| Type | Level 1 screening questionnaire (not diagnostic) |
|---|---|
| Age range | 16–30 months |
| Format | 20 yes/no questions answered by a parent, ~5 minutes; plus a short structured follow-up interview for mid-range scores |
| Who administers | Parents can complete it themselves; scoring/follow-up typically with a pediatric professional |
| Cost | Free for parents and clinicians at the authors' official site, mchatscreen.com, in many languages |
What it asks about
The questions cover everyday behaviors that reflect early social communication: whether your child points to show you things, follows your point, responds to their name, brings objects to share, engages in pretend play, and how they react to sounds and movement. (I don't reproduce the questionnaire here — it belongs to its authors — but the official version is free at the link above.)
How scoring works
- Low risk (score 0–2): no flag right now. Screening repeats at the 24-month visit — development keeps unfolding.
- Medium risk (score 3–7): the follow-up interview (the "/F") is done — a few structured clarifying questions per flagged item. This step matters: it filters out many false alarms. If the score stays elevated after follow-up, referral for evaluation.
- High risk (score 8–20): straight to referral for a comprehensive evaluation and early intervention — no follow-up interview needed.
What a result means — and doesn't
A positive screen means evaluate, not autistic. In the validation research, most children who screened positive (after follow-up) turned out to have some developmental condition that benefited from support — autism or otherwise — which is exactly what a screen is for. A negative screen lowers concern but doesn't rule autism out; children who mask well or whose signs emerge later can pass it. Persistent parental concern outranks a negative screen.
If your child is 18 or 24 months old and hasn't been screened, ask for it by name at the next visit: "I'd like the M-CHAT autism screening done today." The American Academy of Pediatrics recommends it for every child at both ages — with or without concerns.
After the M-CHAT
Elevated result? Two parallel tracks, starting now: a diagnostic evaluation (get on waitlists early) and early intervention, which needs no diagnosis for children under 3 in the U.S.
Medical disclaimer: Educational information only, based on the published M-CHAT-R/F validation research (Robins, Fein & Barton). The M-CHAT-R/F belongs to its authors. This page cannot diagnose your child; consult a qualified clinician.