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Ages & Stages Questionnaires 42 Month Questionnaire 39 months 0 days through 44 months 30 days Please provide the following information. Use black or blue ink only and print legibly when completing.

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How to fill out the Asq 42 Months online

The Ages & Stages Questionnaires® (ASQ) 42 Month Questionnaire is a vital tool for assessing a child's developmental progress. This guide provides step-by-step instructions on how to accurately complete the questionnaire while ensuring clarity and ease of understanding for all users.

Follow the steps to complete the ASQ 42 Month Questionnaire online.

  1. Click ‘Get Form’ button to access the ASQ 42 Month Questionnaire and open it in your online document editor.
  2. Begin by entering the date the ASQ was completed in the specified fields.
  3. Fill in your child's personal information, including first name, last name, gender, and date of birth.
  4. Provide your own information as the person filling out the questionnaire, including your name, relationship to the child, and contact details.
  5. If applicable, provide the names of others assisting in the completion of the questionnaire and the child's ID number.
  6. Complete the program information section, which may include the program's ID and name, as well as the location details.
  7. Proceed to answer each development-related question by indicating whether the child performs the activities regularly, sometimes, or not yet. Make sure to interact with the child during this process and consider their state to ensure accurate responses.
  8. Review each section's totals, including communication, gross motor, fine motor, problem-solving, and personal-social skills.
  9. Evaluate the overall comments and concerns section to document any additional insights about the child's development.
  10. Once all fields have been completed, save your changes, and choose to download, print, or share the form as necessary.

Complete the Ages & Stages Questionnaires online today to support your child's developmental assessment.

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ASQ-3 screens and assesses the developmental performance of children in the areas of communication, gross motor skills, fine motor skills, problem solving, and personal-social skills. It is used to identify children that would benefit from in-depth evaluation for developmental delays.

In the ASQ-3, higher scores indicate more positive outcomes. Each version of the ASQ-3 has different cutoff scores that indicate whether the child's development appears to be on schedule. On the summary sheet of the version you administered, use the bubbles in Item 1 to fill in the total score for each area.

The ASQ-3 comprised 21 age-specific questionnaires for children aged 1–66 months to assess their development in five domains. The domains included communication, gross motor, fine motor, problem solving, and personal-social [22].

ALL children should receive a formalized ASD screening at their 18- and 24-month well-child visits: The American Academy of Pediatrics (AAP) recommends screening all children for ASD at the 18 and 24-month well-child visits in addition to regular developmental surveillance and screening.

ASQ-3 & ASQ:SE Administration Recommendations: Complete the ASQ:SE questionnaire at 6, 12, 18, 24, 30, 36, 48, and 60 month age intervals. Screen children with ASQ-3 at 2 and 4 months, then at 4 month intervals up to 24 months old, and at 6 month intervals until the child reaches 5 years old.

The ADI-R is an assessment tool for autism spectrum disorder that can be used for individuals from toddlers at about age 18 months old through adults. This assessment focuses on the main core symptoms of ASD including social interactions, communication skills, and restricted and repetitive behaviors.

ASQ-3 & ASQ:SE Administration Recommendations: Screen children with ASQ-3 at 2 and 4 months, then at 4 month intervals up to 24 months old, and at 6 month intervals until the child reaches 5 years old.

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