Parent / Guardian Survey

Parent / Guardian Survey

You see your teen in contexts no one else does. Rate honestly based on what you observe at home, with homework, and in daily life.

Student

About You

IEP / 504 Context

Executive Functioning Scales

Rate from 1 (significant challenge) to 5 (consistent strength). These ratings set a baseline — not a grade.

Task initiation3

How easily does your teen start homework, chores, or projects on their own?

1 — Significant challenge5 — Consistent strength
Planning3

How well does your teen plan ahead for big projects, tests, or events?

1 — Significant challenge5 — Consistent strength
Organization3

How organized is your teen with backpack, binders, room, and devices?

1 — Significant challenge5 — Consistent strength
Time management3

How well does your teen judge how long things take and finish on time?

1 — Significant challenge5 — Consistent strength
Working memory3

How well does your teen remember instructions, errands, or what they were just doing?

1 — Significant challenge5 — Consistent strength
Self-monitoring3

How well does your teen notice their own mistakes or off-track behavior?

1 — Significant challenge5 — Consistent strength
Emotional regulation3

How well does your teen handle frustration, stress, or disappointment at home?

1 — Significant challenge5 — Consistent strength
Flexibility / shifting3

How well does your teen roll with changes to plans, schedules, or expectations?

1 — Significant challenge5 — Consistent strength
Goal-directed persistence3

How well does your teen stick with a goal over weeks or months without losing steam?

1 — Significant challenge5 — Consistent strength
Self-advocacy3

How comfortable is your teen asking teachers or adults for help when they need it?

1 — Significant challenge5 — Consistent strength

Context & Goals

Anything Else