2.0
MDES Release:
4.0
Publisher:
Paul H. Brookes Publishing Co.
NCS Contact:

Carol Andreassen
Westat
301-251-1500
*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.
​
Ages & Stages Questionnaires®, Third Edition (ASQ-3™), Squires & Bricker© 2009 Paul H. Brookes Publishing Co. All Rights reserved.Ages & Stages Questionnaires® is a registered trademark and ASQ-3™ is a trademark of Paul H. Brookes Publishing Co.

The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) is a series of 21 age-specific questionnaires and scoring sheets designed to screen a child’s skills in five developmental areas: fine motor, gross motor, problem solving, communication, and personal-social.  The instrument covers ages 1 month to 66 months.

The ASQ-3™ is available in English and Spanish and is a proprietary questionnaire.