Empowering parents

Do you know at what age your child should be making eye contact, drawing a straight line or cutting with scissors? By taking the Ages and Stages Questionnaire, parents can catch developmental delays in their young children and help them get back on track so they are ready for success on their first day of school.

Video by Charles Ashley. Story by Marina Csomor

When Claudia O’Brien found out that her then 12-month-old daughter, Harper, had a slight developmental delay, she was shocked. Harper was a bright and bubbly baby. Her two eldest children, Molly and Van, had typical development as children.

Claudia was sure Harper would pass a quick, simple online screening with flying colors. But when the results came in, she realized Harper needed some help.

“She was a smart little 1-year-old,” Claudia said. “But when it came to certain sections, she couldn’t complete almost anything. That was surprising to me.”

This developmental screening, known as the Ages and Stages Questionnaire (ASQ), is a 10–20 minute questionnaire that allows parents and caregivers to analyze progress and catch any delays in young children. The ASQ, which asks caregivers questions based on their child’s age, can be taken online or on paper at regular intervals starting when an infant is 1 month old until a child is 5 and a half years old. Parents in Wayne, Oakland and Macomb Counties can take the free assessment here: www.helpmegrow-mi.org.

United Way for Southeastern Michigan champions the ASQ because of its effectiveness for catching problems, allowing for intervention during a child’s crucial early years. Most of our Early Childhood work, which strives to make sure parents and caregivers have access to the resources they need to prepare their kids for success from the start, is using the ASQ in some way.

“The ASQ is highly valid, reliable, and accurate,” said Amanda Reed, a member of United Way’s Early Development Team. “It is a great way to partner with and empower parents.”

Although Claudia was surprised by Harper’s ASQ results, she realized how easy it can be to miss meeting developmental milestones as a parent caught up in day-to-day activities, “making breakfast, doing this, doing that, dinnertime, bath time, bedtime.” That’s why the ASQ is meant for all families, whether parents are concerned about the development of their children or not.

The O'Brien family

The O’Brien family

“By the time Harper got to the age where she should be using scissors, it had never once occurred to me that she was at the age to have scissors — I just had never done it,” Claudia said. “Same goes for her writing. She had been using crayons, and I realized she could actually use a pencil and make a letter by now. And I’m a hands-on messy mom, but there are still things that get missed.”

Why Ages and Stages?

Is your infant rolling over or making eye contact? Can your child string beads or draw a straight line?

“The ASQ is unique because it was developed not only so teachers and early childhood professionals can assess kids’ developmental needs, but also so parents can learn what their children should be able to do at their age,” said Michelle Simasko, the Ages and Stages specialist for Great Start to Quality and the Macomb Intermediate School District.

Michelle is the reason Claudia took the ASQ. These mothers, who met when Claudia’s older daughter was in Michelle’s preschool class, have been friends for five years and counting.


“She gets me. I get her.” Our Early Childhood work is more than just assessments. It’s about relationships.

“We just clicked,” Claudia said. “She gets me. I get her.”

As an ASQ specialist, it’s Michelle’s job to get the ASQ into the hands of teachers at Macomb County preschools and daycare centers, and to provide support as they use this tool with their kids. Her position is funded through a United Way grant given to Great Start to increase participation in the ASQ in Macomb, Oakland, and Wayne counties.

The ultimate goal of the ASQ is to make sure children in Southeastern Michigan, like Harper, are ready to learn by the time they get to kindergarten. Catching developmental delays in young children early sets them up for success in the future.

“We all know as early childhood professionals — but parents don’t always know — that the sooner you find out your child has a little tiny delay, and you intervene and you bring them right back up to where they should be, that’s the goal,” Michelle says. “That’s the best thing that can happen.”

Usually after taking the ASQ, a family’s screening goes to an early childhood specialist who reviews the results. If there are any delays that come up, parents get a phone call from the specialist. The specialist will then guide parents through the next steps, send activities to do at home to get a child’s development back on track, and follow up after subsequent screenings.

Parents’ names are not added to a calling list. However, guidance from an early childhood professional is available to those who seek it. Michelle thinks the beauty of the ASQ is that parents are never left alone wondering what to do.

“It can be as private a process as you want it to be,” she says. “You can get as much help as you ask for.”

The results are in

Michelle understands that many parents might not even realize the skills their children should have, whether they’re 4 months or 4 years old. Often children are developmentally behind not because they can’t complete certain tasks but because they haven’t been given the opportunity to try.

“The screening isn’t something to be worried or nervous about,” she says. “It is something to do as a positive step in your parenting.”

The ASQ doesn’t diagnose specific disorders like dyslexia or ADHD, but it does identify developmental delays and show parents how to get their child developmentally back on track if there is a skill they are lacking.

“This is crucial because developmental and social-emotional delays can be subtle and can occur even in children who appear to be developing typically,” said Amanda at United Way. Most children who would benefit from early intervention like the ASQ are not identified until after they have started school and are then at risk of falling, and staying, behind.

The biggest concern for Harper was her fine motor skills. She was raking up toys and other objects instead of using her thumb and pointer finger to pick things up.

After reviewing Harper’s results, Michelle offered Claudia a few activities to do at home to get Harper’s fine motor skills up to speed. Claudia remembers one of the activities involved moving Cheerios back and forth from a bowl to a plate using that thumb-and-pointer-finger grasp. She would show Harper how to do it, and soon Harper had learned the motion.

Two weeks later, Harper took the ASQ again. This time, she passed. Claudia and Michelle were overjoyed. Claudia realized that improving Harper’s fine motor skills was something the toddler was absolutely capable of doing, she just had never been shown how.


Harper and Claudia working on an art project.

Now, a vibrant 4 year old, Harper is still eligible for a few questionnaires. Michelle loves the idea of getting her friend to take the ASQ with Harper at least one more time.

“Although she wouldn’t do so good on this one,” Claudia warned, laughing. “She thinks ‘coconut’ is a letter, so….”

Since taking the ASQ with Harper, Claudia has recommended the screening to other parents. It was so eye-opening for her that she knows other people will benefit, too.

“I think it’s important as a parent to be open-minded to receiving advice, even when something’s not so favorable,” Claudia says. “To hear it about your child, and to take that advice and say, ‘I need some help. I need to know what to do next.’”