• Mayo Clinic Q and A: Helping a child with test anxiety

DEAR MAYO CLINIC: My son is 10 and entering the fourth grade. He has struggled in the past with nerves and anxiety, often visiting the school nurse with complaints of a stomachache or headache. Last year, his teacher noted it happened on days when he had tests. What can I do to help him?

ANSWER: It's normal for both adults and children to feel nervous once in a while. A little anxiety prior to an event like a presentation or test is common and normal especially for children and teens.

While feeling a little nervousness before a test can be helpful in that it can sharpen your mind and focus your attention, some people develop test anxiety. This brings feelings of worry and self-doubt that can interfere with concentration and focus, and affect physical and mental health.

While symptoms of test anxiety vary and can include trouble sleeping the night before a test, people such as your son may experience trouble breathing, a stomachache, a headache or even an elevated heart rate.

The challenge for many parents, especially of younger children, is confirming whether a complaint of headache, stomachache or another ailment is related to an actual illness or anxiety.

For younger students such as your son, it may be hard to determine if they are struggling due to test anxiety or other issues. I suggest that you speak to your son first about his concerns. Then you can develop appropriate strategies to help him.

Also, talk to your son's new teacher. It's helpful to alert his teacher that he may have test anxiety. The teacher can provide insight into what is going on in the classroom. This can be valuable if your son is struggling in the moment so that appropriate accommodations can be reviewed.

I also offer these tips to help prepare your son for tests and alleviate mild test anxiety:

  • Be prepared.
    Having ample time to prepare and study is important to reduce stress. Encourage your child to have the materials necessary to study for a test in one place, including books and notes.
  • Be familiar with the test format.
    Is it multiple choice, short answer or an essay? Knowing the type of test and the format can alleviate some anxiety and help with preparation and study habits.
  • Try relaxation techniques.
    Before the big day, try different techniques to help your child ease nervousness.
  • Create a consistent routine before a test.
    This may include a special meal the night before, quiet time to study, turning off the TV early and limiting the use of other electronics.
  • Get plenty of rest and eat well.
    It's important to get a good night's sleep every day, but especially the night before a test. And make sure your son has a good breakfast the day of the test, as well. Avoid sugary foods and drinks, as well as caffeine, which can elevate the heart rate and cause other concentration issues.

If your child's anxiety is not improving or your child seems to be struggling with learning overall, talk to your pediatrician or primary health care provider to determine if your son might benefit from speaking to another professional or if there is something else that needs to be addressed. Dr. Tina Ardon, Family Medicine, Mayo Clinic, Jacksonville, Florida