ASQ Training of Trainers Institute

The Children’s Trust Fund and the Department of Public Health, is offering an Ages & Stages Questionnaire Training of Trainers(ASQ TOT) institute.

July 28 & 29, 2008

Village at South Farms

645 Saybrook Road

Middletown, CT06457

This ASQ TOT is for professionals willing to provide ASQ community-based trainingswithin the first year. You will receive in depth training on how to facilitate the ASQ child monitoring systems, including the basic and social emotional tools. In addition you will receive technical assistance on planning and facilitating ASQ trainings in your community.

Elizabeth Twombly, M.S., Research Assistantwill facilitate the ASQ TOT. Ms. Twombly is a research assistant at the Early Intervention Program, Center on Human Development, University of Oregon. She provides training and technical assistance to state agencies on the ASQ system. She has been involved in several research studies on the ASQ, including the development of additional intervals for the second edition.

Participating in the ASQ TOT takes commitment on the part of the participant, their agency and Children’s Trust Fund. As an ASQ facilitator you will commit to providing a minimum of two ASQ/ASQ SE trainings in your community. Both trainings must be completed by July 31, 2009.

Participants will be selected to attend this ASQ TOT based on the following criteria:

  • Previous training in using the ASQ
  • Knowledge and experience using ASQ
  • Knowledge of early childhood development
  • Commitment to ASQ as documented on the Agency Memorandum of Agreement

The deadline for applications is Monday July 14, 2008. You will be notified via email if you are accepted to attend the Ages & Stages Questionnaire Training of Trainers. Please complete the attached application and Agency Memorandum of Agreement. Address your application, Agency Memorandum of Agreement and any questions to:

Luz M. Rivera, Primary Prevention Services Coordinator

Children’s Trust Fund

410 Capitol Avenue – 3rd floor

Hartford, CT06106

Phone: 860-418-8770

Fax: 860-418-8780

Email:

Space is limited! There are 35 seats available for this training institute. Continental breakfast, lunch and afternoon snack provided.

Ages & Stages Questionnaire Training of Trainers

Participant Application

Application Deadline ~ Monday, July 14, 2008

July 28 & 29, 2008

Village atSouth Farms

645 Saybrook Road

Middletown, CT06457

Facilitator:

Name ______Position ______

Agency______

Address ______City ______

Email ______Telephone ______

  • When and where were you trained on using the ASQ and/or ASQ: SE?

______

  • Describe your experience using the ASQ and/or ASQ:SE

______

  • Describe any training or experience that demonstrates your knowledge of early childhood development

______

  • Describe your plan to provide ASQ and ASQ:SE community-based trainings

______

  • Complete and submit the attached Agency Memorandum of Agreement

Ages & Stages Questionnaire Training of Trainers

Agency Memorandum of Agreement

Training Participants will commit to:

  • Attend and participate in the entire two-day Training of Trainers on July 28th & 29th
  • Provide a minimum of two (2) community-based trainings by July 31, 2009
  • Be listed as on the ASQ Master Facilitator list
  • Submit required documentation of ASQ trainings to the Children’s Trust Fund

Agency administrator agrees to:

  • Support participant attendance at the two day training
  • Purchase ASQ materials for community-based trainings
  • Sponsor two (2) community-based trainings by July 31, 2009

Children’s Trust Fund agrees to:

  • Provide technical assistance to ASQ Master Facilitator regarding community-based training, materials and documentation
  • Provide feedback based on training evaluation forms

______

Participant SignatureDate

______

Name of Agency

______

Signature of Agency SupervisorDate

______

Children’s Trust Fund Program SupervisorDate

Sponsored by the State of Connecticut Children’s Trust Fund & Department of Public Health