The Autism Treatment Evaluation Checklist (ATEC) is a 77-item diagnostic assessment tool that was developed by (Rimland & Edelson, 1999) at the Autism Research Institute. The ATEC was designed as a comparative subscale for ASD diagnosed individuals – that is to measure change in ASD individuals due to various interventions by difference between the initial (baseline) ATEC scores and later ATEC scores. The ATEC is to be completed by parents, teachers, or others who see the individual’s behaviour on a regular basis, this takes about 10–15 minutes to complete and is designed for use with children aged 5-12.
Scoring
The ATEC consists of four subtest scales: Scale I. Speech/Language/Communication (14 items – score range 0 – 28), Scale II. Sociability (20 items – score range 0 – 40), Scale III. Sensory/Cognitive Awareness (18 items – score range 0 – 36), and Scale IV. Health/Physical Behavior (25 items- score range 0 – 75). The four subscale scores are used to calculate a total score (77 items – score range 0 to 180). Overall scores in each subscale and in total can be used to determine the severity of the participant with higher scores indicating more impairment and lower scores with less impairment.
Psychometric Properties
On evaluation of 1,358 participants the ATEC presented high Pearson split-half (internal consistency) coefficients with uncorrected r values: Scale I. Speech/Language/Communication (r = .92), Scale II. Sociability (r = .84), Scale III. Sensory/Cognitive Awareness (r = .88) and Scale IV. Health/Physical Behaviour (r = .82). Overall the internal consistency reliability of the measure is high (r = .94) for the total score. The ATEC has high correlations with the Childhood Autism Rating Scale (CARS) indicating further support of validity (ρ = .71, p < .0001) (Geier, Kern & Geier, 2013). Furthermore this was also indicative in results with sensitivity, specificity, and accuracy between CARS and total ATEC domains with sensitivity equal to 0.96, specificity at 0.67 and accuracy at 0.82. (Gier et al., 2013).
Clinical Utility
Overall the ATEC is indicative to be a useful screening tool to measure treatment effects and progress over time in ASD (Jarusiewicz, 2002; Lonsdale, Shamberger, & Audhya, 2002; Magiati, Moss, Yates, Charman, & Howlin, 2011). Strengths of the ATEC include high correlation with physical symptoms and biomarkers in ASD, (Adams, Johansen, Powell, Quig, & Rubin, 2011; Kern, Geier, Adams, & Geier, 2010) including quantitative assessment of these features as well as providing domain specific scores with an overall score and percentage of ASD severity. Furthermore the ATEC is simple to administer, easily understood and quick to complete. Limitations include limited research of reliability and validity as well as being based on previous versions of the Diagnostic Statistical Manual of Mental Disorders (DSM) therefore the tool may not be representative of the recent changes to autism in the DSM-5.
Links
Autism Research Institute Website: (http://www.autism.com/ind_atec_survey.asp).
ATEC with online scoring and results: http://www.surveygizmo.com/s3/1329619/Autism-Treatment-Evaluation-Checklist-revised
References:
Adams J. B., Johansen L. J., Powell L. D., Quig D., Rubin R. A. Gastrointestinal flora and gastrointestinal status in children with autism: Comparisons to typical children and correlation with autism severity. (2011). BMC Gastroenterology. 11, 22
Geier, D.A., Kern, J.K., & Geier, M.R. (2013). A comparison of the Autism Treatment Evaluation Checklist (ATEC) and the Childhood Autism Rating Scale (CARS) for the quantitative evaluation of autism. Journal of Mental Health Research in Intellectual Disabilities, Vol. 6, No. 4, pp 255-267.
Jarusiewicz B. Efficacy of neurofeedback for children in the autism spectrum: A pilot study. (2012). Journal of Neurotherapy. 6 pp 39–49.
Kern J. K., Geier D. A., Adams J. B., Geier M. R. A biomarker of mercury body-burden correlated with diagnostic domain-specific clinical symptoms of autism spectrum disorder. (2010). Biometals. 23, pp 1043–1051.
Lonsdale D., Shamberger R. J., Audhya T. Treatment of autism spectrum children with thiamine tetrahydrofurfuryl disulfide: A pilot study. (2002) Neuroendocrinology Letters. 23, pp 303–308.
Magiati I., Moss J., Yates R., Charman T., Howlin P. Is the Autism Treatment Evaluation Checklist a useful tool for monitoring progress in children with autism spectrum disorders? (2011). Journal of Intellectual & Disabilities Research. 55, pp 302–312.
Rimland B., Edelson M. Autism Treatment Evaluation Checklist. Autism Research Institute; 1999. 4812 Adams Avenue, San Diego, CA 92116. Retrieved from https://www.autismeval.com/ari-atec/report1.html.