Children – Ages 7 to 12

Thinking Efficiency Questionnaire

Children
(Ages 7-12)

Parent Name*
First Last
Child Name*
First Last
Child Age
Phone*
Email*
My child does things (homework, getting ready to go, etc.) at the last minute.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child's room is a mess.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child fails to plan (homework, projects, having supplies, etc.).*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child is easily frustrated.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child confuses left and right.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble following directions.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child makes errors on familiar tasks.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has a hard time expressing herself verbally.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble listening.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble expressing himself in writing.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has frequent emotional outbursts or meltdowns.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child is frequently worried, anxious, moody, and/or irratable.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child is self-critical.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child is not living up to her potential.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has difficulty playing with other children.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble learning new things.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child tends to be pessimistic or have a "can't do" attitude.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble setting goals.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child is continually late.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child takes a long time to complete tasks.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child loses things.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child has trouble remembering.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree
My child makes the same mistakes over and over.*
- Strongly Disagree
- Somewhat Disagree
- Neutral
- Somewhat Agree
- Strongly Agree

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Address:
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Mail:
info@criticalthinkingforsuccess.com
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