Ages and Stages Questionnaire Question

[EdnaMarie]

I have to fill it out for a screening to make sure my kids aren't special needs.

There are several things that I could not get DD1 to do, not because she can't do them, but because she kept trying to do other things and I'd have had to explain exactly what was expected of her in order to get her to do them, and it seemed to me that was cheating.

One was, "While your child watches, line up four objects in a row. Does your child copy or imitate you and line up four objects in a row?"

Well, no way! Because she thinks I'm building something. Is that really a milestone, to just copy me? If I tell her, "Do it just like I'm doing it," doesn't that seem to be cheating? But if I don't, she just says (like she did today), "Oh, are you building a bed? Can my car sleep in that bed?"

Same for tunnel. There's a picture of a block tunnel. I ask if she can build one, too. "No thanks, I'm building a truck." "Well... could you try?" "But you built it already." "Just try." "I'm going to do a BIGGER one." :

There is also a picture of a stick figure with limbs and an eye missing and they are supposed to look at it and say that it's a kind of person ("Daddy", "girl", etc.). My child says it is a germ. She presumably means, the personified germs as portrayed on television and in coloring books she got from the health department, not an amoeba. I mean the only germs she's ever seen are personified. Does that count?

When she was supposed to repeat numbers in a sequence ("Say two five."), she said, "Not those numbers, because I'm two and a half." "Well just say them." "You forgot to say please." (Now, keep in mind I'm not supposed to repeat the numbers, I'm only supposed to say them once.) "Please." "No, please WHAT." "Please say [two different numbers]." "Not those numbers, the other numbers."

AAAAAAAAHHHHHHHHHHHHHHHH.

The ONLY "problem solving" one she got is that she uses a chair to get things out of her reach.

Is this section just developmentally inappropriate for my child, or am I doing the test wrong, or what? All the other things seemed really spot-on for her development, and were very easy to test (fine motor, gross motor, communication, personal-social).

Or is she going to get a special-needs diagnosis because she cannot just sit there and properly solve a problem? It doesn't seem to me that these are problem-solving tasks, personally. They involve sheer imitation and obedience and I'm going to be honest... she is a little bit out there in those fields.

Should I lie if I think she's normal and I don't want her to get a diagnosis? What if I'm wrong and really she is way behind and I don't know? How is that possible, when she's doing well in pre-school?

Or should I ask the doctor? I don't know if the doctor will have much time and I don't want her to get irritated, as we need a lot of favors from her for military processing.

Ack. I don't know what to do. I just want to fill in the form and get the box checked to move forward. But I don't want to miss this warning sign or have the doctor check it and be all, "So, how did YOU get her to perform these tasks?"

I also don't want the doc to think I think we're all special. I think I am missing the point of how to do this section of the test.

Help.

[alicia622]

I use this tool at my job. I was taught to do the tasks with the child and parent present. Also, your child should be rested and wanting to work. On tasks that she is refusing to do but you know she can do, I'd check she can do it. The tool will not determine whether she has special needs, rather let you know if she needs further assessment and in what areas. She doesn't have to be able to do everything to 'pass'. I'd wait and try the problems solving section again.

[EdnaMarie]

Thank you! Can I pick your brain a bit more?

She was totally willing to sit down and play with me... but she does not take orders, kwim?

Is the point to see if she can line up four blocks, or if she can imitate me? I know if I tell her, "Make this exact line-up" she will, but the questionnaire asks if she copies me. Presumably that means spontaneously, right? It doesn't say, "Ask your child to copy this."

Is it just poorly phrased?

ETA... I think a big problem is that this is with toys we regularly play with. So unless I tell her it's a test (not that she knows what a test is... but let's say I can some how communicate that we're not playing...) she is going to play in her normal way which means, not listen to me or imitate me, but try to engage me in a narrative about blocks, cars, etc. Even the writing, if it were not for the fact that I was teaching her how to write her name (she can't, obviously, but she likes the IDEA of it ), would have been a no-go. Fortunately there she believes I have expertise and is willing to imitate me. Not so with blocks and toys.

[alicia622]

These are all in the problem solving section- right? So the point of the questions is to see if she can figure out how to do something rather than follow directions/imitate you. So, if she knows how to build a block tunnel but is simply refusing to do so because you want her to do it, I would check yes- because she knows that she has to place the blocks close enough togther so the top one doesn't fall through and also far enough apart to make the tunnel. The one where you ask her to "say two five" is to see if she understands that you are asking her to say the numbers only- does she realize the numbers are different than the word 'say'.


