Autism Screening by Primary Health Care Providers for Toddlers in New York State

In 2008, Governor Paterson signed a law requiring the Department of Health to set up protocols or steps for the early screening of children for autism spectrum disorders (ASDs).

These steps must include standards and guidelines recommended by the American Academy of Pediatrics (AAP). The steps must also include:

  • Routine use of ASD screening tools at regular times during important stages in a child's development.
  • Communication between the health provider and parents regarding the Modified Checklist for Autism in Toddlers (M-CHAT) (Robins, D., 2008; Robins, Fein, & Barton, 1999) screen so that parents become informed about ASDs.
  • Steps for referring children for further evaluation if the screen shows they are at risk for ASDs.

AAP recommends early screening for ASDs for all children at their 18- and 24-month well-child health care visits. More information is available from AAP's website, healthychildren.org.

The M-CHAT and M-CHAT follow-up parent interview is a two-step screening tool meant to be given by primary health care providers to identify a child's risk for an ASD. The M-CHAT screen and follow-up interview, instructions, and supplemental materials are available for free download at http://www2.gsu.edu/~psydlr/DianaLRobins/Official_M-CHAT_Website.html.

The M-CHAT screen and follow-up parent interview can be used to screen toddlers between 16 and 30 months of age. The M-CHAT consists of 23 yes/no questions that parents answer about their child's behavior and development. It can be given and scored by a health care provider as part of a well-child checkup. For children whose scores on the M-CHAT show that they are at risk for ASDs, the M-CHAT follow-up parent interview should be given also by the provider. The interview can be completed in 5-15 minutes. The M-CHAT is simple to use and can be given by a provider with little training in ASDs.

Please Note the Following

  • The M-CHAT is not intended to be used by parents to screen their own children.
  • Giving the paper and pencil M-CHAT screen without giving the follow-up interview is not recommended at this time. Results may not be accurate when the follow-up interview is not used.
  • The M-CHAT and follow-up parent interview is a screening tool. It is not to be used to make a formal or specific ASD diagnosis.
  • A professional who is an expert in diagnosing ASDs should do additional testing for any child who has an M-CHAT score and follow-up parent interview showing a risk for ASD.
  • Not all children shown to be at risk for an ASD based on the M-CHAT and follow-up interview will be diagnosed with an ASD. However, the screening tool can also identify children who are at risk for other developmental delays or disorders that require intervention.
  • If the M-CHAT and parent interview results show that a child under three years old is at risk for an ASD, the child should be referred to the county Early Intervention Program (EIP) for evaluation. A list of county contacts for the EIP is available at http://www.health.ny.gov/community/infants_children/early_intervention/county_eip.htm.