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36 Total Score 2. TRANSFER OVERALL RESPONSES Bolded uppercase responses require follow-up. See ASQ-3 User s Guide Chapter 6. Does either parent have a family history of childhood deafness or hearing impairment If yes explain 6. Does anything about your child worry you If yes explain 20 Month ASQ-3 Information Summary 20 months 30 days Child s name Date ASQ completed Child s ID Date of birth Was age adjusted for prematurity when selecting questionnaire Administering program/provider Yes No 1....
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ages and stages is a screening tool used to assess a child's development across different areas such as communication, motor skills, problem solving, and personal-social skills.
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