Help Me Grow Maine

Toll-Free: 1-833-714-7969

Tel: 207-624-7969

Website:Help Me Grow Maine

Email: [email protected] 

 

 

Welcome to Help Me Grow Maine Ages & Stages Questionnaire! 

The ASQ-3 is a set of questions that focuses on your child’s overall development. ASQ-3 questionnaires range from 1 month to 5 ½ years old. There are different questions on each ASQ-3, based on your child’s current age. The questions look at language, movement, thinking, behavior, and emotions.

 

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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, Third Edition (ASQ-3), to help you keep track of your child's development. The questionnaire may be provided every 2-, 4- or 6-month period. You will be asked to answer questions about some things your child can and cannot do. The questionnaire includes questions about your child's communication, gross motor, fine motor, problem solving, and personal social skills.

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-3!



(put "0" if not premature)


By proceeding with this questionnaire, you agree to allow Help Me Grow Maine to review your answers and follow up with you directly. Help Me Grow Maine will communicate screening results and other basic information about your family with your child’s health care provider and other service providers. When appropriate, a copy of the scored questionnaire in full will be shared with your child’s health care or other service provider to improve support for your family. 

Additionally, Help Me Grow Maine shares developmental screening information with others to provide an overall view of how Maine children are doing and to coordinate support. By clicking “Submit” you are agreeing to share your child’s information and screening results as outlined in the Authorization for Release. This authorization is voluntary. 

 

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.