M-CHAT-R Autism Screening for 22-Month-Olds
At 22 months, children are in an active language and social development phase. The M-CHAT-R captures whether core social communication behaviours — including pointing, shared attention, and play — are present and consistent.
- Questions
- 20
- Format
- Yes / No
- Time
- ~5 minutes
- Completed by
- Parent or caregiver
- Age range
- 16–30 months
About the M-CHAT-R
By 22 months, most children use two-word sentences, ask 'what's that?' repeatedly, and engage in increasingly elaborate pretend play. They show clear recognition of familiar people, strong attachment to primary caregivers, and growing awareness of other children as potential playmates.
These social-communication behaviours are central to several M-CHAT-R items. A child who has developed good vocabulary but whose social engagement feels qualitatively different — limited eye contact, reluctance to show objects, reduced reciprocal play — may still screen positive.
Source: Modified Checklist for Autism in Toddlers, Revised — Robins, Fein & Barton (2009)
Frequently asked questions
- My 22-month-old rarely points at things or asks 'what's that?'. Is this significant?
- Pointing to share interest and asking about objects are important joint attention behaviours. Their absence at 22 months — especially alongside other M-CHAT-R items such as limited social referencing or unusual play patterns — is worth investigating with a full checklist and, if positive, professional follow-up.
- What is the difference between M-CHAT-R and M-CHAT-R/F?
- The M-CHAT-R is the 20-item initial checklist. The M-CHAT-R/F adds a structured follow-up interview for children who screen positive, to reduce false positives before referral. Clinicians often use the follow-up interview as a second step; this tool provides the initial screen. A positive result here warrants a conversation with your paediatrician about the next steps.
- What happens if my child screens at risk?
- A positive screen means enough reported behaviours are present to warrant further evaluation. The recommended next step is a referral to a developmental paediatrician, paediatric psychologist, or specialist autism diagnostic service. Early referral leads to earlier access to support.
- Does a positive screen mean my child has autism?
- No. A positive screen is not a diagnosis. Many children who screen positive do not receive an autism diagnosis after full evaluation. Only a qualified clinician carrying out a comprehensive assessment can diagnose autism spectrum disorder.
- How long does the screening take?
- Most parents complete the M-CHAT-R in 3 to 5 minutes. Results and guidance are available immediately after the last question.
Free · Private · Results in under 15 minutes