Little Dixie Community Action Agency Early Childhood Comprehensive Systems (ECCS) Impact
580-326-3351
204 N 4th St.
Hugo, OK 74743
www.littledixie.org
Follow us on Facebook: Little Dixie ECCS Impact

Welcome to our Little Dixie ECCS Impact ASQ Online screening program! 

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, 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)

I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system. I understand that Little Dixie Community Action Agency Early Childhood Comprehensive Systems (ECCS) Impact will use the results of the screening for reporting purposes. Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the Little Dixie ECCS Impact, the Oklahoma State Department of Education and your local school district you reside in, if applicable. I also understand that Little Dixie Community Action Agency Early Childhood Comprehensive Systems (ECCS) Impact may send the results of the screening, additional information, resources, and/or future screening reminders to the email or mailing address I provide.

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.