The aims of this proposal are to complete development and evaluation of a computerized adaptation of a new tool to more accurately identify toddlers with signs of autism spectrum disorders (ASDs) and to make this tool accessible to varied populations. Early screening for ASD is a new standard for pediatric practice. However, the most widely recommended screen, M-CHAT (Modified Checklist for Autism in Toddlers), has a large over-referral rate and low income families are less able to or do not remember to complete it prior to their visits. This project will create methods for using the M-CHAT in the waiting room by phone (interactive voice response), touch screen kiosk, and laptop, as well as a phone reminder system. The methods will be piloted for acceptability and then the preference, satisfaction, and costs of these methods will be measured in 3 populations. In addition, computerized versions of the M-CHAT and a Follow Up interview (designed to reduce over-referral) have been created and will be validated by evaluating 300 children for ASD who have positive M-CHAT screens regardless of their M-CHAT Follow Up results. It is anticipated that the computerized M-CHAT and M-CHAT/Follow Up combination will improve rates of valid screening for ASD, which is important for early identification and intervention, and also cut the over-referral rate by more than half, saving costs and parent agony.