# 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 ASQ-3. ## 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: 1. Providers can let parents borrow needed material(s). 2. Providers can coach parents how to make or use other materials in the home. See the examples provided in the chart below. 3. 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. --- | 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 | | 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 | | Electronic device that uses finger to draw, finger paint, soapy painting, spaghetti sauce or pudding on a plate that shapes can be drawn in | Problem Solving/Ability to copy from an adult model | | | Paper | Fine Motor/Finger and hand control, grasp, pre-writing | Paper bag, inside or back of envelope, back side of letter or bill | | 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 | ## Materials Needed to Administer | Material | 60 Month Questionnaire | 72 Month Questionnaire | |-----------------------------------------|--------------------------------------------------------------|--------------------------------------------------------| | Ball (small)* | Ball (small)* | Ball (small)* | | Bowl* | Bowl* | Scissors (child safe)* | | Buttons* [use those on stuffed toy or child's clothes] | Crayon* | Book (with story new to the child) | | Crayon* | Scissors (child safe)* | Board game or cards | | Scissors (child safe)* | Zipper* [use one on stuffed toy or child's clothes] | Paper | | Zipper* [use one on stuffed toy or child's clothes] | Child's clothing (e.g., coat, jacket, shirt, loose-fitting pants) | Child's clothing with snaps, buttons, or other fasteners (e.g., coat, jacket, shirt, loose-fitting pants) | | Container with food to scoop | Pencil | Pencil | | Paper | Soap, water, and towel | TM | | Spoon (large) or scoop | | | Items marked with an asterisk (*) are included in the ASQ-3 Materials Kit; visit www.agesandstages.com to order.