According to new guidelines from the American Academy of Pediatrics, we now are using developmental screens above and beyond our usual screening techniques in order to better discover subtle delays in speech, social and motor development.  

These new tools will add another layer of protection for your child,
in that we will be better able to identify children with mild delays and get them early intervention services such as First Steps.  

Studies have shown that the earlier we identify delays in children
and start helping them in these areas, the more successful they are in school and the better they fit in with their peers.

These new tools will also help us identify children with Autism and Autistic-like features at earlier ages.  

We try very hard to make your child's 'Medical Home' as comprehensive and thorough as possible. With these new tools, we feel we are taking the care we provide for your child yet one step further.

Please click on one of the links (on left) to download and print the appropriate questionnaires. As these forms will take at least 10-15 minutes to fill out, try and fill them out at home when you don't have many distractions and bring them in to the office for your provider to go over. If you don't understand any of these questions, please skip them and fill out what you can. We will go over them in detail during your checkup.

Unless otherwise indicated, the former Ages and Stages Question (ASQ) Screening and its contents are the property of Paul H. Brookes Publishing Co., Inc. ("the Publisher") and are protected, without limitation, pursuant to U.S. and foreign copyright and trademark laws.

At this time, due to the recent upgrade from ASQ 2 to ASQ 3, copyright laws prohibit Nassim, McMonigle, Mescia and Associates from providing a blank ASQ Screening form available on our website.

Please contact our office prior to your scheduled appointment and we will gladly provide you a copy via fax, email, pick-up or mail. Currently we are researching a better solution to permit you to complete the ASQ via the web prior to your visit...please stay tuned.

ASQ Well Child Check-up
*9mo *18mo *36mo

Contact Information:
812-949-0405
Option 9 (Forms)