Executive Skills Questionnaire – Teen Version
(Dawson and Guare from Smart But scattered…)
Rate each item below based on how well it describes you, using this rating scale to choose the appropriate score. Then add
the three scores in each section. Use the key on the next page to determine your executive skills strengths (two to three
lowest scores) and weaknesses (two to three highest scores).
1 2 3 4 5 6 7
Strongly Disagree Tend to Neutral Tend to Agree Strongly
Disagree Disagree Agree Agree
Item Score
1. I act on impulse. _____
2. I get in trouble for talking too much in class. _____
3. I say things without thinking. _____
TOTAL SCORE: _____
4. I say, “I’ll do it later” and then forget about it. _____
5. I forget homework assignments or forget to take home needed materials. _____
6. I lose or misplace belongings such as coats, gloves, sports equipment, etc. _____
TOTAL SCORE:
7. I get annoyed when homework is too hard or confusing or takes too long
to finish. _____
8. I have a short fuse – am easily frustrated. _____
9. I get upset when things don’t go as planned. _____
TOTAL SCORE: _____
10. If the first solution to a problem doesn’t work, I have trouble thinking of a
different one. _____
11. I get upset when I have to change plans or routines. _____
12. I have problems with open-ended homework assignments (e.g., deciding what
to write about when given a creative writing assignment). _____
TOTAL SCORE: _____
13. I have difficulty paying attention and am easily distracted. _____
14. I run out of steam before finishing homework or other tasks. _____
15. I have problems sticking with schoolwork or chores until they are done. _____
TOTAL SCORE: _____
16. I put off homework or chores until the last minute. _____
17. I have difficulty setting aside fun activities in order to start homework. _____
18. I need to be reminded to start chores or homework. ____
TOTAL SCORE: _____
19. I have trouble planning for big assignments (knowing what to do first, second, etc.) _____
20. I have difficulty setting priorities when I have a lot of things to do. _____
21. I become overwhelmed by long-term projects or big assignments. _____
TOTAL SCORE: _____
22. My backpack and notebooks aren’t organized. _____
23. My desk or workspace at home or school is a mess. _____
24. I have trouble keeping my bedroom or locker tidy. _____
TOTAL SCORE: _____
25. I have a hard time estimating how long it takes to do something (such as
homework). _____
26. I often don’t finish homework at night and may rush to get it done in school
before class. _____
27. I need a lot of time to get ready for things (e.g., appointments, school,
changing classes). _____
TOTAL SCORE: _____
28. I can’t seem to save up money for a desired object – problems delaying
gratification. _____
29. I don’t see the point of earning good grades to achieve a long-term goal. _____
30. I prefer to live in the present. _____
TOTAL SCORE: _____
31. I don’t have very effective study strategies. _____
32. I tend not to check my work for mistakes even when the stakes are high. _____
33. I don’t evaluate my performance and change tactics to increase success. _____
TOTAL SCORE:
KEY
Items Executive skill Items Executive skill Items Executive skill
1-3 Response inhibition 13-15 Sustained attention 25-27 Time management
4-6 Working memory 16-18 Task initiation 28-30 Goal-directed
7-9 Emotional control 19-21 Planning/prioritizing persistence
10-12 Flexibility 22-24 Organization 31-33 Metacognition
Your executive skills strengths Your executive skills weaknesses
(highest score) (lowest score)
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