Instructions for Use
The M-CHAT is validated for screening toddlers between 16 and 30 months of age, to assess risk of autism spectrum disorders (ASDs). The M-CHAT can be administered and scored as part of a well-child check-up, and also can be used by specialists or other professionals to assess risk of ASDs. The primary goal of the M-CHAT was to maximize sensitivity, meaning to detect as many cases of ASD as possible. Therefore, there is a high false-positive rate, meaning that not all children who score at risk of ASD will be diagnosed with ASD. To address this, we have developed a structured follow-up interview for use in conjunction with the M-CHAT; it is available at http://www.mchatscreen.com or http://www.firstsigns.org. Users should be aware that even with the follow-up questions, a significant number of the children who fail the M-CHAT will not be diagnosed with an ASD; however, these children are at risk of other developmental disorders or delays, and therefore, evaluation is warranted for any child who fails the screening.
The M-CHAT can be scored in less than two minutes. Scoring instructions can be downloaded from http://www.mchatscreen.com or http://www.firstsigns.org. We also have developed a scoring template, which is available on these Web sites; when printed on an overhead transparency and laid over the completed M-CHAT, it facilitates scoring. Please note that minor differences in printers may cause your scoring template not to line up exactly with the printed M-CHAT.
Children who fail more than three items total or two critical items (particularly if these scores remain elevated after the follow-up interview) should be referred for diagnostic evaluation by a specialist trained to evaluate ASD in very young children. In addition, children for whom there are physician, parent, or other professional's concerns about ASD should be referred for evaluation, given that it is unlikely for any screening instrument to have 100 percent sensitivity.
M-CHAT
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 a doll or 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 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., 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