M-CHATTM

Diana L. Robins, Ph.D.

 
EXCITING NEW UPDATE!!! THE M-CHAT REVISED WITH FOLLOW-UPTM (M-CHAT-R/F)TM IS NOW AVAILABLE FOR FREE DOWNLOAD!!! 
We strongly recommend that users switch to the new version, also known as M-CHAT-R/F. The revised tool reduces the false positive rate and detects more ASD cases than the original M-CHAT when used during routine pediatric check-ups. The M-CHAT-R/F is valid for children 16-30 months old. 
The validation paper can be accessed by those with a subscription to Pediatrics. 
Please note that although downloads are available for free from this website, the M-CHAT, M-CHAT-R/F and associated documents are not shareware or freeware. These are copyrighted instrument, and by downloading files from this website, you agree to follow these Guidelines for use:
Reprints/reproductions of the M-CHAT, M-CHAT-R/F and related materials must include the copyright at the bottom of the document. No modifications can be made to title, items, or instructions without permission from the authors. 
The M-CHAT-R and M-CHAT must be used in its entirety. Items may not be extracted to shorten the questionnaire. The use of the Follow-Up is strongly recommended for children who screen positive, particularly for scores in the mid-range (total scores of 3-7). 
Parties interested in reproducing the M-CHAT-R/F, M-CHAT or associated documents in print (e.g., a book or article) or electronically (e.g., as part of a website or software package to be distributed to others) must contact Diana Robins to request permission. 
If you are part of a medical practice, and you want to incorporate the M-CHAT-R/F, M-CHAT-R, or M-CHAT into your own practice’s electronic medical record (EMR), you are welcome to do so, free of charge, provided that as you are making this electronic M-CHAT(-R/F) just for use in your own office's medical record. You must follow the requirements that you do not alter the instrument's name, instructions, items, item order, or the copyright notice at the bottom. If in the future you are ever interested in marketing or distributing any electronic format of the M-CHAT(-R/F), you will need to contact Diana Robins to develop a licensing agreement.
Scoring
A scoring template (print on overhead transparency and lay on top of M-CHAT-R to score) may be downloaded here: M-CHAT-R Scoring Template. Please note, printers often make minor adjustments. If the template doesn’t fit for your printer, you may adjust the spacing for your use. A scoring program may be downloaded here: M-CHAT-R_F_Scoring.xlsx. Note: users must have Microsoft Excel to use this program. 
If you are interested in translating the M-CHAT-R/F into another language, or creating an alternate translation for a language already posted, the requirements are as follows:
Rights for the M-CHAT-R/F are retained by the original authors. The translation must retain the original M-CHAT-R/F copyright at the bottom of the document. It is recommended that translators add a line below the original copyright naming the translator(s) and the date of translation, but this is not required.
All translators are required to submit the final translation to Diana Robins in PDF format, by emailing the document to Diana Robins. We retain the right to post all translations to this website for free download by other users.
The process we recommend for translation is to have someone bilingual translate, and then a second bilingual person who hasn't seen the English version back translate into English. Discrepancies can be identified and fixed through further translation-back translation procedures. This can be repeated as needed until the back-translation is equivalent to the original English.
Translations
Most translations are not yet available for the M-CHAT-R/F. Please follow the instructions below if you would like to translate the M-CHAT-R/F. It is currently being translated into some languages, so if you would like to check before creating a new translation, please email Dr. Robins. Also, if you would like the Follow-Up in powerpoint in order to use the formatting for your translation, please request it from Dr. Robins.
If you are interested in translating the M-CHAT-R/F into another language, or creating an alternate translation for a language above, the requirements are as follows:
Rights for the M-CHAT-R/F are retained by the original M-CHAT-R/F authors. The translation must retain the original M-CHAT-R/F copyright at the bottom of the document. It is recommended that translators add a line below the original copyright naming the translator(s) and the date of translation, but this is not required.
All translators are required to email the final translation to Diana Robins in PDF format. We retain the right to post all translations to this website for free download by other users, and to include the translation in any forthcoming M-CHAT-R/F manual.
The process we recommend for translation is to have someone bilingual translate, and then a second bilingual person who hasn't seen the English version back translate into English. Discrepancies can be identified and fixed through further translation-back translation procedures. This can be repeated as needed until the back-translation is equivalent to the original English.
Please note: We ask that you translate the full M-CHAT-R/F in order for us to post it here. Instructions, permissions, both initial and Follow-Up questions, and scoring information should all be compiled into a single PDF.
Available Translations of M-CHAT-R
Albanian with FollowUp
Chinese
French; for more information on this translation, please email 
Korean
Spanish (Spain) and M-CHAT-R with pictures
Spanish (Argentina_Uruguay)
Languages in progress, as of March, 2014 (complete translations will be posted when available):
Bulgarian
Dutch
French (Canadian)
Italian
Japanese
Macedonian
Persian
Polish
Portuguese (Brazil and Portugal)
Spanish (Western Hemisphere)
Turkish
Urdu

