Home What is Adult ADD? Does ADD Exist? ADD Questionnaire How I Treat ADD Questions / Answers Psych/Neuro Tests Adderall vs Ritalin Vyvanse "High" Dose Stimulants Coaching Gems Research on ADD Reminder System ADD and Psychotherapy Getting Help Ask Dr. Schwartz NY City ADD Specialist Marc Schwartz, MD Guide for Clinicians


Executive Function Questionnaire

Executive functions include planning, managing time, remembering, and reasonably controlling emotional states.  The clinician's assessment of an individual's answers to the questions below (and also of the individual's family's answers, if possible) can help determine whether a patient is experiencing a deficit in executive functions.  

For a number of reasons, simply adding up or analyzing an individual's scores on all the questions is not useful for making the diagnosis of ADD.   A common cause of Executive Function Disorder is ADD, but there are other causes as well, such as depression, Alzheimer's, schizophrenia, and anxiety.  In addition, research has shown that two different people often give very different scores about the same individual's executive functions.  Clinical judgment and experience are required to interpret the answers and make the proper diagnosis.   The main value of the questionnaire is to identify issues that are important to consider when carrying out an evaluation and following a person's progress over the course of treatment. 

 

<

Scoring key
Answer how well each statement describes you when you don't use special aids or tricks you have developed to get around or compensate for difficulties you might have.  Score each answer as follows:

 

0 - doesn't describe me at all

 

1 - describes me somewhat

 

2 - describes me pretty well

 

3 - describes me very well

 

 

Score

INITIATION

 

I have trouble getting started doing things

 

I procrastinate

 

 

 

COMPLETION

 

I have trouble completing things

 

 

 

EXECUTION

 

I don't do tasks efficiently (good job in short time)

 

It is hard for me to do two or three tasks in a row.

 

I don't always do what needs to be done.

 

 

 

DISTRACTION

 

I am easily distracted by things I hear or see even when I am trying to concentrate

 

 

 

PERSEVERANCE AND FOCUS

 

I don't stick to tasks that are optional

 

I can't stick to a task even if I have to

 

I often switch from doing one thing to another

 

 

 

INATTENTIVENESS

 

I don't pay attention when I should

 

I day dream/space out

 

I have trouble listening while others speak to me

 

I am absent minded

 

 

 

MEMORY

 

I have trouble remembering things I want to do

 

I get so deeply into one thing that I forget others

 

I have trouble with my short term memory

 

I lose or misplace things

 

 

 

TIME

 

I confuse appointment times

 

I forget appointments

 

I am often late for appointments

 

 

 

FUTURE AWARENESS AND PLANNING

 

I have trouble making plans long in advance

 

I let my gas tank needle get close to empty

 

I rarely get to trains at least 10 minutes early

 

 

 

ORGANIZATION

 

I get disorganized

 

My personal work area is messy

 

I put on my seat belt after the car has started moving

 

I don't prioritize or plan my day

 

I can't work well without structure or direction

 

I have difficulty taking command of my time.

 

I waste a lot of time doing nothing.

 

 

 

PHYSICAL ACTIVITY (HYPERACTIVITY)

 

I need to keep walking, moving around

 

I have trouble sitting still, I fidget

 

 

 

FRUSTRATION/IMPULSIVENESS

 

I get angry easily

 

I am easily frustrated

 

I get impatient easily

 

I interrupt when other people are talking

 

I am impulsive, do things without thinking

 

I don't express or communicate my anger constructively

 

 

 

ANXIETY

 

I focus and concentrate better if I am somewhat anxious.

 

 

 

MULTI-TASKING (parallel)

 

I have trouble doing more than one thing at a time well

 

I often try to do more than one task at a time

 

I tend to make things more complicated than they need to be

 

 

 

MULTI-TASKING (serial)

 

I dislike tasks that require a long series of steps

 

 

 

SLEEP

 

I have trouble getting to sleep because my mind is going

 

 

 

UNCATEGORIZED

 

I get so deeply into one thing that I forget other things I have to do

 

I believe that there is usually a quick solutions to problems

 

I do not like to commit because I don't know how I will feel in the long term

 

 Copyright Marc Schwartz, MD, 2000-2007, New Haven, CT.  All rights reserved.
Version 2.34


Home What is Adult ADD? Does ADD Exist? ADD Questionnaire How I Treat ADD Questions / Answers Psych/Neuro Tests Adderall vs Ritalin Vyvanse "High" Dose Stimulants Coaching Gems Research on ADD Reminder System ADD and Psychotherapy Getting Help Ask Dr. Schwartz NY City ADD Specialist Marc Schwartz, MD Guide for Clinicians