If your child is younger than 24 months (2 years old), you should screen again at the 2-year check-up. In addition, some mild forms of autism may not appear until the child is closer to school age. Therefore, at any age, if you are concerned that your child has lost skills, is not gaining social or communication skills as expected, or is showing behaviors that seem different from peers or cause interference with social engagement or learning, you should talk to your child’s healthcare professional.

If you have any concerns, you should talk to your child’s healthcare professional. You also can contact your local early intervention agency to request an evaluation of eligibility for early intervention services for your child. If you are in the US you can find your state’s intervention office here: https://www.autismspeaks.org/resource-guide and select “State Early Intervention Providers”.

No. The M-CHAT-R/F does not screen for all developmental delays or concerns. Also, a screening tool cannot be perfect. If you have concerns, you should talk to your child’s healthcare professional. You also can contact your local early intervention agency to request an evaluation of eligibility for early intervention services for your child. If you are in the US you can find your state’s intervention office here: https://www.autismspeaks.org/resource-guide and select “State Early Intervention Providers”.

Parents know their children. We recommend that parents always act on their concerns. If you are concerned, talk to your child’s healthcare professional. You also can contact your local early intervention agency to request an evaluation of eligibility for early intervention services for your child. If you are in the US you can find your state’s intervention office here: https://www.autismspeaks.org/resource-guide and select “State Early Intervention Providers”.
If you are not in the US, you should be able to find out what kind of early intervention services are available in your region. Some additional information about early intervention in other countries can be found here: https://www.autismspeaks.org/international-autism-organizations

Sometimes healthcare professionals are not concerned because it is difficult to see the signs for autism during toddler check-ups. We recommend that if your child screens positive, you should act immediately. There are two things you can do, and they can be done at the same time. One is to determine whether your child is eligible for early intervention services. If you are in the US, you can find your state’s intervention office here: https://www.autismspeaks.org/resource-guide and select “State Early Intervention Providers”.  If you are not in the US, you should be able to find out what kind of early intervention services are available in your region. Some additional information about early intervention in other countries can be found here: https://www.autismspeaks.org/international-autism-organizations. The second is to see an expert clinician to find out if your child has a specific diagnosis, such as autism, a language disorder, or a global developmental delay. Experts who make these diagnoses include psychologists and developmental-behavioral pediatricians. You can ask your child’s pediatrician or healthcare professional, your insurance company, or local hospitals for recommendations to find an expert in your region.

No, we recommend immediate action. Children who need early intervention services to learn skills do better if they start as young as possible. Waiting a year means that valuable intervention time is lost, and might mean that your child is at increased likelihood of falling farther behind his or her peers during this time.

No, the M-CHAT and the M-CHAT-R/F were designed to screen for the likelihood of autism. We know that some children who screen positive have autism, and some children who screen positive have other developmental delays or concerns, such as language or global delays, but that does not mean that the M-CHAT will identify all children with developmental issues.

You can talk to your child’s healthcare professional. If they are not concerned, you can call your local early intervention agency to find out if your child is eligible for early intervention services. If you are in the US, you can find your state’s intervention office here:
https://www.autismspeaks.org/resource-guide and select “State Early Intervention Providers”.
If you are not in the US, you should be able to find out what kind of early intervention services are available in your region. Some additional information about early intervention in other countries can be found
here: https://www.autismspeaks.org/international-autism-organization You also can schedule an evaluation with an expert clinician to find out if your child has a specific diagnosis, such as autism, a language disorder, or a global developmental delay. Experts who make these diagnoses include psychologists and developmental-behavioral pediatricians. You can ask your child’s healthcare professional, your insurance company, or local hospitals for recommendations to find an expert in your region.

No, the M-CHAT and the M-CHAT-R/F were designed to screen for the likelihood of autism. We know that some children who screen positive have autism, and some children who screen positive have other developmental delays or concerns, such as language or global delays, but that does not mean that the M-CHAT will identify all children with developmental issues.

We do not recommend adjusting for prematurity. In part this is because many standardized tests only correct for the first year, and in part because adjusting for prematurity may decrease sensitivity. We are aware that the screen positive rate is elevated in samples of premature children, but evidence shows this is due to an elevated prevalence of autism in these cases. See Hamer et al., 2024, Developmental Medicine and Child Neurology.

As long as you are making this electronic M-CHAT(-R) just for use in your own office’s medical record, you are welcome to do so free of charge, following the requirements that you do not alter the instrument’s name, instructions, items, item order, or the copyright notice at the bottom.

The M-CHAT and M-CHAT-R/F are copyrighted instruments. You are not allowed to post them on a website without permission. However, you are welcome to post a link to our website or post a link directly to the M-CHAT-R/F download from our website, contact Diana Robins to discuss a license agreement.

To create an app, a web-based screening tool, or any other electronic version that you would allow others to use, please contact Diana Robins to discuss a license. agreement.

The M-CHAT and M-CHAT-R/F are copyrighted tools. You are not allowed to make any changes to the title, instructions, item content, item order, or copyright notice without permission from the authors. The reason for this is that we do not know how the instrument will perform if any changes are made.

The M-CHAT and M-CHAT-R/F are designed to be administered and scored without training. Any professional can offer the questionnaires to a parent. Parents also can self-administer the questionnaires. Scoring instructions can be downloaded from https://www.mchatscreen.com

If the Follow-Up interview is not administered (as an interview by a person, such as someone at your primary care health professional’s office, a local early intervention agency, or a specialist, or by a computer program where the follow-up questions immediately follow screen positive results), the instrument will not lose sensitivity, but there will be many more false positives. This will increase the likelihood of referring a child who does not have a developmental delay, since it is still important to refer all screen positive children for evaluation and early intervention.