FOR INFORMATION REGARDING THE ORIGINAL           M-CHAT, PLEASE READ BELOW. 
The Modified Checklist for Autism in Toddlers (M-CHAT™; Robins, Fein, & Barton, 1999) is available for free download for clinical, research, and educational purposes. Please download this document for instructions for use. If you would prefer a version with a header added to collect name, date of birth, and other information, please download this version: M-CHAT with header. 
The M-CHAT Follow-Up Interview™ is available for download here: M-CHAT Follow-Up. The interview is designed to reduce the false positive rate (false positive cases are children who fail the M-CHAT but do not have an autism spectrum disorder). It is highly recommended that M-CHAT users also incorporate the M-CHAT Follow-Up Interview into the screening process, given that recent findings demonstrate that the interview greatly reduces the false positive rate, which avoids unnecessary referrals. For more information, please refer to the following references:
Chlebowski et al. (2013) Pediatrics
Robins (2008) Autism
Kleinman et al. (2008) Journal of Autism and Developmental Disorders
M-CHAT scoring information and programs are available for download here for personal use only. You may not distribute these outside your practice or group. 
*** SCORING UPDATE ***

Our latest paper examining the M-CHAT in low-risk settings (pediatric well visits) indicates that the M-CHAT TOTAL SCORE is the recommended score for assessing ASD risk in toddlers. Over the years we have explored other scores, including the Critical6 and the Best7, and determined that they do not have adequate sensitivity unless combined with Total score, and the do not greatly improve sensitivity above and beyond Total score. The M-CHAT Follow-Up (M-CHAT/F) has been demonstrated to significantly improve positive predictive value (PPV) over the initial M-CHAT screen along; this means that the healthcare provider’s confidence that referrals are needed is much higher when the 2-stage M-CHAT is administered, rather than only the initial questions. 

The PPV of the 2-stage M-CHAT, ow called the M-CHAT with Follow-Up, or M-CHAT/F, indicates that 54% of children who screen positive are likely to be diagnosed with an ASD. Broadening our scope to consider other developmental delays, 89% of children who screen positive are likely to be diagnosed with a developmental delay. Furthermore, 98% of all toddlers who screen positive are likely to dhow a developmental concern warranting further evaluation (although not all cases meet criteria for a specific developmental disorder). See Chlebowski et al. (2013) for more information. 

The current recommended scoring algorithm is as follows:

M-CHAT Total Score 0-2	No Follow-Up necessary. If child is younger than 24 mos, screen again at 24 mos (or after 3 mos has elapsed). Continue developmental surveillance. 

M-CHAT Total Score 3-6	M-CHAT/F is important to evaluate risk. If child continues to score 3 or higher, refer immediately for clinical evaluation and to determine eligibility for early intervention services. Please note, if Follow-Up score is 2 monitor carefully, since child may need referral. 

