Modified Checklist for Autism in Toddlers

Description of Screening Tool

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a 20-item yes/no questionnaire on child behavior and development reported by parents of toddlers between 16 and 30 months of age (Robbins, Fein, & Barton, 2009). The American Academy of Pediatricians (AAP) recommends doing screening for autism at 18 and 24 months of age using the M-CHAT-R (Burns, et al., 2017). The M-CHAT-R is the most commonly validated and recommended tool for screening toddlers for autism spectrum disorder (ASD). A positive M-CHAT is defined as failing to respond ‘’YES’’ for all items except 2, 5, and 12, the response “NO” indicates ASD risk (Toh, Tan, Lau, & Kiyu, 2017). Due to the goal of the M-CHAT-R to maximize sensitivity, there is a high false-positive rate. Training is required to interpret results correctly, understanding that not all children who score at risk will be diagnosed with ASD (Toh et al., 2017). 

The scoring algorithm has 3 classifications; low-risk (total score is 0-2), medium-risk (total score is 3-7), and high-risk (total score is 8-20) (Robbins, Fein, & Barton, 2009). The indications for children with low-risk results are to rescreen after the second birthday. For children with medium-risk, the administration of The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is required. Finally, children at high-risk must be referred for diagnostic evaluation and eligibility for early intervention (Robbins, Fein, & Barton, 2009). 

References

Burns, C.E., Dunn, A.M., Brady, M.A., Starr, N.B., Blosser, C.G. & Garzon, D.L. (2017).

Pediatric Primary Care (6th ed.) St. Louis, MO: Elsevier Mosby.

Robbins, D., Fein, D., & Barton, M. (2009). Modified checklist for autism in toddlers, revised, 

with follow-up. Retrieved from www.mchatscreen.com

Toh, T.-H., Tan, V. W.-Y., Lau, P. S.-T., & Kiyu, A. (2017). Accuracy of Modified Checklist for 

Autism in Toddlers (M-CHAT) in Detecting Autism and Other Developmental Disorders in Community Clinics. Journal of Autism and Developmental Disorders, 48(1), 28–35. doi: 10.1007/s10803-017-3287-x