Autism Screening and Referral — Age Appropriate ASD screen — Clinical Pathway: Primary Care

Autism Screening Clinical Pathway — Primary Care

Age-Appropriate ASD Screen (M-CHAT-R and/or M-CHAT-R/F or SCQ)

All screening tools are based on DSM-5 criteria. You can review those criteria to familiarize yourself with ASD or to review with families.

  • AAP recommends that Screening Tools for ASD for children under age 3 years be done during well-child doctor visits at 18 months and 24 or 30 months.
  • Screening at other ages may be appropriate if a child is at high risk for ASD or if behaviors associated with ASD are present.
  • Children older than 4 who present with parent/provider concerns about ASD may be helped with the SCQ screening tool.

Screening Tools By Age

Age Screening Tool Notes
16-30 mos
  • Available in Epic and CHOP MyChart
  • Use with M-CHAT-R follow-up questionnaire when needed:
    • M-CHAT-R Scoring cutoff:
      • < 3 fails — no follow-up interview
      • 3-7 fails — follow-up interview
      • > 7 fails — refer for evaluation
    • M-CHAT-R/F
      • Low risk: Score 0-2
      • Medium risk: score 3-7, administer specific follow-up interview and refer if score remains 2 or higher
      • High risk: total score 8-20, refer immediately
  • M-CHAT-R/F is available for free online
  • CHOP Care Network has access to M-CHAT-R in Care Navigator
30-48 mos
  • M-CHAT-R and M-CHAT-R/F are validated in age up to 30 months
  • Beyond 30 months, ongoing developmental surveillance is recommended
≥ 4 yrs
with mental age over 2 yrs
  • Social Communication Questionnaire (SCQ)
  • SCQ is available for purchase online
  • Recommended for use.
  • Not yet available in the Care Network
  • If SCQ is not available at practice site, refer patient for evaluation