ASQ Ages & Stages Questionnaire

4-C, in cooperation with the United Way of Dane County and Children’s Service Society, now has the complete set of ASQ materials both in English and in Spanish. This service is available to family childcare providers that have attended a training on the Ages and Stages Questionnaire. The Ages & Stages Questionnaires are a developmental screener given to parents in your program to complete. Developmental screening uses a standardized tool (like a questionnaire) to see how a child’s development compares with other children of the same age. The completed questionnaires are returned to 4-C for scoring and follow up. A goal of United Way is to have all children in Dane County screened at the following ages: 10 months, 18 months, and 24 months or 30 months. Screeners are available for many additional ages from 2 months - 60 months.

To request the ASQ, please complete the ASQ Request Form and return it to 4-C. You can mail or e-mail ( the completed form.

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