Case Study Part III

A young boy sucking his thumb

The nurse scores the M-CHAT-R and determines he has failed three items and has a total score of 3.

You refer to an audiologist for a hearing evaluation and call Matthew’s parents to schedule a Follow-Up Interview

Matthew’s parents return the next week for a follow-up appointment to discuss the results of the screening tool, and you conduct the Follow-Up Interview.


Select items based on M-CHAT-R scores. Administer only those items for which the parent indicated behavior that demonstrates risk for autism spectrum disorder (ASD), meaning the item was failed, and/or those which the health care provider has concerns may not have been answered accurately.

Score the responses to the M-CHAT-R Follow-Up Interview Scoring Sheet (which contains the same items as the M-Chat-R items in the same manner as the M-CHAT-R, but Yes/No has been replaced by Pass/Fail). The Interview is considered screen positive if the child fails any two items on Follow-Up. If a child screens positive it is strongly recommended that the child be referred for early intervention and diagnostic testing as soon as possible.

Please note screening positive on the Follow-up Interview does not diagnose ASD; it indicates increased risk for ASD. If the health care provider has concerns about ASD, children should be referred to a specialist regardless of the score on the M-CHAT-R or M-CHAT-R Follow-up Interview.

Note: Providers may opt to bypass the Follow-up Interview when the M-CHAT-R total score is 8-20 (High-Risk for ASD), and immediately refer the child for diagnostic evaluation and early intervention services.

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