Test Anxiety Strategies

Are There Test Anxiety Strategies That Can Help?

test anxiety strategies, relaxation techniques, test anxiety, relaxation, guided meditation, affirmations

Test Anxiety Strategies - Photo by Tim Gouw

Yes!  There are many test anxiety strategies on how to deal with test anxiety.  First, I'm going to review the causes, the symptoms,  and who gets it before I discuss what test anxiety strategies to use for managing test anxiety.


What is Test Anxiety?

Test anxiety is a feeling someone gets before or during test taking.  It is a type of performance anxiety, that occurs when someone is typically concerned about getting a good outcome.  The result is physical and psychological symptoms that occur before or during tests.  Test anxiety can negatively affect learning and performance.  The good news is there are test anxiety strategies on how to deal with it.  


What Causes Test Anxiety?

It is caused by fear of failure, poor test preparation and/or problematic test taking history.  There is pressure to perform at your best level.  This can motivate the test taker.  However, it may also create fear of failure.  Good test preparation is important for a good test result.  It is also important to prevent test anxiety.  A calm test taker tends to know they've studied to the best of their ability.  They also tend to have studied over time, and not in just a few days or at the last-minute.  If the test taker has had a history of negative experiences with test or poor grades on test, this can also cause anxiety on future tests.


What Are Symptoms of Test Anxiety?

Symptoms are physical, emotional, and/or behavioral.  They range from mild or very intense. 


The physical symptoms may include: headache, nausea, vomiting, diarrhea, fast heart rate, fast breathing rate, feeling like you can't breathe.  If the anxiety is severe enough, a panic attack may occur.  When someone is having a  panic attack, it is generally very debilitating.  A panic attack can make a person feel paralyzed internally or externally, like they can't move, can't talk, & they may feel like they're having a heart attack.


The emotional symptoms may include crying, feeling fear, feeling sadness, and helpless.


The behavioral symptoms may include negative self talk, inability to think clearly, and inability to function.


Who Gets Test Taking Anxiety?

  • Worriers - If your child has a tendency to worry, he/she is more likely to suffer from test anxiety. Even if your child is prepared, your child's worrying could cause test taking anxiety.
  • Perfectionists - If your child aims for self perfection, then he/she is more likely to suffer from test anxiety.  Even if your child does wll in school, the very thought of getting questions wrong, or getting less than an A, leads the perfectionist to have test taking anxiety.
  • Unprepared People - If your child has not learned the subject matter, not practiced with classwork/homework, and/or studied the material, then he/she is more likely to suffer from test anxiety.


How To Manage or Prevent Test Anxiety ?

There are many ways to help your child manage, prevent, and/or minimize test anxiety.  


    Talk About It

  • Ask your child what's making your child feel nervous.
    • Talking about their feelings make children have less anxiety.  Stay calm too as this helps your child stay calm as well
  • Accept mistakes
    • This can be a part of you child's life lessons.  Teaching your child to handle things when the outcome is not what they expected will help them in life, not just in test taking.
  • Boost your child's confidence.
    • Tell them how wonderful they are.  Ask them to give themselves compliments.  What do they like about themselves? About their great brains?
  • Always offer support.
    • Remind your child that you are always there.  Sometimes, they don't want a solution.  Sometimes being a listener is all he/she needs.


    Review Studying Habits & Test Prep

  • Have your child practice on sample tests.
    • Having experience with what the test will feel like will prevent anxiety.
  • Focus on test preparation.
    • Establish a routine for studying and preparing for the upcoming test is very helpful.  Studying a little bit at a time, over a set time period.  It is usually better than craming it in the day before the test.  It also also for better retention of the facts.  
  • Learn your child's best study habits.
    • When does he/she study best?  Is it morning, afternoon, or night?  
    • Does he/she need breaks? 
    • Could hunger be slowing his/her learning/studying? Consider snack breaks in between studying.
    • Does he/she need to do something physical or move around in between studying.
  • Review test taking strategies.
    • Teach your child what to do if they are stuck on a test question.  If they can't answer one, then teach them to mark the question and move on.  They can get back to it later.  
  • Help your child feel their best the day of an exam 
  • Review all methods and test after the test is complete.
    • What were your child's strengths on the test?  Where are their weaknesses?  How could he/she have improved test prep?  What did he/she do that was just right?  What can he/she do again the next time?  Or do differently?  Ask them to evaluate this with you.

