Welcome Little Treasures Family!  You are about to access our ASQ:SE2 Online screening program!

This questionnaire includes questions about your child’s ability to calm down, follow directions, demonstrate feelings, and interact with others.  The SE-2 is offered every 6 months until your child is 3 years old, and then again at 4 years old and 5 years old. 

Select a time your child is happy, alert, and ready to play.  Make it a game and you’ll both have fun!  If completing this questionnaire brings up any questions or concerns, please don’t hesitate to contact me. 

We look forward to your participation in our program.  Have fun completing this questionnaire with your child. Please call or email me at any time if you have any questions or would like to discuss any concerns about your child’s development.

Regards,

 

Melissa Vandever

Child Development Specialist                                                       

Easterseals Eastern PA-Lehigh Valley                                          

www.easterseals.com/esep

[email protected]                                                                 

P: 610-289-0114 x230                                                                      

 

Sara Moreno-Alicea                            

Bilingual MtFFC Specialist 

Easterseals Eastern PA-Berks                                                       

www.easterseals.com/esep                    

[email protected]                                                             

C:  717-926-4960 

View description Hide description

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)



Consent

*I have read the provided information about the MtFFC screenings.  I wish to have my child participate in the screening and monitoring program. 

*I have read, understand, and agree to the online consent.  Please complete the consent here if you haven’t already:  Little Treasure consent with ESEP

*I have received a copy of the HIPAA statement:  ESEP HIPAA

*I agree to be contacted by an Easterseals specialist, who will share the results with me and also give me activities and/or connect you to community resources in line with my child’s individual needs.

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.