42 Month Asq Score Sheet SCORE AND TRANSFER TOTALS TO CHART BELOW See ASQ 3 User s Guide for details including how to adjust scores if item responses are missing 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
1 SCORE AND TRANSFER TOTALS TO CHART BELOW See AS0 3 User s Guide for details including how to adjust scores if item responses are missing 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 Date ASQ 3 completed by parent caregiver Date of review with health professional should be scored as not yet 4 Does your child jump forward at least 6 inches with both feet leaving the ground at the same time 5 Does your child catch a large ball with both hands You should stand about 5 feet away and give your child two or three tries before you mark the answer 6
42 Month Asq Score Sheet
42 Month Asq Score Sheet
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Ifan item cannot be answered refer to the ratio scoring procedure in The ASQ User sGuide 2 Score each item on the questionnaire by writingthe appropriate number on the line by each item answer YES 10 SOMETIMES 5 NOT YET 0 3 Add up the item scores for each area and record these totals in the space provided for area totals 4 We provide up to date evidence based integrative natural complementary alternative and preventive medicine Information in this website is provided for informational purposes only This information is not intended as a substitute for the advice provided by your physician or other healthcare professional
Cover sheets family information sheets in data template format scoring sheets Information Sum mary sheets intervention activities and supplemental materials You may print this PDF in its SCORE AND TRANSFER TOTALS TO CHART BELOW see ASQ 3 User s Guide for details including how to adjust scores if item responses are missing Score each item YES 10 SOMETIMES 5 NOT YET O
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The ASQ 3 Starter Kit contains everything you need to start screening children with ASQ 3 21 paper masters of the questionnaires and scoring sheets a CD ROM with printable PDF questionnaires the ASQ 3 User s Guide and a FREE ASQ 3 Quick Start Guide Transfer scores and information to the ASQ 3 Information Summary sheet Total the points in each of the ve developmental areas and record the scores on the scoring sheet and compare results to the area cuto s
ASQ SCORE INTERPRETATION AND RECOMMENDATION FOR FOLLOW UP You must consider total area scores overall responses and other considerations such as opportunities to practice skills to determine appropriate follow up High Specificity 92 1 for identifying children not at risk for developmental delay between 42 60 months
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SCORE AND TRANSFER TOTALS TO CHART BELOW See ASQ 3 User s Guide for details including how to adjust scores if item responses are missing 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
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1 SCORE AND TRANSFER TOTALS TO CHART BELOW See AS0 3 User s Guide for details including how to adjust scores if item responses are missing 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
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42 Month Asq Score Sheet - Cover sheets family information sheets in data template format scoring sheets Information Sum mary sheets intervention activities and supplemental materials You may print this PDF in its