This blog post was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Ages and Stages Questionnaires: 3rd edition (ASQ-3TM) and parents’ contribution to the 2 year health review - Penny Crouzet

 Telling people that the Government is developing a population measure of child development at age two can sound rather dry; unsurprisingly their eyes start to glaze over….

But when you say that for the first time we will be building a picture of how children are developing at age two across the country, things start to sound a bit more interesting.

And parents will be key players in this, sharing information about their children’s development with their health visitor or community nursery nurse by completing a short questionnaire – the ASQ-3 – as part of their child’s two year health review.

From next year, all health visiting teams will be using ASQ-3 as part of the two year health review. ASQ-3 is a reliable, evidence-based assessment tool, developed in the US. Parents are asked to answer yes, sometimes or not yet to a series of short questions about their child’s development across five different areas: communication and language, fine motor skills, gross motor skills, problem-solving and personal-social development. Examples of questions are: Does your child turn the pages of a book by herself? (She may turn more than one page at a time) and When playing with a favourite soft toy or doll, does your child cuddle it, pretend to feed it, put it to bed, etc?

So why ASQ-3? It was recommended as a suitable tool in research commissioned by the Government. The research reviewed in detail the strengths and weakness of several measures of child development. The Family Nurse Partnership programme uses ASQ-3 and we know that many health visiting teams across the country are already using it too.

There are good reasons for using a parent-completed questionnaire. Research tells us that parent-completed tools are as accurate as those administered by professionals in identifying children with developmental problems.

Parents are experts in their child’s development and we tap into their expertise in this way. Combined with the clinical judgement of a health professional, we start to build a rounded picture of a child’s development and to identify any needs going forward.

Health professionals using ASQ-3 tell us that it helps parents to feel more involved in their child’s health review. Parents report that ASQ-3 encourages them to try out new activities with their children and that they enjoy doing these.

Health professionals will be able to reassure parents that using ASQ-3 is not “testing for tots” and that children do not “pass” or “fail” the questionnaire. Rather, using ASQ-3 as part of the two year health review helps to bring together a parent’s knowledge of their child with a health professional’s clinical judgement, in order to make an overall assessment of a child’s development.

And going back to that rather dry-sounding population measure, using ASQ-3 will not only help to assess individual children, but will also in the long term benefit children and their families more widely. By completing an ASQ-3 questionnaire, parents will be providing information that can be used to build a broad picture of children’s development at age two at local and national level. This information is useful because it will help to assess the impact of services for 0-2 year olds and their families, to judge how well public money is being spent and where improvements could be made. And it will help to decide how services should be shaped in future to meet the needs of children age two and beyond.

Visit the Ages and Stages Questionnaire website:

 Penny Crouzet is the Starting Well Policy Lead at the Department of Health






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