Executive Skills Questionnaire (ESQ) 24

EXECUTIVE SKILLS QUESTIONNAIRE (ESQ) 24

Please answer all 24 questions in the questionaire below then click the Submit button to send your answers to us.

Today's Date	select
Child's First Name
Child's Last Name
Child's Date of Birth	select
Your First Name
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Your Relationship to Child


The following statements describe many behaviors and activities of children. Read each statement and circle the response that best describes your child in the last six months. Select N if the behavior never occurs. Select S if the behavior sometimes occurs. Select O if the behavior often occurs. Select A if the behavior almost always occurs. Please do not skip any items. If you are unsure of the response, give your best estimate. You can change any answer by clicking on another circle.

1. Is easily distracted by noises, activities and other external stimulation.	N	S	O	A
2. Requires constant prompts to continue paying attention.	N	S	O	A
3. Blurts out answers before raising hand in class or in conversations.	N	S	O	A
4. Does not consider the consequences of actions and behaviors.	N	S	O	A

5. Requires ongoing prompts to begin and then continue efforts.	N	S	O	A
6. Has difficulty getting started on daily activities such as waking up or getting dressed.	N	S	O	A
7. Jumps into activities without reading directions.	N	S	O	A
8. Has difficulty with step-by-step directions.	N	S	O	A

9. Gives up quickly when learning new tasks.	N	S	O	A
10. Stops midway through tasks such as doing the dishes or cleaning a bedroom.	N	S	O	A
11. Is stressed by unexpected changes in daily routine.	N	S	O	A
12. Is inflexible and rigid, and gets “stuck” easily.	N	S	O	A

13. Overreacts to insults or teasing.	N	S	O	A
14. Has frequent angry or tearful outbursts.	N	S	O	A
15. Is unable to remember and follow multi-step directions.	N	S	O	A
16. Has difficulty retelling the details of a story in his/her own words.	N	S	O	A

17. Loses money, keys, or other personal items.	N	S	O	A
18. Cannot find homework or assignments.	N	S	O	A
19. Misunderstands how his/her behaviors may impact others.	N	S	O	A
20. Does not review his/her behaviors and learn from mistakes.	N	S	O	A

21. Wastes time while engaged in chores, homework, or activities.	N	S	O	A
22. Is unable to prioritize or understand relative urgency of tasks.	N	S	O	A
23. Has difficulty understanding nonverbal cues or body postures.	N	S	O	A
24. Has difficulty understanding other people’s perspectives.	N	S	O	A

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