The scoring algorithm for M-CHAT-R is as follows:

For most items, YES is a typical response, and NO is an at-risk response. HOWEVER, items 2, 5, and 12 are reverse scored, meaning that NO is a typical response and YES is an at-risk response. To score the M-CHAT-R, add up the number of at-risk responses, and follow the algorithm below:

• Total Score 0-2: The score is LOW risk. No Follow-Up needed. Child has screened negative. Rescreen at 24 months if the child is younger than 2 years old (or after 3 months has elapsed), and refer as needed if developmental surveillance or other tools suggest risk for ASD.
• Total Score 3-7 : The score is MODERATE risk. Administer the M-CHAT-R Follow-Up items that correspond to the at-risk responses. Only those items which were scored at risk need to be completed. If 2 or more items continue to be at-risk, refer the child immediately for (a) early intervention and (b) diagnostic evaluation.
• Total Score: 8-20 : The score is HIGH risk. It is not necessary to complete the M-CHAT-R Follow-Up at this time. Bypass Follow-Up, and refer immediately for (a) early intervention and (b) diagnostic evaluation.

Please note, subsets of items (e.g., best7) are no longer recommended. Total score should include all M-CHAT-R items.

To facilitate scoring, two documents are available for free download: a scoring overlay and an Microsoft excel scoring program.

Scoring template: Print on overhead transparency and lay on top of M-CHAT-R to score. Please note, printers often make minor adjustments. If the template doesn’t fit for your printer, you may adjust the spacing for your use.

The scoring program will automatically score YES and NO responses and total the at-risk items. Note: users must have Microsoft Excel to use this program.