We just had DS's 4 year well child check and part of this included doing a developmental checklist similar to the A&S- while we waited for the doctor to come into the room. Well, of course, DS refused to do the tasks we asked him to do!!!

[Letitia]

I could have written your post.

We just did this for my 2-1/2 yo DD. She said the stick figure was "the running spoon," and it DOES look quite a bit like the spoon in an illustrated version of Hey Diddle Diddle we have. So maybe she doesn't technically get that point on their scoring, but I'm not worried about it.

I also had trouble getting her to line up the blocks, not because she can't line up 4 blocks, but because she also had other priorities about what she wanted to build. I can't remember what I finally said, but she finally did it. She also didn't point to herself in the mirror when I took her to the mirror and said "Where are you?" - she said "There I am, in the mirror."

This was the first time I've done an ASQ that it didn't make my mouth dry with nervousness. My daughter was at risk for neurodevelopmental problems because of events around her birth, and we had to do these when she was a baby every 2 months. Then we stopped at 2, and now I've got to do them again for preschool. What I noticed on the younger ASQ's was that sometimes they included items that she had actually done in the past, but had since moved on from, like putting her feet in her mouth. Her feet lived there at 5-6 months, but hardly ever anymore at 8 or 10 months, whenever it was on the ASQ. I think lining up the blocks was a little like that - she just doesn't blindly imitate me building things anymore although at one point she probably would have. It's just that now with the more complicated tasks it's a little harder to see than feet in the mouth.

And what 2-1/2 year old unquestioningly ever just does what you ask her to do!

[kdtmom2be]

I'm sure if I asked my 2.5yo DD to build me a block tunnel she'd just go get the blocks with the moon-shapes cut out of them and line them up.
We don't have to do any of those silly checklists here... so I'm not much help, but I thought that might put your kid in perspective a bit!

[shanniesue2]

I have worked at several jobs where we've had to give the ASQ. We always did the ASQ during the school day and we did the ASQ-SE (social emotional) at a P/T conference or sent it home for the parents to fill out and bring back.

I agree with Alicia. The point of the ASQ is can she do these things. So if you've observed her doing them not in the context of the assessment, then I would check yes. I know that sometimes, if the test item was something I had seen the child do repeatedly, I would just mark it correct and not worry about "testing" it. I know that this was how the first daycare DS attended would fill his ASQs out. They would complete them based on what they had observed. And if it wasn't something they had seen, they would "test" him. And if he didn't want to cooperate with the "test" they would ask me about it.

But essentially, this is more of a screening than it is "Developmental Testing." Getting a low score in the problem-solving area isn't going to necessarily mean that your DD is all of a sudden special needs. However, it can give you an idea of areas to watch.

In head start, if a child had one area "in the black" we would make note of it, and just keep an eye on their development in that area. If they had more than one area and especially if we or the parents had concerns based on our experience with them, we would refer to the developmental team, and they would come in and observe before starting any official testing process.

P.S. If you're not sure about her ability to complete those block tasks, I would recommend using different toys in a different setting. And I was never told that we couldn't build the tunnel and then say "now I want you to make one" (or something along those lines). I don't think the idea is spontaneous imitation. The idea is can they figure out how to do this?

[EdnaMarie]

Thanks, ladies. Letitia, that is exactly the same, how funny. The running spoon! Cute! I mean... the stick figure doesn't look like a person, really. It is strange. Of course they are going to try to think of "almost persons" that they've seen.

It's not so much that she is refusing to imitate me for the sake of refusing- she just genuinely is more interested in building her own stuff. I've never once seen her look at a line of blocks I built and then build a similar line down to the number of blocks, but why would she do that, ever? I'm not questioning the wisdom of the test, I'm just saying, are there really (neurotypical) kids that will do that without being asked to do it explicitely?

I think I'll just tell her she has to copy me for these things, she has to do it exactly the same, like you suggested, and see. I will tip her off that we're not playing. Otherwise we're never going to get anywhere.

We don't have to do any of those silly checklists here

It's not common here, it's a screening so we can go with my husband when he's stationed overseas. My child is nearly three and has never done one before.

The one where you ask her to "say two five" is to see if she understands that you are asking her to say the numbers only- does she realize the numbers are different than the word 'say'.

How interesting! That seems like a stupid test. Because if the child did not know the meaning of the word "say", would she repeat what you were saying in the first place? Wouldn't she just... not repeat anything? Wouldn't like, "Say two five [child's name]" or "Say two five, please" be a better test of that?

