For all items except 2, 5, and 12, the response "NO" indicates Autism risk; for items 2, 5, and 12, "YES" indicates Autism risk. The following algorithm maximizes psychometric properties of the M-CHAT-R:
LOW-RISK:
Total Score is 0-2; if child is younger than 24 months, screen again after second birthday. No further action required unless surveillance indicates risk for Autism.
MEDIUM-RISK:
Total Score is 3-7; Administer the Follow-Up (second stage of M-CHAT-R/F) to get additional information about at-risk responses. If M-CHAT-R/F score remains at 2 or higher, the child has screened positive. Action required: refer child for diagnostic evaluation and eligibility evaluation for early intervention. If score on Follow-Up is 0-1, child has screened negative. No further action required unless surveillance indicates risk for Autism. Child should be rescreened at future well-child visits.
HIGH-RISK:
Total Score is 8-20; It is acceptable to bypass the Follow-Up and refer immediately for diagnostic evaluation and eligibility evaluation for early intervention.
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