The CHAT or Checklist for Autism in Toddlers is a “psychological questionnaire”, which is designed to evaluate risk for “Autism spectrum disorder” in children ages between 18-24 months. The modified CHAT –R is useful to administer as part of “well-child care” visit as well as can be used to assess the risk of developing ASD (Al-Qabandi et al. 2011). The implementation of M-CHAT is aimed to maximize the meaning and sensitivity to detect most of the ASD cases. The researchers developed the questionnaire format in such a way that not only detects the patient with autism but also the children who have chances to develop autism in future (Miller et al. 2011). This method is easy to implement and calculate the score. In this method, the historian plays the major role. The historian could be parents, grandparents or foster parents of the child who observe the child closely.
According to the case study, the patient is a four-year-old child who is diagnosed as autistic non –verbal patient. The patient was accompanied by his grandmother to the clinic. According to the case study, in this case, the grandmother of the child is the historian who helped the examiner to assess the patient.
The application of the M-CHAT is very easy. There is a questionnaire format prepared by Robins et al. 1999, who have the copyright of M-CHAT (Robins et al. 2014). The questionnaire format must be fully answered by the historian no subset questionnaire is valid.
The Questionnaire format
1. Does your child enjoy being swung, bounced on your knee, etc.? No
2. Does your child take an interest in other children? Yes
3. Does your child like climbing on things, such as upstairs? No
4. Does your child enjoy playing peek-a-boo/hide-and-seek? No
5. Does your child ever pretend, for example, to talk on the phone, take care of a doll, or pretend other things? Yes
6. Does your child ever use his/her index finger to point, to ask for something? No
7. Does your child ever use his/her index finger to point, to indicate interest in something? No
8. Can your child play properly with small toys (e.g. cars or blocks) without just mouthing, fiddling, or dropping them? No
9. Does your child ever bring objects over to you (parent) to show you something? No
10. Does your child look you in the eye for more than a second or two? No
11. Does your child ever seem oversensitive to noise? (e.g., plugging ears) No
12. Does your child smile in response to your face or your smile? Yes
13. Does your child imitate you? (e.g., you make a face-will your child imitate it?) No
14. Does your child respond to his/her name when you call? No
15. If you point at a toy across the room, does your child look at it? No
16. Does your child walk? No
17. Does your child look at things you are looking at? No
18. Does your child make unusual finger movements near his/her face? No
19. Does your child try to attract your attention to his/her activity? No
20. Have you ever wondered if your child is deaf? No
21. Does your child understand what people say? No
22. Does your child sometimes stare at nothing or wander with no purpose? No
23. Does your child look at your face to check your reaction when faced with something unfamiliar? No
From the responses given by grandmother, it can be interpreted that the child scored 20, which is highest. This score indicates that the child has a severe risk to develop Autism.
The questionnaire format was presented to the grandmother of the child, who answered questions carefully. It is found that the historian answered all of the questions “No” except question number 2, 5 and 12. This signifies that the child does not show many symptoms like a normal child. From the assessment, it can be said that the child has a high risk to develop autism.
Following recommendations can be provided to the patient-
Al-Qabandi, M., Gorter, J. W., & Rosenbaum, P. (2011). Early autism detection: are we ready for routine screening?. Pediatrics, 128(1), e211-e217.
Miller, J. S., Gabrielsen, T., Villalobos, M., Alleman, R., Wahmhoff, N., Carbone, P. S., & Segura, B. (2011). The each child study: systematic screening for autism spectrum disorders in a pediatric setting. Pediatrics,127(5), 866-871.
Robins, D. L., Casagrande, K., Barton, M., Chen, C. M. A., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 133(1), 37-45.
Yama, B., Freeman, T., Graves, E., Yuan, S., & Campbell, M. K. (2012). Examination of the properties of the Modified Checklist for Autism in Toddlers (M-CHAT) in a population sample. Journal of autism and developmental disorders, 42(1), 23-34.
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