Autism behavior Checklist toddler

When your child is diagnosed with autism spectrum disorder, there's a lot to learn. You're faced with new terms like "early intervention" and "positive behavior support." It's normal to feel overwhelmed.

But don't worry — you're not alone. Many parents have walked this path before. Many resources and support services are available to you.

Our 7-step checklist can help you find the best path forward. Learn about next steps for your baby, toddler, or preschooler.

Step 1: Learn About Your Child's Needs

Kids with autism might have language delays or trouble communicating with others. They may have unusual or repetitive behaviors, or troubles with learning. No two kids with autism are alike — and, as the parent, you're the expert on your child.

So, when talking to doctors or therapists, ask lots of questions. Tell them your concerns. If you're not happy with the answers, consider getting a second opinion.

Some kids with autism have other conditions like seizures, gastrointestinal problems, and trouble sleeping. If you have any health concerns, tell your doctor. Your child may need to see a specialist and have tests.

When you feel comfortable with your child's autism diagnosis, learn about treatment options that may include therapy and education services.

Step 2: Learn About Education Services

Birth to Age 3: Early Intervention

By federal law, kids younger than 3 who have special needs are entitled to extra support to help them reach developmental milestones, like talking. These services are called early intervention and offered through an individualized family service plan (IFSP).

In early intervention, children learn with the help of therapists at home, at daycare, or at another facility. Parents and caregivers learn how to help improve their child's language and communication. Some of the skills to work on include:

  • making eye contact
  • interacting in a back and forth manner
  • responding to others with gestures or language
  • paying attention to an object or event together (called joint or shared attention)

Kids with autism age 3 or older may get an individualized education program (IEP) from their local school district. This plan will outline the need for things like speech therapy, occupational therapy (OT), or a classroom aide to help with positive behavior choices. To learn more, call your school district's office of special education.

Children who do not qualify for an IEP may be able to get educational assistance through a 504 education plan, which provides support in a regular classroom to help with learning.

Step 3: Find Out About Health Coverage

Therapy to help with the symptoms of autism can help kids thrive, but not all are covered by insurance. Coverage depends on your state — and it's not always easy to figure out.

Here are ways to learn what is covered:

  • Call your health insurance company to find out what services they will pay for.
  • Talk to a social worker on your care team to learn about special programs available to your child.
  • Search online for tools that take the guesswork out of health coverage. Some national autism organizations provide helpful quizzes and other tools to learn what's covered in your state or health care plan.

If you don't have insurance, your state's CHIP (Children's Health Insurance Program) or Medicaid programs may offer coverage to your child. Medicaid also may be able to offer extra coverage if your health insurance doesn't cover all expenses. Coverage is based on your child's disability and need, not on your family's income.

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Step 4: Find Childcare If You Need It

By law, childcare providers cannot discriminate against children with special needs. However, you do want to be sure that the daycare center or childcare provider you choose has the skills and setting necessary to safely accommodate your child. State agencies that handle early intervention usually can provide referrals to appropriate childcare providers.

Step 5: Join Social Groups or Schedule Playdates

As your child grows, find chances to socialize with peers and practice the skills learned in therapy. Parents of toddlers or preschoolers may consider joining a "Mommy and Me" class or schedule neighborhood play dates. These meet-ups can be a valuable learning opportunity for your child.

If possible, sign your child up for social skills training classes. These are specifically for kids who need extra help interacting with others. Kids learn about things like making eye contact, taking turns, and sharing. Most classes are led by a therapist or social worker, and might be covered by insurance or offered as part of IEP.

And don't forget about social opportunities for yourself or your other kids. Many areas have support groups for parents or siblings of kids with autism. Being around others who are going through similar challenges can help you learn new ways of coping.

Step 6: Get Support When You Need It

Life with a young child with autism can be overwhelming. So it's important to take breaks and ask for help when you need it. This may be hard to do at first, but it will allow you to devote more time and energy to your family.

So, ask a family member for help with things like laundry or meal planning. Trade off with your partner watching your child so that each of you can get much-needed "me time." Hire a sitter who feels comfortable caring for your child or consider respite care so that you can go out for a night.

Taking time for yourself can help you recharge. You'll come back to your child ready for fun, love, and all that parenthood has to offer.

Step 7: Secure Your Child's Future

If you haven't written a will or set up a legal and financial framework for your child's future, do so. Talk with an attorney who specializes in special needs law and a financial advisor to find the best way to manage your assets and prepare financially for your child's future.

