M Chat R
Uploaded by
Asia CM Chat R
Uploaded by
Asia C1
Asia Carey
ABA 640
Professor Hutchinson
11 September 2022
An Assessment Tool for Autism Spectrum Disorder
The assessment tool chosen to evaluate is the Modified Checklist for Autism in Toddlers-
Revised or M-CHAT-R. Originally published in 1999 by Diana L. Robins, Deborah Fein, and
Marrianne Barton and revised in 2009, is a 20-question screening (Hall, 2018). The assessment
tool can be completed in approximately 10 minutes by a parent of a child between 16 and 30
months (about 2 and a half years) old (Autism Speaks, 2022). The M-CHAT-R is an effective
screening questionnaire that is often implemented within primary care visits for early detection
of autism spectrum disorder and can be used to determine if further evaluation is needed. There
have been 3 versions from 1999 to 2018, the M-CHAT, M-CHAT-R, and M-CHAT-R/F, with
the latter being the most up to date version. The R stands for “revised” and the F stands for
“finalized”. The version discussed here is the M-CHAT-R.
According to the American Academy of Pediatrics (AAP), it is recommended that: “all
children receive autism-specific screening at 18 and 24 months of age, in addition to broad
developmental screening at 9, 18, and 24 months. Since this recommendation, there has been an
increase in the routine use of developmental screening in primary care” (Alawami, et al., 2019).
With the rising rates of autism diagnoses among children, at the current rate of 1 in 44 children,
implementation of regular screening can be an affordable and effective way to measure a child’s
developmental progress (Autism Speaks, 2022).
2
The M-CHAT-R asks questions such as “If you point at something across the room, does
your child look at it?”, “does your child play pretend or make-believe?”, and “does your child
make unusual finger movements near his or her eyes?” (Autism Speaks, 2022). There are also
questions that include information on possible deafness, interests in other children, the child
showing things to their parents, responding to their name, reciprocating a smile if smiled at, and
more. Some of the key information this tool can provide is lack of gaze monitoring, lack of
protodeclarative of pointing, and lack of pretend play (Hall, 2018). These three key pieces of
information can reflect what is known as joint attention. Joint attention is: “when one person
purposefully coordinates his or her focus of attention with that of another person” (UNC, 2022).
Joint attention is significant in the areas of social and communication skills, which can be a
challenge for individuals with autism. The UNC School of Medicine reports: “Children who are
learning social and communication skills in a typical way will often show examples of joint
attention from the time they are 12 months old. Joint attention is important in helping people
communicate with each other all through life. Children with autism have a hard time with this
kind of communication. For these children, delays in developing joint attention skills lead to
delays in developing language” (UNC, 2022). In summary, any indications of difficulties with
social and communication skills is crucial to assess in early age as to avoid further delays in
areas like language acquisition and development.
The M-CHAT-R is an effective autism assessment tool to use if a parent is concerned
about their child’s behaviors or development. For each question, the responses are scored as
either pass or fail. Each fail is scored as 1, and totaled at the end. A score of 0-2 indicates the
child passed and regular screenings should continue as the child progresses in age. A score of 3-
7 indicates medium risk, and a follow-up interview with a pediatrician or health care professional
3
should be implemented. A score of 8-20 indicates high risk and a recommendation to visit a
pediatrician is warranted to explore early intervention services (CDC, 2020).
4
References
Alawami AH, Perrin EC, Sakai C. Implementation of M-CHAT Screening for Autism in Primary
Care in Saudi Arabia. Global Pediatric Health. January 2019.
doi:10.1177/2333794X19852021
Autism statistics and facts. Autism Speaks. (2022). Retrieved September 4, 2022, from
https://www.autismspeaks.org/autism-statistics-asd
Centers for Disease Control and Prevention. (2020, July 14). M-chat-R scoring instructions.
Centers for Disease Control and Prevention. Retrieved September 12, 2022, from
https://www.cdc.gov/ncbddd/actearly/autism/case-modules/screening/10-scoring.html
Hall, L. J. (2018). Autism spectrum disorders: From theory to practice. Pearson Education, Inc.
Modified checklist for autism in toddlers, revised (M-chat-R™). Autism Speaks. (2022).
Retrieved September 12, 2022, from https://www.autismspeaks.org/screen-your-child
UNC School of Medicine. (2022). About joint attention. Advancing Social Communication and
Play. Retrieved September 12, 2022, from
https://www.med.unc.edu/healthsciences/asap/materials-1/about-joint-attention/
#:~:text=What%20is%20Joint%20Attention%3F,intentionally%20and%20for%20social
%20reasons.
