The ASQ-3 is a developmental screener designed to indicate when children may have delays. The tool is not in-depth enough to determine whether children have a slight delay or significant delays in the Communication area (or any developmental area). If a child has concerns in the Communication area (i.e., scoring in the monitoring zone or below the cutoff), following up with a specific language screen (such as MacArthur-Bates Communicative Developmental Inventory) may be necessary. If you have children that are low in the Communication area, you could also give parents activities, such as the ASQ-3 Learning Activities, and then have them do another questionnaire in 4 months to see how language is coming before referring, especially if over-referral is a problem.