If you are asked to complete the ATEC in order to access a private social media page or website, please note that ARI is not affiliated with any organization nor individual who requires users to complete the ATEC.

Validity

We are aware of eleven (11) studies evaluating the psychometric properties of the ATEC:

Abaoud, A.A., Almalkim, N.S., Bakheit, S.F., & Ateik Al-khadher, M.M. (2020). Psychometric properties of the Autism Treatment Evaluation Checklist in Saudi Arabia. Research in Autism Spectrum Disorders, 7, 101604. doi: https://doi.org/10.1016/j.rasd.2020.101604

Borissov, A., Bakolis, I., Tekola, B., Kinfe, M., Ceccarelli, C., et al. (2021). Adaptation and validation of two autism-related measures of skills and quality of life in Ethiopia. Autism, Online ahead of print. doi: https://doi.org/10.1177/13623613211050751

Freiere, M.H., Andre, A.M., & Kummer, A.M. (2018). Test-retest reliability and concurrent validity of Autism Treatment Evaluation Checklist (ATEC). Journal Brasileiro de Psiquiatria, Letter to the Editor, 67(1). doi: https://doi.org/10.1590/0047-2085000000186

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, 6(4), 255–267.

Jagadeesan, P., Kabbani, A., & Vyshedskiy, A. (2022). Parent-reported assessment scores reflect the ASD severity level in 2-to 7-year-old children. Children, 9(5), 701. doi: https://doi.org/10.3390/children9050701

Magiati, I., Moss, J., Yates, R., Charman, T., & Howlin, P. (2011). Is the Autism Treatment Evaluation Checklist a useful tool for monitoring progress in children with autism spectrum disorders? Journal of Intellectual Disability Research, 55(3), 302–312. doi: https://doi.org/10.1111/j.1365-2788.2010.01359.x

Mahapatra S, Vyshedsky D, Martinez S, Kannel B, Braverman J, Edelson SM, Vyshedskiy A. Autism Treatment Evaluation Checklist (ATEC) Norms: A “Growth Chart” for ATEC Score Changes as a Function of Age. Children. 2018; 5(2):25. https://doi.org/10.3390/children5020025

Memari, A.H., Shayestehfar, M., Mirfazeli, F-S., Rashidi, T., Ghanouni, P., & Hafizi, S. (2013). Cross-cultural adaptation, reliability, and validity of the Autism Treatment Evaluation Checklist in Persian. Iranian Journal of Pediatrics, 23, 269-275. PMID: 23795248

Netson, R, Fucks, A.S., Santos, A.S.S.S., Poloni, L.E.P., Nacano, N.N., Fucks, E., Radi, K., Strong, W.E., Carnaval, A.A., Russo, M., Venkatesh, R., and Vyshedskiy, A. Pediatr. Rep. 2024, 16(1), 174-189; https://doi.org/10.3390/pediatric16010016

Rimland, B. & Edelson, S.M. (1999). Autism treatment evaluation checklist. APA PsycNet. doi: https://doi.org/10.1037/t03995-000

Starling, C.D. (2017). A comparison of the Autism Treatment Evaluation Checklist (ATEC) and the Autism Spectrum Rating Scale (ASRS) for the quantitative evaluation of autism.  Unpublished dissertation, University of the Rockies.

Reliability

The following data are based on the first 1358 initial (baseline) ATEC forms submitted to the Autism Research Institute. “Initial” refers to the first ATEC form submitted for a given individual.

Since the primary function of the ATEC is to measure the efficacy of interventions, it is expected that a number of ATECs will be submitted for each individual periodically during the trial of the intervention, subsequent to the initial (baseline) ATEC.

Reliability

Pearson split-half (internal consistency) coefficient

N=1358

Uncorrected r
Scale I Speech .920
Scale II: Sociability .836
Scale III: Sensory/Cognitive Awareness .875
Scale IV: Health/Physical/Behavior .815
Total ATEC Score .942

Score Distributions

The purpose of the ATEC is to measure change in an individual due to various interventions – that is – the difference between the initial (baseline) ATEC scores and later ATEC scores. Nevertheless, we are often asked for normative data, which permit comparison of one individual with others. Here are the score distributions. (The lower the scores, the better.)

