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 child's skills in five developmental areas: fine motor, gross motor, problem solving, communication, and personal-social. A child's 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
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 contact.||4||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