UACE Developmental Screening
820 E Cottonwood Lane
Suite C
Casa Grande, Arizona 85122

520-836-4651

[email protected]

NOTE: If you have not completed the Ages & Stages Questionnaires®, Third Edition (ASQ-3) within the last three months, please complete that questionnaire first by going to https://asqonline.com/family/c426ba.

Welcome! Completing this questionnaire is an excellent step towards understanding your child’s social-emotional development and the importance of screening before your child starts school. This questionnaire from the Ages & Stages Questionnaires®: Social Emotional, Second Edition (ASQ:SE-2) is a screening tool that will provide a quick check of your child’s social and emotional development. The ASQ:SE-2 is designed to complement the Ages & Stages Questionnaires®, Third Edition (ASQ-3), to provide a more complete assessment of your child’s development. The information you provide will be helpful in determining if there are community resources or services that may be useful for your child or your family.  The University of Arizona Cooperative Extension, Pinal County Developmental Screening Program is very pleased to help you maximize your child’s potential. Remember, all children develop differently. Don’t worry if your child performs some, but not all of the behaviors.

We are delighted to collaborate with you on your child’s success. After the screening is processed, we will contact you within a week with the results. We will also include supportive activities to do with your child which can help his/her development. The screening is not a diagnosis, but rather a tool to help keep track of your child’s development as well as possibly uncover early developmental delays. This can further be evaluated with local resource agencies for proper intervention that can maximize your child’s success before he/she starts school and in transitioning to school.

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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 am completing this Developmental Screening online through the University of Arizona Cooperative Extension, Pinal County for the purpose of evaluating my child's developmental progress. I am aware that after the screening is processed, someone from the developmental screening team will contact me, with the results. I understand the results of the screening may be shared with my child's AHCCCS plan, doctor, First Things First, County, and its partners. I understand the screenings performed are not a medical diagnosis, but only a tool to help keep track of my child’s development as well as possibly uncover early developmental delays which can be followed up with the appropriate resource agency depending on the age of the child. I am aware that I am responsible for following up if a referral for more evaluation is recommended.

 

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