Early Autism Signals Screening: Check Early Social and Communication Signs (16 to 30 Months)
An original 20-item parent-report screening for toddlers aged 16 to 30 months, informed by CDC developmental milestone checklists and the early social-communication signs the screening research points to. This is not the M-CHAT-R; we explain what that tool is and link you straight to the authors' site. Answer 20 short items about your child and get an instant, plain-language result plus a free PDF for your pediatrician.
Reviewed by Michael Callans, MSW 
Early Autism Signals Screening for Toddlers, 16 to 30 Months is a free, confidential 20-question self-assessment, original items, informed by CDC milestones. It takes about 5 minutes, runs entirely in your browser, and gives you a plain-language score across 3 interpretation bands plus an optional in-depth report. It is an educational screening, not a diagnosis.
What this screening looks at
Screening research and pediatric milestone checklists point to a cluster of early social-communication behaviors that often look different in autistic toddlers. This screening organizes what you are noticing into five areas, so your result is easy to read and useful to bring to your pediatrician.
Original, CDC-informed items
Twenty items we wrote ourselves, covering the early social-communication signs that milestone checklists and screening research point to at 16 to 30 months. Not a reproduction of the M-CHAT-R or any other copyrighted instrument.
Social connection and joint attention
Eye contact, social smiling, responding to their name, following a point, and pointing to show or ask for something, the back-and-forth moments where early connection first shows up.
Play, language, and movement
Pretend play, imitation, first words, walking, and a couple of questions about repetitive movements or unusual reactions to sound, the everyday details worth noticing.
| Feature | Typical free quiz | Psychology.com |
|---|---|---|
| Explains what the M-CHAT-R is and links to it | Rarely | Yes, directly to the authors' site |
| Original items, clearly labeled as our own writing | Often unclear where items come from | Yes, clearly labeled |
| Informed by public CDC milestone checklists | Sometimes | Yes, directly |
| Age-appropriate for 16 to 30 months | Sometimes generic | Yes, as designed |
| Clear next step by score range | No | Yes |
| Confidential, no account needed | Often requires signup | Runs in your browser |
| Optional detailed PDF to bring to your pediatrician | No | Yes |
How scoring works
Answers are scored 0–40 in total. Your result falls into one of 3 bands:
| Score | Band | What it suggests |
|---|---|---|
| 27–40 | Few early signals noted | Based on your answers, your child is showing most of the early social-communication behaviors this screening asks about. |
| 14–26 | Some signals worth watching | Based on your answers, some early social-communication behaviors are showing up less than others. Worth a closer look, without alarm. |
| 0–13 | Talk with your pediatrician soon | Based on your answers, several early social-communication behaviors are not yet showing up consistently. Worth a conversation with your pediatrician soon rather than waiting. |
How this screening works
Each of the 20 questions asks how often an early social-communication behavior shows up for your child right now, rated not yet, sometimes, or yes, regularly. Your answers are grouped into five areas: social connection, joint attention and sharing, communication and play, language, and movement and sensory patterns. This five-area grouping is our own way of organizing the questions for a clear result; it is not a validated clinical subscale.
Two of the twenty questions ask about repetitive movements and unusual reactions to everyday sounds. Answering yes, regularly to those two lowers your score, the same direction as answering not yet to the other eighteen, so the total reflects the overall pattern of everything you are noticing, not just a simple checklist count.
What the M-CHAT-R is, and why this page is not it
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a real, validated 20-item autism screening tool, developed by Diana Robins, Deborah Fein, and Marianne Barton. It is the screening most pediatricians in the United States use at the 18 and 24 month well-child visits, and it is genuinely worth asking your pediatrician about by name if they have not already used it with your child.
We do not have a license to repost the M-CHAT-R on this website. The authors' own permissions page states plainly that reposting the M-CHAT-R to a website requires a license agreement, and we do not hold one. So rather than reproduce their instrument without permission, we wrote this page as an original, unaffiliated screening informed by public CDC milestone checklists and the general screening research. It is not the M-CHAT-R, it does not use the M-CHAT-R's items or scoring, and it is not equivalent to it.
If you want the actual M-CHAT-R, the authors welcome a direct link to their site, and you can download it there for free for personal, clinical, or educational use:
https://www.mchatscreen.com/mchat-rf/
Related screenings for autism and early development
This page focuses on toddlers aged 16 to 30 months. If your child is a bit older, or you want a broader picture of language, motor, and social milestones alongside autism traits, the Child Development Test: Milestones Screener (Ages 2 to 5) covers five developmental domains. If speech and language are your main concern, whether or not autism traits are present, the Developmental Language Disorder Test screens specifically for developmental language disorder in children aged 3 to 8. For children aged 4 and up, the Child & Teen Autism Test offers a broader trait screening for that age range.
