Autism Spectrum Disorder Screening Using MCHAT-R

The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R and M-CHAT-R/F; Robins, Fein, & Barton, 2009) is a 2-stage “parental report” screening tool to assess risk for Autism Spectrum Disorder (ASD). The American Academy of Pediatrics (AAP) recommends that all children receive autism screening at 18 and 24 months of age, and the M-CHAT-R is one of the AAP’s recommended tools. The M-CHAT-R is relatively quick and can be scored in a few minutes when proctored by someone familiar with the process (like MacKoul Pediatrics).

The M-CHAT-R can be administered and scored as part of a well-child care visit at MacKoul Pediatrics and can also be used by specialists or other professionals to assess risk for ASD. The primary goal of the M-CHAT-R is to “maximize sensitivity” in a statistical sense, meaning to detect as many cases of ASD as possible — in other words, there is a high “false positive” rate. It is important to note that this means that not all children who score “at risk” will be diagnosed with ASD.

To address this, the creators of the test have developed Follow-Up questions (M-CHAT-R/F) to help make better diagnoses. Parents should be aware that even with the Follow-Up, a significant number of the children who screen positive on the M-CHAT-R will not be diagnosed with ASD; however, these children are at high risk for other developmental disorders or delays. As such. evaluation is warranted for any child who screens positive. A child should likewise be referred for further evaluation any time a parent or pediatrician has persistent concerns about autism, even if the child does not show ASD risk on the M-CHAT-R.

If you and/or your local pediatrician feel that further screening is needed, you can request a free developmental assessment through the Florida Department of Health.


About author MacKoul Pediatrics

MacKoul Pediatrics is an amazing local pediatrics office in Cape Coral, FL where caring, compassionate doctors and nurses work with you to keep your children as healthy as possible. MacKoul cares for children from birth to college age, from Cape Coral, Fort Myers, Naples, and beyond.