Prior Lake-Savage Area Schools
Early Childhood Screening

Edgewood School
5304 Westwood Drive SE
Prior Lake, MN 55378

952.226.0975
[email protected]

 

 

Welcome to our ASQ Online Questionnaire.  We would like you to complete this prior to your child's screening appointment.  The "Screening Date" on this questionnaire is considered the date you are filling it out.  It would be today's date, not the date of your appointment.

Any questions you may have regarding this form can be discussed with the screener who works with your child at their appointment.  If you have have any concerns about your child or his/her development, you should mention them during your appointment.  

We look forward to seeing you and your child.

Thank you. 

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Because your child's first 5 years of life are so important, we want to help you provide the best start for your child. You've been invited to participate in the Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2) to help you keep track of your child's social and emotional development. The questionnaire may be provided for use at 2, 6, 12, 18, 24, 30, 36, 48, or 60 months of age. You will be asked to answer questions about some of your child's behaviors. The questionnaire includes questions about your child's ability to calm down, take direction and follow rules, communicate, perform daily activities (e.g., eating, sleeping), act independently, demonstrate feelings, and interact with others.

Please enter your child's birth date and the number of weeks he or she was born premature below to start the screening. Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the program employees who have invited you to participate in this screening.

We look forward to your participation in ASQ:SE-2!



(put "0" if not premature)


I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system.

Note: By clicking "Submit", you are agreeing to both our Family Access End User License Agreement and any other consent or authorization information outlined on this page.