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Executive Function Assessment

Answer all questions with the number associated with how much you agree (5) or disagree (1) with the statement.


Try not to overthink this. If your response would be significantly different depending on context, you should answer for whatever context is more challenging for you, or the setting where the highlighted behavior is more important.

Impulse Control / Response Inhibition

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. If I’m doing something that feels good, is fun, or pleasantly distracting but I need to do something else, I struggle to hit pause and switch to the thing I need to do.
2. I don't think before I speak or act as much as I really should.
3. I've noticed, or have been told, that I talk over people or interrupt others.
4. My mind doesn't wait to hear all the details before jumping to conclusions.
5. When I’m excited or upset I can find myself taking things too far.

Working Memory

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I don't have a very good memory for facts, dates, and details.
2. I can forget appointments or other things I have committed to do.
3. I can be pretty forgetful and I lose track of things.
4. Keeping mental lists is hard for me beyond a few items and I'm likely to forget things unless I write it down.
5. When talking about or working on something with a significant amount of detail, I struggle to keep most of the important points in mind while I’m talking/working.

Emotional Regulation

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. My emotions can get in the way when performing on the job/ school.
2. Seemingly little things can affect me emotionally or distract me from the task at hand.
3. Even though I may need positive self-created structure in my life, I struggle to maintain it and sometimes even actively resist or sabotage it.
4. When I get upset I can lose sight of what I was doing or thinking about.
5. I can experience sudden, dramatic shifts in mood, either positive or negative, from even small things.

Initiation

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. Procrastination is a major problem for me.
2. I leave the tasks that are challenging or boring to the last minute.
3. I become so overwhelmed by tasks or challenges that I avoid them all together.
4. I need prodding from my manager/ teacher/ parent/ significant other to get started on a task.
5. I have to overcome strong feelings of resistance to start menial or even mildly challenging regular life tasks.

Attention Stability / Distraction Inhibition

A1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. It’s hard for me to stay focused on my work even when I really need to.
2. Once I start an assignment/ task, it's a struggle to sustain my attention and effort through to completion.
3. When I'm interrupted, I find it hard to get back on track.
4. I find myself, after the fact, already engaged in a distractions I had no intention of getting involved with, or didn’t even notice I had started.
5. I find myself “zoning out” on irrelevant thoughts when I need to stay focused.

Planning / Prioritization

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. When I plan out my day or week, it can be difficult to separate priorities from non-priorities.
2. When I have a lot of choices, it's difficult to focus in on the most important things.
3. I don't typically break big tasks or projects down into sub-tasks and timelines.
4. I don't usually put much thought into planning out big projects or tasks and usually just wing it with a rough outline in my head.
5. I don't really have articulated long-term school/career goals or life goals.

Organization

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I'm a pretty disorganized person.
2. I struggle to keep my work areas neat and orderly.
3. Even though I may want to be more organized, I can't seem to set up and maintain systems that work.
4. I go through regular cycles of cleaning or organizing binges followed by long stretches of increasing mess and disorganization.
5. It's a struggle for me to keep physical or digital lists, a planner and/or a calendar to keep track of all the important details of my life.

Time Management

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I find I am late or rushing for work/ school, scheduled appointments and activities.
2. I underestimate how long a trip, task or project will take.
3. My boss/ teacher/ parent/ significant other has to prod me to get something done.
4. I find myself feeling overwhelmed, anxious or angry because I feel like I'm being rushed or unready before I need to get moving or get started on something.
5. I spread myself too thin by thinking I can do more in a window of time than I actually can.

Flexibility

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. Sudden unexpected events or changes in plans make me feel overwhelmed, anxious or angry.
2. Once my schedule or my environment is set up, I really don't like change .
3. I'm pretty resistant to activities, ideas or ways of doing things that are outside my comfort zone.
4. I can become defensive, anxious or resistant when presented with facts or ideas that challenge my positions.
5. I can be a very back-and-white thinker and it's a struggle to change my perceptions, interpretations and opinions.

Self Monitoring / Metacognition

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I don't routinely evaluate my performance or think of ways to improve.
2. I can't easily step back or detach from emotionally charged situations in order to make objective decisions.
3. I don't "read the room" in social or work situations and adjust my behavior based on the reactions of others.
4. I don't really know how I learn best.
5. I experience “wishful” or “catastrophic” thinking, and ruminate on unreal thoughts and fantasies, either positive or negative.

Goal-Directed Persistence / Self-Guiding

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I don't think of myself as being particularly driven to meet goals.
2. I find it hard to forego immediate pleasures and temptations for the sake of my longer-term goals.
3. Achieving the highest levels of performance I can in my chosen field of study or work is not particularly important to me.
4. I can become doubtful and discouraged from my goals by imagined challenges or unforeseen difficulties.
5. If I set a goal for myself and I don't achieve it quickly, my resolve will fade well short of completion.

Stress Tolerance

1 -Disagree / Almost Never

2- Somewhat disagree / Sometimes but not often

3 -Neutral / Sometimes

4 -Somewhat agree / Somewhat frequently

5 - Agree / Frequently

1. I don't work well in competitive, demanding, or fast-paced environments and prefer low stress environments even if they're a little boring.
2. After periods of heightened work/ school pressure, I struggle to let go of the stress and allow myself to recover.
3. I don't know how to, or just don't actively engage in, healthful stress management techniques during periods of high stress.
4. I become shut down or "frozen" when work load or stress levels get too high.
5. I become frustrated and annoyed by everything and everyone, blaming and resenting others when in high stress situations.

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