ASQ was developed and validated as a parent-completed tool, and many studies have found parents to be reliable evaluators of children's behavior. In a case where the professional knows the child well (e.g., child care teacher) and sees different behavior than reported on ASQ, an opportunity arises for discussion with the parent. The professional could ask for more information from the parent to learn more about how the behavior or skill manifests at home and discover how the behavior could be encouraged in the school setting. It's possible that after more in-depth discussion, the parent may have misunderstood the item. But, it's common for children to exhibit different skills/behaviors in different settings or with different caregivers.