Score Distributions
The purpose of the ATEC is to measure change in an individual due to various interventions – that is – the difference between the initial (baseline) ATEC scores and later ATEC scores. Nevertheless, we are often asked for normative data, which permit comparison of one individual with others. Here are the score distributions. (The lower the scores, the better.)

Scale I Scale II Scale III Scale IV
Speech Sociability Sensory/Cognitive Health/Physical/Behavior
Centile
Mild		 Range:
0-28		 Range:
0-40		 Range:
0-36		 Range:
0-75		 Total Range:
0-180
0-9 0-2 0-4 0-5 0-8 0-30
10-19 3-5 5-7 6-8 9-12 31-41
20-29 6-7 8-10 9-11 13-15 42-50
30-39 8-10 11 12-13 16-18 51-57
40-49 11-12 12-13 14-15 19-21 58-64
50-59 13-15 14-15 16-17 22-24 65-71
60-69 16-19 16-18 18-19 25-28 72-79
70-79 20-21 19-21 20-21 29-32 80-89
80-89 22-24 22-25 22-25 33-39 90-103
90-99 25-28 26-40 26-36 40-75 104-179
Severe

A recent study employed the ATEC and MSEC scales to assess autistic children between 2 and 7 years old and found a consistent association between age and symptom severity (https://www.mdpi.com/2227-9067/9/5/701).

52 Published Studies Employing the Autism Research Institute’s

Autism Treatment Evaluation Checklist (ATEC)

[Updated March 20, 2023]

Adams, J.B., Baral, M., Geis, E., Mitchell, J., Ingram, J., Hensley, A., Zappia, I., Newmark, S., Gehn, E., Rubin, R.A., Mitchell, K., Bradstreet, J. et al. (2009). The severity of autism is associated with toxic metal body burden and red blood cell glutathione levels. Journal of Toxicology, doi: https://doi.org/10.1155/2009/532640

Adams, J.B., Johansen, L.J., Powell, L.D., Quig, D., & Rubin, R.A. (2011). Gastrointestinal flora and gastrointestinal status in children with autism – comparisons to typical children and correlation with autism severity. BMC Gastroenterology, 22. doi: https://doi.org/10.1186/1471-230X-11-22

Al Backer, N.B. (2016). Correlation between Autism Treatment Evaluation Checklist (ATEC) and Childhood Autism Rating Scale (CARS) in the evaluation of autism spectrum disorder. Sudan Journal of Paediatrics, 16(1), 17-22. 

    • Note: this study did not find any relationship between the ATEC and the CARS. Unfortunately, the ATEC was scored incorrectly; but neither the editor nor the author published a correction of their analysis.

Aldera, H., Hilabi, A., Elzahrani, M. R., Alhamadh, M. S., Alqirnas, M. Q., Alkahtani, R., Masuadi, E., (2022). Do Parental Comorbidities Affect the Severity of Autism Spectrum Disorder? Cureus, 14(12). https://doi.org/10.7759/cureus.32702

Note: This study uses the ATEC severity cut points to measure autistic traits. It does not measure treatment efficacy.

Amatachaya, A., Auvichayapat, N., Patjanasoontorn, N., Suphakunpinyo, C., Ngernyam, N., Aree-uea, B., Keeratitanont, K., & Auvichayapat, P. (2014). Behavioural Neurology, doi: https://doi.org/10.1155/2014/173073

Azari, H., Morovati, A., Gargari, B. P., & Sarbakhsh, P. (2022). An Updated Systematic Review and Meta-Analysis on the Effects of Probiotics, Prebiotics and Synbiotics in Autism Spectrum Disorder. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-022-00348-0

Charman, T., Howlin, P., Berry, B., & Prince, E. (2004). Measuring developmental progress of children with autism spectrum disorder on school entry using parent report. Autism, 8(1), 89–100.

    • Note: the authors commented on the usefulness of the ATEC.

