Brookes ASQ | ASQ:SE2 - ASQ-3 English

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Delmar School District

200 North 8th Street

Delmar, Delaware 19940

Phone: (302) 846-9544

Fax: (302) 846-2793

Welcome to our ASQ Online screening program!

The first 5 years of your child’s life are important, and we want to help provide the best start for your child. As part of this service, we provide the Ages & Stages Questionnaires, Third Edition (ASQ-3), and the Ages & Stages: Social Emotional 2 (ASQ:SE-2) to help you keep track of your child’s development. Developmental screening is just as important as vision and hearing screenings. The earlier delays are identified, the earlier they can be addressed before they grow larger.

The questionnaire will be provided at least one time per year. You will be asked to answer questions about what your child can and cannot do. This will include questions about your child’s communication, gross motor, fine motor, problem solving, personal-social skills, and interactions with adults and children.

SCREENING INSTRUCTIONS:

*If your child has an IEP/IFSP, you do not need to submit any screenings*

- Unless instructed otherwise, select the FIRST option below to complete both portions of the ASQ (3 and SE-2)

- Include the name of your child's preschool program when prompted

- Review consent and click submit to begin the screenings.

MISSING RESULTS?

If you have not received results within 2 weeks after submission, check the junk/spam folder in your email.

Child Date of Birth
Format: yyyy-mm-dd
Child DOB you entered is in the future, are you sure of that? (Please correct the date before proceeding to the next step). Please enter your child's DOB and not the screening date or today's date (Please correct the date before proceeding to the next step). Child DOB you entered is not valid, please format the date like this: YYYY-MM-DD

Weeks Premature
(put "0" if not premature)

For ASQ-3™ English

Screening Date I am screening my child today (2024-05-09) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

Screening Date I am screening my child today (2024-05-09) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

By giving my consent, I understand that ASQ screening results will be shared with:

· The Delaware Department of Education (DDOE) and the Division of Public Health (DPH) within Delaware Health and Social Services (DHSS) to better support my child.

· My child care program who is required by law to track completed developmental screenings to help better support my child.

· The Birth to Three Early Intervention Program (B23) or my school district of residence and/or school district where my child care is located because they review the screenings and help with next steps.

o I will be contacted with results via email, US mail, or phone call to assist with follow up.

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.