Seeing an infant smile for the first time, pull up, or take their first steps are some of the most exciting moments for families and childcare providers. Since children spend so much time with their childcare providers, you play a significant role in ensuring they reach those exciting developmental milestones.
Your work may involve observing and screening the children in your care for behavioral or developmental delays with resources like the Ages and Stages Questionnaire® (ASQ).
The ASQ® is a great tool that can help screen for developmental delays in infant behavior and provide resources to concerned families hoping to help their baby reach their milestones.
Read on to learn more about the ASQ® screening, how to assess infant behaviors, and what you can do to prepare yourself and your families for the ASQ® assessment.
What are infant development milestones and why are they important?
There are many physical, cognitive, social-emotional, and communication milestones an infant reaches in their first year.
Some of the most common infant milestones include:
- Smiling
- Sitting up
- Laughing
- Pulling up
- Crawling
- Walking
- Talking
- Eating with their fingers
- Associating names with faces
Keep track of children's progress towards developmental milestones with an infant daily sheet.
Engaging in and encouraging infant activities is vital to helping them reach these milestones. Some examples of everyday infant activities that help children reach their developmental milestones are:
- Tummy time: Place your baby on their stomach for a few minutes to help them strengthen their back and neck muscles. The baby must be awake and supervised at all times. According to the American Academy of Pediatrics, it's best to engage in this activity 2-3 times a day for short intervals such as 3 or 5 minutes.
- Talking and singing: Sing, talk to, or read to your baby, and allow them to follow and respond to your voice. This activity helps with language development.
- Looking in the mirror: Place your baby in front of a mirror, and watch how they react to their reflection. This activity is essential for social-emotional development.
- Object tracking: Put a colorful object in front of your baby about 8-12 inches from the face, and move it from side to side. Watch to see if they follow the object with their eyes or if they reach for the object. According to the American Optometric Association, this activity helps an infant’s visual development.
It's important to remember that each child develops at their own pace and that certain factors can play a role in reaching developmental milestones.
Participating in these activities can help the infants in your care engage with you and their surroundings. You can also use these activities to track potential developmental delays.
According to the American Academy of Pediatrics, here are a few developmental observations to look out for:
- Doesn't smile at the sound of your voice by two months
- Doesn't follow moving objects with her eyes by two to three months
- Doesn't reach for and grasp toys by three to four months
- Doesn't babble by three to four months
- Doesn't bring objects to their mouth by four months
- Doesn’t respond to loud sounds
What is ASQ® screening and how to use it to assess infant behaviors?
The Ages and Stages Questionnaire® (ASQ®) is a developmental and social-emotional screening for children from birth to 6 years of age. The purpose of the screening is to highlight or detect developmental delays with the help of families and early educators.
There are a few variations of the ASQ® screenings. However, this article will specifically focus on the ASQ-3® screening, which focuses on five key areas:
- Communication
- Gross motor skills
- Fine motor skills
- Problem-solving
- Personal-social development
There are 21 ASQ-3® questionnaires for children from birth to 5 1/2 years of age.
Here is how the ASQ® works in 3 simple steps:
- The parent completes the questionnaire based on their knowledge of their child.
- You score the questionnaire after the parent returns the screening to you.
- Review the results of the screening with the parent, and discuss the next steps.
Parents complete the screening by answering a series of questions based on the five areas above. In addition, an "overall" section at the end of the questionnaire asks for more general information about the child. Parents will answer each question by marking “yes”, “sometimes”, or “not yet”.
As the parent or provider fills out the questionnaire, they'll take their time to answer these questions based on the interactions they have with their child daily. If they are unsure of the answer to a question, they can partake in an activity with the child to help them answer it. Once completed, they'll return the questionnaire to you for scoring.
Each answer is assigned a numerical value for scoring purposes. You will total up the number based on the following point value system.
Using the following point value system, gather a total from the five developmental areas:
- Yes = 10 points
- Sometimes = 5 points
- Not Yet = 0 points
The questionnaire can be distributed online or on paper, and you can complete the scoring electronically or manually. When done online, the results are available instantly since the score is tallied automatically. Even manual scoring can be done in as little as 3 minutes, according to the ASQ® website.
When sharing the results with parents, you'll want to make sure you discuss activities, tools, and resources that can help their child’s development, like early intervention programs.
How to prepare for the ASQ3® assessment
Decide on a screening tool that is right for your organization.
There are several types of screening tools available, including:
- Mail-out
- Online
- Telephone interview
- Home visit
Your choice most likely depends on cost and available technical support.
Set guidelines and goals for your program.
Take time to think about the guidelines you'd like to put in place for your program, such as how often you'd like to screen and the criteria for being referred for screening. This structure will help ensure you're achieving the goals you'd like to reach for the children in your care.
Put procedures into place.
After you set guidelines and goals, you'll want to implement processes and procedures for your program. Decide who will administer the screenings and when they will be administered. How will you keep track of scores and developmental progress? This plan will ensure you have the proper documentation needed.
Receive training and train your staff.
You'll want to ensure that you and your team can perform the screening accurately from start to finish. Make sure your team understands the purpose of the screening and any strategies for success, including how to speak with families about potential developmental delays.
Get families involved.
This is the most crucial step. You'll ensure families are involved by opening the lines of communication when potential red flags are raised. Families often know what’s best for their children. You'll lean on their knowledge and address their concerns.
FAQs about the ASQ® assessment
Are childcare providers allowed to use the ASQ® assessment?
Yes. However, consult with the parents before moving forward with an evaluation of their child without their knowledge.
Where can the assessment be conducted?
You can complete the assessment in the child's home or school.
What languages are available for ASQ-3®?
English, Arabic, Chinese, French, Spanish, and Vietnamese.
Does the screening only highlight developmental delays?
No, one of the main goals of the screening is to highlight developmental progress as well as catch any developmental delays.
How can I get started with ASQ®?
Visit the ASQ® website for more information about screening tools and how to get started.
Conclusion
The ASQ-3® screening is a resource for you and your families to help detect any potential developmental delays. Encouraging infant activities is vital to helping the children in your care reach their developmental milestones, and it's also one way to determine if screening may be necessary. However, it's important to ensure families are informed and involved in the process to achieve the most accurate results and to partner with them in helping their children overcome any delays.
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