Student Self Assessment-Self Regulation

Please read the following questions then answer each question to the best of your knowledge. If you need help or are unsure of what the question is asking, please ask your teacher for assistance.

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* 1. Please enter your first and last name:

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* 2. What grade are you in?

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* 3. When I have a hard time focusing in school I am able to choose a tool to help me concentrate.

*For example, I practice my breathing, I go and get a drink of water, I use a fidget.

Yes

Sometimes

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* 4. I can ignore distractions and complete my work during class time.

Always

Sometimes

Never

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* 5. I am able to focus on my work without becoming distracted for:

0-5 minutes at a time

5-10 minutes at a time

10-15 minutes at a time

15-20 minutes at a time

Student Self Assessment-Self Regulation

Question Title

* 1. Please enter your first and last name:

Question Title

* 2. What grade are you in?

Question Title

* 3. When I have a hard time focusing in school I am able to choose a tool to help me concentrate. *For example, I practice my breathing, I go and get a drink of water, I use a fidget.

Question Title

* 4. I can ignore distractions and complete my work during class time.

Question Title

* 5. I am able to focus on my work without becoming distracted for:

* 3. When I have a hard time focusing in school I am able to choose a tool to help me concentrate.

*For example, I practice my breathing, I go and get a drink of water, I use a fidget.