Child Development · Screening
ASQ-3 — Ages & Stages Questionnaire
Parent-completed developmental screen for 1-66 months. 5 domains (communication, gross motor, fine motor, problem-solving, personal-social). Used at NHS Health Visitor 1 and 2 year checks. Squires & Bricker 2009.
Last reviewed 2 June 2026
ASQ-3 — Ages & Stages Questionnaires, 3rd ed.
Parent-completed developmental screening
About this page
ASQ-3 is a copyright-protected commercial instrument from Brookes Publishing — we describe the framework but do not reproduce the questionnaire items. The official ASQ-3 is the appropriate tool for actual developmental screening.
agesandstages.comThe 5 ASQ-3 domains
Communication
Receptive and expressive language: cooing, babbling, words, sentences, following directions.
6 items per domain × 21 age-specific questionnaires (1, 2, 4, 6, 8, 9, 10, 12, 14, 16, 18, 20, 22, 24, 27, 30, 33, 36, 42, 48, 54, 60 months).
Visit ages covered
1 mo2 mo4 mo6 mo8 mo9 mo10 mo12 mo14 mo16 mo18 mo20 mo22 mo24 mo27 mo30 mo33 mo36 mo42 mo48 mo54 mo60 mo
How scoring works
- Each item answered "Yes" (10), "Sometimes" (5), "Not yet" (0)
- Each domain scored 0-60 (6 items × max 10)
- Compared to age-specific cutoffs (mean − 2 standard deviations)
- Below cutoff in a domain → refer for further evaluation
Educational tool only — not medical advice. ASQ-3 is the AAP Bright Futures preferred developmental screening instrument at the 9, 18, and 30-month well-child visits. Performance: sensitivity 75-83 %, specificity 78-86 %, NPV 98 %. Used in > 100 countries. Should be administered by a healthcare team, not self-administered for diagnostic purposes. For a free 12-domain milestone tracker, see our /calculators/milestone-tracker page (CDC LTSAE 2022).
What does this mean?
The ASQ-3 (Brookes Publishing, Squires & Bricker) is the AAP Bright Futures preferred screening instrument for developmental delay at the 9, 18, and 30 month well-child visits (with extra age-specific versions across 1–66 months). It samples 5 developmental domains via age-appropriate yes/sometimes/not-yet questions a parent or carer can complete in ~10–15 min. Performance: ~80 % sensitivity and specificity, very high negative predictive value (~98 %). A “below cut-off” result is a SCREEN, not a diagnosis — it triggers referral to early intervention services for a developmental evaluation (in the US, your state’s IDEA Part C programme). Earlier identification matters: studies repeatedly show that early intervention before age 3 in language, motor, and social domains improves long-term outcomes measurably. This page is a descriptive guide — we don’t reproduce the proprietary items; obtain ASQ-3 from your paediatrician or via agesandstages.com.
What is the ASQ-3?
Ages & Stages Questionnaires, 3rd edition. Parent-completed developmental screening. 21 age-specific questionnaires; 5 domains; AAP-preferred.
5 domains
- Communication.
- Gross motor.
- Fine motor.
- Problem-solving.
- Personal-social.
Scoring zones
- Above cut-off: typical.
- Close to cut-off: monitor + repeat.
- Below cut-off: refer.
Red flag milestones
- No smiling by 3 months.
- No babbling by 9 months.
- No words by 18 months.
- No 2-word phrases by 2 years.
- Loss of any skill (regression).
- No eye contact / response to name.
- Can’t sit by 12 months.
- Can’t walk by 18 months.
Preterm + corrected age
Use corrected age until 24 months.
ASQ-3 vs PEDS vs M-CHAT-R
- ASQ-3: milestone checklist; rich detail.
- PEDS: parent concerns; quicker.
- M-CHAT-R: autism-specific 16-30 months.
Different scenarios
Scenario 1: 18-mo, no words, low communication
SALT referral. Repeat 6 weeks.
Scenario 2: 2-yo, low gross motor
Physio assessment.
Scenario 3: Multiple domains below cut-off
Developmental paediatrician.
