Pfeiffer Treatment Center

Autism Treatment Evaluation Checklist (ATEC)
Internet Scoring Program

[If you are not a client of the Pfeiffer Treatment Center,
click here to complete the ATEC]


The Autism Research Institute (ARI) has developed this simple Internet scoring procedure that will calculate subscale scores and a summary score from the ATEC. The scores are weighted according to the response and the corresponding subscale. The higher the subscale and total scores, the more impaired the subject. It is also available in print; however, we request you fill it out on the Internet if possible.

We, the medical team at the Pfeiffer Treatment Center, are very interested in the continued improvement of your child with autism. To achieve this, it is important to evaluate the effectiveness of any interventions over the short and the long term. Using the ATEC prior to treatment, at the introduction of a new therapy, and at regular intervals, in the future can provide very useful measures of the functioning of your child. This can help us determine which interventions are best for your child. Furthermore, as we review the results of many patients, we may be able to determine which interventions are best for certain individuals’ and/ or not for others.

The ATEC subscale and summary scores will be displayed immediately after you input each checklist, the higher the subscale and total scores, the more impaired the person. A copy of these results will be sent to the Pfeiffer Treatment Center to help track your child’s progress and to the Autism Research Institute’s database to help develop norms. Information regarding the identity of each person sent to the ARI database is kept confidential. Identifying information is necessary for the Pfeiffer Treatment Center to put it in your child’s chart.

If you would like to fill out a hardcopy of the ATEC, please download the Adobe Acrobat pdf file, and mail or fax the completed form to the Pfeiffer Treatment Center (4575 Weaver Parkway - Warrenville, IL 60555-4039; Fax: (630) 836-0667). Click here to download and print a hardcopy of the ATEC.

A. Information About ATEC User

Identification number:


Current Therapies

Biomedical
Casein-free diet Gluten-free diet SC Diet
Digestive enzymes Primer III Pfeiffer Compounding
MTP II Vit. B6 & Mg Inositol
GABA DMG TMG
Folinic Acid Methyl B-12 injection Melatonin
Taurine Pro Biotics Natural Anti-fungal Therapies
Education/Other
ABA RDI SI Therapy
Speech Therapy Auditory Int. Training Neurofeedback
Pharmacotherapeutics
Benadryl Prozac Risperdal
Adderall Ritalin Clonidine
Diflucan Sporanox Nystatin
Strattera Paxil

OTHER:

New Therapies

Biomedical
Casein-free diet Gluten-free diet SC Diet
Digestive enzymes Primer III Pfeiffer Compounding
MTP II Vit. B6 & Mg Inositol
GABA DMG TMG
Folinic Acid Methyl B-12 injection Melatonin
Taurine Pro Biotics Natural Anti-fungal Therapies
Education/Other
ABA RDI SI Therapy
Speech Therapy Auditory Int. Training Neurofeedback
Pharmacotherapeutics
Benadryl Prozac Risperdal
Adderall Ritalin Clonidine
Diflucan Sporanox Nystatin
Strattera Paxil

OTHER:

OR

Not Evaluating a Specific Treatment

B. Information Specific to Each ATEC/Person (Research Subject)

Please indicate the approximate time since completing the most recent ATEC, choose "baseline" if this is your first.

Assessment Period
Baseline (starting) 4 weeks 10 weeks 6 months
1 week 5 weeks 12 weeks 9 months
2 weeks 6 weeks 4 months 1 year
3 weeks 8 weeks 5 months >1 year
Other:


Please Click the Appropriate 'Radio Button'

I. Speech/Language/Communication

N = Not true S=Somewhat true V=Very true

1. Knows own name N S V
2. Responds to ‘No’ or ‘Stop’ N S V
3. Can follow some commands N S V
4. Can use one word at a time N S V
5. Can use 2 words at a time N S V
6. Can use 3 words at a time N S V
7. Knows 10 or more words N S V
8. Can use sentences with 4 or more words N S V
9. Explains what he/she wants N S V
10. Asks meaningful questions N S V
11. Speech tends to be meaningful/relevant N S V
12. Often uses several successive sentences N S V
13. Carries on fairly good conversation N S V
14. Has normal ability to commmunicate for his/her age N S V

II. Sociability

N = Not descriptive S=Somewhat descriptive V=Very descriptive

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

III. Sensory/Cognitive Awareness

N = Not descriptive S=Somewhat descriptive V=Very descriptive

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

IV. Health/Physical/Behavior

N = Not a Problem MI=Minor Problem MO=Moderate Problem S=Serious Problem

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