Coben, R., Padolsky, I. (2007). Assessment-guided neurofeedback for autistic spectrum disorder. Journal of Neurotherapy, 11(1), 5-23. doi: https://doi.org/10.1300/J184v11n01_02

Correia, C.T., Almeida, J.P., Santos, P.E., Sequeira, A.F., Marques, C.E., Miguel, T.S., Abreau, R.L., Oliveira, G.G., & Vicente, A.M. (2010). Pharmacogenetics of risperidone therapy in autism: association analysis of eight candidate genes with drug efficacy and adverse drug reactions. The Pharacogenomics Journal, 10, 418-430. doi: https://doi.org/10.1038/tpj.2009.63.

Ding, H., Yi, X., Zhang, X., Wang, H., Liu, H. & Mou, W-W. (2021) Imbalance in the gut microbiota of children with autism spectrum disorders. Frontiers in Cellular and Infection Microbiology, 01 November  2021. doi: https://doi.org/10.3389/fcimb.2021.572752

Feng, X., Jiang, Q., Zhang, Y., Li, T., Wei, W., Yu, J., Li, W., & Li, J. (2022). Pediatric Tuina in children with autism spectrum disorder: A study protocol for a randomized controlled trial. Trials, 23(1), 75. https://doi.org/10.1186/s13063-022-06030-4

Forman, P., Khokhlovich, E., & Vyshedskiy, A. (2022). Longitudinal Developmental Trajectories in Young Autistic Children Presenting with Seizures, Compared to those Presenting without Seizures, Gathered via Parent-report Using a Mobile Application. Journal of Developmental and Physical Disabilities. https://doi.org/10.1007/s10882-022-09851-y

Geier, D.A., Kern, J.K., & Geier, M.R. (2012). A prospective cross-sectional cohort assessment of health, physical, and behavior problems in autism spectrum disorders.  Maedica, 7(3), 193-200.

Ghosh, A., Mahajan, P.B., Tripathy, P.R., Mishra, B.R., Mahapatra, S.C., & Nanda, P. (2015). Exploring health situation of Indian children with autism spectrum disorder using Autism Treatment Evaluation Checklist (ATEC) in an urban area of Odisha: A case study. Journal of Clinical and Diagnostic Research, 9(12), VC05-VC08. https://doi.10.7860/JCDR/2015/16522.6982

Guo, J., & Dongmei, L. (2021). Effects of image-sandplay therapy on the mental health and subjective well-being of children with autism. Iranian Journal of Public Health, 50, 2045-2054. https://doi.10.18502/ijph.v50i10.7505

Hadoush, H., Nazzal, M., Almasri, N.A., Khalil, H., & Alafeef, M. Therapeutic effects of bilateral anodal transcranial direct current stimulation on prefrontal and motor cortical areas in children with autism spectrum disorders: a pilot study. Autism Research, 13, 828-836. doi: https://doi.org/10.1002/aur.2290

Jarusiewicz, B. (2002). Efficacy of neurofeedback for children in the autistic spectrum: a pilot study. Journal of Neurotherapy, 6(4), 39–49. https://doi.org/10.1300/J184v06n04_05

Kasanave, E. V., Khachatryan, L. G., Kaminskaya, T. S., Geppe, N. A., Vadiyan, D. E., & Manukyan, M. S. (2016). Somatic Features and Diet Therapy of Children with Delays in Psychospeech Development of the Autism Spectrum. Neurology, 2015, 2014. https://doi10.31550/1727-2378-2022-21-3-58-65

Kern, J.K., Geier, D.A., Adams, J.B., & Geier, M.R. (2010). A biomarker of mercury body-burden correlated with diagnostic domain specific clinical symptoms of autism spectrum disorder. BioMetals, 23, 1043-1051.

Klaveness, J., Bigam, J., & Reichelt, K. L. (2013). The varied rate of response to dietary intervention in autistic children. Open Journal of Psychiatry, 3(02), 56.

Kostiukow, A., & Samborski, W. (2020). The effectiveness of hyperbaric oxygen therapy (HBOT) in children with autism spectrum disorders. Europe PMC, 48, 15-18.

