M-CHAT Screening: Autism Checklist for Children

Reviewed by:

March 7, 2022

The M-CHAT screening (Modified Checklist for Autism in Toddlers) is an autism test that evaluates a child’s risk for Autism Spectrum Disorder (ASD). Parents can complete the 20 questions in approximately 10 minutes and receive an autism risk assessment for their child. M-CHAT is recommended for children between 16 and 30 months.

Here is an M-Chat screening test you can take today to see if your child is at risk for autism.

Why should parents use the M-CHAT screening test?

Autism Spectrum Disorder is a life-long condition seen in 1 of 54 children by the age of eight. In fact, children as young as 12 months old can show signs of autism.

However, the presence of one or two symptoms identified on this test does not necessarily indicate the presence of autism. It is natural for a child’s motor, communication, and social ability to develop at different rates. As such, it can be difficult to distinguish between natural development and autism-related characteristics.

The M-CHAT screening tool can help you determine whether or not your child may have autism. Your child is not required to be present when you take the assessment. The answers to the questions on the screening tool are based on personal observations of your child. If your child's risk level is medium to high, there is a follow-up section with more questions.

The importance of autism screening at an early age

According to a study published in the Journal of Pediatrics, healthcare providers often delay an autism diagnosis even when parents are concerned. As a result, the actual autism diagnosis may take up to three years.

A late diagnosis could be harmful to the child since early detection and early intervention ABA therapy generally leads to better outcomes for children and their families. Early intervention through Applied Behavioral Analysis (ABA) can help:

  • Toddlers learn and practice socially significant behaviors such as making eye contact, interacting with peers, and conversing - abilities that most children develop naturally.
  • Children with autism may withdraw from human interaction and conversation. Parents can learn the skills they need to help their children from a Board Certified Behavioral Analyst.

Early detection and therapy can be tremendously beneficial for the future success of the child.

How does M-CHAT screening help improve the quality of autism screening?

Doctors can identify children at risk for autism earlier and more accurately with the M-CHAT-R/F than with developmental surveillance alone. Studies have shown that early intervention therapy for children with autism have helped children have greater developmental success

How to use M-CHAT screening?

M-CHAT can be used to evaluate indicators of autism within the comfort of your own home without professional assistance.

The primary goal of the M-CHAT is to assist in the early detection of potential autism. However, not all children who are at risk for autism will be diagnosed. 

Many children who fail the M-CHAT will not be identified with autism even with the follow-up questions. These children are still at risk of additional developmental challenges so every child who fails the screening should still be evaluated by a medical doctor or psychological professional.

The M-CHAT can be scored in less than two minutes. Children who fail three or more total items or two or more key items (especially if these scores remain elevated after the follow-up interview) should seek a professional for further diagnostic examination. 

In addition, any children that a physician, parent, or other professional has expressed concern about autism should be submitted for evaluation.

Is M-CHAT screening reliable?

Although M-CHAT does not provide an autism diagnosis, it does reveal warning signs. The checklist is only intended for personal evaluation. It is not as complete or objective as a qualified professional’s autism assessment. Consider consulting a medical expert who has experience with autism if your M-CHAT results indicate that your child is in the medium to high-risk category. 

Challenges with M-CHAT

The M-CHAT provides early detection of children at risk for autism who would otherwise go unnoticed. However, the follow-up interview questions can take a long time.

Secondary screening is difficult to do in a physician's limited time and few pediatric care centers have the necessary amount of employees to conduct the screening.

According to comments from local physicians and preliminary records review, many physicians in the community miss the follow-up interview questions due to a lack of time or an understanding of the relevance of the follow-up questions.

Mis-scoring of questionnaires, a lack of knowledge of the necessity of screening, and a scarcity of autism-specific resources for children who have screened positive for autism are all challenges in the screening process. These obstacles obstruct reliable evaluation of the impact of screening and prevent children with autism from receiving appropriate and timely care.

About M-CHAT-R (Revised)

The M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) is a revised screening tool that asks 20 questions regarding your child's behavior. It's designed for children between the ages of 16 and 30 months.

Similar to the previous version, you'll be asked questions that represent your child's typical behavior. The results will indicate whether or not further testing is required. You can use the screener's results to talk to your child's healthcare professional about any concerns you have.

Researchers have improved earlier versions of the autism screening tool by adding examples, rephrasing certain questions, and removing others that had not elicited strong responses previously. The researchers collaborated with health care practitioners to screen over 15,000 toddlers who were thought to be at low risk for autism using the updated technique. The researchers discovered that the M-CHAT-R/F classifications resulted in a lower proportion of children (7%) receiving a medium- or high-risk evaluation than previous versions of the checklist (9%). However, the revised checklist recognized more total cases of autism than previous iterations.


Since M-CHAT is designed to be administered by a skilled health care professional, if you take the assessment at home, it is recommended to talk to your doctor about the results.

Songbird therapy is a technology-enabled provider setting a higher standard for children’s autism care. With a deeply passionate team and innovative technology, we’re building a world where every child can access world-class care at home, uniquely tailored to them.

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