M-CHAT-R/FAutism Spectrumfree

Modified Checklist for Autism in Toddlers, Revised with Follow-Up

Two-stage parent-report autism screener for toddlers.

Overview

The M-CHAT-R/F is a two-stage parent-report screening tool for autism risk in toddlers aged 16-30 months. A structured Follow-Up Interview reduces false positives.

Use cases

Universal pediatric autism screening in primary care; epidemiological studies.

Assessment intelligence

Score range
0 – 20
Direction
Higher = worse
Scoring method
Algorithm
Time to score
~5 min
Subscales
  • Total Risk Items
    0-20
Cutoff thresholds & interpretation
SeverityThresholdInterpretation
Low risk0-2No further action unless surveillance suggests risk
Medium risk3-7Administer Follow-Up; refer if score remains ≥2
High risk8-20Bypass Follow-Up; refer immediately for diagnostic evaluation

Two-stage screen with M-CHAT-R/F follow-up interview.

Editorial notes

Detects ~85% of cases at age 24 months in primary-care samples; widely used in well-child surveillance.

Available languages

Validation studies (2)

  • Two-stage M-CHAT-R/F validation in primary care
    Robins DL, Casagrande K, et al. · Pediatrics · 2014
    DOI: 10.1542/peds.2013-1813
  • M-CHAT-R/F follow-up interview impact on positive predictive value
    Chlebowski C, Robins DL, et al. · Journal of Developmental & Behavioral Pediatrics · 2013
    DOI: 10.1097/DBP.0b013e31827d2dca

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