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CFCE--First Connections, JRI
978-429-8284
[email protected]
179 Great Rd. Suite 104a
Acton, MA 01720
www.jri.org/firstconnections

Welcome to our ASQ Online screening program!

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 Questionnaire, Social-Emotional, Second Edition to help you keep track of your child's development. The questionnaire may be provided every 6-month period. You will be asked to answer questions about some things your child can and cannot do and how things are going for you in daily routines like meals and bedtime.

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!

Child Date of Birth

Month Day Year

Weeks Premature
(put "0" if not premature)

Screening Date

I am screening my child today (06-27-2026) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

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.

CFCE--First Connections, JRI978-429-8284[email protected]179 Great Rd. Suite 104aActon, MA 01720www.jri.org/firstconnections

CFCE--First Connections, JRI
978-429-8284
[email protected]
179 Great Rd. Suite 104a
Acton, MA 01720
www.jri.org/firstconnections