M-CHAT-R Autism Screening for 23-Month-Olds
At 23 months, you are approaching the second AAP-recommended screening window. Completing the M-CHAT-R now means results are ready for the 24-month well-child visit — giving you and your paediatrician a concrete starting point for discussion.
- Questions
- 20
- Format
- Yes / No
- Time
- ~5 minutes
- Completed by
- Parent or caregiver
- Age range
- 16–30 months
About the M-CHAT-R
By 23 months, most children use two-word phrases consistently and are beginning three-word combinations. They show curiosity about other children, engage in simple cooperative play, and are beginning to express early empathy — for example, bringing comfort to an upset peer or caregiver.
Children whose language development is relatively good but who show differences in the quality of social engagement — limited reciprocal exchange, preference for solitary activity, or unusual play patterns — may not be identified without a structured checklist. The M-CHAT-R at 23 months captures the full range of relevant social communication behaviours.
Source: Modified Checklist for Autism in Toddlers, Revised — Robins, Fein & Barton (2009)
Frequently asked questions
- Should I wait until the 24-month visit to screen?
- Screening at 23 months means results are available to bring to the 24-month visit, rather than being completed under time pressure in the clinic. The M-CHAT-R is valid at any point between 16 and 30 months — there is no reason to delay if you have current observations to inform your answers.
- My child understands a lot but says very few words. How does that affect the M-CHAT-R?
- Receptive language (understanding) often develops ahead of expressive language (speaking). The M-CHAT-R covers both domains: it includes items about following instructions (receptive) and items about pointing, gesturing, and social responses. A child who understands well but has very limited expression may still screen positive depending on their social communication behaviours.
- 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