M-CHAT Total Score 7-23	Child is at risk for ASD or other developmental delays. It is acceptable to refer immediately without completing the M-CHAT Follow-Up. 

electronic scoring program: M-CHAT_Scoring.xls. Note: You will need Microsoft Excel to use this scoring program. 
The M-CHAT scoring template.doc can be printed on an overhead transparency and then laid over the M-CHAT in order to score more easily. If it does not line up properly with your copy of the M-CHAT, please download the official M-CHAT from this website and try again. If you still have problems, please adjust the word document, since some printers adjust spacing.
Disclaimer. The M-CHAT was developed to be completed by parents of children 16-30 months. If it is used in ways others than intended, one cannot interpret the findings. For example, if used on children younger or older than the age range on which it was validated, or if completed by someone other than a child’s parent, the results may not be valid.

Translations. The M-CHAT™ is available in a number of different languages. Users should be aware that validation of these translations is still under way. When available, references are provided for published work based on a translation. It is expected that translations of the M-CHAT-R/F will be available in the coming months, and they will be posted. The translations available for download are:
Albanian with FollowUp; for more information on this translation, please email
Amharic
Arabic
Arabic_v2 with scoring instructions and FollowUp
Arabic_v3 with FollowUp
Armenian; for more information on this translation, please email
Eastern Armenian with Scoring Instructions
Bangla; for more information on this translation, please email
Bulgarian; with Scoring instructions
Chinese
Czech
Dutch; for more information on this translation, please email
Farsi_Persian 
Filipino_Naganas with FollowUp
Filipino_v2 
Filipino_Tanchanco 
Finnish
French
French_v2
French Canadian
German
Greek; for more information on this translation, please email or see www.pediatrician.gr
Greek_v2; for more information on this translation, please email
Greek Follow-Up
Gujarati 
Haitian_Creole
Hebrew with FollowUp 
Hindi 
Hungarian 
Hungarian_v2
Icelandic
Indonesian
Italian and FollowUp; for more information on this translation, please email
Japanese and Japanese_with_illustrations
Kannada; for more information on this translation, please email
Khmae; for more information on this translation, please email
Korean_HKim and FollowUp; for more information on this translation, please email
Korean_v2 and FollowUp
Kurdish; for more information on this translation, please email
Kurdish_SS
Malay; for more information on this translation, please email
Mongolian with FollowUp 
Norwegian
Persian_SS and FollowUp
Persian_v2 and FollowUp 
Persian_OM
Polish
Portuguese_Brazil 
Portuguese_Portugal; for more information on this translation, please email
Romanian; for more information on this translation, please email
Russian and scoring_instructions; for more information on this translation, please email
Sinhala; for more information on this translation, please email
Slovak
Slovene; for more information on this translation, please email
Somalian; for more information on this translation, please email
Spanish_WesternHemisphere_RP and  Spanish_WesternHemisphere_IdahoGp_FollowUp
Spanish_WH_v2 
Spanish_Spain with FollowUp; for more information on this translation, please email
Swedish and FollowUp
Tamil
Thai
Tigrinya
Turkish; for more information on this translation, please email
Urdu 
Vietnamese; for more information on this translation, please email

If you are interested in translating the M-CHAT into another language, or creating an alternate translation for a language above, the requirements are as follows:
Rights for the M-CHAT are retained by the original M-CHAT authors. The translation must retain the original M-CHAT copyright at the bottom of the document. It is recommended that translators add a line below the original copyright naming the translator(s) and the date of translation, but this is not required.
All translators are required to submit the final translation to Diana Robins in PDF format, by emailing the document to drobins@gsu.edu. We retain the right to post all translations to this website for free download by other users, and to include the translation in the forthcoming M-CHAT manual.
The process we recommend for translation is to have someone bilingual translate, and then a second bilingual person who hasn't seen the English version back translate into English. Discrepancies can be identified and fixed through further translation-back translation procedures. This can be repeated as needed until the back-translation is equivalent to the original English.
Recommended resources about screening:
http://www.firstsigns.org/
http://www.aap.org/healthtopics/autism.cfm
http://www.aap.org/advocacy/releases/Oct07autism.htm
http://www.cdc.gov/ncbddd/autism/screening.htm
http://www.pedstest.com/
For a Japanese language website on screening, please see:
http://www.ncnp.go.jp/nimh/jidou/research.html
PDF Copies of the following M-CHAT-related publications are available for download here:
Chlebowski, C., Robins, D.L., Barton, M.L., & Fein, D. (2013). Large-scale use of the Modified Checklist for Autism in Toddlers in low-risk toddlers. Pediatrics, 131 (4), e1121-1127. PMID:23530174. doi: 10.1542/peds.2012-1525.

