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