Executive Function Skills Questionnaire

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Peg Dawson & Richard Guare Executive Function packet
Read each item below and then rate that item based on the extent to which you agree or disagree with how well it describes you. Use the rating scale below to choose the appropriate score. Then add the three scores in each section. Use the Key to determine your executive skill strengths (2-3 highest scores) and weaknesses (2-3 lowest scores).

This Questionnaire will send you a PDF of your answers.

First Name: *

Email: *

1. I don’t jump to conclusions

Strongly Disagree

Strongly Agree

Clear selection

2. I think before I speak.

Strongly Disagree

Strongly Agree

Clear selection

3. I don’t take action without having all the facts.

Strongly Disagree

Strongly Agree

Clear selection

Response Inhibition
Total for 1-3:

4. I have a good memory for facts, dates, and details.

Strongly Disagree

Strongly Agree

Clear selection

5. I am very good at remembering the things I have committed to do.

Strongly Disagree

Strongly Agree

Clear selection

6. I seldom need reminders to complete tasks

Strongly Disagree

Strongly Agree

Clear selection

Working Memory
Total for 4-6:

7. My emotions seldom get in the way when performing on the job.

Strongly Disagree

Strongly Agree

Clear selection

8. Little things do not affect me emotionally or distract me from the task at hand.

Strongly Disagree

Strongly Agree

Clear selection

9. I can defer my personal feelings until after a task has been completed.

Strongly Disagree

Strongly Agree

Clear selection

Emotional Control
Total for 7-9:

10. No matter what the task, I believe in getting started as soon as possible.

Strongly Disagree

Strongly Agree

Clear selection

11. Procrastination is usually not a problem for me.

Strongly Disagree

Strongly Agree

Clear selection

12. I seldom leave tasks to the last minute

Strongly Disagree

Strongly Agree

Clear selection

Task Initiation
Total for 10-12:

13. I find it easy to stay focused on my work.

Strongly Disagree

Strongly Agree

Clear selection

14. Once I start an assignment, I work diligently until it’s completed.

Strongly Disagree

Strongly Agree

Clear selection

15. Even when interrupted, I find it easy to get back and complete the job at hand.

Strongly Disagree

Strongly Agree

Clear selection

Sustained Attention
Total for 13-15:

16. When I plan out my day, I identify priorities and stick to them.

Strongly Disagree

Strongly Agree

Clear selection

17. When I have a lot to do, I can easily focus on the most important things.

Strongly Disagree

Strongly Agree

Clear selection

18. I typically break big tasks down into subtasks and timelines.

Strongly Disagree

Strongly Agree

Clear selection

Planning/Prioritization
Total for 16-18:

19. I am an organized person.

Strongly Disagree

Strongly Agree

Clear selection

20. It is natural for me to keep my work area neat and organized.

Strongly Disagree

Strongly Agree

Clear selection

21. I am good at maintaining systems for organizing my work.

Strongly Disagree

Strongly Agree

Clear selection

Organization
Total for 19-21:

22. At the end of the day, I’ve usually finished what I set out to do.

Strongly Disagree

Strongly Agree

Clear selection

23. I am good at estimating how long it takes to do something.

Strongly Disagree

Strongly Agree

Clear selection

24. I am usually on time for appointments and activities.

Strongly Disagree

Strongly Agree

Clear selection

Time Management
Total for 22-24:

25. I take unexpected events in stride.

Strongly Disagree

Strongly Agree

Clear selection

26. I easily adjust to changes in plans and priorities.

Strongly Disagree

Strongly Agree

Clear selection

27. I consider myself to be flexible and adaptive to change.

Strongly Disagree

Strongly Agree

Clear selection

Flexibility
Total for 25-27:

28. I routinely evaluate my performance and devise methods for personal improvement.

Strongly Disagree

Strongly Agree

Clear selection

29. I am able to step back from a situation in order to make objective decisions.

Strongly Disagree

Strongly Agree

Clear selection

30. I “read” situations well and can adjust my behavior based on the reactions of others.

Strongly Disagree

Strongly Agree

Clear selection

Metacognition
Total for 28-30:

31. I think of myself as being driven to meet my goals.

Strongly Disagree

Strongly Agree

Clear selection

32. I easily give up immediate pleasures to work on long-term goals.

Strongly Disagree

Strongly Agree

Clear selection

33. I believe in setting and achieving high levels of performance.

Strongly Disagree

Strongly Agree

Clear selection

Goal-Directed Persistence
Total for 31-33:

34. I enjoy working in a highly demanding, fast-paced environment.

Strongly Disagree

Strongly Agree

Clear selection

35. A certain amount of pressure helps me to perform at my best.

Strongly Disagree

Strongly Agree

Clear selection

36. Jobs that include a fair degree of unpredictability appeal to me.

Strongly Disagree

Strongly Agree

Clear selection

Stress Tolerance
Total for 34-36:

Which are your 3 highest scores:

Response Inhibition

Working Memory

Emotional Control

Task Initiation

Sustained Attention

Planning/Prioritization

Organization

Time Management

Flexibility

Metacognition

Goal-Directed Persistence

Stress Tolerance

(please check for me)

Which are your 3 lowest scores:

Response Inhibition

Working Memory

Emotional Control

Task Initiation

Sustained Attention

Planning/Prioritization

Organization

Time Management

Flexibility

Metacognition

Goal-Directed Persistence

Stress Tolerance

(please check for me)

Executive Function Skills Worksheet

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