landing page logo

WithinReach

In addition to the ASQ:3 , WithinReach offers the Ages and Stages Questionnaire: Social-Emotional (ASQ-SE). This tool looks at how kids manage their emotions, communicate their needs, interact with others, and behave in safe and appropriate ways. It helps you celebrate milestones while addressing any concerns as early as possible. ASQ:SE-2 can help identify your child’s social-emotional strengths and areas where your child may need support

When you submit a questionnaire, a Family Support Specialist from WithinReach will call you to discuss the results, recommend activities and explore other resources, such as a play group or community resources.

Some parents choose to share their child's ASQ-SE results with a childcare provider, preschool teacher, or other person in the child's life. If you would like us to copy someone when we send you the results, you will have the opportunity to provide that email address.

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

Weeks Premature
(put "0" if not premature)

Screening Date

I am screening my child today (2024-10-04) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

Consent Form -- Please Read Carefully:

-You must live in Washington State to participate.

-WithinReach staff will review your ASQ results and discuss them only with you (unless you give us permission to share them).

-WithinReach never uses client names or any identifying information when reporting to partners or funders.

-If you provide us your email address, you are giving us permission to send you the results to you over email.

On the next page, we will ask you if we should copy anyone when we send you the results. If you would like us to do that, please be prepared to enter that email address.

Copyright note: Please do not save or distribute blank copies of the ASQ, or use it for commercial purposes. These actions violate the copyright. Thank you for your cooperation!

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.