Screening
New York State Department of Health Clinical Practice Guidelines, Autism
Periodic developmental surveillance by appropriately trained and qualified health care providers is important for all young children. Such routine surveillance provides an active way to identify developmental problems as early as possible.
It is recommended that the process of routine developmental surveillance be ongoing and begin at birth.
It is recommended that developmental surveillance for young children include the following components:
– Eliciting and attending to parents’ concerns
– Obtaining a relevant developmental history
– Observing children accurately
– Sharing opinions and concerns with parents and other professionals who care for the child
Periodic health examinations provide specific opportunities for routine developmental surveillance in young children. During these exams, parent reports about their child’s behaviors and direct observations of the child by the examiner may provide useful clues to help identify concerns about possible developmental problems, including autism.
The periodic exams at 15, 18, and 24 months are particularly useful in providing information about possible autism, since characteristics of autism often begin to emerge during the second year of life.
Preschool Screening Checklists
| Instrument | Type of Screening | Informant | Characteristics |
| The Modified Checklist for Austims in Toddlers (M-CHAT) | 1° & 2°-level | Parent | 23 Item Scale (particularly salient): pointing to express interest, responsiveness to name, interest in peers, showing behavior, response to joint attention, social imitation. |
| Screening Test for Autism in Two Year Olds (STAT) | 2°- level | Specialist | 12-item scale: derived from measures of play, imitation, and social communication; administered in a play-like interaction |
M-CHAT
The M-CHAT (Modified Checklist M-CHAT)
The M-CHAT (Modified Checklist for Autism in Toddlers) is an excellent parent-report screening instrument that can be employed by primary care physicians. It is particularly useful in that the questions are designed to address the crux of what differentiates autism from other developmental disabilities.
The parent is asked to answer “Yes” or “No” to each of 23 questions about his/her child. It is important to recognize that for some of the questions a “Yes” answer is considered a failure, and for others a “No” answer is considered a failure. Six of the items (numbers 2, 7, 9, 13, 14, and 15) are considered “critical items.”
A child fails the checklist (is at-risk for a diagnosis of autism) when two or more critical items are failed OR when any three items are failed. It is important to emphasize that the M-CHAT should be considered a screening tool. Not all children who fail the checklist will meet criteria for a diagnosis on the autism spectrum. However, all children who fail the checklist will require a more in-depth evaluation.
On-line reference to the M-CHAT, including the questions and scoring guide:
