Protocol - Global Mental Status Screener - Child

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Protocol Name from Source:

The Ages & Stages Questionnaires®, Third Edition (ASQ-3™)




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 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.

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.

Equipment Needs

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.


Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration


Life Stage:

Infant, Toddler, Child

Specific Instructions:

The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) is a proprietary, fee-based instrument that is available for purchase from Brookes Publishing Company.

Research Domain Information

Release Date:

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.

Selection Rationale

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.


English, Spanish


Common Data Elements (CDE)Child Cognitive Assessment Score3076136CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Global mental status child proto62770-3LOINC

Process and Review

[link[phenx.org/node/103|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)
Fax: 410-337-8539

General References

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.

Protocol ID:



Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX130702000000Protocol 130702 - proprietary. Check DCW for contact.4N/A