Claudia Part II

A little girl with pigtails

Upon scoring the M-CHAT-R, you note that Claudia failed nine items, and had “unsure” responses two others.

You explain to Claudia’s dad that some of his responses about Claudia’s behavior raised concerns about Claudia’s development.

Claudia and her parents return the next week so you can obtain further history and complete the M-CHAT-R Follow-Up Interview with her mom and dad. Even though you were pretty concerned just by Claudia’s results on the M-CHAT-R screener, you would like to use the follow-up interview to identify the areas of greatest need and where to focus your energies.


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 M-CHAT-R Follow-up Interview items in the same manner as the M-CHAT-R. If an item is failed, it indicates risk for ASD. 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Scoring Sheet (which contains the same items as the M-Chat-R items in the same manner as the M-CHAT-R, but Yes/No has been replaced by Pass/Fail).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 on the Follow-Up Interview 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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