48 MONTH QUESTIONNAIRE - Early Intervention Program - eip uoregon 2025

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  1. Click ‘Get Form’ to open the 48 MONTH QUESTIONNAIRE in the editor.
  2. Begin by filling out the personal information section, including your child's name, date of birth, and your relationship to the child. This helps establish context for the responses.
  3. Carefully read each question regarding your child's social-emotional behaviors. For each statement, check the box that best describes your child's behavior: 'Most of the Time', 'Sometimes', or 'Rarely or Never'.
  4. If any behavior raises a concern, mark the corresponding circle next to that question. This is crucial for identifying areas where support may be needed.
  5. Once all questions are answered, review your responses for accuracy. You can easily edit any section directly in our editor.
  6. Finally, save your completed questionnaire and follow any instructions provided for submission.

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There are 21 ASQ-3 questionnaires for use with children from 1 month to 5 years old (one questionnaire for each age range). Here are the five important areas of development that each questionnaire looks at: Communication: Your childs language skills, both what your child understands and what he or she can say.
ASQA is the national regulator for Australias vocational education and training sector.
Score each item (YES = 10, SOMETIMES = 5, NOT YET = 0). Add item scores, and record each area total. In the chart below, transfer the total scores, and fill in the circles corresponding with the total scores.
The #1 Screening Tool Trusted by Pediatricians Easterseals offers parents and caregivers free access to the confidential online Ages Stages Questionnaires, Third Edition (ASQ-3). The ASQ-3 is a set of questionnaires that helps you track your childs development from one month through age 5.
Easterseals offers parents and caregivers free access to the confidential online Ages Stages Questionnaires, Third Edition (ASQ-3). The ASQ-3 is a set of questionnaires that helps you track your childs development from one month through age 5.
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The Ages and Stages Questionnaires is a screening tool that can be used to screen infants and young children for delays during the crucial first five years of life. ASQ meets the recommendation by the California Department of Social Services to use standardized tools to identify children for referral.
Under the Documents section, click View/Print Documents. 4. Click Download to the right of the ASQ-3 English Questionnaire document.
The Five-to-Fifteen (FTF) questionnaire is validated for identifying developmental problems in children between 5 and 17 years [16,17,18]. FTF scores have been shown to correlate with the corresponding scores of the neuropsychological assessment instrument NEPSY in 5-year-old children [16].

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