M-CHAT (Modified Checklist for Autism in Toddlers)

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.

1. Does your child enjoy being swung, bounced on your knee, etc.? YES NO

2. Does your child take an interest in other children? YES NO

3. Does your child like climbing on things, such as up stairs? YES NO

4. Does your child enjoy playing peek-a-boo/hide-and-seek? YES NO

5. Does your child ever pretend, for example, to talk on the phone or take care of dollsor pretend other things?
YES NO

6. Does your child ever use his/her index finger to point, to ask for something? YES NO

7. Does your child ever use his/her index finger to point, to indicate interest in something? YES NO

8. Can your child play properly with small toys (e.g. cars or bricks) without just mouthing, fiddling, or dropping them?
YES NO

9. Does your child ever bring objects over to you (parent) to show you something? YES NO

10. Does your child look you in the eye for more than a second or two? YES NO

11. Does your child ever seem oversensitive to noise? (e.g., plugging ears) YES NO

12. Does your child smile in response to your face or your smile? YES NO

13. Does your child imitate you? (e.g., you make a face-will your child imitate it?) YES NO

14. Does your child respond to his/her name when you call? YES NO

15. If you point at a toy across the room, does your child look at it? YES NO

16. Does your child walk? YES NO

17. Does your child look at things you are looking at? YES NO

18. Does your child make unusual finger movements near his/her face? YES NO

19. Does your child try to attract your attention to his/her own activity? YES NO

20. Have you ever wondered if your child is deaf? YES NO

21. Does your child understand what people say? YES NO

22. Does your child sometimes stare at nothing or wander with no purpose? YES NO

23. Does your child look at your face to check your reaction when faced with something unfamiliar?
YES NO

M-CHAT Scoring Instructions

A child fails the checklist when 2 or more critical items are failed OR when any three items are failed. Yes/No answers convert to pass/fail responses.

Below are listed the failed responses for each item on the M-CHAT. Bold capitalized items are CRITICAL items.

Not all children who fail the checklist will meet criteria for a diagnosis on the autism spectrum.

However, children who fail the checklist should be evaluated in more depth by the physician or referred for a developmental evaluation with a specialist.

1. No	6. No	11. Yes	16. No	21. No
2. NO	7. NO	12. No	17. No	22. Yes
3. No	8. No	13. NO	18. Yes	23. No
4. No	9. NO	14. NO	19. No
5. No	10. No	15. NO	20. Yes

Modified Checklist for Autism in Toddlers (M-CHAT)*

Diana L. Robins, Ph.D.,1 Deborah Fein, Ph.D.,2 Marianne L. Barton, Ph.D.,2 & James A. Green, Ph.D.2

1Georgia State University 2University of Connecticut

*The full text may be obtained through the Journal of Autism and DevelopmentalDisorders, April 2001

PLEASE NOTE: The M-CHAT was not designed to be scored by the person taking it. In the validation sample, the authors of the M-CHAT scored all checklists. If parents are concerned, they should contact their child’s physician.

Abstract

Autism, a severe disorder of development, is difficult to detect in very young children. However, children who receive early intervention have improved long-term prognoses. The Modified Checklist for Autism in Toddlers (M-CHAT), consisting of 23 yes/no items, was used to screen 1,293 children. Of the 58 children given a diagnostic/developmental evaluation, 39 were diagnosed with a disorder on the autism spectrum. Six items pertaining to social relatedness and communication were found to have the best discriminability between children diagnosed with and without autism/PDD. Cutoff scores were created for the best items and the total checklist. Results indicate that the M-CHAT is a promising instrument for the early detection of autism.

Background

The M-CHAT is an expanded American version of the original CHAT from the U.K (Baron-Cohen et al., 1992; 1996). The M-CHAT has 23 questions using the original nine from the CHAT as its basis. The goal of the ongoing M-CHAT research is to demonstrate adequate psychometric properties of the M-CHAT (sensitivity, specificity, positive and negative predictive power). The M-CHAT is available for clinical and research use, with the following caveats:

1. Clinical use should proceed with caution, given that the current scoring system is designed to maximize sensitivity (i.e., identify as many children with autism spectrum disorders as possible), which results in a number of false positive cases (i.e., children who will not be diagnosed with an autism spectrum disorder, although they fail the M-CHAT). Once cross-validation of the M-CHAT is complete, the scoring may be revised.

2. The M-CHAT is not designed to detect all possible developmental disorders. Any parents who have concerns about their child should see their child’s physician, regardless on the child’s score on the M-CHAT.

M-CHAT research is ongoing at the University of Connecticut and Georgia State University. The follow-up study of the initial sample is expected to be published in the near future. This research is supported by funding from the National Institute of Child Health and Development, the Maternal and Child Health Bureau, and the National Alliance for Autism Research. For more information, please contact Diana Robins at drobins@gsu.edu or Deborah Fein at Deborah.fein@uconn.edu.