Comparison of clinical diagnoses and Rimland E2 scores in severely disturbed children.

Leddet et al. (1986) compared two ways to spot autism in very troubled kids. They looked at regular doctor diagnoses and scores from the Rimland E2 checklist. The goal was to see if the checklist could sort autistic children from non-autistic ones.

The Rimland E2 did a good job telling who was autistic and who was not. It could not, however, split classic infantile autism from autism mixed with other problems. In short, it flags autism but stays quiet on the subtype.

South et al. (2002) later showed the Gilliam Autism Rating Scale misses about half of autistic kids. Both studies warn that checklists alone can let many autistic children slip through.

Mohanakumar Sindhu et al. (2025) found the CELF-5 Screener and Vineland-3 also miss language issues in autistic children. The pattern repeats: one tool is rarely enough.

Goodwin et al. (2012) pushed the idea into adults. Their Autism Quotient missed most diagnosed adults, echoing the Rimland lesson across age groups.

If you screen with only the Rimland E2, you will catch many autistic children, but you will still miss some and you will not learn which subtype you have. Pair it with a second tool, like direct observation or caregiver interview, before you write the diagnosis. This small extra step keeps kids from falling through the cracks and saves you from chasing the wrong goals in treatment.