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

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 American Academy of Pediatrics (AAP) recommends that all children receive autism screening at 18 and 24 months of age, and the M-CHAT is one of the AAP’s recommended tools.

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 Interview^TM (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  (Available in other languages here.)
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.

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 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 a doll or other pretend things? Yes  No

6. Does your child ever use an index finger to point, to ask for something? Yes  No

7. Does your child ever use an index finger to point, to indicate interest in something? Yes  No

8. Can your child play properly with small toys (e.g. cars or blocks) 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. If you make a face, will your child do so?) 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 the unfamiliar? Yes No

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

© 1999 Diana Robins, Deborah Fein & Marianne Barton

For more information and resources, please see our Video Glossary and FAQs and special sections on Diagnosis, Symptoms, Learn the Signs, Treatment, Your Child’s Rights, Asperger Syndrome and PDD-NOS. We also offer a number of resource-packed tool kits for free download (here and here). They include our 100 Day Kit for families who have a child recently diagnosed with autism. These resources are made possible through the generous support of our families, volunteers and other donors.