Of course... my child said today:

"I wanna apple."
"You need to say that in a polite way."
"THAT IN A POLITE WAY!" Shakes butt. Grins.

:

You ladies made me feel better.

[sapphire_chan]

Mark "yes" for those questions. Her behavior isn't a developmental problem, in fact, it's the opposite.

[Susan OQuinn]

Hi Everyone,

I am just finding this post and thought it important to add some explanation for those who read this later.

I am a child development specialist and have been for 20 yrs or so.  I administer the ASQ's both SE and developmental probably for the last ten years....and now make them available online to my clients because they are such an important step in identifying children who could benefit from further support during the crucial early years.  It is reported that about 70% of children who would qualify for supports (that could prevent or mitigate issues later) are not picked up til after they start school. This is simply not good enough!!!! Why not? Because the older a child is the  harder  it is to change or enhance their development  [80% of brain is complete by 3yrs old!!!] So....the screening tools are of HUGE important and are not silly at all!!!

I would like to add to this discussion.

The questionnaire is fairly easy to read....but there is still important areas for interpretation and things that you should be aware of;

When it says DOES your child....it means does she/he perform this task MOST OF THE TIME.....and most is considered to be successfully, about 4/5 times tried.  If not...say sometimes.

When it says CAN your child do this....it means....have your EVER seen him/her perform this task.

It is important to be honest.....as mentioned earlier...children are not expected to know every item...... 

Even though there are only a few skills listed under each area...the truth is, those listed all  require 'prerequisite' skills....so a developmental specialist  (who will be reviewing it I assume) will be able to ask further questions if appropriate. For instance, with the block stacking example shared....the big thing that is being screened there....is attention span. When we look at copying a block pattern (line or otherwise).....it is looking more at spatial and organization skills & ability to follow direction.  As the child ages you will notice that each questionnaire builds on previous skills and the tasks become a bit more complex....ie, stack two blocks....later, 4, etc. Again....it is more than stacking the blocks that is important....its the other skills required to complete it....such as attention, following direction, coordination and so on.  

While the developmental questionnaire is meant to review specific areas of development....you will notice that behaviour issues can increase difficulty with completion....or getting the child to do the tasks. It is important to do the checklist in a fun and play based approach rather than pressure to 'test'.  If behaviour is impacting completion...it will be important to also complete the social-emotional checklist to see if more support is important in this area.  

I have heard some crazy responses for who is the stick person question!!! ....Again...that is about reasoning....can they figure out that it is a 'representation'..[I credit anything that is 'person like'...including dolly, snowman and so on] Soon enough, they will have to be able to draw an organized pic of a person....soo....recognition is the  skill that comes before that.  Someone mentioned pointing....and really....while this doesn't sound like a big deal....being able to point is an example of a HUGELY important skill. When children don't point this is something that is VERY important to explore further. (red flag for autism)  Sometimes....asking the question as is written is critical too.  For instance...'show me __(susan)___....versus 'where are you'...are two different questions....'

As one of the other people pointed out, the ASQ's are screening tools only.  They will help highlight children who would benefit from further support and may benefit from seeing someone like myself for further evaluation!  

I hope this helps!! It really is nothing to fear.....instead, like a dental checkup...its an important part of ensuring your child's optimal developmental success!!  If you want more info...just let me know!! 

GOOD LUCK! :-)

Susan O'Quinn

www.FAMILYHELPonline.ca

[Susan OQuinn]

Hey Everyone-

Just had a couple of questions from a reader and thought I would add to what I have shared.

The ASQ is validated & standardized....which separates it from lots of 'checklists'.  Being validated and standardized means that it has been tested on thousands of children (for each one....and they are available every 2 months from 2 months old to 66 months) & it does what it's supposed to do! If they are not standardized and validated...you really can't get much in regards to direction or what to do next.  Ummm.....it is important to know that it is considered one of the top screening tools for children in North America.

Just so you know....recent research shows that relying on a doctor to pick up a problem finds that those who do so using their own judgement rather than a trusted screener...fail to pick up 70% of children who would benefit from support.  AGH 

The words used and so on are all appropriate for each age (hence the validation). So..if all is going well.....the child should understand the directions as written.    I do know that for young children...the wordier you get, the more room for error. I usually keep instructions VERY short....so that we are in line with their communication level.  So....for instance.....'do this'....'copy me'.....'do like me'....rather than a lengthy request description.  Sometimes to get better attention (esp. for the 'say this' question)....I sing it!!! :-)))

OK...just wanted to add this!! 

Hope this helps.....

Susan

www.FAMILYHELPonline.ca