Protocol - Global Mental Status Screener - Child
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) screens infants and young children from 1 month to 66 months for developmental delays in five areas. The ASQ-3™ is completed by a parent (or child’s caregiver) or by an examiner asking a parent (or child’s caregiver) questions about the child. The protocol includes scoring instructions. Additionally, the Brookes Publishing Company offers an optional online management system for ASQ-3 called ASQ Online.
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) is a proprietary, fee-based instrument that is available for purchase from Brookes Publishing Company.
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) is a series of 21 age-specific questionnaires and scoring sheets designed to screen a childs skills in five developmental areas: fine motor, gross motor, problem solving, communication, and personal-social. A childs scores for each area are compared to cut-off scores to determine a need for monitoring or further assessment.
The Ages & Stages Questionnaires® is a registered trademark of Paul H. Brookes Publishing Co., Inc.
ASQ-3™ is a trademark of Paul H. Brookes Publishing Co., Inc.
Protocol Name from Source:
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™)
Personnel and Training Required
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) User’s Guide contains essential information for using the ASQ-3™. No formal training is required, but training is offered through Brookes Publishing Co. Information on training is available at www.agesandstages.com.
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) uses items commonly found in homes and child care programs (e.g., blocks, mirror, shoelace). The ASQ-3 Materials Kit is available for purchase at www.agesandstages.com.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Self- or proxy-administered questionnaire
Infant, Toddler, Child
Parents of children aged from 1 month to 5 years and 6 months old.
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) was vetted against similar protocols and selected because it is a validated, relatively short parent- (or child caregiver-) reported questionnaire that can be used to screen a large number of children for developmental delays in several important areas.
|Common Data Elements (CDE)||Child Cognitive Assessment Score||3076136||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Global mental status child proto||62770-3||LOINC|
Process and Review
The Expert Review Panel 4 (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.
Guidance from ERP 4 included the following:
· No changes
Jane Squires, PhD, & Diane Bricker, PhD, with assistance from Elizabeth Twombly, MS, Robert Nickel, MD, Jantina Clifford, PhD, Kimberly Murphy, Robert Hoselton, LaWanda Potter, MS, Linda Mounts, MA, & Jane Farrell, MS. The Ages & Stages Questionnaires®: A Parent-Completed Child-Monitoring System, Third Edition. Paul H. Brookes Publishing Co.
The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) is a proprietary protocol and can be obtained through:
Contact person: Customer Service
Brookes Publishing Co.
P.O. Box 10624
Baltimore, MD 21285-0624
Telephone: 1-800-638-3775 (U.S. and Canada) or 1-410-337-9580 (international)
Dionne, C., Squires, J., & Leclerc, D. (2004). Psychometric properties of a developmental screening test: Using the Ages and Stages Questionnaires (ASQ) in Quebec and the US. Journal of Intellectual Disability Research, 48(4-5), 408.
Earls, M., & Hay, S. (2006). Setting the stage for success: Implementation of developmental and behavioral screening and surveillance in primary care practice-The North Carolina Assuring Better Child Health and Development (ABCD) Project, 118(1), e183-e188.
Squires, J., Bricker, D., & Clifford, J. (2010). Developmental screening measures: Stretching the use of the ASQ for other assessment purposes. Infants and Young Children, 23(1), 14-22.
|Variable Name||Variable ID||Variable Description||Version||dbGaP Mapping|
|PX130702000000||Protocol 130702 - proprietary. Check DCW for more||N/A|
Global Mental Status Screener
May 12, 2010
A test to assess the respondent’s overall mental capability.
This measure quickly screens a variety of cognitive domains to determine a respondent’s general mental status. It can be used to detect impaired mental status caused by a variety of conditions, including head injury, stroke, infections, brain tumors, developmental defects, and neurodegenerative disorders such as Alzheimer’s disease.
Neurology, cognition, dementia, aging, Alzheimer’s disease, mild cognitive impairment, MCI, proprietary, gerontology, aging, geriatrics