ACCA Infant Learning Program

907-456-4003

[email protected]

1020 Barnette Street

Fairbanks, Alaska 99701

www.alaskacenter.org

 

*For versions available in Spanish please click here/Disponible en español por favor haga clic aquí: https://www.asqonline.com/family/c04b32

Welcome to Infant Learning Program ASQ Online. Please answer the following questions about your child's development to the best of your ability. We will receive notification when you have submitted your answers and will contact you to talk about your child's areas of strengths and needs. Please don't hesitate to call us if you need assistance. 

Click to access the questionnaires in Spanish: https://www.asqonline.com/family/c04b32

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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, Third Edition (ASQ-3), to help you keep track of your child's development. The questionnaire may be provided every 2-, 4- or 6-month period. You will be asked to answer questions about some things your child can and cannot do. The questionnaire includes questions about your child's communication, gross motor, fine motor, problem solving, and personal social skills.

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-3!



(put "0" if not premature)



We are committed to your privacy and the privacy of your child. Any information you submit in the ASQ online system can only be viewed by our staff who have authorized access to your account. All information collected will be treated as confidential and will only be shared with your written consent.

The State of Alaska EI/ILP has provided funding for this project to provide access to developmental screening for all families. The State EI/ILP staff will be tracking the number of children who are screened but will not be able to view any identifying information. All information collected is protected under the Family Education Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability Act (HIPAA).

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.