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Executive Function Questionnaire for Parents

Determine your child's executive function strengths and weaknesses.   We will email you a report with the results within 24 hours of completion.  

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Part A – Getting Started (Initiation)

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Question 2 of 45

1.  My child puts off homework or chores until the last minute.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 3 of 45

2.  It’s hard for my child to stop a fun activity when it’s time to do homework.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 4 of 45

3.  My child procrastinates.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part B - Organization

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Question 6 of 45

4.  My child’s backpack and notebooks are disorganized.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 7 of 45

5.  My child’s bedroom is messy.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 8 of 45

6.  My child’s desk or workspace is messy.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part C – Managing My Time

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Question 10 of 45

7.  My child has a hard time estimating how long it will take to complete my homework.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 11 of 45

8.  My child is  late to classes and appointments.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 12 of 45

9.  My child has to rush at the end of class to complete class work.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part D – Impulsivity

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Question 14 of 45

10.  My child gets in trouble for talking in class.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 15 of 45

11.  My child speaks before he thinks.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 16 of 45

12.  My child acts on impulse.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part E – Emotional Control

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Question 18 of 45

13.  My child gets upset easily when things don’t go as planned.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 19 of 45

14.  My child gets annoyed when school work is too hard or confusing and takes a long time.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 20 of 45

15.  My child gets angry and frustrated easily

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part F - Flexibility

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Question 22 of 45

16.  My child has trouble adjusting to changes in plans or routines

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 23 of 45

17.  My child doesn’t like assignments in which he has to choose the topic.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 24 of 45

18.  If my child’s first attempt at solving a problem doesn’t work, he tends to shut down, and has trouble thinking of a different way to approach it.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part G – Working Memory

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Question 26 of 45

19.  My child forgets homework assignments or forgets to bring home needed materials.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 27 of 45

20.  My child loses or misplaces things like phones, sports equipment, keys or notebooks.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 28 of 45

21.  My child forgets to attend extracurricular activities or clubs

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part H – Focus

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Question 30 of 45

22.  My child is easily distracted.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 31 of 45

23.  My child gets tired before finishing homework.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 32 of 45

24.  My child has trouble sticking with chores until they are done.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part I – Planning/Prioritization

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Question 34 of 45

25.  My child becomes overwhelmed by big projects, assignments or papers.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 35 of 45

26.  My child has trouble setting priorities when he has a lot of things to do.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 36 of 45

27.  My child can’t work without direction and structure.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part J – Thinking About My Thought Processes

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Question 38 of 45

28.  My child doesn’t check my work for mistakes, even on important exams or assignments.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 39 of 45

29.  My child doesn’t learn from his mistakes and make changes to improve.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 40 of 45

30.  My child doesn’t use effective study strategies.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Part K – Seeing It Through to the End

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Question 42 of 45

31.  My child has trouble saving money for things he  wants.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 43 of 45

32.  My child doesn’t know why it matters if he gets good grades now.

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 44 of 45

33.  My child can be aware that he is making a bad decision, but does it anyway. 

A

1 - Most of the time

B

2 - Frequently

C

3 - Sometimes

D

4 - Very rarely

E

5 - Never

Question 45 of 45

34.  Please share your email address so that we can send you a copy of your report.

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