    Sleep & Screen Time

  • Find your child's best number of sleep hours.
    • Does your child need eight (8) hours a night?  Ten (10)?  Twelve (12)? Try to make sure they get their best sleep before tests.
  • Monitor your child's screen time.
    • If your child has too much screen time, especially at night, or the days or week before an important test can do more harm than good.

    Relaxation, Guided Meditation & Affirmations

  • Practice relaxation techniques.
    • Deep breathing 
    • Taking a bath
    • Listening to relaxing music
    • Create art.  Drawing and/or coloring is fun and relaxing.
    • Play a board game that's fun with the family the day before the exam.
    • Watch a funny movie with your child.  Sometimes, laughter is the best medicine.
  • Use Guided Meditation.
    • I recommend and use, I Am Peace, by Susan Verde.  This is a wonderful book.  It is geared for children.  I think it's a great book for any age.  The last page has a Guided Meditation.  I've read this out loud to my son while he is lying down with his eyes closed.  I must say that both he and I are relaxed at the end, every time.
    • The Balloon
    • Follow the Leader
  • Use Affirmations

E-Cigarette Cancer & Juuling in Teens

What Are E-Cigarettes (E-Cigs)?

E-Cigarette Cancer Increased in Teens unsafe

E-Cigarette Cancer Increased in Teens

E-cigarette cancer chemicals have increased in teens.  Before we get into the details, let's review the background of E-cigarettes.  E-cigs are electronic cigarettes that have liquids that contain many chemicals including nicotine, and fruity and other flavors.  They are battery-powered and mimic cigarettes, but don't have the smell of smoke.  The liquid changes into a vapor due to the heat in an e-cig.  Hence, it’s also called “vaping.”


What is Juuling?

There is a new teen trend called “Juuling.”  Juuling is an e-cig that is thin, looks like a flash drive, and charge in a USB port.  A juul produces less smoke which disappears more quickly. Hence, teens are able to juul at school and home without parents’ knowledge.  In comparison to smoking cigarettes, one juul pod (cartridge) has as much nicotine as a pack of cigarettes.


What are the Signs if Your Teen is Juuling?

The signs of e-cigarette smoking & juuling are:

  •     Increased thirst
  •     Sore throat
  •     Caffeine sensitivity - they decrease their caffeine intake.
  •     Nosebleeds
  •     Higher rates of pneumonia


E-Cigarette Cancer Causing Chemicals

Juul Looks Like a Flashdrive

Juul Looks Like a Flashdrive

They’ve been advertised as a safe alternative to cigarettes.  They’ve also been advertised as an aid to stopping smoking.  Since e-cigs don't burn tobacco, they don't burn the same amounts of tar ans carbon monoxide.  However, e-cigarettes are unsafe, contain high levels of nicotine, and do not help in smoking cessation.  E-cigs and juuls have many cancer-causing chemicals (acrylonitrile, acrolein, acrylamide, benzene and ethylene and propylene oxide, and crotonaldehyde).


Study Showed E-Cigarette Cancer Chemicals Increased in Teens


In a recent study of 100 teens from the San Francisco Bay area by the University of California-San Francisco study: 67 teens used e-cigs only, 16 used both e-cigs and conventional cigs and 20 didn't smoke or vape at all.  Urine and salivary gland fluids tested positive for cancer-causing chemicals in teen smokers.  It revealed that teens who used e-cigs and cigarettes had three (3) times higher amounts of these e-cigarette cancer causing chemicals in their body fluids as compared to the teens that used only e-cigs.  It revealed that the teens that used e-cigs only had three (3) times higher amounts of these e-cigarette cancer causing chemicals in their body fluids as compared to the teens that didn't smoke at all.  Lastly, the study also showed that teens who used fruit-flavored e-cigarettes had significantly elevated levels of acrylonitrile as compared with those who used other flavors, such as menthol. 


Is Advertising Increasing E-Cig Usage by Teens?

The CDC has reported that teens view ads for e-cigarettes more than before; the exposure increased from about 69% in 2014 to about 78% in 2016.  Retail stores have exposed teens to e-cigs the most in comparison to other ads like those found on TV, internet, or magazines.  Since studies show that ads for tobacco products show increased use by teens, it is very likely that ads for e-cigs are also increasing use among teens.


