Online M-CHAT-R autism screening test
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screening tool designed to identify children who may be at risk for autism spectrum disorder (ASD). The questionnaire consists of 20 yes/no questions that parents answer about their child's social, communication, and play behaviors.
The M-CHAT-R is most appropriate for toddlers. If your child is older, please visit our CAST screener.
While autism is typically diagnosed in early childhood, some children on the spectrum may not receive a diagnosis until much later. The CAST is a valuable tool for recognizing these cases and ensuring children get the help they need. If your child is younger than 4, please complete the M-CHAT screening tool instead of the CAST.
How the M-CHAT-R screener works
Overview
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R), is a brief parent-completed questionnaire used to help identify signs of autism in children between 16 and 30 months of age. It’s designed to be simple, accessible, and easy to complete at home.
How long does the M-CHAT-R take?
Most parents complete our no-cost, online M-CHAT-R screening in under five minutes.
What do the M-CHAT-R questions focus on?
The M-CHAT-R covers early developmental behaviors that are commonly seen in children with autism spectrum disorder, including:
- Social engagement (e.g., Does your child show interest in other children? Do they respond when you call their name?)
- Communication cues (e.g., Does your child point to ask for something? Do they use gestures to communicate?)
- Joint attention (e.g., Does your child look in the same direction as you when you point at something?)
- Imaginative play (e.g., Does your child pretend to do things like cooking or feeding a doll?)
- Sensory sensitivity or atypical behavior patterns (e.g., Does your child engage in repetitive motions like spinning or flapping?)
M-CHAT-R scoring
The M-CHAT-R includes 20 yes/no questions that assess a toddler’s behavior related to social interaction, communication, and play. Each question is scored to help determine if a child may be at risk for autism spectrum disorder.
How the M-CHAT scoring works
Each response is scored as either 0 or 1 point, depending on whether the behavior described is typical or a potential sign of autism.
The total score is the sum of all responses, ranging from 0 to 20.
- Most questions:
- A “yes” response usually indicates typical development and scores 0 points.
- A “no” response may indicate a red flag and scores 1 point.
- Some reverse-scored items:
- For a few specific questions, a “no” may indicate typical development and scores 0, while a “yes” scores 1.
- These questions are worded this way because the behaviors they ask about are considered atypical when they do occur.
Score range
Interpretation
Recommended action
0-2
Low likelihood of autism traits
No further action needed unless other concerns exist
3-7
Possible autism traits
Follow up with a professional autism evaluation
8-20
High likelihood of autism
Immediate clinical assessment is recommended
The M-CHAT-R is an autism screening tool, not a diagnostic tool. A higher score suggests that your child may benefit from additional evaluation, but it does not confirm an autism diagnosis.
What happens after the M-CHAT-R?
After completing the M-CHAT-R, one of our Clinic Admissions Associates (CAAs) will review your child's responses. You'll typically be contacted within one business day to discuss the results and recommended next steps.
Depending on your child’s score, here’s what to expect:
Low score(0–2)
- Most children in this range are unlikely to be on the autism spectrum.
- You will receive confirmation of this low-risk result within one business day.
- No further action is usually needed, though you can continue to monitor your child’s development or consult your pediatrician if concerns arise.
Medium score (3–7)
- This score suggests that your child may benefit from closer monitoring.
- While this result does not necessarily indicate autism, we encourage you to speak with your child’s pediatrician about your concerns.
- They may recommend a more detailed autism diagnostic evaluation
High score(8–20)
- A high score does not mean your child has autism, but it indicates a greater likelihood and the need for further evaluation.
- You’ll be contacted within one business day to discuss next steps, which may include scheduling an ADOS-2 diagnostic assessment.
- The ADOS-2 is a gold-standard, in-person tool used to determine whether your child meets criteria for an autism diagnosis.
M-CHAT-R autism screening tool
M-CHAT-R is © 2009 Robins, Fien, and Barton
Please answer these questions about your child. Keep in mind how your child usually behaves. If you have seen your child engage in a behavior a few times, but they do not usually do it, then please answer no. Please check yes or no for every question.
M-CHAT-R frequently asked questions
What is the goal of the M-CHAT-R?
The goal of the M-CHAT-R is to identify toddlers who may benefit from early autism intervention services, such as applied behavioral analysis (ABA) therapy for autism.
Why is it important to identify autism early?
Identifying autism spectrum disorder in children early is important because it allows for timely access to early intensive behavioral interventions (EIBIs), such as applied behavior analysis therapy. ABA therapy has been proven through decades of research to help children with autism improve their communication and social skills, prepare them for school, and reduce target behaviors. Caregivers play a vital role in monitoring their child’s development and advocating for their child’s needs.
What happens after I complete the M-CHAT-R?
You’ll be contacted within one business day to discuss your child’s results and next steps, which may include a diagnostic assessment such as the ADOS-2.
Can I complete the M-CHAT-R more than once?
Yes. If you have ongoing concerns or your child is still within the 16–30-month age range, you can retake the M-CHAT-R at a later time.
How reliable is the M-CHAT-R compared to other screening tools?
The M-CHAT-R is one of the most widely used autism screeners for toddlers. It's designed to be highly sensitive. However, like all screeners, it’s not perfect and should be followed by further evaluation if needed.
How accurate is the M-CHAT-R?
The M-CHAT-R is a validated tool that can detect potential autism cases, but, as with any screener, it may falsely flag children who do not have ASD. This is why follow-up interviews or diagnostic testing are essential for accurate diagnosis.
