Quantitative Checklist for Autism in Toddlers (Q-CHAT)

The Quantitative Checklist for Autism in Toddlers (Q-CHAT) is an assessment tool designed to identify early signs of autism spectrum disorder (ASD) in young children, typically those aged 18 to 24 months. It is an extension and quantitative adaptation of the original Checklist for Autism in Toddlers (CHAT), developed to provide a more nuanced understanding of the range of behaviors associated with ASD. The Q-CHAT consists of a series of questions aimed at evaluating specific behavioral traits and developmental milestones that may indicate the presence of ASD characteristics in toddlers.

The tool is structured to capture a broad spectrum of behaviors and skills, including social interaction, communication, and repetitive behaviors. Items on the Q-CHAT assess, for instance, a child's use of eye contact, response to their name, pointing behavior, and interest in social play. These elements are crucial for early identification of ASD, allowing for timely intervention. The checklist is designed to be completed by parents or primary caregivers, reflecting observations of the child's behavior in natural settings. This approach ensures that the assessment is grounded in the child's everyday interactions, enhancing the relevance and applicability of the findings.

The use of the Q-CHAT in clinical and research settings underscores the ongoing efforts to improve early detection of ASD. Early identification is linked to better outcomes, as it enables the initiation of support and intervention strategies at a young age. This tool contributes to the broader field of early childhood assessment by providing a straightforward, accessible means of screening for ASD-related behaviors. While the Q-CHAT does not diagnose ASD, its utility lies in flagging behaviors that warrant further professional evaluation. In doing so, it supports a proactive approach to developmental monitoring, encouraging the engagement of health professionals in cases where a child may benefit from additional assessment or intervention.

Please answer the following questions about your child.

  1. Does your child look at you when you call his/her name?
  2. How easy is it for you to get eye contact with your child?
  3. When your child is playing alone, does s/he line objects up?
  4. Can other people easily understand your child’s speech?
  5. Does your child point to indicate that s/he wants something (e.g. a toy that is out of reach)?
  6. Does your child point to share interest with you (e.g. pointing at an interesting sight)?
  7. How long can your child’s interest be maintained by a spinning object (e.g. washing machine, electric fan, toy car wheels)?
  8. How many words can your child say?
  9. Does your child pretend (egg care for dolls, talk on a toy phone)?
  10. Does your child follow where you’re looking?
  11. How often does your child sniff or lick unusual objects?
  12. Does your child place your hand on an object when s/he wants you to use it (e.g. on a door handle when s/he wants you to open the door, on a toy when s/he wants you to activate it)?
  13. Does your child walk on tiptoe?
  14. How easy is it for your child to adapt when his/her routine changes or when things are out of their usual place?
  15. If you or someone else in the family is visibly upset, does your child show signs of wanting to comfort them (e.g. stroking their hair, hugging them)?
  16. Does your child do the same thing over and over again (e.g. running the tap, turning the light switch on and off, opening and closing doors)?
  17. Would you describe your child’s first words as:
  18. Does your child echo things s/he hears (e.g. things that you say, lines from songs or movies, sounds)?
  19. Does your child use simple gestures (e.g. wave goodbye)?
  20. Does your child make unusual finger movements near his/her eyes?
  21. Does your child spontaneously look at your face to check your reaction when faced with something unfamiliar?
  22. How long can your child’s interest be maintained by just one or two objects?
  23. Does your child twiddle objects repetitively (e.g. pieces of string)?
  24. Does your child seem oversensitive to noise?
  25. Does your child stare at nothing with no apparent purpose?
  1. C Allison, S Baron-Cohen, S Wheelwright, T Charman, J Richler, G Pasco, and C Brayne. . J Autism Dev Disord 38(8): 1414-1425 ().