Checklist for autism in toddlers (CHAT)

  • A screening test designed to be used in children from 18 months to 36 months.

    CHAT Section A - Questions for Parents

       Yes or No
    Does your child enjoy being swung, bounced on your knee, etc.?  

    Does your child take an interest in other children?

     
    Does your child like climbing on things, such as up/on chairs?  
    Does your child enjoy playing peek-a-boo / hide & seek?  
    Does your child ever pretend, for example, to make a cup of tea using a toy cup and teapot, or pretend other things (pouring juice)? [Pretend Play (PP)]  

    Does your child ever use his or her index finger to point, to ask for something?

     

    Does your child ever use his or her index finger to point, to indicate interest in something? [Protodeclarative Pointing (PDP)]

     
    Can your child play properly with small toys (e.g. cars or blocks) without just mouthing, fiddling, or dropping them?  

    Does your child ever bring objects over to you (parent), to show you something?

     
    Shaded boxes indicates critical question most indicative of autistic characteristics

    CHAT Section B - Pediatrician's Questions / Observations

       Yes or No

    Eye Contact: During the appointment, has the child made eye contact with you?

     

    Gaze monitoring (GM): Get the child's attention, then point across the room at an interesting object and say, "Oh Look! There's a (name of a toy)!" Watch the child's face. Does the child look across to see what you are pointing at? (To record a YES, make sure the child does not just look at your hand, but at the object you are pointing at).

     

    Pretend Play (PP): Get the child's attention, then give the child a miniature toy cup and teapot and say, "Can you make a cup of tea?" Does the child pretend to pour out tea and drink it? (If you can elicit an example of pretending in some other game, score a YES on this item).

     

    Protodeclarative Pointing (PDP): Say to the child, "Where's the light?" or "Show me the light." Does the child point with their index finger at the light?

    (Repeat this with, "Where's the bear?" or some other unreachable object if the child does not understand the word light. To record a YES on this item, the child must have looked up at your face around the time of pointing).

     

    Block Tower: Can the child build a tower of blocks?
    (If so how many?)

     
    Shaded boxes indicates critical question most indicative of autistic characteristics
    • Overall the more "NOs" the higher the chance of Autism

    In the Baron Cohen studies:

    • Failing all questions with shaded boxes - risk of Autism 80-85%
    • Passing all questions with shaded boxes - risk of Autism 0%

    References

    • Baron Cohen, S et al Can autism be detected at 18 months? The needle the haystack and the CHAT. British Journal of Psychiatry 161:839-843.(1992)
    • Baron Cohen S. et al Early identification of autism by the CHecklist for Autism in Toddlers (CHAT) J.R.Soc.Med. 93: 521-525 (2000)
    • Baird G.et al A screening instrument for autism at 18 months of age:a 6 year follow up study. Am.Acad.Child and Adolesc. Psychiatry 39:694-702 (2000)