Autism Treatment Evaluation Checklist (ATEC)
The ATEC 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). Once you submit the form, we'll email you the score. The lower the score, the fewer the problems. Sourced from: https://autism.org/autism-treatment-evaluation-checklist/
Name of Child
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First Name
Last Name
Gender
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Please Select
Male
Female
N/A
Date of birth
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Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
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Form completed by
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First Name
Last Name
Your Relationship to Child
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Your email address
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Country of residence
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1. Speech/Language/Communication
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Rows
Not True
Somewhat True
Very True
1. Knows own name
2. Responds to ‘No’ or ‘Stop’
3. Can follow some commands
4. Can use one word at a time (No!, Eat, Water, etc.)
5. Can use 2 words at a time (Don't want, Go home)
6. Can use 3 words at a time (Want more milk)
7. Knows 10 or more words
8. Can use sentences with 4 or more words
9. Explains what he/she wants
10. Asks meaningful questions
11. Speech tends to be meaningful/relevant
12. Often uses several successive sentences
13. Carries on fairly good conversation
14. Has normal ability to communicate for his/her age
Section 1 Score
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2. Sociability
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Rows
Not descriptive
Somewhat descriptive
Very descriptive
1. Seems to be in a shell – you cannot reach him/her
2. Ignores other people
3. Pays little or no attention when addressed
4. Uncooperative and resistant
5. No eye contact
6. Prefers to be left alone
7. Shows no affection
8. Fails to greet parents
9. Avoids contact with others
10. Does not imitate
11. Dislikes being held/cuddled
12. Does not share or show
13. Does not wave ‘bye bye’
14. Disagreeable/not compliant
15. Temper tantrums
16. Lacks friends/companions
17. Rarely smiles
18. Insensitive to other's feelings
19. Indifferent to being liked
20. Indifferent if parent(s) leave
Section 2 Score
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3. Sensory/Cognitive Awareness
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Rows
Not descriptive
Somewhat descriptive
Very descriptive
1. Responds to own name
2. Responds to praise
3. Looks at people and animals
4. Looks at pictures (and T.V.)
5. Does drawing, coloring, art
6. Plays with toys appropriately
7. Appropriate facial expression
8. Understands stories on T.V.
9. Understands explanations
10. Aware of environment
11. Aware of danger
12. Shows imagination
13. Initiates activities
14. Dresses self
15. Curious, interested
16. Venturesome - explores
17. “Tuned in” — Not spacey
18. Looks where others are looking
Section 3 Score
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4. Health/Physical/Behavior
Rows
Not a problem
Minor problem
Moderate problem
Serious problem
1. Bed-wetting
2. Wets pants/diapers
3. Soils pants/diapers
4. Diarrhea
5. Constipation
6. Sleep problems
7. Eats too much/too little
8. Extremely limited diet
9. Hyperactive
10. Lethargic
11. Hits or injures self
12. Hits or injures others
13. Destructive
14. Sound-sensitive
15. Anxious/fearful
16. Unhappy/crying
17. Seizures
18. Obsessive speech
19. Rigid routines
20. Shouts or screams
21. Demands sameness
22. Often agitated
23. Not sensitive to pain
24. “Hooked” or fixated on certain objects/topics
25. Repetitive movements (stimming, rocking, etc.)
Section 4 Score
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Submit form
Once you submit the form, we'll email you a copy of the results and the final ATEC score for your records.
Overall Score
I am happy for my data to be stored and kept for this purpose.
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