FDA Sued for Delay in E-Cig Regulations

The American Academy of Pediatrics (AAP) and its Maryland chapter, the Campaign for Tobacco-Free Kids, four other public health groups and five pediatricians filed a lawsuit against the FDA for delaying submission product-review applications for cigars and e-cigarettes until August 2021 and August 2022, respectively. This leaves children at increased risk of cancer and other negative side effects from e-cigs.


Learn & Talk About the Risks of E-Cigarettes with Your Kids


It is important to learn all about the signs, symptoms, and risks associated with e-cigarettes.  The U.S. Surgeon General has created a website with lots of information about e-cigs and how to talk to your kids about this.  Remind them to respect their bodies and care for themselves.  Positivity goes a long way.  Talk to them today about e-cigarette cancer in teens. 


Sexual Abuse Gymnastics Scandal

Sexual Abuse by MSU’s Former Dean on Medical Students

Olympics Sexual Abuse, Michigan, Female Athletes, Female Medical Students

Olympics Sexual Abuse -  Photo by Claudia Soraya on Unsplash

On Tuesday, March 27, 2018, William Strampel, former dean of Michigan State University's (MSU) osteopathic medical school from 2002 to 2017, was arrested Monday evening and taken to jail on four charges — one felony and three misdemeanors.  He was charged with sexual assault and sexual harassment against four (4) former medical students at MSU.  He also failed to deal appropriately with complaints about Larry Nassar.  The Michigan Attorney General’s Office has an ongoing investigation of the role others at the school may have played in crimes committed by Mr. Nassar, the former MSU and USA Gymnastics physician accused by more than 250 girls and women of sexual abuse. 

Nassar Sentencings

In January 2018, Former U.S. Olympics Medical Doctor, Nassar was sentenced to 175 years for sexual abuse of over 250 female athletes.  Prior to that he was sentenced to 60 years jail time for ownership of thousands of images of child pornography.  

Nassar Coverup

How did he do so much to so many young girls and ladies? He sexually abused over 250 girls and women.  Surely, people knew.  Now, Strampel, his ex-boss at MSU Medical School has been charged with sexual assault and harassment of female medical school students.  Nassar was USA Gymnastics' national medical coordinator since 1996 until he was fired in 2015.  In April 2014, when Amanda Thomashow, a MSU student, complained about Nassar's sexual abuse of her on campus, Mr. Strampel stopped Nassar from treating students for two (2) months, then came up with protocols, in order to prevent the same "misunderstanding" from happening again.  However, Strampel never told anyone at MSU or the authorities the accusations, Nassar's conduct, or Strampel's plans.  In August, only two (2) months later, another woman complained again.  Nassar admitted he didn't follow any of Strampel's guidelines. 

Nassar Fired

One has to wonder why?  Simply, Strampel admitted to Michigan State police and the FBI that he never followed up to see if Nassar was following the protocols.  Protecting MSU's reputation may have indeed had something to do with it.  However, Strampel was also protecting himself.  Authorities have since found evidence to Strampel’s own crimes on his work computer.  Allegedly, investigators found about 50 photos of pornography, many of them he solicited from MSU students Also, shockingly, a video of Nassar performing “treatment” on a young female patient. So Strampel knew all along, but did nothing to stop, prevent, or report it.  Clearly, he was protecting himself.

Female Gymnastics Athletes Accuse Nassar

Mr. Nassar's sexual abuse of female athletes was not limited to USA Gymnastics, it also included his time spent with the USA Olympic team at Karolyi Ranch (now closed, former US Women's National Team Training Center and a US Olympic Training Site), MSU, Twistars gymnastics club in Michigan, his office, and his home, sometimes while parents were in the room.  He'd explain that his intravaginal therapy was medical treatment for their hip and physical injuries.  However, even if there weren't hip injuries, he would still perform his intravaginal treatments.  He also didn't use exam gloves.

