M-CHAT-R Autism Screening for 27-Month-Olds
At 27 months, foundational social communication behaviours are well-established in typically developing children, making the M-CHAT-R an effective tool for identifying those whose development may differ — even if language has progressed on schedule.
- Questions
- 20
- Format
- Yes / No
- Time
- ~5 minutes
- Completed by
- Parent or caregiver
- Age range
- 16–30 months
About the M-CHAT-R
Children at 27 months typically use three-word sentences, engage in cooperative imaginative play, and show early theory-of-mind precursors — an awareness that other people have different thoughts and feelings. Social interactions are increasingly complex and reciprocal.
A child who has developed solid language but who prefers sameness, shows limited interest in cooperative play, or has difficulty reading social cues may not have been identified in earlier screening. The M-CHAT-R at 27 months captures whether these underlying social communication foundations are present.
Source: Modified Checklist for Autism in Toddlers, Revised — Robins, Fein & Barton (2009)
Frequently asked questions
- My 27-month-old has good language but poor eye contact. Should I be concerned?
- Reduced eye contact alongside otherwise typical development can be a normal variant, but it can also be one element of an autism presentation. In isolation it is not diagnostic, but combined with other M-CHAT-R items — limited social referencing, unusual play, or strong insistence on sameness — it warrants professional follow-up.
- Is 27 months too late for early intervention to make a difference?
- No. Early intervention is beneficial at any point in early childhood, and evidence for its effectiveness extends well beyond the toddler years. Identifying autism at 27 months still enables access to speech therapy, occupational therapy, and specialist autism support at a neuroplastically important time.
- 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