Kleinman, J.M., Robins, D.L., Ventola, P.E., Pandey, J., Boorstein, H.C., Esser, E.L., Wilson, L.B., Rosenthal, M.A., Sutera, S., Verbalis, A.D., Marshia, G., Barton, M. Hodgson, S., Green, J., Dumont-Mathieu, T., Volkmar, F., Chawarska, K., Klin, A., & Fein, D. (2008). The Modified Checklist for Autism in Toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism and Developmental Disorders. Available at JADD Online First, September 20, 2007. 
Pandey, J., Verbalis, A., Robins, D.L., Boorstein, H., Klin, A., Babitz, T., Chawarska, K., Volkmar, F., Green, J., Barton, M., & Fein, D. (2008). Screening for autism in older and younger toddlers using the Modified Checklist for Autism in Toddlers.. Autism 12 (5), 513-535.
Robins, D. L. (2008). Screening for autism spectrum disorders in primary care settings. Autism 12 (5), 537-556.
Robins, D.L. & Dumont-Mathieu, T. (2006). The Modified Checklist for Autism in Toddlers (M-CHAT): A review of current indings and future directions. Journal of Developmental and Behavioral Pediatrics, 27 (Supplement 2), S111-S119.
Robins, D., Fein, D., Barton, M., Green, J. (2001). The Modified Checklist for Autism in Toddlers (M-CHAT): An initial investigation in the early detection of autism and Pervasive Developmental Disorders. Journal of Autism and Developmental Disorders, 31 (2), 131-144.
Robins, D., Fein, D., & Barton, M. (2001). Reply to Charman et al.‘s commentary on the Modified Checklist for Autism in Toddlers. Journal of Autism and Developmental Disorders, 31 (2), 149-151.
Wiggins, L.D., Piazza, V., & Robins, D.L. (2012, online). Comparison of a broad-band screen versus disorder-specific screen in detecting young children with an autism spectrum disorder. Autism: The International Journal of Research & Practice. PMID: 23262658. Published Online December 21, 2012, doi: 10.1177/1362361312466962.


References for publications related to M-CHAT Translations
Canal-Bedia, R., Garcia-Primo, P., Martin-Cilleros, M.V., Santos-Borbujo, J., Guisuraga-Fernandez, Z., et. al. (2010). Modified Checklist for Autism in Toddlers: Cross-cultural adaptation and validation in Spain. Journal of Autism and Developmental Disorders.
Eldin, A.S., Habib, D., Noufal, A., Farrag, S., Bazaid, K., Al-Sharbati, M., Badr, H., Moussa, S., Essali, A., & Gaddour, N. (2008). Use of M-CHAT for a multinational screening of young children with autism in the Arab countries. International Review of Psychiatry, 20 (3), 281-289. 
Inada, N., Kamio, Y., & Koyama, T. (2010). Developmental chronology of preverbal social behaviors in infancy using the M-CHAT: Baseline for early detection of atypical social development. Research in Autism Spectrum Disorders, doi:10.1016/j.rasd.2009.12.003.
Inada, N., Koyama, T., Inokuchi, E., Kuroda, M., & Kamio, Y. (2010). Reliability and validity of the Japanese version of the Modified Checklist for autism in toddlers (M-CHAT), Research in Autism Spectrum Disorders, doi:10.1016/j.rasd.2010.04.016.
Kamio, Y., Inada, N., Koyama, T., Inokuchi, E., Tsuchiya, K., & Kuroda, M. (online). Effectiveness of using the Modified Checklist for Autism in Toddlers in two-stage screening of Autism Spectrum Disorder at the 18-month health check-up in Japan. Journal of Autism and Developmental Disorders. 
Losapio, M.F., Pondé, M.P. (2008). Tradução para o Português da escala M-CHAT para rastreamento precoce de autismo. [Translated Title: Translation into Portuguese of the M-CHAT Scale for early screening of autism.] Revista de Psiquiatria do Rio Grande do Sul, Vol 30(3), 221-229.
Lung, F-W., Chiang, T-L., Lin, S-J., & Shu, B-C. (2011). Autism-risk screening in the first 3 years of life in Taiwan Birth Cohort Pilot Study. Research in Autism Spectrum Disorders, 5, 1385-1389.
Nygren, G., Sandberg, E., Gillstedt, F., Ekeroth, G., Arvidsson, T., & Gillberg, C. (2012). A new screening programme for autism in a general population of Swedish toddlers. Research in Developmental Disabilities, 33, 1200-1210.
Perera, H., Wijewardena, K., & Aluthwelage, R. (2009). Screening of 18–24-Month-Old Children for Autism in a Semi-Urban Community in Sri Lanka. Journal of Tropical Pediatrics, 55(6):402-5.
Rogé, B., Chabrol, H., & Unsaldi, I. (2009). Le dépistage précoce de I'autisme: Quelle faisabilité? [Translated Title: Early screening autism: How far?] Enfance, Vol 61(1), 27-40.
Yates, K. & LeCouteur, A. (2009). Diagnostyka autyzmu [Translated Title: Diagnosing autism]. Paediatrics and Child Health, 19: 55-59.