The Checklist for Autism in Toddlers (CHAT) is a psychological questionnaire designed to evaluate risk for autism spectrum disorder in children ages 18–24 months. The 14-question test is filled out by the parent and a pediatrician or physician and takes approximately 5 minutes to complete.[1] The CHAT has shown good reliability and validity in assessing child autism risk in recent studies.[1][2][3] Some research has identified barriers, such as socioeconomic status and parent education level, to the validation of both the CHAT and the Modified Checklist for Autism in Toddlers (M-CHAT) as a reliable and valid screener for children of all backgrounds.[4]

Checklist for Autism in ToddlersPurposeassess autism in 18-24 month toddler

The CHAT was initially developed in the early 1990s to screen for autism in children as young as 18 months. Prior to this point, diagnosis of autism was rare in children younger than 3 years old.[2] Additionally, no specialized screening tool had been developed to detect early signs of autism in young children.[3] This clinical standard for the diagnosis of autism was seen as potentially detrimental because interventional supports early on in life had shown improved outcomes in development.[3] The construction of the CHAT drew off of the theoretical basis that certain developmental markers are rarely seen in individuals with autism, yet these behaviors are often demonstrated in typical development by 15 months of age, and therefore the absence of these behaviors could indicate a potential autism diagnosis at an early age.[2] Specifically, the CHAT aims to distinguish the presence of joint attention and pretend play.[3]

The first 9 questions (part A) of the CHAT identify common play habits and behaviors for infants between ages 18–24 months, and the last five questions (part B) concern the child’s behavior and reaction to certain stimuli initiated by the physician. In parts A and B, the parent and physician, respectively, indicate whether or not the child displays these behavioral characteristics.[5]

Domain breakdown

5 of the 14 questions on the CHAT are key items that factor into risk classification. The 5 key items are as follows:

  • A5- Pretend play
  • A7- Protodeclaractive pointing
  • B2- Following a point
  • B3- Pretending
  • B4- Producing a point [6]

Scoring

Questions from The Checklist for Autism in Toddlers (CHAT) are assessed using a scoring mechanism of key items that splits results into three groups based on risk:

  • High Risk: A choice response of “no” for the key items of “pretend play” (A5), “protodeclarative pointing” (A7), “following a point” (B2), “pretending” (B3), and “producing a point” (B4), classifies the individual as being in the high risk autism group. Individuals who fall into this group should refer to a developmental clinic to discern an official diagnosis.
  • Medium Risk: A choice response of “no” for the key items of “protodeclarative pointing” (A7), and “producing a point” (B4) classifies the individual as being in the medium risk autism group. Individuals who fall into this group should be retested a month later or refer to a developmental clinic.
  • Low Risk: Children who do not fall in either medium or high risk groups are classified as low risk for autism, but should still be retested a month later for reliability.[5]

  1. ^ a b Baird, G; Charman, T; Baron-Cohen, S; Cox, A; Swettenham, J; Wheelwright, S; Drew, A (June 2000). "A screening instrument for autism at 18 months of age: a 6-year follow-up study". Journal of the American Academy of Child and Adolescent Psychiatry. 39 (6): 694–702. doi:10.1097/00004583-200006000-00007. PMID 10846303.
  2. ^ a b c Baron-Cohen, S; Allen, J; Gillberg, C (December 1992). "Can autism be detected at 18 months? The needle, the haystack, and the CHAT". The British Journal of Psychiatry. 161: 839–43. doi:10.1192/bjp.161.6.839. PMID 1483172. S2CID 196176.
  3. ^ a b c d Baron-Cohen, S; Wheelwright, S; Cox, A; Baird, G; Charman, T; Swettenham, J; Drew, A; Doehring, P (October 2000). "Early Identification of autism by the CHecklist for Autism in Toddlers (CHAT)". Journal of the Royal Society of Medicine. 93 (10): 521–525. doi:10.1177/014107680009301007. PMC 1298126. PMID 11064690.
  4. ^ Khowaja, MK; Hazzard, AP; Robins, DL (June 2015). "Sociodemographic Barriers to Early Detection of Autism: Screening and Evaluation Using the M-CHAT, M-CHAT-R, and Follow-Up". Journal of Autism and Developmental Disorders. 45 (6): 1797–808. doi:10.1007/s10803-014-2339-8. PMC 4442731. PMID 25488122.
  5. ^ a b "CHAT (CHecklist for Autism in Toddlers): Autism Screening at 18–24 months of age" (PDF). Checklist for Autism in Toddlers. Retrieved 23 October 2015.
  6. ^ "CHAT - Checklist for Autism in Toddlers". www.paains.org.uk. Retrieved 2015-10-27.

  • Volkmar, Fred; Siegel, Matthew; Woodbury-Smith, Marc; King, Bryan; McCracken, James; State, Matthew; AACAP Committee on Quality Issues (February 2014). "Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder". Journal of the American Academy of Child and Adolescent Psychiatry. 53 (2): 237–57. doi:10.1016/j.jaac.2013.10.013. PMID 24472258.
  • CHAT English version
  • AutismSpeaks
  • EffectiveChildTherapy.Org information on autism spectrum disorders

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