Scoring M-CHAT


*** SCORING UPDATE ***

The M-CHAT has been updated. For the most recent version of the tool, please see the M-CHAT-R/F tabs. If you have reason to continue using the original M-CHAT, please see below.

Our latest paper examining the M-CHAT in low-risk settings (pediatric well visits) indicates that the M-CHAT TOTAL SCORE is the recommended score for assessing ASD risk in toddlers. Over the years we have explored other scores, including the Critical6 and the Best7, and determined that they do not have adequate sensitivity unless combined with Total score, and the do not greatly improve sensitivity above and beyond Total score. The M-CHAT Follow-Up (M-CHAT/F) has been demonstrated to significantly improve positive predictive value (PPV) over the initial M-CHAT screen along; this means that the healthcare provider’s confidence that referrals are needed is much higher when the 2-stage M-CHAT is administered, rather than only the initial questions.

The PPV of the 2-stage M-CHAT, now called the M-CHAT with Follow-Up, or M-CHAT/F, indicates that 54% of children who screen positive are likely to be diagnosed with an ASD. Broadening our scope to consider other developmental delays, 89% of children who screen positive are likely to be diagnosed with a developmental delay. Furthermore, 98% of all toddlers who screen positive are likely to show a developmental concern warranting further evaluation (although not all cases meet criteria for a specific developmental disorder). See Chlebowski et al. (2013) for more information.

The current recommended scoring algorithm is as follows:

  • M-CHAT Total Score 0-2: No Follow-Up necessary. If child is younger than 24 mos, screen again at 24 mos (or after 3 mos has elapsed). Continue developmental surveillance.
  • M-CHAT Total Score 3-6: M-CHAT/F is important to evaluate risk. If child continues to score 3 or higher, refer immediately for clinical evaluation and to determine eligibility for early intervention services. Please note, if Follow-Up score is 2 monitor carefully, since child may need referral.
  • M-CHAT Total Score 7-23: Child is at risk for ASD or other developmental delays. It is acceptable to refer immediately without completing the M-CHAT Follow-Up.

Electronic scoring program: M-CHAT_Scoring. Note: You will need Microsoft Excel to use this scoring program.

The M-CHAT scoring template.doc can be printed on an overhead transparency and then laid over the M-CHAT in order to score more easily. If it does not line up properly with your copy of the M-CHAT, please download the official M-CHAT from this website and try again. If you still have problems, please adjust the word document, since some printers adjust spacing.

Disclaimer: The M-CHAT was developed to be completed by parents of children 16-30 months. If it is used in ways others than intended, one cannot interpret the findings. For example, if used on children younger or older than the age range on which it was validated, or if completed by someone other than a child’s parent, the results may not be valid.