The Executive Functioning Checklist
Response inhibition (aka impulse control)
Makes careless mistakes just to get work “done”
Gives up as soon as they encounter a problem or challenge
Blurts out answers instead of raising hand
Does all the fun parts of an assignment rst to avoid the hard parts
Starts work before teacher nishes giving directions
Engages in “risky” behavior
Avoids or doesn’t complete homework
Struggles to take turns
Interrupts others while they’re talking
Touches others bodies or possessions without permission
Planning & Prioritizing
Can’t chunk larger assignments into smaller pieces
Doesn’t know where to start on a project or assignment
Gets “stuck” easily
Often turns in assignments late because they underestimated complexity
Prefers multiple choice questions to open-ended responses
Struggles to take notes since everything seems equally important
Has di culty making decisions
Struggles with strategizing and/or multi-step problem solving
Mental exibility
Can become xated on aspects of a routine (wants to sit in the same place, eat the same
food, wear the same clothes, etc)
Struggles with transitions: between classes, activities, home/school, weekend/weekday, etc.
Copes poorly when schedules or routines change
Can become “hyper-focused” on one topic, idea, activity, etc.
Struggles to switch gears
Working Memory
Really struggles to take notes from lectures )writing and listening at the same time)
Experiences “information overload” easily when too much is presented too quickly
Finds mental math especially challenging
Struggles to remember multi-step directions and follow them out
May frequently forget what they were planning to say after raising hand or starting to speak
Might need to read text passages (especially dense or long-winded ones) over and over to
fully comprehend meaning
Struggles with tracking the ow of conversations and participating appropriately
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Emotional Control
Can have angry outbursts at slight provocations
Quick to call things “unfair”
Struggle to preservers thought di culties in homework
Overreacts to negative situations )when disciplined, getting a bad grade, losing a game)
May unexpectedly laugh hysterically or burst into tears
Seems to have rapid mood changes
Appears not to car about others’ feelings
Task Initiation
Doesn’t know where to start on an assignment or project, even if directions were just given
Has trouble focusing again after a break
Procrastinates starting work until the last minute
Finds other things to do instead of work (frequently going to the bathroom, sharpening
pencil, being on phone, etc)
Frequently seen with their head down during work time
Asks for help all the time, even when you know they understand the material and are capable
of the work
Self-Monitoring
Unaware of how much e ort they do or don’t put into their work
Think of grades somewhat magically, and confused/surprised by poor grades
Doesn’t recognize when their behavior negatively a ects others
Talks too loudly or quickly
Might need to be told to sit down, stop touching that, put that down, etc, multiple times
Doesn’t think to check around them to gauge appropriate social behavior
Might unknowingly exhibit “annoying” repetitive behaviors like pencil tapping, knee-
bouncing, or the like, even when others complain
Organization
Frequently loses assignments, supplies, library books, important messages, etc
Doesn’t change behaviors, even if they seem to want to/see consequences for
disorganization
Doesn’t use planners, even if given one
Has a disastrous-looking backpack, bedroom, and/or work space and has trouble nding
anything
Loses electronic les/emails because they can’t remember where they stored them, or under
what le name
Name of child: _____________________________
Person lling out form: ____________________________________________
Relationship to child: _____________________________________________
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