Executive Functioning Evaluation Tool

Evaluation Tool

Executive Functioning Evaluation
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Executive Functioning Evaluation

Teacher assessment, student self-assessment, comparison, support plan, and learning plan.

Data Auto-saving
1 — Rarely / Not observed
2 — Emerging / Inconsistent
3 — Developing / Mostly consistent
4 — Proficient / Consistent

Teacher Summary

Rate all items to see overall score and interpretation.

How do YOU think you are doing?

Read each statement and choose the answer that best describes you. There are no wrong answers — be honest!

1 — Not really me
2 — Sometimes me
3 — Usually me
4 — Definitely me!

My Summary

Answer all questions to see your score.

Support Plan

Complete the teacher planning questions below, then fill in the written plan.

Teacher Planning Questions

Select all that apply.


Describe the specific tool, resource, or accommodation you will give the student.


List the instructional steps you will follow to introduce and model the tool.

Weekly Schedule Template

Fill in key times and tasks for each day.

Click “+ add slot” to add more time blocks per day.

Written Support Plan

Goals

Responsibilities & communication

Review date

Big Picture Learning Plan

A goal-based plan to guide student projects and learning journeys.

1. Student Information

2. My Big Goal

Start with the big vision. What do you want to achieve or be able to do?

3. Why This Goal Matters to Me

Understanding why helps keep you motivated.

4. Breaking Down My Goal into Steps

Big goals are easier to achieve when broken into smaller, clear targets.

5. Resources & Support

What will help you succeed? (mentor, book, website, workshop, internship, etc.)

6. Timeline & Milestones

Map out when each step will happen.

7. Evidence of Learning

How will you show what you’ve learned? Select all that apply.

8. Success Indicators

How will I know I’ve achieved my goal?

9. Reflection & Next Steps

Reflecting on what you learned helps build long-term growth.

10. Advisor / Mentor Feedback