Joey Wahler (Host): It impacts a great number of students during childhood, so we're discussing test anxiety. Our guest is Dr. Colleen Cornelius. She's an Assistant Professor of Pediatrics for UK HealthCare.

This is Uk HealthCast, a podcast presented by UK HealthCare. Thanks for joining us. I'm Joey Wahler. Hi, Dr. Cornelius. Welcome.

Colleen Cornelius, PhD: Hi. Thanks so much for having me.

Host: Absolutely. Glad you could be with us. And this is a topic I've not tackled before, obviously, it's something you do all the time. So first, just how common is test anxiety among children?

Colleen Cornelius, PhD: Well, it's actually quite common, as many as 40% of kids experience test anxiety. So if you think about it, any given classroom, a classroom of 30 kids, there are a little fewer than 15 that will be experiencing test anxiety at some point. And test anxiety, if we're talking about what it is, it's the feeling of uneasiness or dread before, during, and even after taking a test, that obsessing over how you're going to do, how you did. Some people experience so much worry surrounding tests that it interferes with their ability to think and do their best on a test. And it impacts those with low grades, but also those with a 4.0 GPA. So, this time of year, test anxiety becomes a big issue as we're talking about AP exams and state testing, end of semester exams, all approaching in addition to the regular tests that occur daily in the classroom.

Host: Indeed. Just you mentioning those different tests has given me a little bit of anxiety feeling right now, thinking back to to back in the day. So to pick up on that, when does normal nervousness over an upcoming school test or after one crossover into anxiety? What are those symptoms?

Colleen Cornelius, PhD: Anxiety is normal to have for test time. I think a lot of times, we think or children think that they should be calm when it comes to test time. But when it comes to the point, a little bit of anxiety is good. It helps with energizing and focusing for a test. But when it comes to the point that kids can no longer focus, can no longer perform their best, that's when you know you've crossed over the line a little bit.

Host: Speaking of which, at what age would you say students can start having these feelings of beyond anxiousness, if you will, about a test?

Colleen Cornelius, PhD: You can see it in really young kids, elementary school kids, middle school kids, high school, college kids. You'll see it all through the ages as kids are being asked to perform in the classroom. I think it's really Important for parents. As you think about your kids, some kids are able to really articulate how terrified they may be about performance at school. Others may have behaviors and symptoms that parents can observe. School avoidance, trouble sleeping, headaches, stomach aches, all of those can also be symptoms of test anxiety or performance anxiety in school.

Host: So specifically, what type of kid does this typically impact most? Is there any particular profile, if you will?

Colleen Cornelius, PhD: Certainly, you're going to see it a lot with children who are very anxious in general, who are perfectionists, very high achievers in the classroom. Certainly, those kids who want to perform well for their teachers, for their parents, you're going to see it in them as well. anybody who holds something important to them. There's a chance that test anxiety might be something that would arise.

Host: It is interesting that you say it might impact those that excel more than those that don't. I would think kids that are not as prepared as they should be for a test would have more pangs of anxiousness than those that are getting straight A's, but not the case necessarily, right?

Colleen Cornelius, PhD: Absolutely not. And it's interesting that you should say that because, although test anxiety may impact kids who are not properly prepared for a test, really, test anxiety causes or happens with kids who believe they're not properly prepared for a test. So, they may actually be very well prepared. They just think that they're not. In that sense, it may be that child who has a 4.0 who has convinced themselves that even though they studied for days on end, that they are not prepared for the test. And so, they go into the test very anxious.

Host: Where would you say this pressure feeling, so to speak, typically comes from? What causes it? What's behind it?

Colleen Cornelius, PhD: It can come from a lot of different areas. Intrinsically, kids may believe that they need to be the best in the classroom, that they need to perform the best. It may be peer driven in what their friends and other classmates are doing. It can come from home and what brothers and sisters are doing, or family expectations. There's so many different sources that it can come from. And it's important to really think about all of the different areas of a child's life and how they can impact that child in the classroom.

Host: Gotcha. And so, that being said, any advice for parents and family siblings perhaps to help mitigate this over anxiousness for a student to help prevent or lessen it?

Colleen Cornelius, PhD: Absolutely. I've got four tips or tricks that families can use. The first is encouraging really good study habits. Some children may not study enough, but others may not be studying effectively, highlighting rereading texts or some of the most inefficient ways to study. So, teaching your child effective study methods, like taking practice tests can be really helpful. Quizzing themselves and also coming up with, and then answering questions are super effective techniques. Spreading out studying across several days, that's important too. It really helps kids learn pathways back to the information they learned the day before and allows kids to sleep, which is when memory transfers short-term to long term.

