Free M-CHAT-R Autism Screening Test for Toddlers
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is the most widely used screener for spotting toddlers who may show early signs of autism spectrum disorder (ASD). It is completely free and takes two minutes: answer 20 quick yes or no questions about your child and see what the results mean right away, with follow-up from the Alpaca Health care team.
The M-CHAT-R is designed for toddlers 16 to 30 months old. Have an older child or want a broader check? See all screening options
Take the M-CHAT-R autism screening test
Answer the 20 questions below based on how your child usually behaves. If you have seen a behavior only once or twice, answer as if your child does not do it. At the end, enter your email to see your child's score and what it means, and a member of the Alpaca Health care team will follow up.
Your M-CHAT-R result
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Sign up for intake todayOur team reviews every response and follows up with clear next steps. This screener does not provide a diagnosis.
Your responses are private and are used only to share your results and next steps. The M-CHAT-R is a screening tool, not a diagnosis.
M-CHAT-R™ is © 2009 Robins, Fein, & Barton.
What happens after you submit
You see your child's score and what it means right away
You can book a free evaluation on the spot if you would like one
The Alpaca Health care team reviews your responses and follows up to talk through next steps
What the screening test measures
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a parent-report questionnaire that flags toddlers who may benefit from a full autism evaluation. It was created by Robins, Fein, and Barton in 2009 and is one of the most widely used and researched early autism screeners. It is designed for children 16 to 30 months old and takes two minutes.
The M-CHAT-R asks 20 yes or no questions about everyday behavior. It is not a test your child takes or a diagnosis. It is a structured way for you to share what you notice, so you and your child's doctor can decide whether a closer look makes sense. A higher score means a full evaluation is a good next step, not that your child is autistic.
What it looks at
Joint attention
Whether your child follows your point, shares interest, and looks where you look.
Communication and gestures
Whether your child points to ask for things, waves, or uses gestures to be understood.
Social engagement
Whether your child responds to their name, makes eye contact, and shows interest in other children.
Pretend play
Whether your child pretends during play, such as feeding a doll or talking on a toy phone.
Sensory and repetitive patterns
Whether your child makes unusual finger movements, is sensitive to noise, or has repetitive behaviors.
A two-step design
The M-CHAT-R is the first stage of a two-part tool called the M-CHAT-R/F. If a child's score falls in the medium range, a trained provider works through a short set of follow-up questions about the specific behaviors that were flagged. This second step lowers the number of children referred unnecessarily while still catching those who need support.
What toddlers typically do at each age
The M-CHAT-R looks at whether your child is meeting the social and communication milestones most children reach by this age. Here is a rough guide for 16 to 30 months. Every child develops at their own pace, so a missed milestone is a reason to look a little closer, not to panic.
Around 18 months
Points to show you something interesting
Uses a few single words and copies words you say
Notices when you leave and comes to you for a hug
Plays simple pretend, like feeding a doll
Follows a simple one-step direction
Around 24 months
Uses two-word phrases like more milk
Points to things in a book when you ask
Notices when others are hurt or upset
Looks at your face to see how you react
Plays near other children
Around 30 months
Uses about 50 words and short sentences
Plays alongside and sometimes with other children
Follows two-step directions
Uses objects to pretend, like a block as a phone
Shows you something they made or did
These milestones are drawn from the CDC's developmental checklists. If your child is not doing several of these, the M-CHAT-R and a conversation with your pediatrician can help you understand why.
How scoring works and what your score means
Scoring is standardized and always the same. Each of the 20 questions adds to a total between 0 and 20, with items 2, 5, and 12 reverse-scored. Here is what each score range means and the next step we suggest.
Your child's score
What it means
What to do next
0 to 2
Low likelihood
Your child is showing the social and communication behaviors typical for their age. The signs the M-CHAT-R looks for are not standing out right now.
No next step is needed. Keep enjoying and watching your child's milestones, and screen again at their next checkup or any time something changes.
3 to 7
Moderate likelihood
A few answers suggest it is worth a closer look. This is common, and most children in this range turn out not to be autistic. It just means more information would help.
Talk with your pediatrician, or book a free ADOS-2 evaluation with Alpaca Health to get clear answers. If support turns out to help, starting early makes a real difference.
Talk to the Alpaca Health team8 to 20
High likelihood
Several answers point to a higher chance of autism. A high score is not a diagnosis, but it is a clear signal that a full evaluation is the right next step.
