CFCE - North Suburban Child and Family Resource Network/Wakefield Public Schools
781 246 5187
[email protected]
30 Farm Street
Wakefield, Massachusetts 01880
nsfamilynetwork.org

Dear Parent/Guardian,

The Massachusetts Department of Early Education and Care (EEC) and the North Suburban Child & Family Resource Network (CFCE serving the towns of Lynnfield, Malden, Melrose, North Reading, Reading, Stoneham, Wakefield and Winchester) would like to invite you to engage in developmental screening with your child using the Ages and Stages Questionnaire (ASQ). Developmental screening provides families the opportunity to share and learn about their child’s development, to celebrate their growth, and to address any questions or concerns they may have about what “typical” development looks like. The ASQ is designed to be filled out by families. It is user-friendly and should only take about 10 minutes to complete. It can be filled out on paper or online. Your child’s early education and care program can also do it with you in person and provide you with the results.

 



(put "0" if not premature)



 Why We Collect ASQ® Data: 

North Suburban Child and Family Resource Networkand EEC collect ASQ® screening data to identify trends and patterns in the early education and care settings in order to better support the programs with resources and professional development opportunities.  EEC is only analyzing the combined scores of all the screening results.  The specific names of children are not included in the analysis.   

ASQ® results are confidential.  Both North Suburban Child and Family Resource Network and EEC follow the Massachusetts confidentiality laws to ensure that your and your child’s personally identifiable information is protected.   

EEC signed a data-sharing agreement with United Way to jointly develop a data platform to analyze the combined data.  The data-sharing agreement ensures that all individuals accessing the data will maintain confidentiality and ensure your and your child’s privacy. 

 

If you do not wish to have your child’s information entered into the online database, you may decline this option.  Your child may be screened using the ASQ® paper version of the questionnaire, and no information will be shared.

 

ONLINE CONSENT FORM

 

Please read the text below and click on the “submit button” if you choose to proceed with the Ages & Stages Questionnaires® (ASQ®) screening online via the Family Access Link provided to you by North Suburban Child and Family Resource Network. 

I acknowledge that I have read the information provided by the Department of Early Education and Care (EEC) about the ASQ® screening process and choose the following option:

 

 

 

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.