M-CHAT
INSTRUCTIONS

Please fill out the following about how your child usually is. Please try to answer every question. If the behavior is rare (e.g., you’ve seen it once or twice) please answer as if the child did not do it.


  1. YesNo
  2. YesNo
  3. YesNo
  4. YesNo
  5. YesNo
  6. YesNo
  7. YesNo
  8. YesNo
  9. YesNo
  10. YesNo
  11. YesNo
  12. YesNo
  13. YesNo
  14. YesNo
  15. YesNo
  16. YesNo
  17. YesNo
  18. YesNo
  19. YesNo
  20. YesNo
  21. YesNo
  22. YesNo
  23. YesNo

* Required