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Pediatrics Questionnaires: The M-CHAT

Updated: Apr 23, 2019

I want to use the next few posts to describe some of the questionnaires you are given to complete when you take your child to the pediatrician (or in some cases mailed before the visit). No, we are not trying to torture you by asking you to fill out paperwork while watching a toddler. We use them as screening tools because we don't see your child in his element enough to establish important developmental trends.

Autism spectrum disorder affects about 1 in 59 children, according to the Centers for Disease Control. Autism spectrum disorder most strongly affects the developmental domains of speech and social interaction. Early detection and referral for therapies such as applied behavioral analysis (ABA) supports learning and may reduce symptoms.

The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up, or M-CHAT-R/F, , is a screening tool to detect signs of autism in toddlers. I use it at the 18 and 24 month visits and it can be used any time from 16-30 months of age. In most cases, a "yes" answer is developmentally normal and a "no" answer contributes to an "at risk" score. Scores of 0-2 are normal or "low-risk" and I will screen at the next visit as appropriate or evaluate further if there are still concerns. Scores of 3-7 are considered "moderate-risk". The M-CHAT-R/F now includes subsequent clarifying questions to be asked by the pediatrician in response to any aberrant answers on the initial twenty. If two or more items continue to be at-risk after follow-up questions are administered, I refer for Early Intervention services and depending on the case, to Speech Therapy, Audiology, Developmental Pediatrics, or others. Scores of 8-20 on the MCHAT-R/F are "high-risk" and I refer the patient urgently for further evaluation.

The M-CHAT is effective because in my experience, signs of autism spectrum disorder appear by 2-2 1/2 years of age. I have referred many patients based on M-CHAT results. I have also had many patients with scores of three that when clarified with follow-up questions change to the low-risk range.

Of course, I ask general developmental questions and make observations at each visit (especially if the child is willing to interact at that moment) and use other questionnaires as appropriate.

Have a wonderful day!

M-CHAT-R is copyright ©2009 Diana Robins, Deborah Fein, Marianne Barton. Link used with permission from the copyright holders.

Autism Speaks: April is World Autism Month

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