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