Weeks Premature
(put "0" if not premature)

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

List others assisting with completion of the questionnaire

Participation in this program is voluntary and at no cost to you.  Once your child’s results have been reviewed by your child’s teacher, they will be shared with you, along with resources and activities that will increase your child’s growth and development.

Following submission of your screening, your child’s identifying information will be removed and your child’s statistical results will be combined with that of others in this program to increase state and national understanding of child development. This data will be studied to help improve access to services for all children and early intervention supports for children across Wayne County.

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.