What to do next
Whatever your result, the next move is the same conversation, just with different urgency: talk to your child's pediatrician. Bring your score and, if you have it, the breakdown of which areas were flagged, and ask specifically whether they can run the actual M-CHAT-R with your child if they have not already. Pediatricians can request a referral to Early Intervention services directly, and in most places in the United States you do not need a diagnosis in hand to start that process. Early support during the toddler years, when the brain is forming connections fastest, tends to have the biggest impact, which is exactly why screening exists at the ages it does.
Methodology & sources
This is an original, house-built screening, not the M-CHAT-R and not affiliated with its authors. Its items were written independently. Seventeen of the twenty are mapped to milestones in the Centers for Disease Control and Prevention's Learn the Signs, Act Early checklists, which are public domain materials developed with the American Academy of Pediatrics; the remaining three (following a point, repetitive hand movements and unusual reactions to sound) come from the published early-autism screening literature, principally the 2015 Pediatrics early-identification recommendations, and the DSM-5-TR sensory reactivity criterion rather than from a milestone. Any toddler autism screener has to ask about the same handful of early behaviours, response to name, following and using a point, showing things to share, pretend play, imitation, gesture and unusual sensory or repetitive behaviour, because those are the behaviours the research identifies; the wording, examples, order and scoring here are our own, and we keep an item-by-item provenance record.
Our 20 items span five areas: social connection, joint attention and sharing, communication and play, language, and movement and sensory patterns, five items for social connection, three for movement and sensory patterns, four for each of the others. Eighteen items score a point for each level of "yes" on a behavior that typically develops in this age range; two items, about repetitive hand or finger movements and unusual reactions to everyday sounds, are scored in the opposite direction, so that noticing them more often lowers the total. The three result ranges used here, roughly the top third, middle third, and bottom third of the 0 to 40 point scale, are our own educational bands, not a validated clinical cutoff from any published instrument.
This is a screening for education and reflection. It cannot diagnose autism, and it does not replace the M-CHAT-R or any other validated tool your pediatrician may use. A formal diagnosis is made by a qualified specialist, such as a developmental pediatrician, child psychologist, or psychiatrist, using developmental history, direct observation, and often additional testing over more than one visit.
References
- Centers for Disease Control and Prevention. Learn the Signs. Act Early: CDC's Developmental Milestones. Available at cdc.gov/act-early/milestones/index.html.
- Robins DL, Casagrande K, Barton M, Chen CL, Dumont-Mathieu T, Fein D. Validation of the Modified Checklist for Autism in Toddlers, Revised With Follow-up (M-CHAT-R/F). Pediatrics. 2014;133(1):37–45.
- Zwaigenbaum L, Bauman ML, Stone WL, et al. Early identification of autism spectrum disorder: recommendations for practice and research. Pediatrics. 2015;136(Suppl 1):S10-S40. doi:10.1542/peds.2014-3667C
- Zwaigenbaum L, Bauman ML, Choueiri R, et al. Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics. 2015;136(Suppl 1):S60–S81.
- Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018;392(10146):508–520.
Cite this source
Psychology.com. (2026, September 15). Early Autism Signals Screening for Toddlers, 16 to 30 Months. Psychology.com. https://psychology.com/tests/m-chat
Early Autism Signals Screening for Toddlers, 16 to 30 Months FAQ
Is this the official M-CHAT-R?
No. This is an original screening we wrote ourselves, informed by public CDC milestone checklists. The M-CHAT-R is a separate, validated 20-item tool from Diana Robins, Deborah Fein, and Marianne Barton, and we do not have a license to reproduce it on this website. We explain what it is and link to the authors' site so you can access it directly.
How is this screening scored?
Eighteen of the twenty items score points as your child shows the behavior more often. Two items, about repetitive movements and reactions to everyday sounds, score in the opposite direction, so noticing them more often lowers the total. The full score sorts into three ranges: few early signals noted, some signals worth watching, or talk with your pediatrician soon.
What happens after a score in the watching or talk-to-your-pediatrician range?
Bring your score and the area breakdown to your pediatrician. Ask them to run the actual M-CHAT-R if they have not already, especially around the 18 or 24 month visit. If your score is in the lowest range, they may refer you directly for a full developmental evaluation and an early intervention eligibility evaluation.
Does a reassuring score mean my child is definitely not autistic?
Not with certainty. No brief parent-report screener, including this one, catches everything, and traits can emerge later. If something you are noticing does not fit a reassuring score, trust your own observations and raise it with your pediatrician anyway.
What ages is this screening for?
It is written for toddlers aged 16 to 30 months, the same age range the validated M-CHAT-R covers and the window pediatricians typically screen for autism at the 18 and 24 month well-child visits.
Can this test diagnose autism?
No. Only a qualified specialist, such as a developmental pediatrician, child psychologist, or psychiatrist, can diagnose autism, using developmental history, direct observation, and often testing across more than one visit. This screening tells you whether that evaluation is worth pursuing.
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