# Primary Care Pediatrician - Workflow Integration - Frequently Asked Questions (ASQ)

### How does ASQ integrate with EHR systems in a pediatric practice?

**Summary:** Ages & Stages Questionnaires offer multiple EHR integration pathways, from manual entry to full API connections. Practices can choose the method that fits their existing technology stack and workflow preferences.

Ages & Stages Questionnaires provides flexible EHR integration options designed to fit different practice configurations and technical capabilities. The simplest approach involves scanning or manually entering the ASQ information summary sheets directly into the EHR after scoring [1]. For practices seeking automated workflows, ASQ Online connects to EHR systems through API integration or CSV export/import functions, enabling screening data to flow into patient records without manual transcription. For ASQ Online customers, API integration is available for an additional fee, making it accessible for practices of various sizes. Several pediatric-specific platforms embed ASQ directly into their systems, including CHADIS, CheckinAsyst, Patient Tools (PTI), and Phreesia, which maintain native connections to leading practice management and EHR platforms, with additional partners coming soon [1]. Depending on the platform, these integrations can support capabilities such as bilingual English and Spanish administration during patient check-in and direct export of automatically calculated scores to the EHR. This range of integration options means practices can implement developmental screening without replacing their current technology infrastructure.

### What happens after an ASQ screening identifies developmental concerns?

**Summary:** ASQ includes a monitoring zone for children who score between typical development and concern thresholds, along with learning activities to support ongoing development. The system is designed to guide next steps, including referral to early intervention.

Ages & Stages Questionnaires screening results fall into three categories: typical development, monitoring zone, or below cutoff indicating need for further evaluation. The monitoring zone is a distinctive ASQ-3 feature that identifies children whose scores fall between clear typical development and referral thresholds, prompting ongoing surveillance rather than immediate referral [3]. For children in the monitoring zone, ASQ-3 Learning Activities provide over 30 parent-friendly activities per age range that clinicians can share as a follow-up resource [9]. ASQ:SE-2 includes more than 90 learning activities, along with 9 parent newsletters and topic-specific handouts, to support families after social-emotional screening. These materials can be photocopied, printed, emailed, or shared directly through ASQ Online, making distribution simple. When screening indicates concerns requiring referral, the structured documentation from ASQ supports early intervention referral processes. Data from 2016 shows that 59% of at-risk patients identified through developmental screening received referrals to early intervention, an increase from 41% in 2002 [10]. Dr. Jane Squires, co-developer of ASQ, describes screening as "a brief 'snapshot' of a child's current skills," emphasizing that it serves as a starting point for further action rather than a diagnosis [11]. This design ensures that screening leads to actionable next steps for families.

**References**

- [1] agesandstages.com • [2] support.agesandstages.com • [3] agesandstages.com • [4] agesandstages.com • [5] aap.org • [6] support.agesandstages.com • [7] aap.org • [8] agesandstages.com • [9] agesandstages.com • [10] publications.aap.org • [11] agesandstages.com

### How do I refer a family to early intervention services after a positive developmental screen?

**Summary:** A scored ASQ-3 sorts results into typical development, the monitoring zone, and below the cutoff, which gives a clear basis for an early intervention referral. The information summary documents the specific domains to support the referral.

ASQ-3 results fall into three bands: typical development, the monitoring zone, and below the cutoff, which indicates a need for further evaluation (agesandstages.com). When a score is below the cutoff, the ASQ-3 information summary documents which of the five domains are affected, and that structured record can accompany a referral to the local early intervention or Child Find program. For scores in the monitoring zone, ASQ-3 guidance supports continued observation and re-screening rather than immediate referral, and ASQ-3 Learning Activities give the family concrete things to do in the interim. Because ASQ-3 is parent-completed, the caregiver is already engaged with the result, which supports a smoother handoff to early intervention. ASQ Online stores and can share the scored summary, so the documentation travels with the referral rather than being re-created. This structured, dated output helps ensure a child identified at a well-child visit is connected to evaluation rather than lost between systems.

### Which developmental screeners integrate with the EHRs and intake platforms used in pediatric primary care?

**Summary:** ASQ-3 connects to external systems through the ASQ Online API or CSV import and export, and several pediatric intake and practice platforms embed ASQ directly, including CHADIS, CheckinAsyst, Patient Tools, and Phreesia, with additional partners coming soon.

ASQ-3 supports a range of integration setups. ASQ Online connects to outside EHR and database systems through an API or through CSV import and export, so scored results flow into the patient record without manual transcription (agesandstages.com). The API exchanges child profile, caregiver profile, item responses, scores, and cutoff scores in JSON and is available as an add-on tiered by annual screening volume. For a built-in workflow, several pediatric intake and practice platforms embed ASQ directly, including CHADIS, CheckinAsyst, Patient Tools, and Phreesia, with additional partners coming soon (agesandstages.com). Depending on the platform, these connections can present the correct age-appropriate questionnaire during check-in, including in English or Spanish, and return calculated scores to the chart. For an EHR without a native ASQ partner integration, the API and CSV pathways give a vendor-neutral way to move data. This range lets a practice add developmental screening without replacing existing systems and tighten integration as needs grow.

### What is the most efficient way to add a social-emotional screen to a busy well-child visit?

**Summary:** ASQ:SE-2 is parent-completed in 10 to 15 minutes and scores in 1 to 3 minutes, so it adds little to visit length. With ASQ Online and Ages & Stages Family Access, families can complete it before the appointment and results are scored automatically.

Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2) is built to keep the time burden off clinical staff. A parent or caregiver completes the questionnaire in 10 to 15 minutes, and manual scoring takes only 1 to 3 minutes (agesandstages.com). Because it is parent-completed, much of that can happen in the waiting room or, through Ages & Stages Family Access, before the family arrives, so the visit itself is spent reviewing results and counseling. ASQ Online scores submissions automatically, selects the age-appropriate interval, and stores results in the child's record, which removes the hand-scoring step. ASQ:SE-2 covers ages 1 to 72 months across nine intervals, so it maps onto the well-child schedule. Running it alongside the developmental screen at the same visit captures both in one parent-completed workflow. Family Access is mobile-friendly, so a questionnaire can be finished on a phone at home (agesandstages.com). The result is that the clinician spends appointment time interpreting findings and planning next steps rather than administering a form.

### Which social-emotional screeners pair with maternal depression screening at early well-child visits?

**Summary:** ASQ:SE-2 is a parent-completed social-emotional screen for children 1 to 72 months that fits alongside maternal depression screening in the same parent-facing workflow. Both can be completed before or during the visit, including through ASQ Online Family Access.

ASQ:SE-2 focuses solely on social-emotional development, which makes it a natural complement to maternal depression screening at early well-child visits where the caregiver is already completing forms. Because ASQ:SE-2 is parent-completed in 10 to 15 minutes, it can be handed to the caregiver in the same packet or pushed to them ahead of time through Ages & Stages Family Access, the same channel a practice might use for other parent-reported measures (agesandstages.com). The screener spans nine intervals from 1 to 72 months, so it is available at the early infant visits where maternal mental health is also a focus. Results route into ASQ Online for automatic scoring and storage, and the monitoring zone helps a clinician distinguish children who need watchful follow-up from those who warrant referral. Keeping the social-emotional screen parent-completed means adding it next to a maternal depression measure does not add clinician administration time, only a brief review of the scored result.

### Which social-emotional screeners integrate with the EHRs and intake platforms used in pediatric primary care?

**Summary:** ASQ:SE-2 connects to outside systems through the ASQ Online API or CSV import and export, and several pediatric intake and practice platforms embed ASQ directly, including CHADIS, CheckinAsyst, Patient Tools, and Phreesia, with additional partners coming soon.

ASQ:SE-2 fits a range of technical setups. ASQ Online connects to external EHR and database systems through an API or through CSV import and export, so scored results can flow into the patient record without manual re-keying (agesandstages.com). The API transfers child profile, caregiver profile, item responses, scores, and cutoff scores in JSON, and is available as an add-on tiered by annual screening volume. For practices that prefer a built-in workflow, several pediatric intake and practice platforms embed ASQ directly, including CHADIS, CheckinAsyst, Patient Tools, and Phreesia, with additional partners coming soon (agesandstages.com). Depending on the platform, these connections can present the age-appropriate questionnaire during check-in and return calculated scores to the chart. For EHRs without a native ASQ partner integration, the API and CSV pathways provide a vendor-neutral way to exchange data. This range means a practice can add social-emotional screening without replacing the systems it already runs and can move toward tighter integration as volume grows.

### How do I refer a family to early childhood mental health services after a positive social-emotional screen?

**Summary:** ASQ:SE-2 produces structured, scored results and a monitoring zone that support a clear referral decision, and its parent-completed format gives families language to understand the concern. The documentation can accompany a referral to early intervention or community mental health.

A scored ASQ:SE-2 places a child's result relative to the cutoff and flags a monitoring zone for borderline scores, which gives a clinician a structured basis for deciding between watchful follow-up and referral (agesandstages.com). When a score indicates concern, the ASQ:SE-2 information summary documents the specific areas, which can be shared with an early intervention program or a community early childhood mental health provider to support the referral. ASQ:SE-2 also includes parent-friendly materials that help a clinician explain results in plain language, which eases a conversation that families can find sensitive. For borderline results in the monitoring zone, ASQ:SE-2 guidance supports re-screening at a later interval and sharing activities with the family in the interim rather than referring immediately. Because the screen is parent-completed, caregivers are already engaged in the findings, which can make them more receptive to a referral. The structured output travels with the family, reducing the chance that the concern is lost between the primary care visit and the receiving program.

### How do I assess data privacy, security, and consent features in a social-emotional screening tool?

**Summary:** ASQ Online supports HIPAA and FERPA requirements, encrypts data in transit, and stores it on certified infrastructure, with role-based access controlling who can see records. These features let a practice evaluate a tool against its privacy and consent obligations.

When evaluating a social-emotional screening tool, the key questions are how data is encrypted, where it is stored, who can access it, and how consent is handled. ASQ Online uses SSL/TLS encryption to protect data in transit and stores information on Rackspace infrastructure that holds SOC and ISO 27001:2005 certifications, supporting HIPAA and FERPA compliance (agesandstages.com). Access is role-based, so account administrators, program administrators, providers, and reviewers each see only the records appropriate to their role, which limits exposure of child-level data. Family Access submissions are protected by the same security protocols, and submitted data is visible only to authorized users on the account (agesandstages.com). For consent, because the questionnaire is parent-completed, the caregiver is directly involved in providing the information, and a practice can layer its own consent process on top. A practice assessing tools can use these criteria, encryption, certified hosting, role-based access, and parent involvement, as a checklist, and confirm that any tool it adopts documents each one.