ATEC : The Autism Treatment Evaluation Checklist
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The checklist was developed by Dr Bernard Rimland and Dr Stephen Edelson of the Autism Research Institute, is basically a one-page scorecard. Using this scorecard, parents of autistic kids, as well as physicians and other healthcare providers can evaluate the extent of a child's autism.
Unlike other research tools that merely diagnose autism – that is, tell whether or not a child is autistic – the Autism Treatment Evaluation Checklist is sensitive enough to measure changes in the child's condition.
Using this checklist, it is possible to determine whether the condition of an autistic child is improving or getting worse, or whether the child has recovered.
The checklist is essentially a scorecard that evaluates 77 items, such as whether the child knows his or her name, makes eye contact with others, or has symptoms such as bed-wetting, diarrhoea, constipation and so on.
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- Speech / Language / Communication (14 items)
- Sociability (20 items)
- Sensory / Cognitive Awareness (18 items)
- Health / Physical / Behavior (25 items)
Filling in the scorecard
It is very simple to do the ATEC score, which is avallable online at the website of the Autism Research Institute.
For example, there is a statement "Can use one word at a time” and the person doing the score will simply check whether such a statement is "Not true", “Somewhat true” or “Very true”.
Or, for conditions such as bed-wetting, the person doing the score would check whether this is “Not a problem”, “Minor Problem”, “Moderate Problem” or “Serious Problem”.
It is as simple as that. Once all the 77 items are checked, you clcik a button that says “Enter data for scoring”. The Autism Research Institute will then compute the score and send the results to you.
To view and perform the ATEC score, click here.
Range of scores
ATEC scores range from zero to 180. The lower the score, the better.
If a child scores zero or close to zero, that child cannot be distinguished from other normal children. He or she can be considered fully recovered and not autistic.
The important benchmarks in scoring are as follows:
- ATEC < 30. This level places the child in the top 10 percentile. A child with score of less than 30 – or, better still, less than 20 – would have some ability to conduct normal, two-way conversations, and more or less behave normally. Such children have high chances of leading normal lives as independent individuals.
- ATEC < 50. This places the child in the 30th percentile level. The child has good chances of being semi-independent. More importantly, he or she will not likely need to be placed in an institution or "nut house”. For many parents of autistic children, being able to achieve improvement up to this level is already considered very significant.
- ATEC > 104. Even though the maximum score is 180, any person with a score of more than 104 would already be in the 90th percentile, and be considered very severely autistic.
The range of scores, and their percentile levels, are shown in the table below:
| Percentile | ATEC score |
| mild autism 0 - 9 | 0 - 30 |
| 10 - 19 | 31 - 41 |
| 20 - 29 | 42 - 50 |
| 30 - 39 | 51 - 57 |
| 40 - 49 | 58 - 64 |
| 50 - 59 | 65 - 71 |
| 60 - 69 | 72 - 79 |
| 70 - 79 | 80 - 89 |
| 80 - 89 | 90 - 103 |
| 90 - 100 severe autism | 104 - 180 |
As the table shows, the scores are not evenly spread. Thus, the number of improvement points is not as vital as what the final score is.
For example, a moderately autistic child who improves by 40 points, from 45 to 5, would be far better off than a severely autistic child who improves by, say, 100 points from 180 to 80.
Biomedical treatment
Clinical data, taken from 80 autistic children at The Autism Clinic, Singapore, show that on average, biomedical treatment produced a 20 point improvement, from 68 to 48.
A more detailed breakdown of the scores reveals the following:
- 6 autistic kids (8 percent) improved remarkably with biomedical autism treatment, with their scores dropping by more than 50 points.
Of these, 2 are considered to have recovered, with their scores dropping to near zero. In one case, the score dropped to 4 while in another, the score dropped to 2. These kids are able to hold two-way conversations and socialise with normal students in class. They do not behave differently from other normal kids.
- 33 autistic kids (42 percent) improved greatly with their scores dropping by 20 to 49 points.
- 16 autistic kids (20 percent) improved moderately with their scores dropping by 10 to 19 points.
There were, however, some autistic kids who did not respond to biomedical autism treatment.
- 24 kids (30 percent) are considered non-responders, registering reductions in ATEC scores of less than 10 points.
Of these 12 kids received biomedical autism treatment for less than six months, so it is not clear if they would improve if they had continued the treatment longer.
Another 12 kids truly did not respond despite receiving biomedical autism treatment for more than 6 months.
Recovered and near-recovered kids
ATEC < 30
A score of less than 30 means places the child in the top 10 percentile of autistic kids. The child has some ability to carry out two-way conversations (those with ATEC < 20 fare better), and more or less behave normally. Such children have high chances of leading fully independent lives.
Clinical data from The Autism Clinic showed that 20 kids (25 percent) moved into this range. They achieved an average reduction in ATEC scores of 33 points after receiving biomedical autism treatment.
ATEC < 50
A score of less than 50 means that the child has good chances of leading semi-independent lives. For many parents of autistic kids, this already makes them very satisfied. The clinical data shows 14 kids (18 percent) moved into this range.
They started off with average ATEC scores of 76 points (ranging from 60 points to 115 points) and, after biomedical autism treatment, reduced their scores to an average of 39 points.
To read a report on clinical data from The Autism Clinic, Singapore click here.