A 2-year-old child has no meaningful words, limited eye contact, does not respond to name, engages in repetitive hand-flapping, and has no pointing gesture. These features have been present since 12 months. Which developmental screening tool is the RECOMMENDED instrument for autism spectrum disorder screening at 18–24 months?
- A Denver Developmental Screening Test (Denver II)
- B Childhood Autism Rating Scale (CARS)
- C Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) ✓
- D Vineland Adaptive Behavior Scales
Correct answer: C. Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R)
Explanation
The Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) is the recommended universal autism spectrum disorder (ASD) screening tool for 16–30 months of age, endorsed by AAP for use at 18-month and 24-month well-child visits. It is a parent-completed questionnaire with 20 items assessing social communication behaviors. Denver II is a general developmental screening tool, not ASD-specific. CARS is a diagnostic observational scale used by clinicians (not a screening tool). Vineland assesses adaptive behavior for diagnostic purposes in established disability.
Reference: Ghai Essential Pediatrics, 10th ed.
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