Which statement about autism screening with M-CHAT-R is correct?

• A. Screen only at 24 months
• B. Screen at 3 years old only
• C. No autism screening is recommended
• D. Screen with M-CHAT-R at 18–30 months and continue development surveillance thereafter

Answer: (D)

Autism screening is universal during a defined early window, with ongoing development surveillance after that window. The M-CHAT-R is intended for use in children aged 18 to 30 months. Administering it within this period helps identify children who may have autism earlier, when interventions can be most helpful. If the screen suggests risk, a follow-up interview (M-CHAT-R/F) helps confirm concerns before moving to diagnostic evaluation. Even if the screen is negative, clinicians should continue development surveillance at all well-child visits to monitor progress in social, language, and behavioral domains. Therefore, the correct approach is to screen with M-CHAT-R at 18–30 months and continue development surveillance thereafter. The other options are inconsistent with recommended practice because they either miss the optimal screening window, delay screening, or skip screening altogether.