Upper Elementary Executive Skills questionnaire from “Smart but Scattered” by Peg Dawson and Richard Guare. I’ve modified the wording of some of the statements a little.
For each statement, score how well you think it applies to you using the following scale.
- Strongly Agree = 5
- Agree = 4
- Neutral = 3
- Disagree = 2
- Strongly Disagree = 1
- I can handle conflict with peers without getting into a physical fight, though I may lose my temper.
- I can follow rules without the immediate presence of a person of authority.
- I can calm down or de-escalate quickly from an emotionally charged state if prompted by an adult.
[Total scores 1 to 3 to get your Upper Elementary Response Inhibition score]
- I can remember to follow a routine chore, for example after school, without reminders.
- I can bring books, papers etc. to and from school.
- I can keep track of my changing daily schedule, for example different activities after school.
[Total scores 4 to 6 to get your Upper Elementary Working Memory score]
- I don’t overreact if I lose a game or don’t get chosen for a reward.
- I can accept not getting what I want when I’m working or playing in a group.
- I act with restraint in response to teasing.
[Total scores 7 to 9 to get your Upper Elementary Emotional Control score]
- I can spend 30 to 60 minutes on a homework assignment.
- I can complete a chore that takes 30 to 60 minutes, but I may need a break.
- I am able to attend sports practice, church service or another activity for 60 to 70 minutes.
[Total scores 10 to 12 to get your Upper Elementary Sustained Attention score]
- I am able to do a three- to four- step routine that has been practiced.
- I can complete three to four classroom assignments in a row.
- I can follow an established homework schedule, but may need a reminder to get started.
[Total scores 13 to 15 to get your Upper Elementary Task Initiation score]
- I can make plans to do something special with a friend, for example go to the movies.
- I can figure out how to earn or save money for a more expensive purchase.
- I can carry out a long-term project for school, with most steps broken down by someone else.
[Total scores 16 to 18 to get your Upper Elementary Planning/Prioritisation score]
- I can put my belongings in an appropriate location in my bedroom or elsewhere in the house.
- I bring in toys from outdoors after use or at the end of the day, but I may need a reminder.
- I keep track of homework materials and assignments.
[Total scores 19 to 21 to get your Upper Elementary Organisation score]
- I can complete daily routines within reasonable time limits without assistance.
- I can adjust my homework schedule to allow for other activities, for example starting early if there’s an evening Scout meeting.
- I can start long-term projects long enough in advance to reduce a “time crunch” at the end, though I may need help with this.
[Total scores 22 to 24 to get your Upper Elementary Time Management score]
- I can save allowance for three to four weeks to make a desired purchase.
- I am able to follow a practice schedule to get better at a desired skill, but may need reminders.
- I can maintain a hobby over several months.
[Total scores 25 to 27 to get your Upper Elementary Goal-Directed Persistence score]
- I don’t “get stuck” on things like disappointments or slights (getting stuck also known as perseveration).
- I can adapt when plans change due to unforseen circumstances.
- I can do open-ended homework assignments, but may need help.
[Total scores 28 to 30 to get your Upper Elementary Flexibility score]
- I can anticipate the result of a course of action in advance, and make adjustments accordingly, for example to avoid getting in trouble.
- I can articulate several solutions to problems and explain the best one.
- I enjoy the problem-solving component to a homework assignment or game.
[Total scores 31 to 33 to get your Upper Elementary Metacognition score]
Now make a note of the areas you scored highest and lowest in to discover your strengths and weaknesses. Read explanations of the executive skills.
This is part of the Executive Skills – Smart but Scattered collection of blog posts.