M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised)
Screens for autism spectrum disorder risk in toddlers 16-30 months to prompt early evaluation and intervention
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- questionnaire
- Care settings
- Outpatient
When it activates
Scribeable activates a calculator from the encounter. The M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) can activate when the transcript or pasted chart context documents any of these:
- Autism screening
- ASD risk assessment
- Developmental screening
- 18-month well-child check
- 24-month well-child check
- Social developmental concern
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: F84.
Inputs the note needs
1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| M-CHAT-R total score (0-20) from 20 yes/no parent-report items | symptom |
Scoring
20 yes/no items. Some items scored "yes"=pass, others "yes"=fail. Total fail count = score. Score 0-2: Low risk (if child <24 months, rescreen at 24 months). Score 3-7: Medium risk (administer follow-up interview M-CHAT-R/F). Score 8-20: High risk (refer immediately for diagnostic evaluation and early intervention).
Interpretation
Score 0-2: Low risk — rescreen at 24 months if under 24 months. If concerns persist despite low score, refer regardless. Score 3-7: Medium risk — administer M-CHAT-R Follow-Up (M-CHAT-R/F) structured interview to reduce false positives. If follow-up score >=2, refer for evaluation. Score 8-20: High risk — bypass follow-up interview and refer directly for developmental evaluation and early intervention services. PPV improves significantly with follow-up interview (47% vs 14% without). Early intervention before age 3 significantly improves outcomes.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Robins 2009/2014.
- Robins DL et al. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F)Robins et al. (M-CHAT-R) 2014 · 2014 · Level I · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a questionnaire: a patient-reported or clinician-rated instrument, where a spare activation carries low harm.
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