Ages Stages 18 Month Form PDF Details

The Ages & Stages Questionnaires 18 Month (ASQ-3) form screens children aged 17 months 0 days to 18 months 30 days. Fill it out using black or blue ink. Start by recording the child's name, gender, date of birth, and whether the child was born prematurely.

What the Form Covers

The questionnaire assesses five developmental areas: communication, gross motor, fine motor, problem-solving, and personal-social skills. Each section contains targeted questions to observe and record age-specific abilities. Try each activity with the child before recording an answer for the most accurate results.

Scoring and Next Steps

The final section asks about hearing, speech, physical abilities, and family medical history. Bring the completed form to your child's next pediatric visit. For related tools, see the ASQ 14-month questionnaire, the ASQ-3 questionnaire, and the ASQ 54-month questionnaire.

QuestionAnswer
Form NameAges Stages 18 Month Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other names18month asq, ages stages 18 questionnaires, ages stages 18 month pdf, printable asq forms

How to Edit Ages Stages 18 Month Form Online for Free

Use FormsPal to fill in or edit the 18 month ASQ questionnaire online. Follow these steps to complete the ages stages 18 month form quickly.

Step 1: Click the "Get Form" button at the top of this page to open the PDF editor.

How you can fill out 18 month questionnaire asq stage 1

Step 2: Fill in the child's basic information: Country, Email address, Child ID, Program ID, Program name, Home telephone number, Other telephone number, age at administration in months, and whether the child was born prematurely.

Child ID, If premature adjusted age in, and Other telephone number inside 18 month questionnaire asq

Step 3: Work through the developmental sections. Answer YES, SOMETIMES, or NOT YET for each activity. Try each activity with your child before responding. The form covers five skill areas: communication, gross motor, fine motor, problem-solving, and personal-social development.

SOMETIMES, NOT YET, and At this age many toddlers may not inside 18 month questionnaire asq

Step 4: Complete the Communication section. This section asks whether your child says eight or more words, imitates two-word phrases, and responds to simple instructions like "Show me the kitty."

Does your child say two or three words together and Does your child imitate a two-word phrase inside 18 month questionnaire asq

Step 5: Finish the Gross Motor and Fine Motor sections. These ask whether your child walks well, bends and stands without help, climbs on objects to reach a toy, and walks down stairs with assistance.

Filling out part 5 of 18 month questionnaire asq

Step 6: Review your answers, then click "Done." Download, email, or save the completed form to your FormsPal account.

Looking for other age-range forms? The ASQ 14-month questionnaire covers younger children, while the child and adolescent health form covers older age groups.