M-CHAT-R Autism Screening for 28-Month-Olds
At 28 months, the M-CHAT-R is still within its validated age range and continues to provide a structured, evidence-based way to assess whether social communication behaviours are on track — particularly useful if concerns have emerged gradually over time.
- Questions
- 20
- Format
- Yes / No
- Time
- ~5 minutes
- Completed by
- Parent or caregiver
- Age range
- 16–30 months
About the M-CHAT-R
By 28 months, most children form complex multi-word sentences, show empathy towards others in distress, and engage in imaginative cooperative play. Growing independence and self-regulation are apparent, though emotional regulation is still developing.
If behavioural patterns at 28 months — such as strong insistence on routines, repetitive play, or difficulty with social transitions — differ noticeably from those of peers, the M-CHAT-R provides a structured starting point for a professional conversation.
Source: Modified Checklist for Autism in Toddlers, Revised — Robins, Fein & Barton (2009)
Frequently asked questions
- My 28-month-old has significant sensory sensitivities and tantrums. Can M-CHAT-R help?
- The M-CHAT-R focuses on social communication behaviours and is not a behavioural or sensory assessment. However, a positive screen would support a broader referral where sensory sensitivities and behavioural patterns could be assessed in full context alongside social communication findings.
- Are there any limitations to using M-CHAT-R at 28 months?
- The M-CHAT-R is validated through 30 months and is appropriate at 28 months. Some children who have developed compensatory strategies by this age may respond differently than at 18 months. A negative screen does not rule out autism if professional concerns persist — discuss any ongoing concerns with your paediatrician regardless of the score.
- 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