Workflow Map

This workflow map outlines the steps involved in a screening program for a home visiting agency and who is responsible for each step.

Distribute ASQ®-3 questionnaire AS alerts HV 1 month prior to upcoming ASQ-3 target date. AS prints appropriate ASQ-3 interval with child’s name and ASQ-3 target date; AS passes to HV.

Complete ASQ-3 HV provides ASQ-3 to parent 1 week prior to ASQ-3 target date. Parent completes ASQ-3 prior to ASQ-3 target date (with HV support).

Score ASQ-3 HV scores ASQ-3 during home visit with parent. or HV scores ASQ-3 immediately after home visit if scores are expected to be close to or above cutoff scores.

Scores below cutoffs Scores close to cutoffs Scores well or parent concerns above cutoffs HV discusses ASQ-3 results with HV discusses results with family HV discusses results with family supervisor. within 1 week. within 1 week. HV (and supervisor, when needed) HV and parent determine appropri-HV provides general ASQ-3 communicates screening results ate follow-up (e.g., provide parent–child activities. with family. targeted information on behavior HV provides copy of ASQ-3 Infor- HV and parent determine appropri- of concern, make referrals). mation Summary to AS. ate follow-up (e.g., make referrals). HV provides copy of ASQ-3 Infor- HV provides copy of Information mation Summary to AS. Summary to AS.

Referrals No referral Screening summary and follow-up Parent and HV make referral(s) HV provides in-house follow-AS records ASQ-3 scores. for to EI/ECSE and/or up as indicated. AS schedules child for next services from other AS records ASQ-3 scores. screening. agencies AS schedules child for re- screening.

Eligible for services Not eligible for services Key:

• AS – administrative staff HV alerts AS regarding eligi-HV provides in-house follow-up as indicated.

• EI/ECSE – early intervention/early bility and removal from AS records ASQ-3 scores. childhood special education screening program. AS schedules child for re-screening.

• HV – home visitor(s) Adapted from ASQ*®-3 User’s Guide by Squires, Twombly, Bricker, & Potter.* © 2009 Paul H. Brookes Publishing Co., Inc. All rights reserved. Ages & Stages Questionnaires® and ASQ® are registered trademarks and the ASQ-3 logo is a trademark of Paul H. Brookes Publishing Co., Inc.