Counters were reset on 12/20/2013















Official_M-CHAT_Website_files/M-CHAT-R_F.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_F.pdfhttp://pediatrics.aappublications.org/content/early/2013/12/18/peds.2013-1813.abstractmailto:dianalrobins@gmail.com?subject=M-CHAT-R%20reproduction%20requestmailto:drobins@gsu.edu?subject=M-CHAT%20license%20inquiryOfficial_M-CHAT_Website_files/M-CHAT-R_Scoring_Template.docxOfficial_M-CHAT_Website_files/M-CHAT-R_Scoring_Template.docxOfficial_M-CHAT_Website_files/M-CHAT-R_F_Scoring.xlsxmailto:dianalrobins@gmail.com?subject=M-CHAT-R/F%20translationmailto:dianalrobins@gmail.com?subject=M-CHAT-R/F%20translationmailto:dianalrobins@gmail.com?subject=M-CHAT-R/F%20TranslationOfficial_M-CHAT_Website_files/M-CHAT-R_Albanian.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_Albanian_FollowUp.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_F_Chinese.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_F_French.pdfmailto:eric.lemonnier@chu-brest.fr?subject=French%20translation%20of%20M-CHAT-R/F%20Official_M-CHAT_Website_files/M-CHAT-R_F_Korean.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_F_Spanish_Spain.pdfOfficial_M-CHAT_Website_files/MCHAT-R_Spain_20pictures.pdfOfficial_M-CHAT_Website_files/M-CHAT-R_F_Spanish_Argentina_Uruguay.pdfOfficial_M-CHAT_Website_files/M-CHAT_new.pdfOfficial_M-CHAT_Website_files/M-CHAT_header.pdfOfficial_M-CHAT_Website_files/M-CHAT_FollowUp.pdfOfficial_M-CHAT_Website_files/Chlebowski_M-CHAT_Pediatrics_2013.pdfOfficial_M-CHAT_Website_files/Robins_Autism08.pdfOfficial_M-CHAT_Website_files/Kleinman_Followup_JADDMay08.pdfOfficial_M-CHAT_Website_files/M-CHAT_Scoring.xlsOfficial_M-CHAT_Website_files/M-CHAT%20scoring%20template_2013.docOfficial_M-CHAT_Website_files/M-CHAT_Albanian.pdfmailto:info@malteser.al?subject=Albanian%20translation%20of%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Amharic.pdfOfficial_M-CHAT_Website_files/M-CHAT_Arabic.docOfficial_M-CHAT_Website_files/M-CHAT_Arabic_v2.pdfOfficial_M-CHAT_Website_files/M-CHAT_Arabic_v2_score.pdfOfficial_M-CHAT_Website_files/M-CHAT_Arabic_v2_FollowUp.pdfOfficial_M-CHAT_Website_files/M-CHAT_Arabic3_rev.pdfOfficial_M-CHAT_Website_files/M-CHAT_Arabic3_FollowUp.pdfOfficial_M-CHAT_Website_files/M-CHAT_Armenian.pdfmailto:janet@a1speechtherapy.com?subject=Armenian%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_EasternArmenian.pdfOfficial_M-CHAT_Website_files/M-CHAT_Bangla.pdfmailto:naila.z.khan@googlemail.com?subject=Bangla%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