Materials Needed to Administer ASQ 3.pdf
Materials Needed to Administer
Infant 2–16 Months
12 Month Questionnaire
- Baby bottle (clear)*
- Ball (small)*
- Blocks or toys (small): 2*
- Book (with pictures)*
- Bowl*
- Crayon*
- Mirror*
- Shoelace* [use for string]
- Stuffed toy*
- Toy (small)*
- Cheerios or other small food
- Child's clothing (e.g., coat, hat, jacket, pants, shoes, shirt, socks)
- Crib rail or supportive furniture
14 Month Questionnaire
- Baby bottle (clear)*
- Ball (small)*
- Blocks (small): 6 or more*
- Book (with pictures)*
- Bowl*
- Stuffed toy*
- Toy (small)*
- Spoon*
- Crayon*
- Cheerios or other small food
- Child's clothing (e.g., hat, mittens, pants, shoes, socks)
- Furniture (something to climb onto, like a chair)
16 Month Questionnaire
- Baby bottle (clear)*
- Ball (small)*
- Blocks (small): 6 or more*
- Bowl*
- Crayon*
- Book (with pictures)*
- Mirror*
- Spoon*
- Stuffed toy*
- Child's clothing (e.g., hat, mittens, pants, shoes, socks)
- Cheerios or other small food
- Furniture (something to climb onto, like a chair)
Materials Needed to Administer
Toddler 18–33 Months
22 Month Questionnaire
- Baby bottle (clear)*
- Ball (large)*
- Beads*
- Blocks (small): 6*
- Book (with pictures)*
- Crayon*
- Cup*
- Fork*
- Shoelace*
- Spoon*
- Stuffed toy*
- Jar (clear plastic with screw lid)*
- Cheerios or other small food
- Child's clothing (e.g., coat) or a towel
- Light switch
24 Month Questionnaire
- Baby bottle (clear)*
- Ball (large)*
- Beads*
- Blocks (small): 7*
- Book (with pictures)*
- Crayon*
- Shoelace*
- Spoon*
- Stuffed toy*
- Jar (clear plastic with screw lid)*
- Cheerios or other small food
- Child's clothing (i.e., coat) or a towel
- Furniture (something to climb onto, like a chair)
Materials Needed to Administer
Preschool 36–60 Months
48 Month Questionnaire
- Ball (large)*
- Ball (small)*
- Bowl*
- Buttons* [use them on stuffed toy or child's clothes]
- Coloring book*
- Crayon*
- Puzzle (5- to 7- piece interlocking)*
- Scissors (child safe)*
- Child's clothing (e.g., coat, jacket, shirt, loose-fitting pants)
- Container with food to scoop (such as applesauce)
- Ladder with rungs
- Paper
- Soap, water, and towel
54 Month Questionnaire
- Ball (large)*
- Ball (small)*
- Spoon (large) or scoop
- Toothbrush and toothpaste
- Container with food to scoop (such as applesauce)
- Paper
- Pencil
- Soap, water, and towel
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Items marked with an asterisk(*) are included in the ASQ-3 Materials Kit; visit www.agesandstages.com to order.