Skip to content

Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F)

CONTENTS

CONTENTS

Assessment Rating

B - Psychometrics Demonstrated

Developer: Diana Robins, PhD, Deborah Fein, PhD, & Marianne Barton, PhD

B
See entire scale

Assessment Rating

B - Psychometrics Demonstrated

Developer: Diana Robins, PhD, Deborah Fein, PhD, & Marianne Barton, PhD

B
See entire scale

Description / Purpose

The M-CHAT-R/F screens for risk for autism spectrum disorder.

The M-CHAT-R/F is a two-stage screening tool. It is designed to be completed by parents of children 16-30 months old. The initial screening consists of 20 yes/no questions about the child's usual behavior. Children who score in the low-risk range (0-2) need no referrals unless surveillance suggests risk for autism. Parents of children in the moderate risk range (3-7) should complete the relevant Follow-Up questions, and if the score on Follow-Up is 2 or higher, the child should be referred for diagnostic evaluation and early intervention. Children who score in the high-risk range (8+) should be immediately referred for evaluation and intervention.

Target Population: 16-30 months

Time to Administer: 5 minutes for first stage, 5-10 minutes for Follow-Up

Completed By: Parent/guardian

Available Modalities: Pen and paper and computerized. web-based screening is currently undergoing validation, but commercial electronic tools are available (e.g., www.m-chat.org) *Please note that m-chat.org is a licensee and pays fees to use the M-CHAT-R; paper download available free from www.mchatscreen.com

Scoring Information:

The website, www.mchatscreen.com, offers several scoring options; M-CHAT-R/F can be hand scored in less than one minute, scoring overlay and excel scoring program are available for download

Language Notes:

See www.mchatscreen.com for languages. Original M-CHAT available in many more languages than M-CHAT-R/F

Training Requirements:

No training needed

Availability:

Paper/PDF downloads are free and available at www.mchatscreen.com Entities who wish to incorporate M-CHAT into electronic tools must have license agreement – see website

Languages Available: English

Description / Purpose

The M-CHAT-R/F screens for risk for autism spectrum disorder.

The M-CHAT-R/F is a two-stage screening tool. It is designed to be completed by parents of children 16-30 months old. The initial screening consists of 20 yes/no questions about the child's usual behavior. Children who score in the low-risk range (0-2) need no referrals unless surveillance suggests risk for autism. Parents of children in the moderate risk range (3-7) should complete the relevant Follow-Up questions, and if the score on Follow-Up is 2 or higher, the child should be referred for diagnostic evaluation and early intervention. Children who score in the high-risk range (8+) should be immediately referred for evaluation and intervention.

Target Population: 16-30 months

Time to Administer: 5 minutes for first stage, 5-10 minutes for Follow-Up

Completed By: Parent/guardian

Available Modalities: Pen and paper and computerized. web-based screening is currently undergoing validation, but commercial electronic tools are available (e.g., www.m-chat.org) *Please note that m-chat.org is a licensee and pays fees to use the M-CHAT-R; paper download available free from www.mchatscreen.com

Scoring Information:

The website, www.mchatscreen.com, offers several scoring options; M-CHAT-R/F can be hand scored in less than one minute, scoring overlay and excel scoring program are available for download

Language Notes:

See www.mchatscreen.com for languages. Original M-CHAT available in many more languages than M-CHAT-R/F

Training Requirements:

No training needed

Availability:

Paper/PDF downloads are free and available at www.mchatscreen.com Entities who wish to incorporate M-CHAT into electronic tools must have license agreement – see website

Languages Available: English

Contact Information

Diana L. Robbins, PhD

Contact Information

Diana L. Robbins, PhD

Summary of Relevant Psychometric Research
This tool has received the Measurement Tools Rating of B – Psychometrics Demonstrated based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.
View All Research Articles

  • Robins, D.L., Casagrande, K., Barton, M.L., Chen, C., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F). Pediatrics, 133 (1), 37-45.

    Participants: 15,612 toddlers

    Summary:

    This study validates the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), a screening tool for low risk toddlers, and demonstrates improved utility compared with the original M-CHAT. The reliability and validity of the M-CHAT-R/F were demonstrated, and optimal scoring was determined by using receiver operating characteristic curves. Children whose total score was >3 initially and >2 after follow-up had a 47.5% risk of being diagnosed with autism spectrum disorder (ASD) and a 94.6% risk of any developmental delay or concern. Total score was more effective than alternative scores. An algorithm based on 3 risk levels is recommended to maximize clinical utility and to reduce age of diagnosis and onset of early intervention. The M-CHAT-R/F detects ASD at a higher rate compared with the M-CHAT while also reducing the number of children needing the follow-up. Children in the current study were diagnosed 2 years younger than the national median age of diagnosis.

Summary of Relevant Psychometric Research

This tool has received the Measurement Tools Rating of B – Psychometrics Demonstrated based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.
View All Research Articles

  • Robins, D.L., Casagrande, K., Barton, M.L., Chen, C., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F). Pediatrics, 133 (1), 37-45.

    Participants: 15,612 toddlers

    Summary:

    This study validates the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), a screening tool for low risk toddlers, and demonstrates improved utility compared with the original M-CHAT. The reliability and validity of the M-CHAT-R/F were demonstrated, and optimal scoring was determined by using receiver operating characteristic curves. Children whose total score was >3 initially and >2 after follow-up had a 47.5% risk of being diagnosed with autism spectrum disorder (ASD) and a 94.6% risk of any developmental delay or concern. Total score was more effective than alternative scores. An algorithm based on 3 risk levels is recommended to maximize clinical utility and to reduce age of diagnosis and onset of early intervention. The M-CHAT-R/F detects ASD at a higher rate compared with the M-CHAT while also reducing the number of children needing the follow-up. Children in the current study were diagnosed 2 years younger than the national median age of diagnosis.