The Modified Checklist for Autism in Toddlers (M-CHAT™) is a scientifically validated tool for screening children between 16 and 30 months of age to assess their risk for autism spectrum disorder (ASD). It was developed by neuropsychologists Diana Robins and Deborah Fein and clinical psychologist Marianne Barton.

The M-CHAT’s primary goal is to detect as many cases of ASD as possible. Therefore, there is a high false positive rate, meaning that many children who score at risk for ASD will not be diagnosed with ASD. To address this, the authors developed a structured M-CHAT Follow-up InterviewTM (downloadable here).

Even with the follow-up questions, a significant number of children whose results show risk for ASD will not meet the diagnostic criteria on a more comprehensive evaluation by a specialist. Nonetheless, these children are at risk for a range of developmental disorders and delays and, therefore, should receive further evaluation. Conversely, a child should be referred for further evaluation any time a parent or professional has persistent concerns about autism, even if the child does not show ASD risk on the M-CHAT. If you and/or your physician feel that further screening is needed, you can request a free developmental assessment through your state department of health.

Instructions for Taking and Scoring the M-CHAT

A child should be referred for further evaluation when any three answers suggest risk for ASD, as indicated by the list of ASD risk responses that follow the questions. Please answer questions to reflect your child’s usual behaviors. If the behavior is rare (e.g., you’ve seen it only once or twice), answer as if the child has not acquired the behavior.

Autism Speaks has also launched an automated version of the Modified Checklist for Autism in Toddlers which you can access by going to this web page.  It is not intended to take the place of screening and diagnosis by a trained professional. Rather it is a useful tool that parents can use if they are concerned about their toddler’s development and whether their child should be evaluated by a healthcare provider or developmental specialist.

1. Does your child enjoy being swung, bounced on your knee, etc.?

2. Does your child take an interest in other children?

3. Does your child like climbing on things such as stairs?

4. Does your child enjoy playing peek-a-boo/hide-and-seek?

5. Does your child ever pretend, for example, to talk on the phone or take care of a doll or other pretend things?

6. Does your child ever use an index finger to point, to ask for something?

7. Does your child ever use an index finger to point, to indicate interest in something?

8. Can your child play properly with small toys (e.g. cars or blocks) without just mouthing, fiddling, or dropping them?

9. Does your child ever bring objects over to you (parent) to show you something?

10. Does your child look you in the eye for more than a second or two?

11. Does your child ever seem oversensitive to noise? (e.g., plugging ears)

12. Does your child smile in response to your face or your smile?

13. Does your child imitate you? (E.g. If you make a face, will your child do so?

14. Does your child respond to his/her name when you call?

15. If you point at a toy across the room, does your child look at it?

16. Does your child walk?

17. Does your child look at things you are looking at?

18. Does your child make unusual finger movements near his/her face?

19. Does your child try to attract your attention to his/her own activity?

20. Have you ever wondered if your child is deaf?

21. Does your child understand what people say?

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

23. Does your child look at your face to check your reaction when faced with the unfamiliar?

Having three or more of the following responses suggests risk for autism. 

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