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KANA Kodiak Infant Learning Program
907-486-1366
arwen.botz@kodiakhealthcare.org
mailing: 3449 Rezanof Dr East
physical: 194 Alimaq Dr
Kodiak, Alaska 99615

Welcome to the KANA Kodiak Infant Learning ASQ:Social-Emotional Online page. KANA and the State of Alaska Early Intervention/Infant Learning Program are providing this free resource to periodically screen and possibly identify delays for all children birth through five years of age. If you have questions or concerns about a child's development, please contact our office at 907 486-1366. Thank you for your participation.

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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!

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)

Screening Date I am screening my child today (2023-03-28) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

By completing the ASQ:SE Online questionnaires, you are consenting to have your responses released to the KANA Kodiak Infant Learning Program. This information will not be shared with any other parties without additional written consent and is solely used to monitor your child's development and possibly identify developmental concerns

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.