Kyrylova, L. G., & Miroshnykov, O. O. (2022). Клінічна оцінка ефективності нейропротекторної терапії в дітей з порушеннями мовленнєвого й когнітивного розвитку. INTERNATIONAL NEUROLOGICAL JOURNAL, 18(4), Article 4. https://doi.org/10.22141/2224-0713.18.4.2022.954

LaGasse, A.B. (2014). Effects of a music therapy group intervention on enhancing social skills in children with autism. Journal of Music Therapy, 51(3), 250-275.

Leung, J. Y.-L., Mackenzie, L., & Dickson, C. (2022). Outcomes of assistance dog placement in the home for individuals with autism spectrum disorder and their families: A pilot study. Australian Occupational Therapy Journal, 69(1), 50–63. https://doi.org/10.1111/1440-1630.12768

Levin, J., Khokhlovich, E., & Vyshedskiy, A. (2022). Longitudinal developmental trajectories in young autistic children presenting with sleep problems, compared to those presenting without sleep problems, gathered via parent-report using a mobile application. Research in Autism Spectrum Disorders, 97, 102024. https://doi.org/10.1016/j.rasd.2022.102024

Li, Y-Q., Sun, Y-H., Liang, Y-P., Zhou, F., Yang, J., & Jin, S-L. (2021). Effect of probiotics combined with applied behavior analysis in the treatment of children with autism spectrum disorder: a prospective randomized controlled trial. Chinese Journal of Contemporary Pediatrics, 12, 1103-1110.

Lin, Y., Jin, H.-J., Zhao, N., Yang, Y., Mao, J., Li, Z., Shi, M.-Y., & Huang, R. (2023). [Clinical observation on syndrome-differentiation acupuncture combined with rehabilitation training for autism spectrum disorder]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion, 43(1), 31–35. https://doi.org/10.13703/j.0255-2930.20220322-0006

Loukeris, S.L., & Soulis, S-G. (2021). Retention in kindergarten for students with autism spectrum disorders as an influencing factor in the cognitive and social domains. Education and Training in Autism and Developmental Disabilities, 56, 240-248.

Lun, T., Lin, S., Chen, Y., Zhao, Y., Wang, D., Li, L., & Yu, J. (2023). Acupuncture for children with autism spectrum disorder: A systematic review and meta-analysis. Medicine, 102(8), e33079–e33079. https://doi.org/10.1097/MD.0000000000033079

Mahapatra, S., Khokhlovich, E., Martinez, S., Kannel, B., Edelson, S.M., & Vyshedskiy, A. (2018). Longitudinal Epidemiological Study of Autism Subgroups Using Autism Treatment Evaluation Checklist (ATEC) Score.  Journal of Autism and Developmental Disorders, published online 30 July 2018, https://doi.org/10.1007/s10803-018-3699-2

Meiri, G., Bichovsky, Y., & Belmaker, R.H. (2009). Omega 3 fatty acid treatment in autism. Journal of Child and Adolescent Psychopharmacology, 19. doi: https://doi.org/10.1089/cap.2008.0123

Memari, A.H., Ziaee, V., Mirfazeli, F.S., & Kordi, R. (2012). Investigation of autism comorbidities and associations in a school-based community sample. Journal of Child and Adolescent Psychiatric Nursing, 25(2), 84-90. doi: https://doi.org/10.1111/j.1744-6171.2012.00325.x

Memishevikj, H., & Hodzhikj, S. (2010). The effects of equine-assisted therapy in improving the psychosocial functioning of children with autism. The Journal of Special Education and Rehabilitation, 11(3/4), 57-67.

Nakhla, M.A.Y., Zaky, E.A., Nabeh, E.S., & El Aziz, A.W. (2021) Assessment of 25 hydroxy cholecalceferol level in autistic children; is there a role for it in the treatment of autism spectrum disorder? QJM: An International Journal of Medicine, 114, Suppl. 1. doi: https://doi.org/10.1093/qjmed/hcab113.039

Pineda, J.A., Brang, D., Hecht, E., Edwards, L., Carey, S., Bacon, M. Futagaki, C., Suk, D., Tom, J., Birnbaum, C., & Rork, A. (2008). Positive behavioral electrophysiological changes following neurofeedback training in children with autism. Research in Autism Spectrum Disorders, 2(3), 557-581.

