WEBSITE Executive Skills Questionnaire for Children (PreK-K)

Executive Skills Questionnaire for Children (Preschool/Kindergarten)

Adapted from: Dawson & Guare, 2009
Name

First NameLast Name
Email
example@example.com
Date

MonthDayYear
Date
1) Acts appropriately in some situations where danger is obvious (e.g., avoiding hot stove).
2) Can share toys without grabbing.
3) Can wait for a short period of time when instructed by an adult.
4) Runs simple errands (e.g., gets shoes from bedroom when asked).
5) Remembers instructions just given.
6) Follows two steps of a routine with only one prompt per step.
7) Can recover fairly quickly from a disappointment or change in plans.
8) Is able to use nonphysical solutions when another child takes toy away.
9) Can play in a group without becoming overly excited.
10) Can complete a 5-minute chore (may need supervision).
11) Can sit through preschool "circle time" (15-20 minutes).
12) Can listen to one to two stories at a sitting.
13) Will follow an adult directive right after it is given.
14) Will stop playing to follow and adult instruction when directed.
15) Is able to start getting ready for bed at set time with one reminder
16) Can finish one task or activity before beginning another.
17) Is able to follow a brief routine or plan developed by someone else (with model or demo).
18) Can complete a simple art project with more than one step.
19) Hangs up coat in appropriate place (may need one reminder).
20) Puts toys in proper location (with reminder).
21) Clears off place setting after eating (may need one reminder).
22) Can complete daily routines without dawdling (with some cues/reminders).
23) Can speed up and finish something more quickly when given a reason to do so.
24) Can finish a small chore within time limits (.e.g., make bed before turning on tv).
25) Will direct other children in play or pretend play activities.
26) Will seek assistance in conflict resolution for a desired item.
27) Will try more than one solution to get to a simple goal.
28) Is able to adjust to change in plans or routines (may need warning).
29) Recovers quickly from minor disappointments.
30) Is willing to share toys with others.
31) Can make minor adjustment in construction project or puzzle when first attempt fails.
32) Can find novel (but simple) use of a tool to solve a problem.
33) Makes suggestions to another child for how to fix something.
Calculation
1-3 Response Inhibition
Calculation
4-6 Working Memory
Calculation
7-9 Emotional Control
Calculation
10-12 Sustained Attention
Calculation
13-15 Task Initiation
Calculation
16-18 Planning/Prioritization
Calculation
19-21 Organization
Calculation
22-24 Time Management
Calculation
25-27 Goal-Directed Persistence
Calculation
28-30 Flexibility
Calculation
31-33 Metacognition
Should be Empty:

Executive Skills Questionnaire for Children (Preschool/Kindergarten)