Infant-Toddler Checklist ITC
Infant-Toddler Checklist ITC overview
Creator and Context
The Infant-Toddler Checklist (ITC) is a parent completed developmental screener for communication and symbolic behaviour in very young children.
It was developed by Amy Wetherby and Barry Prizant as part of the Communication and Symbolic Behavior Scales Developmental Profile, published by Brookes Publishing in 2002.
The checklist itself is a free download, but it is copyrighted, and reprinting or reposting requires permission from the publisher.
Presenting Conditions
The ITC covers seven clusters, which roll up into three composites plus a total:
Social composite: emotion and eye gaze, communication, gestures
Speech composite: sounds, words
Symbolic composite: understanding, object use
Administration
Completed by the parent or carer in five to ten minutes, and scored by a professional. Most items use a three point scale. A small number use frequency bands. There is also an open question about whether the parent has any concerns about their child's development.
It asks about current typical behaviour, with no recall window.
Desired Audience
Parents of children aged 6 to 24 months. Corrected age should be used where the child was born four or more weeks premature. The evidence supports use from 9 months onward; validity below 9 months is not established.
The window in which early support does most good closes fast, and most developmental concerns are not raised until a child is well past two. A five minute checklist a parent can complete at a routine health visit is one of the few realistic ways to catch that earlier.
Considerations
It is a broadband developmental and communication screener, not an autism test, and must not be presented as one.
It is not validated at 6 to 8 months.
Correct for prematurity.
A positive screen means refer, not label.
The standard scores and percentile norms sit in the paid manual. Only the raw score concern thresholds are in the free checklist.
The checklist is free to download but reprinting or reposting, which includes embedding it in a product, requires permission from Brookes Publishing.
How to score the Infant-Toddler Checklist ITC
Conducting the assessment
The parent completes 24 items about the child's current communication, gestures, sounds, words, understanding and play, plus a question about any concerns they have.
Interpretation
Raw cluster scores roll up into three composites and a total, which convert to standard scores and percentiles using the published tables.
The criterion for concern is a score more than 1.25 standard deviations below the mean: a composite standard score of 6 or below, a total of 81 or below, or a percentile of 10 or below.
The referral rule: refer for developmental evaluation if the social, symbolic or total score is below criterion. If only the speech composite is below criterion, monitor and re administer in three months, and refer if it remains below.
Raw score thresholds are tabulated by month of age from 6 to 24 months and must be applied exactly, not interpolated.
Clinical Considerations
Use the age specific thresholds. A score that is fine at 12 months is a concern at 24.
Take the parent's stated concern seriously in its own right, independent of the score.
A positive screen triggers a referral, not a conversation about autism.
Infant-Toddler Checklist ITC use cases
Universal developmental screening at routine child health visits
Early identification of communication and symbolic behaviour delays
Identifying children who warrant a full developmental evaluation
Research into early identification
Category
Children & Young People
Research Summary
Wetherby, A. M., & Prizant, B. M. (2002). Communication and Symbolic Behavior Scales Developmental Profile, First Normed Edition. Baltimore: Paul H. Brookes Publishing.
Wetherby, A. M., Brosnan-Maddox, S., Peace, V., & Newton, L. (2008). Validation of the Infant-Toddler Checklist as a broadband screener for autism spectrum disorders from 9 to 24 months of age. Autism, 12(5), 487 to 511.
Pierce, K., Carter, C., Weinfeld, M., et al. (2011). Detecting, studying, and treating autism early: The one year well baby check up approach. Journal of Pediatrics, 159(3), 458 to 465.
Other Assessment Guides
Young Person's CORE YP-CORE
A guide to the YP-CORE, the 10 item measure of psychological distress in young people aged 11 to 16. Covers scoring, the gender and age specific clinical cut offs and the reliable change index.
Me and My Feelings Questionnaire
A guide to the Me and My Feelings questionnaire, the 16 item school based screen for emotional and behavioural difficulties in children. Covers the two subscales, cut offs and its limits as a screener.
Strengths and Difficulties Questionnaire SDQ Parent
A guide to the parent completed Strengths and Difficulties Questionnaire (SDQ). Covers the five scales, the four band scoring thresholds, the impact supplement and how to use it with teacher and self report versions.
Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