Another thing that we can do is we can help kids think about how they're going to prepare for the actual test day. So, arrive early so you're not rushing to class. Skim questions before you're actually beginning that test so you know what's expected of you when you're taking that test. Do what I call a brain dump. All the information that you've been holding in your head. Equations, dates, formulas, put it down on the test itself, up in the corner, down at the bottom of the page, so that you can really clear your mind and focus on what the test is asking you. Read directions carefully. Circle, underline key words. Mark questions that you wanna return to later so you're not spending too much time on any one piece. Leave time to double check answers. Use positive self-talk. I think it's important that we encourage our kids to do this as well. Having kids say to themself, "I prepared really well for this test. I can make this happen. This is just one test of many this grading period," can all be helpful. And then lastly, get a good night's sleep the night before. Remembering that sleep is very important for your ability to focus that next day.

My third tip is understanding-- and we talked a little bit about this already-- but understanding that anxiety can actually be a good thing. It can help improve test performance by energizing and focusing that test taker. So, what children often think is that they should be really calm before and during a test. And when they aren't, they become anxious. And then, they become anxious about their anxiousness, which causes that downward spiral. So, encouraging our kids to expect and accept some anxiety as simply part of the testing process I think can really be helpful.

And then, the last tip, the fourth one is use strategies to help control anxiety when those other tips aren't working. So if anxiety is becoming too overwhelming, it can be managed with strategies such as controlled breathing. Anxiety itself causes us to have quick shallow breathing, which makes us feel panicked. Deep slow breathing sends a calming signal to the brain, which helps to reduce anxiety. You can google deep breathing techniques such as box breathing or finger breathing and practice using them with your child at home when they're really calm so that they can use them when they're in the classroom, when they're anxious. There are all kinds of numerous apps available to help as well, such as Calm, Headspace, MindShift, Smiling Mind that can actually walk children through controlled breathing and other coping strategies as well. And those could be useful to controlling anxiety somewhat.

Host: Great advice indeed. And so a couple of other things for you, including going back for a moment to something you touched on earlier. You said that this often starts for kids from the earliest grades in school. How about in preschool or pre-kindergarten? Perhaps there aren't tests as we know them a few years later, but can the groundwork be laid there in some way as parents or even teachers to help avoid that test anxiety in a more formal sense a little bit later on? How does it start?

Colleen Cornelius, PhD: So, I think, as parents, what we really can do to help our kids and give our kids the right mindset as they're heading into those school years is to really focus on their effort rather than the final outcome, right? "As long as you try your best, then mom and dad are going to be so proud of you. I just want you to work really hard and try your best at school today, and I'm not concerned about what the end result is." And I think if we go ahead and lay the groundwork there with effort versus outcome, that can help kids along the way.

Host: If needed, which resources should parents take advantage of to help their kids with this?

Colleen Cornelius, PhD: Certainly, the internet has a lot to offer, but other things or other people to consider, if symptoms, anxieties continues to spike is reach out to your child's teacher, reach out to the school counselor. A therapist can help your child with tips and tricks, and really work through test anxiety.

I think the big thing to think about as parents is test anxiety is not uncommon. And it's something that doesn't have to be permanent. So, there are resources, there is help available. Reaching out for it as soon as you start to see that what you're trying at home isn't helping is the perfect time.

Host: And then in summary, Dr. Cornelius, generally speaking here, you've been very positive and we love that about the different many things really that can be done to address all this. What would you say, generally speaking, the chances are of successfully addressing the situation when kids with test anxiety have it going too far as we've discussed?

Colleen Cornelius, PhD: I think that certainly there's a lot of research that proves that if the child and the parents are willing to try the strategies that are available, that it is absolutely possible that children can overcome test anxiety and can move forward. And certainly, if problems continue, then making sure you're reaching out to a professional that can continue to help and support that child, because it does not have to be something that the child has and forever is burdened with.

Host: Well, folks, we trust you are now more familiar with avoiding and addressing too much test anxiety. Dr. Colleen Cornelius, valuable information. Indeed, I feel better already. I don't know if I've got another test in my future. But if I do, I'm ready. Thanks so much again,

Colleen Cornelius, PhD: Thank you.

Host: And for more information, please do visit ukhealthcare.uky.edu. Now, if you found this podcast helpful, please do share it on your social media. And thanks so much again for being part of UK HealthCast, a podcast from UK HealthCare.