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In the course of a typical primary care clinic, a pediatric resident performs a screening for autism spectrum disorder (ASD) as recommended by the American Academy of Pediatrics (AAP). She uses the Modified Checklist for Autism in Toddlers (M-CHAT) to screen two of her patients, ages 18 and 24 months.

LOW-RISK: Total Score is 0-2; if child is younger than 24 months, screen again after second birthday. No further action required unless surveillance indicates risk for ASD. MEDIUM-RISK: Total Score is 3-7; Administer the Follow-Up (second stage of M-CHAT-R/F) to get additional information about at-risk responses.

Low-risk is a total score of 0-2 and mentions if a child is younger than 24 months then they should wait until their next birthday to be tested again and no further action is required.

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screener that will ask a series of 20 questions about your child's behavior. It's intended for toddlers between 16 and 30 months of age. The results will let you know if a further evaluation may be needed.

The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), simplifies wording of the original M-CHAT. The current validation study indicates that the M-CHAT-R/F improves the ability to detect autism spectrum disorders in toddlers screened during well-child care visits.

An M-CHAT total score of 7 serves as an appropriate clinical cutoff, and providers can bypass the M-CHAT/F and refer immediately to evaluation and intervention if a child obtains a score of ≥7.

SCORING THE M-CHAT A child fails the M-CHAT when 2 or more CRITICAL ITEMS are failed or when any 3 items are failed.

To score the M-CHAT-R, add up the number of at-risk responses, and follow the algorithm below: Total Score 0-2: The score is LOW risk. No Follow-Up needed. ... Total Score 3-7 : The score is MODERATE risk. ... Total Score: 8-20 : The score is HIGH risk.