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    ESQ Parents Teachers - Eng

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    nightbreezesv
    The document is an executive skills questionnaire for parents and teachers to evaluate a child's behaviors related to executive functioning. It contains 33 questions across various executive skill areas and provides space to record scores and note strengths and weaknesses.

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    © All Rights Reserved
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    ESQ Parents Teachers - Eng

    Uploaded by

    nightbreezesv
    23 views2 pages
    The document is an executive skills questionnaire for parents and teachers to evaluate a child's behaviors related to executive functioning. It contains 33 questions across various executive skill areas and provides space to record scores and note strengths and weaknesses.

    Original Title

    ESQ parents teachers_Eng

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    © © All Rights Reserved

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    The document is an executive skills questionnaire for parents and teachers to evaluate a child's behaviors related to executive functioning. It contains 33 questions across various executive skill areas and provides space to record scores and note strengths and weaknesses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    23 views2 pages

    ESQ Parents Teachers - Eng

    Uploaded by

    nightbreezesv
    The document is an executive skills questionnaire for parents and teachers to evaluate a child's behaviors related to executive functioning. It contains 33 questions across various executive skill areas and provides space to record scores and note strengths and weaknesses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    FORM 2.

    Executive Skills Questionnaire for Parents/Teachers


    Big problem 1
    Moderate problem 2
    Mild problem 3
    Slight problem 4
    No problem 5
    Item Score
    1. Acts on impulse
    2. Gets in trouble for talking too much in class
    3. Says things without thinking
    TOTAL SCORE:

    4. Says, “I’ll do it later” and then forgets about it


    5. Forgets homework assignments or forgets to bring home
    needed materials
    6. Loses or misplaces belongings such as coats, mittens, sports
    equipment, etc.
    TOTAL SCORE:
    7. Gets annoyed when homework is too hard or confusing or takes
    too long to finish
    8. Has a short fuse; easily frustrated
    9. Easily upset when things don’t go as planned
    TOTAL SCORE:

    10. Difficulty paying attention; easily distracted


    11. Runs out of steam before finishing homework or other tasks
    12. Problems sticking with schoolwork or chores until they are done
    TOTAL SCORE:

    13. Puts off homework or chores until the last minute


    14. Difficulty setting aside fun activities in order to start homework
    15. Needs many reminders to start chores
    TOTAL SCORE:

    16. Trouble planning for big assignments (knowing what to do first,


    second, etc.?
    17. Difficulty setting priorities when has a lot of things to do
    18. Becomes overwhelmed by long-term projects or big assignments
    TOTAL SCORE:
    (continued)

    From Executive Skills in Children and Adolescents, Third Edition, by Peg Dawson and Richard Guare. Copyright © 2018
    The Guilford Press. Permission to photocopy this form is granted to purchasers of this book for personal use or use with
    students (see copyright page for details).
    Executive Skills Questionnaire for Parents/Teachers (page 2 of 2)

    Item Score
    19. Backpack and notebooks are disorganized
    20. Desk or workspace at home or school is a mess
    21. Trouble keeping bedroom or locker tidy
    TOTAL SCORE:

    22. Has a hard time estimating how long it takes to do something


    (such as homework?
    23. Often doesn’t finish homework at night; rushes to get it done in school
    before class
    24. Slow getting ready for things (e.g., appointments, school,
    changing classes?
    TOTAL SCORE:

    25. If the first solution to a problem doesn’t work, has trouble thinking
    of a different one
    26. Resists changes in plans or routines
    27. Has problems with open-ended homework assignments (e.g., doesn’t
    know what to write about when given a creative writing assignment?
    TOTAL SCORE:

    High School Students Only


    28. Lacks effective study strategies
    29. Doesn’t check work for mistakes even when the stakes are high
    30. Doesn’t evaluate performance and change tactics in order to
    increase success
    TOTAL SCORE:

    31. Can’t seem to save up money for a desired object; problems


    delaying gratification
    32. Doesn’t see the value in earning good grades to achieve
    a long-term goal
    33. Seems to live in the present
    TOTAL SCORE:
    KEY
    Items Executive Skill Items Executive Skill
    1–3 Response inhibition 4–6 Working memory
    7–9 Emotional control 10–12 Sustained attention
    13–15 Task initiation 16–18 Planning/prioritization
    19–21 Organization 22–24 Time management
    25–27 Flexibility 28–30 Metacognition
    31–33 Goal-directed persistence

    Child’s Executive Skills Strengths Child’s Executive Skills Weaknesses

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