2-1-1 Broward

Dial 2-1-1 or 954-537-0211

Welcome,

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)


If your child is between birth and 5 1/2 years and lives in Broward County in Florida she/he can participate in the study. If you decide to participate you will complete two questionnaires about your child's development and you will be asked to supply some background information on your family such as education and ethnic group. The questionnaire and background information will take about 10-30 minutes to complete.

The website is secure and password protected to ensure participant confidentiality. Your email address will only be used to respond to your requests. This database is secure and password protected, accessible only to the specialists. Any identifying information connected to your computer (IP address) will not be recorded at any time.

 

Submitting the questionnaire indicates that you have read the information provided above. In addition, it indicates that you are willingly agreeing to participate and you allow Help Me Grow Broward care coordinators to share demographic, screening, and referral activities as needed. You may withdraw your consent or discontinue participation at any time without penalty, and you are not waiving any legal claims, rights, or remedies. 

Sincerely,

Francisco Isaza

Program Director

954-390-0493 ext. 210

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.

landing page left footer logo
landing page right footer logo