Results of Screening Questionnaire

Kent State University

Ashley Drungil
email: adrungi1@kent.edu

Childs Name: AG Parents: GG & MG

Childs date of Birth: February 2012 Date of Screening: March 3, 2017
Childs Chronological Age: 60 months, 11 Location of Screening: AGs home
days
Childs Adjusted Age (if necessary): N/A

Reason for Referral: AGs parents completed a 60-month Ages and Stages Questionnaires-
Third Edition (ASQ-3) and a 60-month Ages and Stages Questionnaires: Social Emotional-
Second Edition (ASQ: SE-2) as part of a class assignment.

Background Information: AG loves to spend time with her twin sister, EG, her mother, and her
father. GG is a lawyer and MG works for a police department. AG attends a local preschool
program three times per week. AGs preschool teachers report success from AG in the program
where she has also made strides socially by making friends with her classmates. AG enjoys
playing outside at the park, making crafts, watching movies, baking, and partaking in dance
classes on the weekend. AGs parents report that overall, she is a happy and healthy 5-year old.

Current Assessment: The ASQ-3 and the ASQ:SE-2 were administered by the Kent State
University graduate student through an in-person parent interview with the child present. The
ASQ-3 and ASQ:SE-2 are tools used to gain information on multiple different areas of the
childs development. These areas include communication (e.g., following three unrelated
directions and using comparison words), gross motor (e.g., catching a ball with two hands and
skipping with alternating feet), fine motor (e.g., using child-safe scissors, copying letters),
problem solving (e.g., counting to 15, naming numbers), personal-social (e.g., taking turns with
other children and using the toilet by herself), and social emotional (seeming happy and using
words to tell you her wants and needs). Results of this screening can identify the areas in which
the child demonstrates strengths, as well as areas where the child may need extra supports in.
The childs scores on the screening are compared to ASQ-3 and ASQ:SE-2 cutoff scores. Child
scores that are below ASQ-3 cutoff scores indicate areas where further evaluation or additional
supports may be needed. Child scores in the social emotional area are based off of the ASQ:SE-
2, where scores above the cutoff may indicate a need for additional supports or further
evaluation.

Summary of Scores

AGs Scores ASQ-3/ASQ:SE-2 Cutoff Scores*

Communication 60 33.19
Gross Motor 60 31.28
Fine Motor 55 26.54
Problem Solving 60 29.99
Personal-social 60 39.07
Social Emotional (ASQ:SE-2) 15 95

Communication, Gross Motor, Fine Motor, Problem Solving, Personal-social, and Social
Emotional: AG scored above the cutoff scores in the developmental areas of communication,
fine motor, problem solving, and personal-social. AG scored well below the cutoff score in the
social emotional area of development. These scores indicate that overall, AGs development
appears to be on track when compared to other children her age.

Overall Questions: Parents did not have concerns about AGs development, however, they did
indicate concerns with AGs fearful behaviors and health. Recently, AG has been seen by an ENT
for chronic cough and fever and is scheduled to have her tonsils taken out in April. AGs parents
have major concerns about her worrying about upcoming events which is why they have decided
not to tell AG about getting her tonsils taken out until closer to the appointment.
AG also recently had an x-ray of her right arm due to concerns of a fracture. Another main
concern of her parents is her paralyzing fear of dogs and AGs fear of doctors visits.

Recommendations: AGs overall development appears to be on schedule relative to same-age

peers. AG is able to communicate with four- and five-word sentences and talk about something
that already happened. AG can catch a large ball with two hands and copy letters. AG is also able
to name the letters in her name and use the toilet by herself. AG has strengths in the social
emotional area of development as well, where she can use words to describe her feelings and the
feelings of others. AGs attainment of these skills has demonstrated that her development is on
schedule, however, there are ways to build upon these skills and keep her development moving
forward. One activity that can be done at home includes teaching AG when and how to call 911.
Role playing talking to the operator or creating a song about it are ways to teach the child this
ability. Another activity that can be done at home to promote fine motor learning is to have AG
draw a picture of her family and have her describe it. Saving the responses to the description
would be a fun way to remember what she says. Based on overall questions, it may be beneficial
for AG to receive a mental health evaluation if her persistent worrying and fear of dogs continues
to be a concern. However, these behaviors can be considered somewhat typical for her age. AG
should also be rescreened using the ASQ-3 and ASQ:SE-2 in 6 months which can be accessed at
the childs pediatricians office. Other resources and information on the ASQ-3 and ASQ:SE-2
can be accessed at this website: http://agesandstages.com/

Student signature and date:

Ashley E. Drungil 3/9/17

*For ASQ-3, scores below the cutoff score indicate that further evaluation may be recommended;
for ASQ:SE, scores above the cutoff score indicate that further evaluation may be recommended.