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Please return this questionnaire by Forms for 48 and 60 months focus on behaviors common in. __________________ if you have any questions or concerns about your child or about this questionnaire, contact

Use black or blue ink only and print legibly when completing this form The ages and stages questionnaire On the following pages are questions about activities babies may do

Your baby may have already done some of the activities described here, and there may be some your baby has not begun doing yet.

Explore ages and stages questionnaires (asq) for child development Complete your child's asq today! So, at the 4 month visit, a child who is 4 weeks premature would still be evaluated using the 4 month asq because the adjusted age at this visit is 3 months For example, the corrected age for a 10 week premature baby at 6 months would be 3.5 months, for which the 4 month asq is valid.

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