Birth to Three Early Intervention Program
Hope Sanson, Part C Data Manager
Hope.Sanson@delaware.gov
410 Federal Street
Dover, Delaware 19901
https://dhss.delaware.gov/dhss/dph/birthtothree/index.htm

Welcome to our ASQ Online screening program!

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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 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.