• (415) 577-4750
  • allison@drwaterworth.com
  • (415) 577-4750
  • allison@drwaterworth.com

The Conundrum of Test Accommodations for Anxiety

The number of young people dealing with anxiety is on the rise. Ask any Director of Student Disability Services and you will hear that there has been an exponential increase in students requesting test accommodations because of anxiety or ‘test anxiety.’

Test anxiety is not a recognized condition in the Diagnostic and Statistical Manual -5th Edition (DSM-5), this being the text which governs the categories for mental health conditions. In the community of educational therapists, test anxiety is a recognized occurrence but not a recognized condition. While some might think of it as a specific phobia, akin to a fear of heights or spiders or elevators, the DSM notes that it is different. Thus, as a psychologist, I cannot conclude a report with a diagnosis of Test Anxiety. That said, I have rarely evaluated a student who reported chronic test anxiety who did not also report other symptoms of anxiety -i.e., generalized anxiety, social anxiety, performance anxiety, obsessive thoughts. Often a student does not realize that he or she is suffering from a larger syndrome of anxiety, locating most of their stress in test anxiety, which feels dramatic and impairing.

The challenge of offering test accommodations for anxiety is inherent in what is known about treating anxiety, or intense fear. Put simply, to treat a fear one must eventually face and conquer it; this is the primary method to curing the fear entirely. One must realize that the fear is irrational and exaggerated and learn to remain calm in the face of it. To treat a fear of flying, for example, one must realize the fear is irrational, that flying is safe, and be taught by a professional how to methodically diminish a panicked response. Treatment of fears and phobias in this manner is highly effective. Extinguishing the freeze (fight or flight) response is challenging for anyone, much less an adolescent who is in the midst of major emotional changes. With proper professional treatment, however, it is highly attainable, for all but the most stubborn forms of anxiety.

It is not rational to be intensely afraid of a test – a test cannot tangibly harm you. “But,” I can hear the student say, “If I fail this test it WILL harm my chances of getting in to a good college.” Actually, failure of one test is unlikely to change the course of one’s future. That said, failure is an essential part of life, and one must be able to cope and deal with it when it occurs. As the adults and professionals who guide students, it is our job to impart the big picture and assist students in coping with failure, not just alleviate their current stress.

Research shows that even when students report substantial test anxiety, their test performance is not appreciably diminished. In other words, while they may feel distressed and on the verge of panic, they continue to think clearly enough to perform to their potential. To quickly offer test accommodations to a student with anxiety will not help them to overcome their fear, though it will lead to an immediate sense of relief -for the student and probably his or her parents. We can probably agree that our current culture fosters comfort and achievement, more so than grit and resilience, though we may opine a desire to foster both.

A thorough assessment from a trained clinician is a valuable tool in determining whether a student possesses the capacity to remain mostly calm in a typical test setting, or whether the anxiety is severe enough to warrant immediate relief in the form of test accommodations. In either scenario, the student should be educated about the nature of anxiety, how it increases like a phobia when left untreated. The student should be educated that the goal will be to return to the classroom setting at some time in the future, once they have learned calming techniques. This lets the student know that we believe in their capacity to manage their feelings and that even if panic occurs, it is not dangerous or life-threatening.