Medical Diagnostics & Clinical Scoring

M-CHAT-R for Autism

Use the Modified Checklist for Autism in Toddlers (M-CHAT-R) to screen children between 16 and 30 months for autism spectrum disorder.

Points to things to show interest

Yes

Wonder if child is deaf

Play pretend or make-believe

Yes

Climb on things

Yes

Unusual finger movements near eyes

Point with one finger to ask for help

Yes

Point with one finger to show interest

Yes

Interested in other children

Yes

Show items by bringing them to you

Yes

Respond when name is called

Yes

Smile back when you smile

Yes

Upset by everyday noises

Walks independently

Yes

Look in eye when talking/playing

Yes

Try to copy what you do

Yes

Turn head to look at what you point at

Yes

Try to get you to look at something

Yes

Understand what you say

Yes

Look at your face to see how to react

Yes

Wander around with no goal

Total Fail Score

Risk CategoryLow Risk (0-2)

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M-CHAT-R Overview

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a scientifically validated, parent-completed questionnaire designed to screen children between 16 and 30 months of age for autism spectrum disorder (ASD).

The Importance of Early Screening

Early detection of autism is critical because early intervention services (like speech and behavioral therapies) are significantly more effective when started during the toddler years, taking advantage of high early-brain neuroplasticity. The AAP recommends universally screening all children at 18 and 24 months.

Risk Categories and Follow-up

The questionnaire consists of 20 yes/no questions about the child's behavior (e.g., eye contact, pointing, response to name).

0-2 (Low Risk): No further action needed unless developmental surveillance indicates otherwise.
3-7 (Medium Risk): The clinician should administer the Follow-Up interview (M-CHAT-R/F) to clarify ambiguous answers. If the follow-up score remains ≥ 2, referral is needed.
8-20 (High Risk): Immediate referral for a comprehensive diagnostic evaluation and early intervention services is strongly recommended without waiting for the follow-up interview.

Score = Total number of 'Failed' behavioral items

Frequently Asked Questions

No. The M-CHAT-R is strictly a screening tool, not a diagnostic tool. A high score means your child has a higher likelihood of an ASD or another developmental delay, and must be evaluated by a specialist (like a developmental pediatrician) for an actual diagnosis.

Parental intuition is very important. Even if the screening is negative (low risk), if you or the pediatrician have ongoing concerns about the child's development, a referral to a specialist should still be made.

The survey mixes typical behaviors (where a 'No' indicates a fail, like 'Does your child point?') and atypical behaviors (where a 'Yes' indicates a fail, like 'Does your child make unusual finger movements?'). This is to ensure parents read each question carefully rather than just checking 'Yes' down the entire list.

M-CHAT-R for Autism

M-CHAT-R Overview

The Importance of Early Screening

Risk Categories and Follow-up

Frequently Asked Questions

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