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The Q-CHAT (Quantitative CHecklist for Autism in Toddlers): A Normally Distributed Quantitative Measure of Autistic Traits at 18–24 Months of Age: Preliminary Report

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Abstract

We report a major revision of the CHecklist for Autism in Toddlers (CHAT). This quantitative CHAT (Q-CHAT) contains 25 items, scored on a 5 point scale (0–4). The Q-CHAT was completed by parents of n = 779 unselected toddlers (mean age 21 months) and n = 160 toddlers and preschoolers (mean age 44 months) with an Autism Spectrum Condition (ASC). The ASC group (mean (SD) = 51.8 (14.3)) scored higher on the Q-CHAT than controls (26.7 (7.8)). Boys in the control group (27.5 (7.8)) scored higher than girls (25.8 (7.7)). The intraclass correlation for test-retest reliability was 0.82 (n = 330). The distribution in the control group was close to normal. Full examination of the clinical validity of the Q-CHAT and test properties is underway.

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Notes

  1. The CAST was formerly known as the Childhood Asperger Syndrome Test, but was renamed in recognition that it is relevant for the whole autistic spectrum, not just Asperger Syndrome (Baron-Cohen et al. in preparation).

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Acknowledgments

We are grateful to the Big Lottery Fund for their generosity in funding this study, to the UK Mental Health Research Network for supporting the study, to the parents/guardians who completed the questionnaires, and to Cambridgeshire and Peterborough Primary Care Trusts for facilitating the mailing of the questionnaires. These results were first reported at the International Meeting for Autism Research (IMFAR), Montreal, April 2006. The Q-CHAT Advisory Group gave valuable feedback. The development of the Q-CHAT was supported with funding from the MRC UK. We are grateful to Richard Mills and Sarah Chivers at the National Autistic Society UK, and to Bonnie Auyeung and Fiona Matthews for discussions of this work.

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Correspondence to Carrie Allison.

Appendix: Q-CHAT items

Appendix: Q-CHAT items

Section 1. Please answer the following questions about your child. Try to answer every question if you can.

  1. 1.

    Does your child look at you when you call his/her name?

    • always

    • usually

    • sometimes

    • rarely

    • never

  2. 2.

    How easy is it for you to get eye contact with your child?

    • very easy

    • quite easy

    • quite difficult

    • very difficult

    • impossible

  3. 3.

    When your child is playing alone, does s/he line objects up?

    • always

    • usually

    • sometimes

    • rarely

    • never

  4. 4.

    Can other people easily understand your child’s speech?

    • always

    • usually

    • sometimes

    • rarely

    • never

    • my child does not speak

  5. 5.

    Does your child point to indicate that s/he wants something (e.g. a toy that is out of reach)

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  6. 6.

    Does your child point to share interest with you (e.g. pointing at an interesting sight)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  7. 7.

    How long can your child’s interest be maintained by a spinning object (e.g. washing machine, electric fan, toy car wheels)?

    • several hours

    • half an hour

    • 10 min

    • a couple of minutes

    • less than a minute

  8. 8.

    How many words can your child say?

    • none—s/he has not started speaking yet

    • less than 10 words

    • 10–50 words

    • 51–100 words

    • over 100 words

  9. 9.

    Does your child pretend (e.g. care for dolls, talk on a toy phone)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  10. 10.

    Does your child follow where you’re looking?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  11. 11.

    How often does your child sniff or lick unusual objects?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  12. 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)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  13. 13.

    Does your child walk on tiptoe?

    • always

    • usually

    • sometimes

    • rarely

    • never

  14. 14.

    How easy is it for your child to adapt when his/her routine changes or when things are out of their usual place?

    • very easy

    • quite easy

    • quite difficult

    • very difficult

    • impossible

  15. 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)?

    • always

    • usually

    • sometimes

    • rarely

    • never

  16. 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)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  17. 17.

    Would you describe your child’s first words as:

    • very typical

    • quite typical

    • slightly unusual

    • very unusual

    • my child doesn’t speak

  18. 18.

    Does your child echo things s/he hears (e.g. things that you say, lines from songs or movies, sounds)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  19. 19.

    Does your child use simple gestures (e.g. wave goodbye)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  20. 20.

    Does your child make unusual finger movements near his/her eyes?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  21. 21.

    Does your child spontaneously look at your face to check your reaction when faced with something unfamiliar?

    • always

    • usually

    • sometimes

    • rarely

    • never

  22. 22.

    How long can your child’s interest be maintained by just one or two objects?

    • most of the day

    • several hours

    • half an hour

    • ten minutes

    • a couple of minutes

  23. 23.

    Does your child twiddle objects repetitively (e.g. pieces of string)?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

  24. 24.

    Does your child seem oversensitive to noise?

    • always

    • usually

    • sometimes

    • rarely

    • never

  25. 25.

    Does your child stare at nothing with no apparent purpose?

    • many times a day

    • a few times a day

    • a few times a week

    • less than once a week

    • never

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Allison, C., Baron-Cohen, S., Wheelwright, S. et al. The Q-CHAT (Quantitative CHecklist for Autism in Toddlers): A Normally Distributed Quantitative Measure of Autistic Traits at 18–24 Months of Age: Preliminary Report. J Autism Dev Disord 38, 1414–1425 (2008). https://doi.org/10.1007/s10803-007-0509-7

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