Arrange a full autism evaluation soon. Alpaca Health offers free ADOS-2 evaluations for children 18 months to 6 years, with no waitlist, so you do not have to wait for answers.
Start a free evaluationThe M-CHAT-R is a screening tool, not a diagnostic tool. A higher score means an evaluation is recommended. It does not confirm or rule out autism on its own.
From screening to diagnosis to ABA therapy
A screener is a starting point. Here is how the rest of the path usually works, and how Alpaca Health can help at each step.
1
Screen at home
The M-CHAT-R above gives you a quick read on whether a full evaluation makes sense.
2
Get a professional evaluation
A qualified professional confirms a diagnosis using tools like the ADOS-2 along with your child's history. Alpaca Health offers free ADOS-2 assessments for children 18 months to 6 years old, and your pediatrician or state early intervention program can also evaluate at no cost.
3
Start support
After a diagnosis, many children begin ABA therapy. Alpaca Health matches your family with a local provider, with no waitlists and Medicaid and major insurance accepted.
Not sure where to begin? The Alpaca Health team can walk you through it.
Helpful autism resources for families
Early signs of autism in infants and toddlers
The early behaviors many parents notice first, and when to act on them.
How much ABA therapy costs
What evaluations and ABA therapy cost, and how insurance and Medicaid help.
Does Medicaid cover ABA therapy?
How Medicaid coverage works for autism evaluation and ABA therapy.
More on autism screening
Guides on screening, diagnosis, and what the results mean for your family.
ABA therapy for toddlers
How early ABA therapy works and what to expect after a diagnosis.
In-home ABA therapy
ABA therapy delivered at home, with no waitlists and Medicaid accepted.
M-CHAT-R frequently asked questions
How accurate is the M-CHAT-R?
The M-CHAT-R is one of the most validated toddler autism screeners and is designed to be highly sensitive, meaning it is built to catch as many children who may be autistic as possible. Like every screener, it is not perfect and can flag children who are not autistic, which is why a positive result should always be followed by a professional evaluation.
Does a high score mean my child is autistic?
No. A high score means a full evaluation is recommended, not that your child is autistic. Only a qualified professional can diagnose autism, using a full evaluation that includes direct observation, your child's history, and standardized tools such as the ADOS-2.
Is the M-CHAT-R free, and does an evaluation cost anything?
The screener is completely free. If your child's result suggests a closer look, Alpaca Health offers free ADOS-2 evaluations for children 18 months to 6 years old, and ABA therapy is covered by Medicaid and major insurance plans. Talk to the Alpaca Health team
What if my child is younger than 16 months or older than 30 months?
The M-CHAT-R is validated for children 16 to 30 months old. If your child is younger, screen again closer to 18 months. If your child is older, a different screener or a direct conversation with your pediatrician is a better fit. Our team can point you to the right option.
Can I take the M-CHAT-R more than once?
Yes. Development changes quickly at this age. If you still have concerns or your child is still under 3, you can retake the M-CHAT-R later and share the results with your child's doctor.
What is the goal of the M-CHAT-R?
The goal is to catch possible signs of autism early, when support makes the biggest difference. It flags toddlers who may benefit from a full evaluation and, if needed, early intervention such as ABA therapy.
Why does identifying autism early matter?
A child's brain is most adaptable in the first few years, so starting support early leads to better long-term outcomes in communication, learning, and everyday skills. An early diagnosis also opens the door to insurance-covered therapy and school accommodations sooner.
What is the difference between a screener and a diagnosis?
A screener like the M-CHAT-R is a short questionnaire that flags whether a full evaluation is worth doing. A diagnosis comes from a qualified professional after an in-depth evaluation using tools like the ADOS-2, direct observation, and your child's history. A screener points you in the right direction, but it never diagnoses on its own.
Sources
Robins DL, Casagrande K, Barton M, et al. Validation of the Modified Checklist for Autism in Toddlers, Revised With Follow-up (M-CHAT-R/F). Pediatrics, 2014.
American Academy of Pediatrics. Recommends autism-specific screening at the 18- and 24-month well-child visits.
Centers for Disease Control and Prevention. Autism spectrum disorder screening and the Learn the Signs. Act Early. program.
M-CHAT-R/F official instrument and scoring instructions, mchatscreen.com.
Reviewed by Samantha Ridout, BCBA
Board Certified Behavior Analyst, Clinical Reviewer at Alpaca Health. Last reviewed July 2026.
Take the first step today
A five-minute screener can bring clarity and open the door to early support. If you have questions or want to talk with someone, the Alpaca Health team is here.
