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Study Skills Survey  (print to use)

 Student_________________________Rated by______________________Date_______

 #

Circle the most accurate number:

Not True

Not Often True

Som Times True

Often True

Almost Always True

1

Student has difficulty knowing what assignments need to be done each day.  

0

 1

 2

 3

 4

2

Student’s notebook is disorganized.

0

 1

 2

 3

 4

3

Student gets poor grades and says he or she “doesn’t have any homework.”

 0

 1

 2

 3

 4

4

Student is getting low grades in relation to true ability.

 0

 1

 2

3

 4

5

Student has poor concentration when doing homework at home

 0

1

2

3

4

6

Student does homework and forgets to turn it in or loses it.

 0

1

2

3

4

7

Student studies with the radio or TV on.

0

1

2

 3

4

8

Student does not plan long-term assignments well.

0

1

2

3

4

9

Student procrastinates or has a hard time getting started studying

0

 1

2

3

4

10

Student becomes angry or defensive when you try to talk about homework.

0

1

2

3

4

                                                                           Add Up Your Score: 

   
Score What it Means:
   

    0-5

Awesome!  The kid’s not human!

  6-10

Excellent

11-15

Good

16-20

Fair -  start home plan or head off trouble with the Academic Skills Workshop

21-25

Intervention advised - enroll in the Academic Skills Workshop

26-30

Intervention strongly advised – enroll in the Academic Skills Workshop

31-35

Urgently needs help -  use Academic Skills Workshop/consider evaluation with Dr. Q

36-40

Educational Crisis! - Consult with Dr. Q for evaluation first.

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