A major obstacle in autism research has been the lack of a valid means of measuring the effectiveness of various treatments. Over the years, researchers have published hundreds of studies attempting to evaluate different biomedical and psycho-educational interventions intended to benefit autistic children. Much of this research has produced inconclusive or, worse, misleading results, because there are no useful tests or scales designed to measure treatment effectiveness. Lacking such a scale, researchers have resorted to using scales such as the Childhood Autism Rating Scale (CARS), the Gilliam Autism Rating Scale (GARS), or the Autism Behavior Checklist (ABC), all of which were designed to diagnose autism- to tell whether or not a child is autistic--and not to measure treatment effectiveness.
Two recent reviews have commented on the problem: "Often, investigators have to use diagnostic instruments to measure changes in response to treatment. . .this approach has not been very successful. . .because most diagnostic instruments. . .are not sufficiently sensitive to changes within an individual."1 " ...[M]easures of clinical improvement to validate treatment outcomes are even more seriously deficient."2
The Autism Treatment Evaluation Checklist (ATEC) was developed by Bernard Rimland and Stephen M. Edelson of the Autism Research Institute, to fill this need, which is especially urgent right now because of the 20 or more studies starting soon to evaluate secretin.
The ATEC is a one-page form designed to be completed by parents, teachers, or caretakers. It consists of 4 subtests: I. Speech/Language Communication (14 items); II. Sociability (20 items); III. Sensory/ Cognitive Awareness (18 items); and IV. Health/Physical/Behavior (25 items).
Unlike most of the scales, it is not copyrighted and may be used free of charge by any researcher. Copies are available on request from the Autism Research Institute or at the ARI web site.
Users of the ATEC may have it scored free (4 subscores and a total score) by entering the responses via computer to the ATEC form on the website for immediate and free-of-cost scoring. ATEC forms are only accepted online.
Results of research using the ATEC will appear in future issues of the ARRI (only with the express permission of the researchers who use ATEC, of course).
- Lord, Catherine, in: Handbook of Autism and Pervasive Developmental Disorders (1997). Ed. by D.J. Dohen and F.R. Volkmar, Wiley, New York City (p. 477).
- Accordo, P., and Bostwick, H., "Zebras in the living room: The changing faces of autism," Journal of Pediatrics, Vol. 135, No. 5, Novemember 1999, p. 533.
The ATEC is not a diagnostic checklist. It basically provides several subscale scores as well as a total score to be used for comparison at a later date. Basically, the lower the score, the fewer the problems.
Thus, if a person scores a '20' on one day, and then a '15' two weeks later, then the individual showed improvement. In contrast, if the score was '30,' then the individual's behavior worsened.
Many parents and teachers use the ATEC to monitor how well the child is doing over time. In addition, researchers have used the ATEC to document improvement following an intervention by comparing the baseline ATEC scores with the post-treatment ATEC scores.
You can learn more about interpreting the ATEC scores at: http://www.autism.com/index.php/ind_atec_report
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