My Pediatrician Screened my Child for Autism: What does that mean?

The American Academy of Pediatrics recommends autism screening for all children at the 18-month and 24-month well-child checks. A “Level 1” autism screening tool should be given at those check-ups. Level 1 screening tools are designed to identify children at risk for developmental disorders, including autism, among the general population (Dow et al., 2020) - meaning they should be done with all children, regardless of whether or not autism is suspected.

Though there are other tools that may be used, the Modified Checklist for Autism in Toddlers, Revised, with Follow-up (M-CHAT-R/F) (Robins et al., 2014) is, by far, the most widely used autism screening tool in pediatric practices (Mazurek et al., 2018). It is a 20-question screening that is administered via parent report. That means that, as the caregiver, you will be asked to indicate your answers to the questions on the form or, alternatively, your practitioner may ask you the questions verbally. You can see the full screening here: M-CHAT-R/F. Scroll to the bottom of the page, where you will find the green link to the screening tool on the left. 

As a screening tool, the M-CHAT is not used to diagnose autism. It simply identifies those children who may need further evaluation to determine if autism is present. If your child scores in the MODERATE-Likelihood range (a score of 3-7) or HIGH-Likelihood range (a score of 8-20) on the M-CHAT, your practitioner will likely refer you to a specialist for further evaluation. We’ll talk more about what an evaluation might look like in later posts!

It is important to know that many children whose M-CHAT scores indicate increased likelihood, will not be diagnosed with autism. This is because the M-CHAT is a screening tool that is designed to identify as many cases of autism as possible (Robins et al., 2014). It is also important to know that recent research shows that the M-CHAT does not always detect autism in children showing more subtle characteristics (Schjolberg et al., 2021; Schrader et al., 2020). This includes younger children, as the characteristics of autism tend to intensify and become more recognizable over time in the first 5 years (About Autism in Toddlers, n.d.). For these reasons, it is important for you to be familiar with the traits of autism, and to speak openly with your pediatrician if you have concerns or questions. You can visit the parent-friendly Autism Navigator website (https://www.autismnavigator.com) to learn more about the signs of autism in young children. 

I hope this post did a little bit to help de-mystify the autism screening and referral process for you!

Leslie

References

Autism Navigator, (n.d.). About autism in toddlers [online course]. https://resources.autismnavigator.com/aboutAutism/course.html

Dow, D., Day, T. N., Kutta, T. J., Nottke, C., & Wetherby, A. (2020). Screening for autism in a naturalistic home setting using the Systematic Observation of Red Flags (SORF) at 18-24 months. Autism Research, 13, 12ba2-133. doi:10.1002/aur.2226

Mazurek, M. O., Curran, A., Burnette, C., & Sohl, K. (2019). ECHO autism STAT: Accelerating early access to autism diagnosis. Journal of Autism and Developmental Disorders, 49(1), 127–137. https://doi.org/10.1007/s10803-018-3696-5

Robins, D. L., Barton, M. L. & Fein, D. (2001). The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) [Database record]. APA PsycTests. https://doi.org/10.1037/t67574-000

Schjolberg, S., Shic, F., Volkmar, F. R., Nordahl-Hansen, A., Stenberg, N., Torske, T., Larsen, K., Riley, K., Sukhodolsky, D. G., Leckman, J. F., Chawarska, K., & Oien, R. A. (2021). What are we optimizing for in autism screening? Examination of algorithmic changes in the M-CHAT. Autism Research, 15(2), 296-304. 

Schrader, E., Delehanty, A. D., Casler, A., Petrie, E., Rivera, A., Harrison, K., Paterniti, T., Sebastiany, L., Nottke, C., Sohl, K., Levy, S. E., & Wetherby, A. (2020). Integrating a new online autism screening tool in primary care to lower the age of referral. Clinical Pediatrics, 59(3), 305-309.