ASQ 3 Materials and Item Adaptation Guide.pdf
ASQ-3 Materials and Item Adaptation Guide
ASQ®-3 questionnaires ask parents to observe their young children and/or try activities to elicit important developmental skills. Items generally reflect activities that parents commonly do with their children using materials found in many homes. However, there may be times when activities are not appropriate given a family’s spiritual or cultural beliefs or if the family does not have access to suggested materials. Providers should check with parents to make sure they are comfortable with activities on the questionnaire and have materials needed to try items prior to completing.
Adapting Materials or Items
If a family does not have a suggested material in their home or an item is inappropriate to try given a child’s cultural context, providers have options for how to proceed:
- Providers can let parents borrow needed material(s).
- Providers can coach parents how to make or use other materials in the home. See the examples provided in the chart below.
- Providers can problem solve with parents to adapt an item as long as the targeted skill (item intent) is maintained. When thinking about adapting items, providers should consider the area of the item for clues to the primary intent of the item:
- Communication: Assesses language skills, both what a child understands and how they follow directions (receptive) and how they vocalize, use words, and start to make sentences (expressive)
- Gross motor: Assesses large muscle movement and coordination (body, arms, and legs)
- Fine motor: Assesses eye–hand and hand–finger movements and coordination, and pre-writing skills
- Problem solving: Assesses skills of thinking and learning, how child solves problems, and pre-academic skills
- Personal-social: Assesses self-help skills (e.g., feeding, dressing, toileting) and social interactions with others
Example: Adapting an ASQ-3 item while maintaining the item intent
Consider an item about using writing tools to copy shapes that is found in both the Fine Motor and Problem Solving areas.
- In the Fine Motor area, the ability to grasp a writing tool and control movements to copy a shape assesses pre-writing skills.
- In the Problem Solving area, the ability to copy an adult model assesses thinking and learning skills.
- For the Problem Solving item, it would be okay for the child to demonstrate copying a shape by using their finger in paint, a soapy surface, or spaghetti sauce on a plate.
- If an item is culturally inappropriate, it cannot be adapted, or materials are unavailable, omit the item. Follow ASQ-3 rules for omitting items:
- Up to 2 items per area may be omitted.
- If items are omitted, area totals must be adjusted. ASQ Online and the ASQ Calculator app do score adjustment calculations.
| Material | Area/Item Intent | Examples of How to Make Materials or Adapt Items |
|---|---|---|
| Ball: large playground, soccer, beach-ball sized ball | Gross Motor/Coordination and control of body, arms, legs | Large piece of paper crumpled into large ball (if possible, use tape around paper ball), soccer ball sized pillow, soft toy |
| Ball: small tennis or other easy to hold in hand ball | Gross Motor/Coordination and control of hands and arms | Piece of paper crumpled into small ball (about the size of a tennis ball); if possible, tape around paper ball), small soft toys that child can easily hold |
| Beads: small, to string | Fine Motor/Eye-hand coordination and coordination of hands together; pincer grasp with thumb and forefinger | *Dead alternatives: Pasta that has a hole, such as penne (tube) or wheel pasta, Cheerios or other cereal with hole, buttons with large holes; different materials will be easier or more difficult to string *String alternatives: Yarn, pipe cleaner, shoelace, dental floss, fishing line; tie knot at end; more rigid stringing materials are easier but anything child can string with is fine |
| Book: with pictures | Communication/Receptive and expressive items | Magazine with simple pictures child will recognize (e.g., animals, foods, etc.), home-made, simple story book with beginning, middle and end, or children's book online using tablet or phone |
| Fine Motor/Finger and hand control to flip pages of book | Magazine or adult book; omit item if too difficult | |
| Blocks: small (approx. 1 inch) | Fine Motor/Eye-hand coordination, coordination of fingers and hand | Smooth flat rocks; spools of thread, small boxes, food chunks (examples, carrot, zucchini, banana, cantaloupe); items need to be similar in size (approx. 1 inch x 1 inch) and stackable; parent should try to stack items—omit item if too difficult to find a good alternative |
| Problem Solving/Ability to copy from an adult model | Above items or materials such as jar lids, juice can lids, pieces of food; items should be small and all same type of item—the do not need to be stackable | |
| Crayons, marker, pencil, pen | Fine Motor/Ability to grasp, control movements, pre-writing | Small stick the size of crayon that child's hand can grasp, or as they get older use tripod grasp to practice writing; can draw in sand or dirt instead of paper |
| Problem Solving/Ability to copy from an adult model | Electronic device that uses finger to draw, finger paint, soapy painting, spaghetti sauce or pudding on a plate that shapes can be drawn in | |
| Fork (child size) | Personal-Social/Ability to feed self, get food, transfer to mouth | Tortillas or spongey breads to scoop up food, chopsticks |
| Ladder with rungs | Gross Motor/Ability to coordinate use of arms and legs to climb | Large rock or small tree to climb, playground equipment such as climbing walls, dome climbing structure, monkey bars; close adult supervision is necessary |
| Mirror | Problem Solving/Name recognition Personal-Social/Self-awareness | Video camera on computer, selfie camera on phone, picture of child (printed or on phone) |
| Paper | Fine Motor/Finger and hand control, grasp, pre-writing | Paper bag, inside or back of envelope, back side of letter or bill |
| Puzzle (6-piece, interlocking) | Problem Solving/Ability to focus; visual spatial awareness | Home-made puzzle using front of cereal box, full-page picture from a magazine, or simple picture drawn on a full-size piece of paper or cardboard; cut into 6 pieces |
| Scissors (child-safe) | Fine Motor/Finger and hand strength and coordination | Adult scissors; must be small sized and have close parent supervision; if not, omit item |
| Zipper | Communication/Receptive understanding of concepts; up/down; ability to follow directions | Magnet on refrigerator, felt board with felt piece; have child hold arm out, and show them how to move hand up/down |