# Administering ASQ-3 in Virtual Environments:
## Guidelines for Providers Working Together with Parents

### 1–2 weeks before target screening date

#### 1. Prepare parent for screening.

- Send what’s needed to the parent:
  - ASQ-3 Materials List
  - ASQ-3 Parent Guide
  - Correct ASQ-3 questionnaire for child’s age (HINT: Use ASQ Calculator App)
  - Mail paper questionnaire.
  - Email guide and list with online Family Access URL

- Use the parent’s preferred method:
  - Email guide and list with online Family Access URL (and instructions to download/print questionnaire).
  - Text jpg images.

#### 2. Introduce screening and ASQ-3 using video conferencing or phone.

- Review ASQ-3 Parent Guide and ASQ-3 questionnaire with the parent.
- Schedule home visit to go through ASQ-3 questionnaire responses together.
- Ask the parent:
  - “Do you have any questions?”
  - “Do you have any concerns about completing ASQ-3?”
  - “What do you need to get started? We will go through ASQ-3 together at our next visit, but it would be great to start looking for or trying some of these activities over the next few days.”
  - “How can I help support you?”

#### 3. Support parent to gather and adapt materials/activities as needed using video conferencing or phone.

- If a family does not have needed materials, problem solve with the parent how to make or use other materials in the home to elicit the skill.
- See ASQ-3 Materials & Item Adaptation Guide for guidance and suggestions.
- Up to 2 items per area may be omitted.
- See ASQ-3 Materials & Item Adaptation Guide for guidance and suggestions.
- ASQ Online automatically adjusts scores; use ASQ Calculator app for help with omitted item score adjustment calculation (or refer to ASQ-3 User’s Guide).
- Omit items if materials are unavailable or cannot be adapted; follow ASQ-3 rules for omitting items:
  - Area totals need to be adjusted if items are omitted.

### On target screening date

#### 4. Support parent to complete ASQ-3 using video conferencing or phone.

- Complete ASQ-3 together via interactive video conferencing.
- Go through questionnaire item-by-item and observe as many skills as possible.
- Some items will need to be scored using parent report*.
- Complete ASQ-3 together over the telephone.
- Go through questionnaire item-by-item and talk about parent’s observations.

### Remember this about parent report*:

- ASQ-3 is designed to be a parent-completed tool.
- Research on reliability and validity was with parent-completed questionnaires.
- There are items that are not appropriate to try or are difficult—or impossible—to observe together. Parent report may be used to score these items.
- As needed, providers may ask the parent open-ended questions about their observations to increase confidence in their report. Here are some examples:
  - “That’s great that you saw/heard your child. . . .”
  - “Can you tell me more about what you saw/heard?”
  - “How did your child show you that? What did they do?”
  - “What words are they using? I’ll write them down.”

### 5. Document ASQ-3 item responses while video conferencing or talking to parent to complete questionnaire together, and then score it.

- Use ASQ Online to record responses; questionnaire scoring is automatic.
- Use a paper copy of the questionnaire and Information Summary to record and score.
- Use the Special Release fillable ASQ-3 Information Summary form to document responses to all questions—item responses in Section 5 and Overall responses in Section 3:
  - Record 6 items for each of the 5 areas.
  - Either use Y, S, N, or X responses (YES, SOMETIMES, NOT YET, missing), or use points (10, 5, 0).
- Score and chart screening results as appropriate after the video conference or call.

### No more than 1 week after screening

#### 6. Discuss ASQ-3 screening results with parent using video conferencing or phone.

- Begin the meeting by celebrating the child.
- Review the completed questionnaire:
  - Highlight all the skills the child is doing (YES responses)
  - Discuss concerns noted in the Overall Section: “Can you tell me more about. . . ?”
- Review ASQ-3 results by area (with or without Information Summary):
  - On schedule areas (above cutoff): “This area is a strength; your child is right on track.”
  - Monitor areas: “This area shows that your child would benefit from some practice. I have ideas and fun activities I can share with you.”
  - Referral areas (below cutoff): “This is an area that we may want your child’s health care provider or an education specialist to look at more closely.”

#### 7. Determine appropriate follow-up with parent.

- The parent should take the lead in making decisions about follow-up.
- Facilitate health and agency (EI/ECSE) referrals that are safe and appropriate at this time. Use professional judgement when making referrals during this health crisis. 
- Parent–child activities and resources online all can be helpful in the current situation. See ASQ-3 User’s Guide, agesandstages.com, and ASQ Online for free resources. Consider sharing ASQ-3 Learning Activities by age and area for more enrichment.
- Many parents will benefit from ongoing support by video conference or telephone to take advantage of follow-up resources. Continue to coach the parent about how to set up opportunities to safely play and support their child’s development in the home environment.

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*Adapted from ASQ®-3 User’s Guide and ASQ training materials by ASQ Training Development Team © 2020 Brookes Publishing. All rights reserved.*