M-CHAT-R SCORING TEMPLATE

Typical responses are indicated below. Items 2, 5, and 12 are typically NO. All other items are typically YES.
If response agrees with below, assign a score of 0. If response does not agree with below, assign a score of 1.

Score is 0-2: LOW RISK: No further action; rescreen if < 24 month old
Score is 3-7: MEDIUM RISK: Administer Follow Up interview and rescore;
Refer if ≥2 after Follow Up interview
Score is 8-20: HIGH RISK: Refer immediately