Female Gymnastics Athletes Resist Nassar’s “Treatment”

These young girls felt uncomfortable with his treatments, but didn't know that it was sexual abuse.  They didn't want his treatments anymore.  Mattie Larson gave herself a head injury in order to avoid going to Karolyi Ranch.  She was abused from the time she was 14 years old for five (5) years until she retired in 2011 at 19 years old.  Olympic Gold medaist, Aly Raisman was one of many young women who confronted Larry Nassar in court prior to his sentencing regarding the sexual abuse.  She had spoken in a most compelling, strong and determined manner.  The video of Aly Raisman's court speech is compelling beyond words.  Other Olympic gold gymnasts, Simon Biles and Gabby Douglas state they were abused by Nassar as well.  Lawsuits by Aly Raisman and another olympic gymnast, McKayla Maroney have been filed against MSU, USOC, and USA Gymnastics. 

First Male Gymnastics Athlete Accuses Nassar

On March 2, 2018, Jacob Moore became the first male athlete to accuse Nassar of sexual abuse. How many other men will follow?  Time will tell; but I wouldn’t doubt that there’s many more.  He and his sister filed a lawsuit against, stating they were sexually abused and harassed by Nassar.  Moore, his sister, along with 200 women filed a federal lawsuit against Nassar, USA Gymnastics and MSU. Moore states that Nassar brought Moore to his basement treating his shoulder injury with genital and pubic acupuncture.

Fallout from the Scandal

In the fallout of the scandal, many more people in position of high authority in their perspective organizations have resigned, been suspended, or fired.  Their involvement, lack of action, suppression of information, ability to ignore and look away, essentially helped  Nassar commit his many crimes against these ladies.  MSU's President Lou Anna Simon and Athletic Director Mark Hollis, USA Gymnastics Board of Directors’ Chairman Paul Parilla, Vice Chairman Jay Binder and Treasurer Bitsy Kelley all resigned after Mr. Nasar'sNasar's sentencing.  USA Gymnastics suspended former U.S. women’s national team coach John Geddert, the owner of the Twistars. US Olympic Committee (USOC) CEO Scott Blackmun resigned as well. How many more will fall?  Undoubtedly many more will fall.  Wait and see.  

Talking to My Patients About Sexual Abuse?

It is important to talk to both our daughters and our sons about sexual abuse.  It’s important to discuss details. Of course, age appropriate conversations need to take place.  As a pediatrician, whenever it’s time to examine genitalia, I’ve always done so with the parent/trusted adult in the exam room.  I talk with children about feeling safe when a parent or a trusted adult is around, that know one should look at you, touch you, or touch your private boy/girl parts, mouth, or bottom alone, not even a girl doctor like me. 

How Do I Talk with My Kids about Sexual Abuse?

On a personal note, we have had this conversation with our son several times since he was seven (7) years old.  The talk has changed over the years.  As his body self-awareness increased, suddenly, I realized I was only discussing his “front” genitalia.  One day, I asked my young son, “What if someone wants to touch you butt?  What if they want to put something in your mouth?”  Shockingly, his young self said, “Okay.”  I had to teach him that it wasn’t okay.  Does Mommy or Daddy every put anything in your mouth?  Your butt? Then, he realized it wasn’t okay.  

Nowadays, I talk with him directly about Larry Nassar, how he groomed these girls and the boys, the horrible secrecy, the bravery of the girls and the boys who tell their stories.   Frankly, he needs to know that these monsters exist, that they don’t look like monsters, that their friendly at first, until they trap you.  But they can be stopped. He can avoid them, and needs to talk about them just like these women and young man did. 

I’ve also taught him that if he sees something happening to someone else, he needs to say something.  Children sometimes don’t want anyone to know what they’ve seen. They may not feel safe.  They may not feel their parents can be safe if they tell.  So, it’s important to let them know that abuse can be reported anonymously by calling 1-800-FL-ABUSE.  Silence is dangerous.  

How to Talk About Sexual Abuse with Your Children

It is so important to talk with our children about sexual abuse.  These brave young girls, women, and young man have helped open doors to this conversation.  No one ever thinks it will happen to their children.  Usually, it's by someone the child knows, as opposed to a total stranger.  In fact, the sexual abuser usually grooms them to make them feel special.  The MeToo Movement showcases exactly how important it is for parents to discuss sexual abuse with their children.  It is an uncomfortable discussion.  But it’s never enough conversation.  Repetition over the different ages is crucial, as children’s understanding increases with age.  Parents are the key.  Reading the AAP article about sexual abuse can help you start this conversation, recognize risk factors, and prevent sexual abuse from happening to your children.  Talk about it, the abuse you talk about today may be the abuse you prevent tomorrow.

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