M-CHAT Modified Checklist for Autism in Toddlers

Lexicon [Measures] - M-CHAT 

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a screening tool to identify early signs of autism  in toddlers. The M-CHAT-R is a caregiver-reported questionnaire that assesses the presence of behaviors associated with ASD in toddlers aged 16 to 30 months. It is intended to screen for potential developmental concerns and determine the need for further evaluation.

Limitations

The M-CHAT-R has some limitations, including the potential for false positives or false negatives, as it is a screening tool rather than a diagnostic instrument. It relies on caregiver-reported information, which may be subject to biases or inaccuracies.

Measure, Scoring & Interpretation
The M-CHAT-R is typically administered by a clinician or early intervention specialist.  It consists of 20  items that cover different areas of development, including social communication, joint attention, play, and repetitive behaviors. Caregivers indicate whether the behaviors are observed in their child or not (scored as 1 for Yes and 0 for No). The total score is calculated by summing the scores across all items. 

The M-CHAT-R also includes a follow-up interview with additional questions to further explore areas of concern. Scoring and interpretation guidelines are provided with specific cutoff scores to identify children who may be at risk for ASD and require further evaluation.

History, Limitations, and Revisions
The M-CHAT-R is an updated version of the original M-CHAT,. It was developed by Diana Robins, Deborah Fein, and Marianne Barton in 2009. 

Citation:
Robins, D. L., Fein, D., & Barton, M. L. (2009). The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R). Retrieved from https://mchatscreen.com/wp-content/uploads/2021/07/M-CHAT-R.pdf

Kindness is the language that everyone can understand

Equanimity is the serenity that comes from within

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Winter Thaw

Golden sun swathes the trees
Winter thaw, nature awakes
Twittering birds in flights of awe
Dancing from tree to tree to tree


I woke upto sunshine today though the temperature is still in the 30s. My window view continues to be provide awe for me.

Joy is the light that shine within us

 

Contemplation, one line a day #Mental Health

Equanimity is the anchor that keeps us grounded

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Hoarfrost and Icicles

glazed ice drape the leafless trees
ice sculptures of neural dendrites
...glistening at 27 degrees

white latticed cobwebs cover the brush.
fine needle crystals, it's hoarfrost.
water vapor turned solid, sublimation.
icicles drip by my windowsill
add to the morning chill

Comorbidity of ADHD puts you at higher risk for Mental Health

This article on ADHD talks about research from Bath University in the UK. 

Essentially it says

• Mental health risk higher in ADHD alone > Mental Health risk in Autism alone
• The risk is higher when there are co-morbidities (ie: Autism+ADHD)

Research confirms what many us have already felt and known about comorbidity of Autism+ADHD. The net effect is not a simple sum, but exponential. 

What makes me sad is for the most part stimulant meds seem to work ADHD like they are supposed to. But when it comes to autism+ADHD, the same meds are still a wild guess and most don't work in autism like they do in the non-autism population with paradoxical effects.

 

Optimism is the lens that allows us to see the world through the eyes of possibility.

Equanimity is the balance that allows us to move forward

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Black Ice

Thin and clear, hard to see,
Black ice makes roads slippery.
Silent and unseen, it lies ahead,
A slippery trap, ready to paralyze one dead


Zoom classes on schedule today

Postsynaptic receptors will rule the day. 
But no commute is relief!

Moments like Fleet

 Its already month 2 of 2023. Time does rush past. 

Months speed by, moments like fleet

Leaving memories, both sweet and beat. 

Where have the days gone, oh so fast

Never to return, from the past.

Hold tight, each moment's just right

Be supported to joy, day and night. 

Time waits for no one, it's true

Our lives are worth living, cherish it anew

Multilingual and Autism

Multilingual and Autism

Therapists often tell families to only speak English so as to not confuse the autistic child. I think that's not a good idea as it results in a loss of cultural identity. During my elementary years there was so much time spent on teaching me St Patrick's day (what relevance do green men and rainbows have for me) instead of say teaching me about Diwali (more relevant to me). Many of us have extended family who only speak their native tongue. Life exists outside of the special education classroom and therapy. 

Autism loves to get stuck on sameness, so you may be inadvertently encouraging that very thing. For instance, in my early years - I used to watch Thomas the Tank engine pretty obsessively. I would avoid the Ringo Starr narrated version but loved the George Carlin version - the Brit accent felt like an alien foreign language. 

It's good to also be exposed to different accents associated with the different languages for another important reason. We will be be surrounded by caregivers/educators with diff accents. No one thinks about this aspect. 

I had a class aide in elementary who's accent I never understood. She was a new immigrant who was barely learning to speak English herself and I just could not make out her high pitched accent. It was not due to cognition on my part, how could I respond if I have not understood the question/instruction which as far as I was concerned was in an alien language.  Sometimes I would try to watch her lips, trying to synchronize the visual of her lip movements with the audio I was hearing - it was a lot to process and it was often easiest to give up and engage in stimming behaviors (comforting) instead. Rather ironical as she was supposed to be teaching me. No one thinks about this aspect. 

Anyway, I did get over the Ringo Starr thing eventually. Interestingly, the accent thing is not so striking in singing. I love Beatles music (simple lyrics that you can actually get your mouth around) and i did not realize Adele was Brit till i saw her talk at an awards ceremony.

Equanimity is the calm at the center of the storm

Towards a more humane society. #MentalHealth. Contemplation, one line a day.

 

Capturing Joy

 This time in Jan 2022

With my Haas Scholars Cohort on the UC Berkeley Campus. 

We were back to in-person meetings though fully masked indoors. 

Kevin, 2nd from Left, just got into Columbia Law. 

Huge Congrats Kevin! You will surely change the world with your work on prison reform. 

Freezing Rain

Ground temperature, below-freezing

Air temperature, above-freezing
liquid raindrops fall, temperature bends.
Drops hit the ground, instant freeze
Freezing rain, slick roads of unease.

Local vs Distributed Information

[Concepts in Sensorimotor Research]

Class Discussion  in my Multisensory Processing seminar class, see details of paper here. 

Implications for autism. Application and interventions is my big thought always.

I think by now it is pretty established that there are glitches in multisensory processing in autistics.

Past studies indicate TBW (Temporal Binding Window) larger in autistics - individual cortical columns were strong, but not talking to columns in other domains.

I want to highlight that this paper says that this balance between distributed vs local information can be a tool to explore differences in multisensory processing. The paper also goes on to say that this can be used to develop effective interventions aimed at improving performance on tasks requiring coordination between different sensory modalities.

So how exactly can we start to do this. What kind of experiment design can we set up so that we get to big goal of interventions. Do we first check for what regions of the brain are involved in autistics, while we do a task.

Melancholy

Melancholy creeps upon my heart

A feeling, deep and dark, it starts

A longing for something lost

A sorrow that comes at any cost.

Joy is the hope that comes with the belief that anything is possible

Contemplation, one line a day. #MentalHealth

 

A tempest tossed

 

A tempest tossed

In a world of noise and chaos,

My mind is a storm, a tempest tossed.

The overwhelming sensation,

Meltdown, a state of frustration.

My senses heightened,

Sounds and lights, so brightened.

A cacophony of noise,

A confusion that destroys.

A feeling of impending doom.

As I try to find an escape room.

But there is no escape,

From this overwhelming state.

I am trapped in my mind,

A prisoner of my own fate.

Is there a glimmer of hope,

A lifeline to help me cope.

To regain control, and continue on

But in the middle of the meltdown, all that is long gone.