CHAT -
Checklist for Autism in Toddlers
Child’s Name:____________________________
Current Date: ____________________________
Date of Birth: ____________________________
Child’s Age: _____________________________
Section A (Ask Parent)
1.
Does your child enjoy being swung, bounced on your knee,
etc.?
Yes / No
2. Does your
child take an interest in other children?
Yes /No
3.
Does your child like climbing on things, such as up stairs?
Yes /No
4.
Does your child enjoy playing peek-a-boo/Hide-and-seek?
Yes /No
5.
Does your child ever pretend, for example, to make a cup of
tea using a toy cup & teapot, or pretend other things?
Yes /No
6.
Does your child ever use his /her index finger to point, to
ask for something?
Yes /No
7.
Does your child ever use his/her index finger to point, to
indicate interest in something?
Yes /No
8.
Can your child play properly with toys (e.g. cars or bricks)
without just mouthing, fiddling, or dropping them?
Yes /No
9.
Does your child ever bring objects over to you (parent), to
show you something?
Yes /No
Section B (GP or Health Visitor’s
Observation)
1.
During your appointment, has the child made
eye contact with you?
Yes /No
2.
Get child’s
attention, then point across the room at an
interesting object and say "Oh look! There’s
a [name a
toy]!" Watch child’s
face. Does the child look across to see
what you are pointing at? (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.
Yes /No
3. Get the child’s
attention, then give child a miniature toy
cup & teapot (or substitute toy pitcher and cup for
juice)
and say "Can you make a cup of tea (juice)?" Does the
child pretend to pour out tea (juice), drink it, etc.?
If you
can elicit an example of pretending in some other game,
score a yes on this item.
Yes /No
4.
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? (Repeat this with "Where’s
the teddy?" or
some other unreachable object, if the child does not
understand the word "light". To record yes on this
item,
the child must have looked up at your face around the
time
of pointing).
Yes /No
5.
Can the child build a tower of bricks? (How many bricks?)
Yes /No