M-Chat

Child's Name(Required)
Parent/Caregiver's Name(Required)
1. If you point at something across the room, does your child look at it?(Required)
(For example: if you point at a toy or an animal, does your child look at it?)
2. Have you ever wondered if your child might be deaf?(Required)
3. Does your child play pretend or make-believe?(Required)
(For example: pretend to drink from an empty cup, pretend to talk on a phone, or pretend to feed a doll or stuffed animal?)
Does your child like climbing on things?(Required)
(For example: stairs, furniture, playground equipment.)
5. Does your child make unusual finger movements near his or her eyes?(Required)
(For example: does your child wiggle his or her fingers close to his or her eyes?)
6. Does your child point with one finger to ask for something or to get help?(Required)
(For example: pointing to a snack or toy out of reach.)
7. Does your child point with one finger to show you something interesting?(Required)
(For example: pointing to an airplane in the sky or a big truck in the road.)
8. Is your child interested in other children?(Required)
(For example: does your child watch other children, smile at them, or go to them?)
9. Does your child show you things by bringing them to you or holding them up for you to see — not to get help, but to share?(Required)
(For example: showing you a flower, a stuffed animal, or a toy truck.)
10. Does your child respond when you call his or her name?(Required)
(For example: does he/she look up, babble, or stop what he/she is doing?)
11. When you smile at your child, does he/she smile back?(Required)
12. Does your child get upset by everyday noises?(Required)
(For example: a vacuum cleaner or loud music?)
13. Does your child walk?(Required)
14. Does your child look you in the eye when you talk to, play with, or dress him/her?(Required)
15. Does your child try to copy what you do?(Required)
(For example: wave bye-bye, clap, make funny noises.)
16. If you turn your head to look at something, does your child look around to see what you’re looking at?(Required)
17. Does your child try to get you to watch him/her?(Required)
(For example: look at you for praise, say “look” or “watch me”?)
18. Does your child understand when you tell him/her something?(Required)
(For example: if you don’t point, can he/she understand “put the book on the chair” or “bring me the blanket”?)
19. If something new happens, does your child look at your face to see how you feel about it?(Required)
(For example: if he/she hears a strange or funny noise or sees a new toy, will he/she look at you?)
20. Does your child like movement activities?(Required)