Scenario 4: Normal screen but parent intuition off
Trust intuition. Second opinion.
Scenario 5: Preterm 12-mo chronological
Use corrected age until 24 months.
Care guidance
- Routine surveillance.
- Trust parental concerns.
- Early intervention works.
- Regression always warrants assessment.
- HV good first port of call.
Sources
- Squires J, Bricker D. Ages & Stages Questionnaires 3rd edition. Brookes Publishing 2009.
- AAP. Bright Futures developmental surveillance.
- NICE NG170. Autism in under 19s.
Recommended for this calculator
Frequently asked questions
What is the ASQ-3?
AGES & STAGES QUESTIONNAIRES, 3rd edition — parent-completed developmental screening tool. 21 age-specific questionnaires covering 1-66 MONTHS. Each has 30 items across 5 DOMAINS: communication, gross motor, fine motor, problem-solving, personal-social. AAP Bright Futures preferred screener. Takes 10-15 min. NHS Health Visitor often uses at 1-year + 2-year checks.
How does ASQ-3 differ from PEDS?
ASQ-3: parent CHECKLIST of specific milestones ('does your child stack 3 blocks?'). PEDS: parent CONCERNS questionnaire ('do you have concerns about...?'). BOTH validated; AAP-supported; often used together. ASQ-3 richer detail; PEDS quicker.
What ages?
1-66 months. Different questionnaire per age interval (2, 4, 6, 8, 9, 10, 12, 14, 16, 18, 20, 22, 24, 27, 30, 33, 36, 42, 48, 54, 60 months). Used multiple times for surveillance. Especially valuable at 9, 18, 30 months.
What does an abnormal score mean?
Falls below cut-off in one or more domains. Doesn't diagnose — flags need for further assessment. Options: re-screen 4-6 weeks later; formal developmental assessment via paediatrician; specific therapy referrals (SALT, OT, physio). Most children with abnormal ASQ-3 turn out OK with monitoring.
What if my child is preterm?
USE CORRECTED AGE (chronological minus weeks of prematurity) until 24 MONTHS. Example: born 32 wk, now 6 mo chronological = 6 mo - 8 wk = ~4 mo corrected. After 2 years: chronological.
Red flag milestones — call HV today
No smiling by 3 months; no babbling by 9 months; no words by 18 months; no 2-word phrases by 2 years; loss of any skill (regression); no eye contact / response to name; can't sit independently by 12 months; can't walk by 18 months; repetitive / restricted behaviours; lack of interest in other children by 3 years.
What does the ASQ-3 cover?
5 DOMAINS: communication (language); gross motor (large movements); fine motor (hand skills); problem-solving (cognitive); personal-social (interaction, self-care). Plus optional ASQ:SE-2 for social-emotional.
How is it scored?
Each question YES (10), SOMETIMES (5), NOT YET (0). Domain totals vs age-specific cut-offs. Three zones: above (typical); close (monitor + repeat); below (refer).
Where do I get an ASQ-3?
OFFICIAL versions paid (Brookes Publishing). NHS HV delivers at routine checks. PRIVATE practitioners use. Online unofficial versions exist but less reliable. PROFESSIONAL administration recommended.
Do I need to worry if HV mentions ASQ-3?
Routine surveillance — not a worry signal. HV asks because it's standard. Results usually reassuring; inform whether further checks needed. Bring your observations + concerns; trust parental knowledge.
What if I disagree with score?
Get a second opinion. Parent intuition counts. Request developmental paediatrician referral via GP / HV. Private assessment £200-500. Don't let one screen close the question.
What's early intervention?
Therapy + support for developmental delays. UK NHS: SALT (speech and language); OT; physiotherapy; Portage (home-based); autism diagnostic team (NICE NG170); EHCP for school-age. Earlier = better outcomes.
How does this relate to other calculators on BumpBites?
Companion: /calculators/peds-tool; /calculators/mchat-r; /calculators/milestone-tracker; /calculators/baby-percentile; /calculators/baby-age; /calculators/separation-anxiety; /calculators/sleep-regression.