Holmes School
508 N Kenilworth Ave
Oak Park, Illinois 60302

708-524-3100
czelaya@op97.org

Welcome to the Ages & Stages Questionnaire (ASQ:SE-2) online.  The ASQ is a screening instrument that will provide a quick check of your child's social and emotional development.  Please answer the questions on the questionnaire, and record any observations or concerns you would like to share with the team at Holmes.

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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)

By completing this questionnaire, you agree to let us share your responses with your child's teachers.

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.