ARI/Form

ATEC-1/11-99 Autism Treatment Evaluation Checklist (ATEC) Project/Purpose:

Bernard Rimland, Ph.D. and Stephen M. Edelson, Ph.D.

Autism Research Institute
4182 Adams Avenue, San Diego, CA 92116
www.autism.org Scores: I II III IV Total

This form is intended to measure the effects of treatment. Free scoring of this
form is available on the Internet at: www.autism.org
Name of Child _____________________ _____________________ Male Age ___________
Last First Female Date of Birth ___________
Form completed by: ______________________ Relationship: ________________ Today’s Date ___________

Please circle the letters to indicate how true each phrase is:
I. Speech/Language/Communication: [N] Not true [S] Somewhat true [V] Very true
N S V 1. Knows own name N S V 6. Can use 3 words at a time N S V 11. Speech tends to be meaningful/
N S V 2. Responds to ‘No’ or ‘Stop’ (Want more milk) relevant
N S V 7. Knows 10 or more words N S V 12. Often uses several successive
N S V 3. Can follow some commands sentences
N S V 4. Can use one word at a time N S V 8. Can use sentences with 4 or N S V 13. Carries on fairly good
(No!, Eat, Water, etc.) more words conversation
N S V 5. Can use 2 words at a time N S V 9. Explains what he/she wants N S V 14. Has normal ability to com-
(Don't want, Go home) N S V 10. Asks meaningful questions municate for his/her age

II. Sociability: [N] Not descriptive [S] Somewhat descriptive [V] Very descriptive
N S V 1. Seems to be in a shell – you N S V 7. Shows no affection N S V 14. Disagreeable/not compliant
cannot reach him/her N S V 8. Fails to greet parents N S V 15. Temper tantrums
N S V 2. Ignores other people
N S V 9. Avoids contact with others N S V 16. Lacks friends/companions
N S V 3. Pays little or no attention when
addressed N S V 10. Does not imitate N S V 17. Rarely smiles
N S V 4. Uncooperative and resistant N S V 11. Dislikes being held/cuddled N S V 18. Insensitive to other's feelings
N S V 5. No eye contact N S V 12. Does not share or show N S V 19. Indifferent to being liked
N S V 6. Prefers to be left alone N S V 13. Does not wave ‘bye bye’ N S V 20. Indifferent if parent(s) leave

III. Sensory/Cognitive Awareness: [N] Not descriptive [S] Somewhat descriptive [V] Very descriptive
N S V 1. Responds to own name N S V 7. Appropriate facial expression N S V 13. Initiates activities
N S V 2. Responds to praise N S V 8. Understands stories on T.V. N S V 14. Dresses self
N S V 3. Looks at people and animals N S V 9. Understands explanations N S V 15. Curious, interested
N S V 4. Looks at pictures (and T.V.) N S V 10. Aware of environment N S V 16. Venturesome - explores
N S V 5. Does drawing, coloring, art N S V 11. Aware of danger N S V 17. “Tuned in” — Not spacey
N S V 6. Plays with toys appropriately N S V 12. Shows imagination N S V 18. Looks where others are looking

Use this code: [N] Not a Problem [MO] Moderate Problem

IV. Health/Physical/Behavior: [MI] Minor Problem [S] Serious Problem
N MI MO S 1. Bed-wetting N MI MO S 10. Lethargic N MI MO S
19. Rigid routines
N MI MO S 2. Wets pants/diapers N MI MO S 11. Hits or injures self N MI MO S
20. Shouts or screams
N MI MO S 3. Soils pants/diapers N MI MO S
21. Demands sameness
N MI MO S 12. Hits or injures others
N MI MO S
22. Often agitated
N MI MO S 4. Diarrhea N MI MO S 13. Destructive
N MI MO S
23. Not sensitive to pain
N MI MO S 5. Constipation N MI MO S 14. Sound-sensitive
N MI MO S
24. “Hooked” or fixated on
N MI MO S 6. Sleep problems N MI MO S 15. Anxious/fearful certain objects/topics
N MI MO S 7. Eats too much/too little N MI MO S 16. Unhappy/crying N MI MO S 25. Repetitive movements
N MI MO S 8. Extremely limited diet N MI MO S 17. Seizures (stimming, rocking, etc.)
N MI MO S 9. Hyperactive N MI MO S 18. Obsessive speech

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