The Modified Checklist for Autism in Toddlers (M-CHAT; Robins, Fein, & Barton, 1999) is available for free download for clinical, research, and educational purposes. There are two authorized websites: the MCHAT and supplemental materials can be downloaded from www.firstsigns.org or from Dr. Robins’ website, at http://www.mchatscreen.com
Users should be aware that the M-CHAT continues to be studied, and may be revised in the future. Any revisions will be posted to the two websites noted above.
Furthermore, the M-CHAT is a copyrighted instrument, and use of the M-CHAT must follow these guidelines:
- Reprints/reproductions of the M-CHAT must include the copyright at the bottom (©️ 1999 Robins, Fein, & Barton). No modifications can be made to items or instructions without permission from the authors.
- The M-CHAT must be used in its entirety. There is no evidence that using a subset of items will be valid.
- Parties interested in reproducing the M-CHAT in print (e.g., a book or journal article) or electronically (e.g., as part of digital medical records or software packages) must contact Diana Robins to request permission (firstname.lastname@example.org).
Instructions for Use
The M-CHAT is validated for screening toddlers between 16 and 30 months of age, to assess risk for autism spectrum disorders (ASD). The M-CHAT can be administered and scored as part of a well-child check-up, and also can be used by specialists or other professionals to assess risk for ASD. The primary goal of the M-CHAT was to maximize sensitivity, meaning to detect as many cases of ASD as possible. Therefore, there is a high false positive rate, meaning that not all children who score at risk for ASD will be diagnosed with ASD. To address this, we have developed a structured follow-up interview for use in conjunction with the M-CHAT; it is available at the two websites listed above. Users should be aware that even with the follow-up questions, a significant number of the children who fail the M-CHAT will not be diagnosed with an ASD; however, these children are at risk for other developmental disorders or delays, and therefore, evaluation is warranted for any child who fails the screening.
The M-CHAT can be scored in less than two minutes. Scoring instructions can be downloaded from http://www.mchatscreen.com or www.firstsigns.org. We also have developed a scoring template, which is available on these websites; when printed on an overhead transparency and laid over the completed M-CHAT, it facilitates scoring. Please note that minor differences in printers may cause your scoring template not to line up exactly with the printed M-CHAT.
Children who fail 3 or more items total or 2 or more critical items (particularly if these scores remain elevated after the follow-up interview) should be referred for diagnostic evaluation by a specialist trained to evaluate ASD in very young children. In addition, children for whom there are physician, parent, or other professional’s concerns about ASD should be referred for evaluation, given that it is unlikely for any screening instrument to have 100% sensitivity.
Please fill out the following about how your child usually is. Please try to answer every question. If the behavior is rare (e.g., you've seen it once or twice), please answer as if the child does not do it.