Connecting NJ
42 Delsea Drive S
Glassboro, NJ 08028
856-431-4180 (Intake Line)
[email protected]

Dear Parent/Caregiver, 

Congratulations on taking steps to get a better understanding about your child’s growth and development.

We are excited about your interest in this online screening tool to help you keep track of and learn about your child's development. The Ages & Stages Questionnaire: Social-Emotional (ASQ-SE), can be used by families living in Cumberland County with any child from age 2 months to 5 years. The questions ask about your child's Social Emotional development, and includes topics such as self-regulation, compliance, adapative functioning, autonomy, affect, social-communication, and interaction with people!

 

 Within a few days after we receive your completed ASQ-SE, we will contact you to share the results and offer follow-up activities and resources.

 To use this online screening tool, begin by entering your info below and clicking "submit'.

 We look forward to your participation in ASQ-SE!

Sincerely,

 

Connecting NJ

a Program of Help Me Grow NJ


The Weeks Premature field below refers to how many weeks early your child was born. 
Based on 40 weeks being full term, if your child was born at 36 weeks or earlier be sure to put in how many weeks early.  Example: If your child is born at 35 weeks, put in 5 weeks; if your child is born at 32 weeks, put in 8 weeks. If you have any questions, please be sure to contact us at: 856-431-4180 and ask to be connected to our Cumberland County Early Childhood Specialist, Rachel Figueroa!

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Because your child's first 5 years of life are so important, we want to help you provide the best start for your child. You've been invited to participate in the Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2) to help you keep track of your child's social and emotional development. The questionnaire may be provided for use at 2, 6, 12, 18, 24, 30, 36, 48, or 60 months of age. You will be asked to answer questions about some of your child's behaviors. The questionnaire includes questions about your child's ability to calm down, take direction and follow rules, communicate, perform daily activities (e.g., eating, sleeping), act independently, demonstrate feelings, and interact with others.

Please enter your child's birth date and the number of weeks he or she was born premature below to start the screening. Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the program employees who have invited you to participate in this screening.

We look forward to your participation in ASQ:SE-2!



(put "0" if not premature)



I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system.

Note: By clicking "Submit", you are agreeing to both our Family Access End User License Agreement and any other consent or authorization information outlined on this page.