Ages and Stages Report Form

Child’s Name: Student A Date of Birth: 6/21/13d

Date of Examination: 2/20/2018 Date of Report:2/23/18

Chronological Age: 4 years. 7 months. 30 days

Examiner’s Name: Samantha McKenna Brummer

Name(s) of Assessment: ASQ – 3

Name(s) of Other Assessment Procedures: None

Reason for Referral:

ECE 362 Class Assignment

Background Information:
Student A, lives in Brookings with her parents and her brother. While Student A and her family live in a
house in the city area of Brookings, both sets of her grandparents live out of state, one in Ohio and one in
Kansas. Luckily, they are able to stay in contact through phone calls, facetimes, and occasional visits, usually
around the holidays. Her family is a middle-class socioeconomic family and both parents have stable jobs
within the community. Her father works at SDSU in the Animal Science Department and her mother works at
Mickelson Middle School in Brookings. Student A’s brother is turning eight this March and enjoys spending his
time playing videogames and Pokémon. Student A is a very energetic and outgoing individual who enjoys
arts/crafts, barbies, and playing with her pet dog, Riley.
Student A’s parents consider her a very respectful and engaging child; from my experiences with
Student A, I would agree. Her parents believe that Student A is quick to make friends, but also an independent
child who is content with playing alone. She is not involved in scheduled programs that would meet regularly,
but she is quick to make friends. Student A can be shy around adults sometimes, but also forms close
connections with them, in the classroom, she is very fond of her Teacher. When her parents are having trouble
with listening, they often count backwards from 3 to 1 to tell Student A how long she has before it needs to get
done. Student A is afraid of the dark and this showed through when we were in the light room at the beginning
of the semester. She asked us to keep the lights on and we did. We explained to the other children that the lights
had to stay on, but we could still do our activity.
This is Student A’s first semester enrolled in the Pugsley school program and each afternoon/evening,
she is picked up by either her mother or father. When Student A is not in school, she attends childcare at Bright
Horizons here in Brookings. At Bright Horizons, her parents mentioned that during naptime she often sucks her
tumb during naps and needs her teddy to feel secure. So far Student A has adapted to the classroom very well,
she says goodbye to her parents when they drop her off, and she is excited upon their return. At school, and at
home, Student A enjoys making arts/crafts, building, playing with dolls/teddys, etc. I have not noticed her
sucking her thumb in any situations and am happy to see her excelling.

Assessment Results:
Student A is on schedule for her developmental profile according to her age group. Student A scored full
points of 60 on her gross motor and problem solving. Student A had the most fun executing the gross motor
actions because they allowed her to get up and move around after sitting for a while. She was especially proud
of how well she could hop on one foot, how far she could jump with her feet together, and how she could
balance on one foot. Student A breezed through the problem-solving questions and looked at me as if I was silly
for asking what color something was. She often engages in dramatic play in our classroom, especially in the role
of a kitten. Student A counted to fifteen on her own, but after that her numbers got a little jumbled. When first
asked, she told us she couldn’t, after rewording it from “can you count to the number 15?” to “can you show me
how high you can count?”, Student A became more engaged.
In the areas of communication and personal-social, Student A scored a 50. Student A was able to
describe objects, follow unrelated directions, and speak in four-to-five-word sentences. The two areas that
Student A was not as proficient in was sentence tense. Instead of saying “we painted one said then folded it to
make it the same” Student A told me “we painted one side then foldeded it to make it the same” when I asked
her about how she made her painted butterfly wings. I marked sometimes for both of the sections because the
word endings would go back and forth between being correct and incorrect. For personal-social development,
Student A forgot to dry her hands a few times, but knew that she needed to wash them, for this occurrence I
marked “sometimes”. I also marked sometimes for dressing/undressing herself. Although she is able to unbutton
buttons, if they are smaller it is more difficult.
The final area assessed was fine motor skills. Student A was very good at drawing a shape that I showed
her (image 1), but had trouble tracing directly over an image in front of her. Student A also had some trouble
staying within the lines of the circle due to her back and forth coloring technique this is common at this age
(image 2). The only “not yet” I had to mark on her assessment was for number four in fine motor. Although
Student A drew me a fairly straight line underneath the line I asked her to trace, she was not able to trace
directly on the line. When drawing a photo of herself, she made sure to include many features including, arms,
legs, hair, and even her ears (image 3). Finally, Student A did a great job cutting a straight line that I had drawn
on a piece of paper (image 4). Although Student A did struggle in some areas of this category, she enjoyed
doing all of them and works on them through her play and arts/crafts.

Recommendations:
Since Student A is on schedule developmentally, the best thing to help her gross motor skills would be
to keep practicing hands on activities since fine motor was her most challenging area! Since Student A loves
doing arts/crafts, including objects that require more control and precision could be beneficial. Reminding
Student A of the little things she forgets to do, such as drying her hands after washing them, is simple and easy
for us to do in our classroom. Overall, continuing to support Student A’s interests and utilizing those interests to
enhance her learning will help her develop and grow on schedule according to the ASQ assessment.

Self-Evaluation of Testing:
This experience was very eye opening for me. I was not aware of how different each screening area is,
even for a five-month difference in age. Going into this assignment I was nervous and unsure of the details that
needed to be taken down. However, after reading through all the information provided and talking to
peers/teachers, I became more confident. I asked Student A’s dad if it was okay for me to assess her, and he was
very polite when I spoke with him. He listened to my explanation and then took the time to read through the
agreement before signing. The hardest part of this assessment for me was finding a way to make it more fun and
engaging for Student A. I had the opportunity to assess her when the other children in my small group were all
out sick/out of town, so Student A was the only one at school. While finishing up her project, I was able to ask
her questions, and while she drew me a photo of herself, I was also able to ask her questions.
This experience has taught me that it is important to be prepared and have a game plan about how the
engage the child. Rather than making it seem like an assessment, I tried to make it as conversational as possible.
I was also able to make a game out of the motor skills and allowed Student A to be creative with how she
approached the questions and situations. Overall, I think this assessment went well for it being my first time
conducting it, but over time I will become more familiar with the materials and gain the confidence to make it a
more enjoyable process for the student and myself.