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The CHAT Test

What is the CHAT ?

CHAT stands for The CHecklist for Autism in Toddlers. It was developed by a team of researchers to help identify children who are at risk of developing Social-communication disorders. It is administered by a health visitor or GP at the 18 month check up.

How is the CHAT scored ?
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 happens 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.

The CHAT Test

Section A Questions for the parent

A1 Does your child enjoy being swung,bounced on your knee, etc. ?

A2 Does your child take an interest in other children ?

A3 Does your child like climbing on things, such as stairs ?

A4 Does your child enjoy playing peek-a-boo / hide and seek ?

A5 Does your child ever PRETEND , for example to make a cup of tea using a toy cup and teapot, or pretend other things ?

A6 Does your child ever use his/her index finger to point, to ASK for something.?

A7 Does your child ever use his/her index finger to point, to indicate INTEREST in something ?

A8 Can your child play properly with small toys (e.g. cars or bricks) without just mouthing, fiddling or dropping them ?

A9 Does your child ever bring things to you (parent) to SHOW you something. ?

Section B Health visitor or GP observation

Bi During the appointment has the child made eye contact with you ?

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 ?

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. ?

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 ?

Bv Can the child build a tower of bricks ? If so how many. (No of bricks.........)

* 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.


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