The ASQ rule for prematurity
The Ages & Stages Questionnaires (ASQ-3 and ASQ:SE-2) are filled in by parents to screen a young child's development. A baby born early is compared with children of the same developmental age, so the ASQ developers say to adjust the age when:
- the child was born 3 or more weeks before the due date (at or before 36 weeks), and
- the child is under 2 years old chronologically. From age 2, use the actual age.
The same guidelines apply to the ASQ-3 and the ASQ:SE-2. ASQ's developers used 39 weeks as a full-term pregnancy, so weeks premature = 39 weeks − gestational age at birth. (They note programs using 38 or 40 weeks may do so as long as they're consistent; this calculator uses 39.)
Worked example (from the ASQ developers)
A child born March 10, 2017 is screened on July 15, 2018 and was born 5 weeks (35 days) early.
- Chronological age: 2018-07-15 minus 2017-03-10 = 1 year, 4 months, 5 days.
- The child is under 2 and was 3 or more weeks early, so adjust.
- 35 days can't come out of 5 days, so borrow a month as 30 days: 1 year, 3 months, 35 days.
- Subtract 35 days: adjusted age = 1 year, 3 months, 0 days (15 months). On the age chart that's the 16 month ASQ-3 and the 18 month ASQ:SE-2.
ASQ-3 age ranges
| Child's age | ASQ-3 questionnaire |
|---|---|
| 1 mo 0 d – 2 mo 30 d | 2 month |
| 3 mo 0 d – 4 mo 30 d | 4 month |
| 5 mo 0 d – 6 mo 30 d | 6 month |
| 7 mo 0 d – 8 mo 30 d | 8 month |
| 9 mo 0 d – 9 mo 30 d | 9 or 10 month |
| 10 mo 0 d – 10 mo 30 d | 10 month |
| 11 mo 0 d – 12 mo 30 d | 12 month |
| 13 mo 0 d – 22 mo 30 d | 14, 16, 18, 20 or 22 month (each covers the month before and its own month) |
| 23 mo 0 d – 25 mo 15 d | 24 month |
| 25 mo 16 d – 28 mo 15 d | 27 month |
| 28 mo 16 d – 31 mo 15 d | 30 month |
| 31 mo 16 d – 34 mo 15 d | 33 month |
| 34 mo 16 d – 38 mo 30 d | 36 month |
| 39 mo 0 d – 44 mo 30 d | 42 month |
| 45 mo 0 d – 50 mo 30 d | 48 month |
| 51 mo 0 d – 56 mo 30 d | 54 month |
| 57 mo 0 d – 66 mo 0 d | 60 month |
| 66 mo 1 d – 77 mo 30 d | 72 month |
From the ASQ-3 and ASQ:SE-2 combined age administration chart. Always check the age range printed on the questionnaire itself.
How the dates are counted
Chronological age is counted in calendar years, months and days, borrowing the days of the previous month when needed, like the age calculator. When subtracting prematurity, a month is borrowed as 30 days, as in the ASQ worked example. Results can differ by a day from other tools near month ends; the publisher's own ASQ Age Calculator is the reference if a child is right at the edge of an interval.
Limitations
- This only works out ages and intervals. It doesn't score questionnaires or interpret results; that's for the program or professional using ASQ.
- If the due date was set by an early ultrasound, weeks premature can be worked out from the due date instead; enter whichever your program uses.
- ASQ is a screening tool, not a diagnosis. Questions about a child's development belong with their pediatrician.
Sources
- Ages & Stages Questionnaires (Brookes Publishing): Considerations when screening premature children
- Ages & Stages Questionnaires: Tips for using ASQ with premature children (PDF)
- Ages & Stages support: Is age adjusted for prematurity when using ASQ:SE-2?
- Ages & Stages: ASQ-3 and ASQ:SE-2 combined age administration chart