Tame the Monster of Test Anxiety to Help Students with ADHD

Jed Applerouth

As parents of students with ADHD, many of you understand personally the relationship between ADHD and academic test anxiety.  Test anxiety affects 61% of students at some point during their academic careers. However, students with ADHD are much more likely than their peers to experience it consistently.


Anxiety can hit when:

  • kids are thinking about taking a test,
  • while preparing for the test and
  • during the actual test.

Your child will unconsciously evaluate the degree of threat posed by the test. His or her anxiety response will vary accordingly: the greater the perceived threat, the greater the anxiety.

How does test anxiety work?

Once the brain’s amygdala senses a threat, the sympathetic nervous system goes into gear, setting off a flood of hormones to ready your child to fight, flee, freeze or fold.  The stress hormone, cortisol, is the primary culprit.  Though useful in small doses, as cortisol floods the system, physical stress symptoms cause distraction, and working memory is sacrificed. “Wait.  What did I just read?” In addition to elevated cortisol levels, fearful thoughts interfere with cognitive ability.

What symptoms might my child show?

If your child suffers from test anxiety, you might know some of the tell-tale symptoms: test anxious students are

  • more susceptible to procrastination,
  • spend more time preparing for tests than those with low levels of test anxiety,
  • dedicate up to 40% of their time on task-irrelevant thoughts,
  • perform at a lower level on standardized tests,
  • frequently exhibit poor motivation, and
  • have a more negative self- evaluation than non-anxious students.

What an overlap exists between the symptoms of ADHD and test anxiety! Other behaviors associated with test anxiety follow this same trend. Students with high test anxiety exhibit difficulties with concentration, attention, and memory that interfere with:

  • reading and understanding test directions and items
  • retrieving words, facts, and concepts
  • organizing thoughts and answers

If your student has test anxiety, he or she will have a greater likelihood of performing poorly on tests, even when the content has been studied or previously mastered.  Your child may experience repeated mental blocks or feel overwhelmed during testing.  He or she may seek unnecessary assistance from others, cheat on tests, or feign illness and miss school on testing days.

Research suggests that elementary students are more likely to show physical signs of test anxiety, such as sweaty palms, upset stomach, shallow breathing, muscle tension, elevated heart rate. Older students are more likely to experience behavioral and affective symptoms, such as avoidance or asking many questions. Research also shows that test anxiety increases as students advance through school.

Researchers have found that students with disabilities experience test anxiety at higher rates than their peers without disabilities.  When diagnosing a student with test anxiety, it’s important to consider other potential challenges, such as processing speed deficits, learning differences and skill deficits. During exams, students with LD reported more stress, nervousness, frustration, helplessness, uncertainty and difficulty concentrating than their peers.

Strategies for Managing Test Anxiety

All is not lost! I have personally worked with dozens of test-anxious students and know you can help your kids overcome test anxiety.  Different strategies will work for different students, and you need to be flexible and have a robust bag of tricks.

For students with ADHD, here are some strategies to try:

  • An essential component is taking care of the body as well as the mind.  Sleep and exercise are fundamental for allowing your child to better regulate anxiety and cortisol levels.
  • Cognitive rehearsal, visualizing the “perfect test day” with incredible sensory detail: the more vivid the imagery, the better.
  • Declawing the test: stripping away the power it can hold over the student.  Several of my tutors have taken a copy of the fear-inspiring test, put it on the table in front of their students and spent several minutes mocking and laughing out loud at the test!  It has helped.
  • New research out of the University of Chicago shows that talking about anxiety is good, but 10 minutes of expressive writing about the anxiety is even better for diminishing anxious symptoms.  In writing, the brain is better able to focus and control excessive rumination and unhelpful thoughts.
  • Students can learn the art of relaxation during a test, from deep breathing to clenching and unclenching fists and forced yawning. Students can practice re-centering themselves when they know they’ve missed a question.
  • Another promising modality is an innovative body-centered technique called tapping: information on tapping can be found here and at this site.
  • Positively reframing the symptoms of test anxiety can have a dramatic effect on academic performance.  Explain to students that their physical responses, such as sweaty palms or rapid heartbeat, can be helpful for thinking and reasoning,  Students who have some arousal, some stress, actually perform better!  This reframe can keep students centered and focused on success, even if their body is experiencing some stress.

There are many ways for you to help your child overcome test anxiety.  You may need to try a few before you find the technique(s) that work best for your child.  Be creative and patient, and don’t hesitate to engage the support of teachers, tutors or coaches.  Helping your child develop skills in self-regulation will provide benefits for decades to come.

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