How ASQ-3 Monitoring in Early Years  Contributes to Child Development

September 28, 2023 By Andrew Alpin In Pediatric Health
Early intervention in the growing stages of a child can play a crucial role in growth and development. Moreover, developmental milestones matter because a parent does not want to witness those special moments of specific achievements, such as your baby’s first steps, the day they began speaking, or even the first activity with play bricks. Parents are the most influential figures in a child’s development, and monitoring a child’s activity helps a great deal in understanding a child’s potential, strengths, and skills for better growth. One valuable tool assisting parents in this incredible journey of child development is the ASQ-3 tool, or Ages and Stages Questionnaires, third edition.
What Is The ASQ-3 Tool?
The ASQ-3 is a standard evidence-based screening tool that parents, educators, and healthcare professionals use to monitor a child’s development and growth. Targeting children from birth to 5 years old, it consists of questionnaires covering various areas of child development, which include communication, motor skills, problem-solving, personal-social skills, and adaptive behavior. The ASQ-3 monitoring process involves questions to assess whether a child is meeting age-appropriate developmental milestones which help identify strengths and potential areas of concern. The ASQ consists of two screening tool:
  • The Ages and Stages Questionnaire, 3rd Edition (ASQ-3), which covers five areas of child development
  • The Ages and Stages Questionnaire Social-Emotional, Second Edition (ASQ: SE-2), covering only social-emotional development
The Five Main Domains of ASQ 3
The ASQ-3 covers five crucial areas of child development which together form a comprehensive assessment of a child’s development. The questions include a child’s ability or inability to perform specific tasks or skills with answer options that require a parent to select “Yes,” “Sometimes,” or “Not yet.” The five domains of ASQ 3 are:
  1. Communication: Assesses a child’s language and communication skills. It includes the child’s ability to listen and understand spoken language, express themselves verbally, and use nonverbal communication such as gestures and facial expressions. It also evaluates receptive and expressive language development, including speech that others can understand.
  2. Gross Motor Skills: Gross motor skills assess how a child uses physiology and muscles, such as arms and legs, to perform activities like crawling, walking, running, jumping, and balancing. This area also includes physical coordination and motor development, monitoring a child’s ability to achieve developmental milestones like sitting up, crawling, and walking.
  3. Fine motor skills: How a child moves and coordinates the small muscles in the hands and fingers.
  4. Problem-Solving (Cognition): This area assesses a child’s cognitive development, including problem-solving abilities, creativity, reasoning skills, and understanding of cause-and-effect relationships. It examines how well a child can think, reason, make decisions, play with toys, and solve problems at different developmental stages. 
  5. Personal-Social Skills: Personal-social skills include a child’s social and emotional development. It evaluates a child’s ability to develop relationships, interact with others, form attachments, manage emotions, and engage in age-appropriate social behaviors. It also includes self-help skills like dressing, eating, toileting, and self-hygiene.
Completing ASQ3
The ASQ-3 questionnaires take approximately 10 to 15 minutes to complete, where scores are calculated based on the answers provided in all five categories. Based on the scorecard, a child will fall into one of the following zones.
  • Above cutoff: The child’s development is normal 
  • Close to cutoff (monitoring zone): Needs monitoring for concerning behavior and development.
  • Below Cutoff: The child may need to be evaluated by a specialist 
Sample question of ASQ3
Ages And Stages Questionnaires 2 (Emotional and Social Development)

The Ages and Stages Questionnaires, Second Edition (ASQ-2), is an earlier version of the developmental assessment tool compared to ASQ-3. Today, ASQ-2 covers seven elements of the social and emotional development of children aged 1 to 6 years. ASQ-2 provides a comprehensive overview of a child’s social and emotional skills within personal and social interactions. These assessments can help identify areas of concern where a child may need additional support in their social and emotional development.

  1. Self-regulation: Assesses a child’s ability to remain calm or adjust their behavior in response to situations and their environment.
  2. Compliance: How a child follows the rules and directions.
  3. Adaptive functioning: How a successfully deals with their physical needs, such as sleeping and eating.
  4. Autonomy: A child’s growing independence.
  5. Affect: How a child demonstrates their feelings and feels empathy for others
  6. Social communication:  How a child communicates with others verbally or nonverbally to express their thoughts, feelings, and needs.
  7. Interaction with people: How a child interacts with family members, peers, and others
Completing the ASQ: SE-2
As in the ASQ3, answers to questions in the ASQ2 deal with various types of behavior and require a parent to answer with options such as “Often or always,” “Sometimes,” or “Rarely or never.” These indicate if there is an area of concern. The ASQ2 also deals with family history and parental problems with a space for comments, red flags, and follow-up provisions with healthcare providers. The cutoff scores place a child into the following zones.
  • 0-50 Low or no risk:  The child’s social-emotional development is expected.
  • 50-65 Monitoring zone:  Needs monitoring by parents, and concerning issues should be reviewed by a healthcare provider.    
  • Over 65  Above the cutoff score: Needs evaluation by a child specialist 
The ASQ Is Not a Diagnosis.
Parents subjected to ASQ screening should understand that the questionnaire is not a diagnosis. It is a formal assessment of a child’s strengths and areas of concern at specific times. It is intended to identify children who need additional evaluation for developmental delays or disorders. All children are different; some might take longer to develop in certain areas than others. It does not necessarily indicate any abnormality and the child could be as average as a child with better ASQ scores when both are older.
How ASQ3 Contributes to Child Development

Studies have shown how developmental screeners like the ASQ3 provide valuable insight into a child’s nature of development. It helps healthcare professionals identify infants and young children with developmental concerns as early as possible. These are some of the ways the ASQ-3 helps in child development.

Identifies early developmental delays

Early identification of developmental delays or concerns can help parents and professionals pinpoint areas where a child may need extra support or intervention. Addressing problems in the early stages is crucial to reduce potential challenges and provide children with the resources and therapies to reach their full potential.

Targeted Interventions

Based on the results of the ASQ-3 questionnaires, parents and professionals can create a customized plan to support a child’s specific needs in the targeted areas required most. These interventions can include speech, occupational, behavioral, and more, designed to address the child’s unique developmental challenges.

Empowering Parents

ASQ-3 allows parents to participate in their child’s development actively and helps them understand their child’s strengths and areas requiring attention. This also creates a good relationship between parents, healthcare professionals, and educators, working towards the child’s needs and well-being.

Holistic Development

 ASQ-3 monitoring doesn’t just focus on academic or cognitive skills but assesses a child’s comprehensive development. This recognizes every aspect of child development, including social, emotional, and physical development, equally essential for well-rounded growth. 

Tracking Progress Over Time

ASQ-3 monitoring can be a continuous and ongoing process, allowing parents and professionals to track a child’s progress over time. This helps ensure that interventions are effective and that a child makes the expected developmental gains as scheduled.

Conclusion

Screening a child’s development regularly helps identify delays and areas of concern to get them the help they need for their development and growth. ASQ-3 monitoring is a valuable assessment tool to ensure every child can thrive and reach their full potential. 

ASQ-3 type questionnaires are regularly part of Ensocure Integrated Medicine’s nanny and child care services. With Ensocure, your child receives the best care through nannies trained to impart the care required at every stage of a child’s development and growth.