Baron-Cohen
et al. Can autism be detected at 18 months? The
needle, the haystack, and the CHAT. Br J
Psychiatry. 1992;161:839-43.
Baron-Cohen et al. Psychological markers in the
detection of autism in infancy in a large
population. Br J Psychiatry.
1996;168:158-63.
The CHAT is
an accurate and elegant autism screening
tool for early autism diagnosis. Studies have
found that the CHAT is 85% accurate in diagnosing
children with autism and 100% accurate in
diagnosing a developmental delay in general.
This tool can
be used by primary care physicians and
pediatricians who see young children first and are
the entry point into the health care system for
infants and toddlers. The earlier they can confirm
a diagnosis of autism, the more effective
behavioural treatment is likely to be. Physicians
can use the CHAT on children 18 months of age or
older.
Section
A: Questions for the parent
A1 Does your child enjoy being
swung,bounced on your knee, etc. ?
YES/NO
A2
Does your child take an interest in other children
? YES/NO
A3
Does your child like climbing on things, such as
stairs ? YES/NO
A4
Does your child enjoy playing peek-a-boo / hide and
seek ? YES/NO
A5
Does your child ever PRETEND , for example to make
a cup of tea using a toy cup and teapot, or pretend
other things ? YES/NO
A6
Does your child ever use his/her index finger to
point, to ASK for something.?
YES/NO
A7
Does your child ever use his/her index finger to
point, to indicate INTEREST in something ?
YES/NO
A8
Can your child play properly with small toys (e.g.
cars or bricks) without just mouthing, fiddling or
dropping them ? YES/NO
A9
Does your child ever bring things to you (parent)
to SHOW you something. ? YES/NO
Section
B: Health visitor or physician observation
Bi During the appointment has the
child made eye contact with you ?
YES/NO
Bii
Get the childs attention, then point
across the room at an interesting object and say "
Oh look! There`s a (name of toy) " Watch the childs
face.
Does the child look across at what you are pointing
at ? YES/NO*
Biii
Get the childs attention, then give the child a
miniature tea pot and tea cup and say "Can you make
a cup of tea?"
Does the child pretend to pour out tea, drink it,
etc. ? YES/NO**
Biv
Say to the child "Where`s the light?", or "Show me
the light".
Does the child POINT with his/her index finger at
the light ? YES/NO***
Bv
Can the child build a tower of bricks ? If so how
many. (No of bricks.........)
YES/NO
* To record
YES on this item ensure the child has not simply
looked at your hand but has actually looked at the
object you are pointing at.
** If you can
elicit an example of pretending in some other game
score a YES for this item.
*** Repeat
this with "where`s the teddy?" or some other
unreachable object if the child does not understand
"light". To record YES on this item the child must
have looked up at your face around the time of
pointing.
Scoring
The CHAT is
very easy to score. There are 5 key
items:
A5 Pretend
play
A7
Protodeclaractive pointing
Bii Following
a point
Biii
Pretending
Biv Producing
a point
If a child
fails all 5 key items, they have a high risk of
developing autism. Children who fail items A7 and
Biv have a medium risk of developing
autism.
What to do
if a child fails CHAT ?
Any child
that fails the CHAT should be re-screened
approximately one month later. As with any
screening instrument , a second CHAT is advisable,
so that those children who are just slightly
delayed are given time to catch up. Any child who
fails the CHAT for a second time should be referred
to a specialist for diagnosis since CHAT is not a
diagnostic tool.
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