Bulgarian.pdfOfficial_M-CHAT_Website_files/M-CHAT_Bulgarian_Scoring.pdfOfficial_M-CHAT_Website_files/M-CHAT_Chinese.pdfOfficial_M-CHAT_Website_files/M-CHAT_Czech.pdfOfficial_M-CHAT_Website_files/M-CHAT_Dutch.pdfmailto:Mieke.Dereu@UGent.be?subject=Dutch%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Farsi_Persian_SS.pdfOfficial_M-CHAT_Website_files/M-CHAT_Filipino_Naganas.pdfOfficial_M-CHAT_Website_files/M-CHAT_Filipino_Nanagas_FollowUp.pdfOfficial_M-CHAT_Website_files/M-CHAT_Filipino2.pdfOfficial_M-CHAT_Website_files/M-CHAT_Filipino_Tanchanco.pdfOfficial_M-CHAT_Website_files/M-CHAT_Finnish.pdfOfficial_M-CHAT_Website_files/M-CHAT_French.pdfOfficial_M-CHAT_Website_files/M-CHAT_French_v2.pdfOfficial_M-CHAT_Website_files/M-CHAT_FrenchCanadian.pdfOfficial_M-CHAT_Website_files/M-CHAT_German.pdfOfficial_M-CHAT_Website_files/M-CHAT_Greek.pdfmailto:drdimi@yahoo.com?subject=Greek%20translation%20of%20the%20M-CHAThttp://www.pediatrician.gr/Official_M-CHAT_Website_files/M-CHAT_Greek2.pdfmailto:ppervanid@med.uoa.gr?subject=Greek%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Greek_Follow-Up.pdfOfficial_M-CHAT_Website_files/M-CHAT_Gujarati.pdfOfficial_M-CHAT_Website_files/M-CHAT_Haitian_Creole.pdfOfficial_M-CHAT_Website_files/M-CHAT_Hebrew.pdfOfficial_M-CHAT_Website_files/M-CHAT_Hebrew_FollowUp.pdfOfficial_M-CHAT_Website_files/M-CHAT_Hindi.pdfOfficial_M-CHAT_Website_files/M-CHAT_Hungarian.pdfOfficial_M-CHAT_Website_files/M-CHAT_Hungarian_version2.pdfOfficial_M-CHAT_Website_files/M-CHAT_Icelandic.pdfOfficial_M-CHAT_Website_files/M-CHAT_Indonesian.pdfOfficial_M-CHAT_Website_files/M-CHAT_Italian_2012.pdfOfficial_M-CHAT_Website_files/M-CHAT_Italian_2012_FollowUp.pdfmailto:erica.salomone@unito.it?subject=Italian%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Japanese.pdfOfficial_M-CHAT_Website_files/M-CHAT_Japanese_pic.pdfOfficial_M-CHAT_Website_files/M-CHAT_Kannada.pdfmailto:nsoar2@uky.edu?subject=Kannada%20translation%20of%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Khmae.pdfmailto:ldubeysd@gmail.com?subject=Khmae%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Korean_HKim.pdfOfficial_M-CHAT_Website_files/M-CHAT_Korean_HKSeung_FollowUp.pdfmailto:hkim@fairfield.edu?subject=Korean%20translation%20of%20the%20M-CHATOfficial_M-CHAT_Website_files/M-CHAT_Korean2.pdfOfficial_M-CHAT_Website_files/M-CHAT_Korean2_FollowUp.docxOfficial_M-CHAT_Website_files/M-CHAT_Kurdish.pdfmailto:barron.patterson@Vanderbilt.Edu?subject=Kurdi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