Ren, H., Ren, G., Zhan, Y., & Jia, Z. (2022). Examining the efficacy of dance movement and music mixed treatment on social communication impairment in children with autism—Based on family parent-child situation. Frontiers in Psychology, 13, 937564. https://doi.org/10.3389/fpsyg.2022.937564

Rinaldi, A., Martins, M. C. M., Maioli, M., Rinaldi, S., & Fontani, V. (2022). REAC Noninvasive Neurobiological Stimulation in Autism Spectrum Disorder for Alleviating Stress Impact. Advances in Neurodevelopmental Disorders. https://doi.org/10.1007/s41252-022-00293-3

Ruan, H., Eungpinichpong, W., Wu, H., & Aonsri, C. (2023). Physiological and Psychological Effects of Parent-Delivered Traditional Thai Massage in Children With Autism: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 12(1), e41839. https://doi.org/10.2196/41839

Salgueiro, E., Nunes, L., Barros, A., Maroco, J., Salgueiro, A.I., & do Santos, M.E (2012). Effects of a dolphin interaction program on children with autism spectrum disorders —   an exploratory research. BMC Research Notes, 5, 199. doi: https://doi.org/10.1186/1756-0500-5-199.

Sampanthavivat, M., Singkhwa, W., Chaiyakul, T., Karoonyawanich, S., & Ajpru, H.  (2012). Hyperbaric oxygen in the treatment of childhood autism: A randomised controlled trial. Diving and Hyperbaric Medicine, 42(3), 128-133.

Shaaban, S.Y., El Gendy, Y.G., Mehanna, N.S., El-Senousy, W.M., El-Feki, H.S.A., Saad, K., & El-Asheer, O.M. (2017). The role of probiotics in children with autism spectrum disorder: A prospective, open-label study. Nutritional Neuroscience, 21(9), 676-681.  doi: https://doi.org/10.1080/1028415X.2017.1347746

Shirian, S.A., & Dera, H.A. (2015). Descriptive characteristics of children with autism at Autism Treatment Center, KSA. Physiology & Behavior, 151, 604-608. doi: https://doi.org/10.1016/j.physbeh.2015.09.001.

Sotoodeh, M.S., Arabameri, E., Panahibakhish, M., Kheiroddin, F., Mirdoozandeh, H., & Ghanizadeh, A. (2017). Effectiveness of yoga training program on the severity of autism. Complementary Therapies in Clinical Practice, 28, 47-53. doi: https://doi.org/10.1016/j.ctcp.2017.05.001.

Sayorwan, W., Phianchana, N., Permpoonputtana, K., & Siripornpanich, V. (2018). A study of correlation between VEP and clinical severity in children with autism spectrum disorder. Autism Research and Treatment, 2018, 8 pages. doi: https://doi.org/10.1155/2018/5093016

Tangviriyapaiboon, D., Traisathit, P., Siripornpanich, V., Suyakong, C., Apikomonkon, H., Homkham, N., Thumronglaohapun, S., & Srikummoon, P. (2022). Detection of Electroencephalographic Abnormalities and Its Associated Factors among Children with Autism Spectrum Disorder in Thailand. Healthcare, 10(10). https://doi.org/10.3390/healthcare10101969

    • Note: This study uses the ATEC severity level cut points to measure autistic traits. It does not measure treatment efficacy.

Whitehouse, A. J., Granich, J., Alvares, G., Busacca, M., Cooper, M. N., Dass, A., … others. (2017). A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism Spectrum Disorder. Journal of Child Psychology and Psychiatry. Retrieved from https://doi.10.1111/jcpp.12752/full

Vyshedskiy, A., & Khokhlovich, E. (2023). Joint Engagement is Associated with Greater Development of Language and Sensory Awareness in Children with Autism Spectrum Disorder. Journal of Developmental and Physical Disabilities. https://doi.org/10.1007/s10882-022-09887-0

Xia, R.R. (2011). Effectiveness of nutritional supplements for reducing symptoms in autism         spectrum disorder: A case report. The Journal of Alternative and Complementary         Medicine, 17(3).  doi: https://doi.org/10.1089/acm.2010.0146.