ATT can provide a range of behavioural assessments, which could be conducted to monitor our bioemdical  intervention plan on a regular basis (base-line assessments as well a follow-up on a 6-12 monthly basis). These could also be conducted independently of a biomedical treatment plan.

Social Communication Questionnaire (SCQ)

by Michael Rutter, M.D., FRS, Anthony Bailey, M.D., and Catherine Lord, Ph.D.


Previously known as the Autism Screening Questionnaire (ASQ), this brief instrument helps evaluate communication skills and social functioning in children who may have autism or autism spectrum disorders. Completed by a parent or other primary caregiver in less than 10 minutes, the SCQ is a cost-effective way to determine whether an individual should be referred for a complete diagnostic evaluation.

The questionnaire can be used to evaluate anyone over age 4.0, as long as his or her mental age exceeds 2.0 years. It is available in two forms--Lifetime and Current--each composed of just 40 yes-or-no questions. Both forms can be given directly to the parent, who can answer the questions without supervision. (Forms are available in Spanish as well as English.)

The Lifetime Form focuses on the child's entire developmental history, providing a Total Score that's interpreted in relation to specific cutoff points. This score identifies individuals who may have autism and should be referred for a more complete evaluation--with the Autism Diagnostic Interview-Revised (ADI-R) or the Autism Diagnostic Observation Schedule (ADOS), for example. SCQ content parallels that of the ADI-R, and the agreement between SCQ and ADI-R scores is high and substantially unaffected by age, gender, language level and performance IQ. This indicates that the SCQ is a valid screener, providing a reasonable picture of symptom severity.

Moving from developmental history to present status, the Current Form looks at the child's behavior over the most recent 3-month period. It produces results that can be helpful in treatment planning, educational intervention, and measurement of change over time.

In addition to its screening and educational applications, the SCQ can also be used to compare symptom levels across various groups--children with developmental language disorders, for example, or youngsters with medical conditions typically associated with autism spectrum disorders.

Because the SCQ is brief, quick, easily administered, and relatively inexpensive, it allows clinicians and educators to routinely screen children for autism spectrum disorders. This in turn permits early intervention.

The Autism Diagnostic Observation Schedule -Generic (ADOS-G)

ADOS is a semi-structured assessment of communication, social interaction and play or imaginative use of materials for individuals suspected of having autism or other pervasive developmental disorders (PDD).

The ADOS-G consists of standard activities that allow the examiner to observe the occurrence or non-occurrence of behaviors that have been identified as important to the diagnosis of autism and other pervasive developmental disorders across developmental levels and chronological ages. The examiner selects the module that is most appropriate for a particular child or adult on the basis of his/her expressive language level and chronological age. Structured activities and materials, and less structured interactions, provide standard contexts in which social, communicative and other behaviors relevant to pervasive developmental disorders are observed. Within each module, the participant's response to each activity is recorded. Overall ratings are made at the end of the schedule. These ratings can then be used to formulate a diagnosis through the use of a diagnostic algorithm for each module. In effect, the ADOS-G provides a 30 to 45 minute observation period during which the examiner presents the individual being assessed with numerous opportunities to exhibit behaviors of interest in the diagnosis of autism/PDD through standard 'presses' for communication and social interaction. 'Presses' consist of planned social occasions in which it has been determined in advance that a behavior of a particular type is likely to appear (Murray, 1938).

The modules provide social-communicative sequences that combine a series of unstructured and structured situations. Each situation provides a different combination of presses for particular social behaviors. Module 1, based on the PL-ADOS, is intended for individuals who do not consistently use phrase speech (defined as non-echoed. three-word utterances that sometimes involve a verb and that are the child's spontaneous, meaningful word combinations). Materials for Module 1 have been selected for young children, but materials from other modules may be substituted if desired. Module 2 is a combination of the ADOS and PL-ADOS and is intended for individuals with some phrase speech who are not verbally fluent. Module 3 is based on the ADOS and is intended for children for whom playing with toys is age- appropriate, (usually under 12 - 16 years of age) who are verbally fluent. Verbal fluency is broadly defined as having the expressive language of a typical four year-old child: producing 4. range of sentence types and grammatical forms, using language to provide information about events out of context and producing some logical connections within sentences ( e.g., "but" or "though"). There may be some continued grammatical errors. Module 4 includes the socioemotional questions of the ADOS as well as additional tasks and some interview items about daily living. It is intended for verbally fluent adolescents and adults. The difference between Modules 3 and 4 lies primarily in whether information about social-communication is more appropriately acquired during play or a conversational interview. The modules overlap in activities, but together contain a range of tasks from observing how a young child requests that the examiner continue blowing up a balloon in Module 1 to a conversation about social relationships at school or work in Module 4. Modules 1 and 2 will often be conducted while moving among different places around a room, reflecting the interests and activity levels of young children or children with very limited language; Modules 3 and 4 take place sitting at a table and involve more conversation and language without a physical context. Though the superficial appearance of the different modules is quite varied, the general principles involving the deliberate variation of the examiner's behavior using a hierarchy of structured and unstructured social behaviors are the same.

Because the focus of the ADOS-G is on observation of social behavior and communication, the goal of the activities is to provide interesting, standard contexts in which interactions occur. Standardization lies in the hierarchy of behavior employed by the examiner and the kinds of behaviors taken into account in each activity during the overall ratings. The activities serve to structure the interaction; they are not ends in themselves. The object is not to test specific cognitive abilities or other skills in the activities, but to have tasks that are sufficiently intriguing that the child or adult being assessed will want to participate. What the examiners do not do (such as deliberately waiting to see if the participant will initiate an interaction or try to maintain it) is often as important as what they do.

The Autism Treatment Evaluation Checklist (ATEC)

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, Here.

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).

This assessment can be done every 3 months by the parents at home- Whilst the reliability of the measures is insufficient for a rigorous evaluation of outcomes, it remains an easy tool to use for parents to monitor their child's evolution.

More testings will be incorportaed shortly to the child's receptive language (British Picture Vocabulary Scale), non verbal IQ (Ravens Matrices) and working memory (AWMA). More to follow.