A new version of the popular autism screening tool, the M-CHAT, has been released. The new screening tool, the M-CHAT-R, or the Modified Checklist for Autism in Toddlers-Revised, is an updated questionnaire that evaluates the risk of possible autism spectrum disorder for children between 16-30 months old. It does not diagnose autism, but helps parents and physicians identify children who would benefit from further testing.

The M-CHAT-R is a list of 20 yes or no questions that are typically answered by parents in the presence of a pediatrician or other healthcare provider. The questions gauge the child’s social, communication, and play skills. To make the screening tool easier to understand, the new M-CHAT-R includes examples of the behaviors in question. In some of the questions, parents are asked about their child’s eye contact, pointing, response to their name, and pretend play.

Based on parental responses, children score at a low, medium, or high risk for possible autism spectrum disorder. If a child scores in the low-risk range, no additional examination is needed. Children scoring in the high-risk range are recommended to receive more extensive evaluation for possible autism, as well as evaluation for early intervention and therapy to improve any delayed skills. If a child scores in the medium-risk range, parents participate in the M-CHAT-R follow-up interview and provide more details about the child’s at-risk behaviors.

Depending upon the parent’s answers to the M-CHAT-R/F interview, the child may or may not be referred for further testing.

It’s important to note that the M-CHAT-R was designed to be a sensitive screening test, as it over-identifies children for additional examination. When children receive further testing, some may be identified as having autism spectrum disorder while others may have a specific developmental delay such as delayed communication skills.  Early identification of a delay allows for earlier treatment.

The M-CHAT-R is a free test and takes less than five minutes for parents to complete. It is available in English and will soon be available in other languages.  Regardless of a child’s at-risk score on the M-CHAT-R, he or she may benefit from further developmental evaluation if a parent or healthcare provider has concern about possible autism spectrum disorder.

Reviewed by Dr. Sara Connolly, February 2019


  • The M-CHAT-R checks for possible autism spectrum disorder and the need for further testing for children that are 16-30 months old.
  • The five-minute parent questionnaire asks about some of the child’s social, communication, and play skills.
  • Regardless of the child’s score on the M-CHAT-R, further developmental evaluation is recommended if a parent or pediatrician has concern about autism.


  1. National Institutes of Health. Revised Autism Screening Tool Offers More Precise Assessment.
  2. M-CHAT-R Follow-Up.
  3. Pediatrics. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F).


  1. The M-CHAT is offered online free in through several organizations. So if cost is a concern, parents can complete and then score it on their own, then bring any concerns to their doctors. Billing for M-CHAT varies by insurance and location so if unsure, ask your pediatrician’s office if completing the screen at the office will incur an additional cost.

  2. Thanks for explaining this! Interesting story – my pediatrician’s nurse told me we’d be charged extra for it when she was rooming my son for his well visit. When I asked what it was and knew that my son was fine, I declined it. But I can’t help but think how many parents out there have declined a helpful screening test because they didn’t want to pay (and how many diagnoses are missed?). I really hope most offices do better and offer this for free like you say!


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