Self-Regulation Questionnaire

1. I have a hard time controlling my temper.
2. I get so frustrated I feel ready to explode.
3. I get upset easily.
4. I am afraid I will lose control over my feelings.
5. I slam doors when I am mad.
6. I develop a plan for all my important goals.
7. I think about the future consequences of my actions.
8. Once I have a goal‚ I make a plan to reach it.
9. I get distracted by little things.
10. As soon as I see things that are not working‚ I do something about it.
11. I get fidgety after a few minutes if I am supposed to sit still.
12. I have a hard time sitting still during important tasks.
13. I find that I bounce my legs or wiggle with objects.
regulate his/her emotions‚ behavior‚ cognitions
This instrument can be found on page 3 of “ASSESSING SELF-REGULATION: A GUIDE FOROUT-OF-SCHOOL TIME PROGRAM PRACTITIONERS”‚ available online at:
Never True = 1‚ Sometimes True = 2‚ Mostly True = 3‚ Always True = 4
Reverse coding items 1‚ 2‚ 3‚ 4‚ 5‚ 8‚ 10‚ 11‚ 12 and 13.
Child’s ability to regulate his/her emotions (items 1‚ 2‚ 3‚ 4‚ 5)‚ behavior (items 9‚ 10‚ 11‚ 12)‚ and cognitions; child’s goal-setting ability (items 6‚ 7‚ and 8)

Novak‚ S.P.‚ & Clayton‚ R. R. (2001). The influence of school environment and self-regulation on transitions between stages of cigarette smoking: A multilevel analysis. Healthy Psychology‚ 20‚ 196-207.

Bandy‚ T. & Moore‚ K. (2010). Assessing self-regulation: A guide for out-of-school time program practitioners. Results-to-Research Brief #2010-23. Child Trends.