Transcript What are the ASQ? - Associates In Pediatric Therapy

Ages & Stages Questionnaires® (ASQ-3)
A Parent-Completed, Child-Monitoring System
Ages & Stages Questionnaires® is a registered trademark of Paul H. Brookes Publishing Co., Inc.
Training Objectives
 Define and discuss the benefits of
developmental screening
 Describe features of the ASQ-3
 Score the ASQ-3
 Describe ASQ-3 cutoff scores
 Interpret ASQ-3 information in
relation to other referral
considerations
ASQ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2008 by Paul H. Brookes Publishing Co. All rights reserved.
For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com
What is the ASQ-3?
 Parent- or caregiver-completed screening tool
that encourage parental/caregiver involvement
 Series of questionnaires for children ages 1
months to 5 ½ years
 Tool to accurately identify children at risk for
developmental delay
ASQ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2008 by Paul H. Brookes Publishing Co. All rights reserved.
For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com
Domains Screened by the ASQ-3
ASQ-3 (screens 5 domains):
 Communication
 Gross motor
 Fine motor
 Problem solving
 Personal-social
ASQ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2008 by Paul H. Brookes Publishing Co. All rights reserved.
For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com
Features of the
Ages and Stages
Questionnaires
(ASQ-3)
Features: ASQ-3 Intervals
21 Questionnaire intervals:
 2, 4, 6, 8, 9, 10, 12, 14, 16, 18, 20, 22, 24
 27, 30, 33, 36 (spaced 3 months apart)
 42, 48, 54, 60 (spaced 6 months apart)
ASQ-3 Intervals
 9 month vs. 10 month forms
 9 month developed for pediatricians to use at 9
month check-up.
 When screening 9 month old child use 10 month
ASQ-3 as it is more stringent.
Features: ASQ-3 Cover Page
•Administration window indicated on ASQ-3 cover
page.
•16 month “window” is 15 months, 0 days to 16
months, 30 days.
Features: ASQ-3 Cover Page
Gathers information to choose correct ASQ-3 Interval.
 Date ASQ Completed
 Childs Date of Birth
 Prematurity question (up to 24 months)
 Calculate Age at administration or Adjusted age and
compare with administration window.
Features: ASQ-3 Areas & Questions




5 developmental areas (e.g., Communication)
6 questions in each area
Questions are in hierarchical order
Questions #5 and #6 are average skills for children of that
age interval
 (i.e., a 12 month skill for a 12 month child).
 Response options: Yes, Sometimes, Not Yet
 Written at 4th to 5th grade reading level
Features: ASQ-3 Overall Section
 Un-Scored Section
 Looks at quality of skills (e.g., speech)
 Example: “Does your baby use both hand equally well?”
 “No” response indicates possible medical diagnosis. Important to
follow up.
 Parent concerns very predictive.
 Any concerns or questionable responses require follow-up
Features: ASQ-3 Summary Sheet
 Each ASQ-3 interval has unique summary sheets.
 Summary sheets have five sections:
 Child/family information
 Bar graph with cutoffs
 Overall section
 Follow-up action taken (new to ASQ-3)
 Optional section: Individual item responses
How to
Administer ASQ-3
Prescreening Activities
 Obtain consent.
 Explain purpose of screening and review
questionnaire content.
 Schedule screening.
 Select Correct ASQ-3 Interval.
 If possible, provide parent with ASQ-3 prior to
administration.
 Assemble materials (if necessary).
ASQ-3
Administration:
Andrew Scoring
Exercise
Andrew: ASQ-3 Cover Page
 Date ASQ Completed: October 14, 2008.
 Child’s Name: Andrew
 Child’s Date of Birth: April 30, 2007
 Vicky (mother) filling out questionnaire.
What is Andrew’s actual Age at ASQ
Administration in months and days?
Age at Administration: Andrew
Date ASQ Completed: October 14, 2008.
Child’s Date of Birth: April 30, 2007
=
2008 10 (9)
2007 4 mo
1 year 5 mo
14 (+30) days
30 days
14 days
Andrew’s Age at administration is 17 months 14 days
Choosing the correct ASQ-3
when the child is premature.
 Adjusted age:
 Subtract weeks of
prematurity from
child’s age at
administration to
create an adjusted
age.
 Use adjusted age to
choose appropriate
ASQ-3 interval.
Adjusted Age: Andrew
Andrew was born 6 weeks premature.
What is Andrew’s Adjusted Age?
17 months 14 days – 6 weeks = 16 months
(Andrew’s Age at administration)
Andrew’s adjusted age is 16 months.
Andrew should receive the 16 month ASQ.
Possible Responses to the ASQ
 Yes = the child is performing the skill
 Sometimes = the child is performing the skill
on occasion, but not always
 Not Yet = the child is not yet performing the
skill
Scoring the ASQ-3
Step 1: Review responses. If any missing items, try to
obtain answers. If items inappropriate, omit item.
Step 2. Calculate area totals: “yes”= 10;
“sometimes”= 5; “not yet”= 0.
Step 3: If any items omitted, calculate new area
total (example to follow).
Scoring the ASQ-3 (cont.)
Step 4: Review overall
section responses. Ask for
further clarification and
make notes if needed.
Step 5: Transfer information
to ASQ-3 Summary Page.
ASQ-3 Omitted item?
Create a new total area score so child is not penalized.
1) Divide total area score by the number of items answered in
that area.
45 (area score)  5 (items) = 9 points.
2): Add this average item score to the total area score to get a
new total score.
45 + 9 points = new total of 54 points
Understanding ASQ Summary
 Values in the chart’s un-shaded areas = child appears
to be developing typically
 Values in the grey shaded areas (“Monitoring Zone”)
= child may need extra practice and experience in
this domain, child’s progress should be monitored. (1.00-(-)1.99 SD below the mean)
 Values within the charts black shaded areas = child
should be referred for further evaluation. (-2 SD
below the mean)
16 Month ASQ-3 Scoring Chart
Andrew, Case Study
ASQ-3 “Bell Curve”
(Not to Scale)
Number
of
children
Monitor
Zone
ASQ-3
Cutoff
-2SD
0
52.2%
32%
15.8%
-1SD
Scores (in points) on ASQ
60
Follow-up &
Referral Criteria
 Above monitor zone
 Provide follow up activities & rescreen in 6-12 months.
 All areas scored in white zone
 Monitor zone
 Score is between 1-2 SD below average. (1 area in grey zone)
 Provide follow up activities to practice specific skills.
 Rescreen in 6 months in areas of concern.
 Make community referrals as appropriate.
Follow-up/Referral Criteria (cont.)
Below cutoff in one or more
areas:
 Score is below 2 standard
deviations below average. (2 or
more areas in grey zone or 1 or
more areas in black.)
 Refer for further assessment
Example of Follow-Up Actions
Andrew, Case Study
Talking to Families
 “The ASQ is a tool to check on your child’s
development.”
 “Your child will be able to do some of the items,
but not all of the items.”
 “Answers help show your child’s strengths and
any areas where your child may need support or
more practice”
ASQ-3 User’s Guide
 Includes information on
planning screening systems and
procedures
 Provide example letters,
activities, and case studies
 Contain technical reports
 Cover all topics in depth