The Modified Checklist for Autism in Toddlers (M-CHAT-R) App
Please answer these questions about your child. Keep in mind how your child usually behaves. If you have seen your child do the behavior a few times, but he or she does not usually do it, then please answer fail. Please select pass or fail for every question. Thank you very much.
Assessment Results
User Guide
M-CHAT-R™ Assessment Tool User Guide
Instructions for Use
The M-CHAT-R/F is designed to be used with the M-CHAT-R. The M-CHAT-R is valid for screening toddlers between 16 and 30 months of age to assess risk for autism spectrum disorder (ASD). Users should be aware that even with the Follow-Up, a significant number of the children who fail the M-CHAT-R will not be diagnosed with ASD; however, these children are at risk for other developmental disorders or delays, and therefore, follow-up is warranted for any child who screens positive.
Screening Process
Once a parent has completed the M-CHAT-R, score the instrument according to the instructions. If the child screens positive, select the Follow-Up items based on which items the child failed on the M-CHAT-R; only those items that were originally failed need to be administered for a complete interview.
Each page of the interview corresponds to one item from the M-CHAT-R. Follow the flowchart format, asking questions until a PASS or FAIL is scored. Please note that parents may report “maybe” in response to questions during the interview. When a parent reports “maybe,” ask whether most often the answer is “yes” or “no” and continue the interview according to that response. In places where there is room to report an “other” response, the interviewer must use their judgment to determine whether it is a passing response or not.
Scoring and Recommendations
Score the responses to each item on the M-CHAT-R/F Scoring Sheet (which contains the same items as the M-CHAT-R, but Yes/No has been replaced by Pass/Fail). The interview is considered to be a screen positive if the child fails any two items on the Follow-Up.
If a child screens positive on the M-CHAT-R/F, it is strongly recommended that the child be referred for early intervention and diagnostic testing as soon as possible. Please note that if the healthcare provider or parent has concerns about ASDs, children should be referred for evaluation regardless of the score on the M-CHAT-R or M-CHAT-R/F.
Getting Started
Patient Information Section
- Child's Name: Enter the child's full name
- Date of Birth: Enter using the date picker
- Filled out by: Name of the person completing the assessment
- Relationship to child: Specify relationship (parent, guardian, healthcare provider)
- Today's Date: Current date of assessment
Completing the Assessment
Important Guidelines
- Answer all 20 questions in order
- If behavior is rarely observed (seen only once or twice), answer "No"
- Select either "Yes" or "No" for each question
- Read the examples provided with each question carefully
Question Format
Each question includes:
- Main question text
- Practical examples in italics
- Yes/No radio button options
Scoring Algorithm
For all items except 2, 5, and 12, the response “NO” indicates ASD risk; for items 2, 5, and 12, “YES” indicates ASD risk. The following algorithm maximizes the psychometric properties of the M-CHAT-R:
Low-Risk
Total Score: 0-2
- If the child is younger than 24 months, screen again after their second birthday.
- No further action is required unless surveillance indicates a risk for ASD.
Medium-Risk
Total Score: 3-7
- Administer the Follow-Up (second stage of M-CHAT-R/F) to gather additional information about at-risk responses.
- If the M-CHAT-R/F score remains at 2 or higher, the child has screened positive.
- Action required: Refer the child for diagnostic evaluation and eligibility evaluation for early intervention.
- If the score on Follow-Up is 0-1, the child has screened negative. No further action is required unless surveillance indicates a risk for ASD.
- The child should be rescreened at future well-child visits.
High-Risk
Total Score: 8-20
- It is acceptable to bypass the Follow-Up and refer immediately for diagnostic evaluation and eligibility evaluation for early intervention.
Tool Features
- Automatic Scoring: Results calculated instantly upon submission
- Age-Based Recommendations: Suggestions tailored to child's age
- Clear Risk Indicators: Color-coded risk levels for easy interpretation
- Save & Reset: Options to clear form and start new assessment
Best Practices
- Complete all questions in one sitting
- Ensure the respondent is familiar with child's daily behavior
- Consider child's usual behavior, not occasional instances
- Document results in patient's medical record
- Review results with family/caregivers
- Provide appropriate referrals based on risk level
Technical Support
- Compatible with all modern web browsers
- Works on desktop and mobile devices
- No internet connection required after initial load
- Data remains private and is not stored online
