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Is your child experiencing headaches, sweating, shakiness, rapid heartbeats, racing thoughts, difficulty concentrating and seeming more on edge than usual? Are they suddenly complaining of stomachaches even though nothing has changed from their diet? Has their sleep schedule suddenly been thrown out of whack? Do these symptoms seem to appear right before an exam and spontaneously end afterwards? Maybe it's a cholinergic crisis or maybe… it's test anxiety. 


Test anxiety affects children of all ages - from 1st grade to high school, adults in post-graduate programs, but especially in teenagers. It can stem from pressure (from themselves or others), high expectations, fear of failure, lack of preparation, past negative experiences or lack of control of the situation. What these factors all share in common is that they can all trigger your body's stress response and put your teen in fight or flight mode. Their body becomes so focused on how they'll survive the threat, that they have trouble thinking clearly or seeing the big picture.


Luckily, while test anxiety may feel scary, it is manageable with proper support. As parents, this means supporting your teen in building resilience, confidence and a positive mindset.


The first step to supporting your teen is to identify their anxiety level. Anxiety does not always look like panic! It can appear as:

  • Emotional signs: irritability, tearfulness, withdrawal
  • Cognitive signs: overthinking, negative self-talk, avoidance
  • Physical signs: headaches, stomachaches, racing heart, trouble sleeping

Encourage your teen to talk about what may be causing them stress. Listen without judgment, acknowledge their concerns and let them know that you are there to support them. 


Here are some tips to help manage their anxiety: 

  1. Shift their mindset
    1. Offer different perspectives - tests are a challenge, not a threat. Mistakes are learning opportunities, not failures.
    2. Provide positive affirmations to replace the negative thoughts. Improvement is only achieved by making mistakes and learning from them. If no mistakes were made, there would be no room to grow!
    3. Try viewing the test as a game. Having a small "prize" (like ice cream) for completing the exam. Not only does this reward them for their effort, but it also gives them something to look forward to
  2. Encourage smarter preparation
    1. Start studying early
    2. Study regularly and in short increments rather than cramming a last-minute long session
    3. Space review of prior topics
    4. Emphasize understanding the material over memorization
    5. Take practice tests and timed exercises
  3. Teach simple stress-management tools to use during the exam – Practice these beforehand to see what works for them
    1. Deep breathing: Inhale for 4, hold for 2, exhale for 6–8
    2. Reciting positive mantras: "This is just a test" "I studied for this." "I can do this" "I have confidence in myself"
    3. Practice the 5-4-3-2-1 grounding method. Have your teen say:
      1. 5 things they see
      2. 4 things they feel
      3. 3 things they hear
      4. 2 things they smell
      5. 1 thing they taste
  4. Support healthy routines – physical and emotional wellbeing are equally important to mental health
    1. Make sure they get enough sleep by encouraging a regular bedtime
    2. Offer balanced, protein-rich meals and prioritize hydration
    3. Encourage regular physical activity and mandatory breaks from studying
  5. Focus on effort, not outcomes – This is one of the best things a parent can do to build long-term confidence, minimize pressure and reduce fear of failure
    1. Praise preparation and persistence
    2. Avoid overemphasizing grades
    3. Celebrate progress, not perfection
  6. What to do on test day:
    1. Keep the morning calm and predictable
    2. Avoid last-minute pressure or heavy discussions
    3. Offer reassurance without over-coaching
    4. Remind them: “You’ve prepared. Just do your best.”
       

Your support, presence, and encouragement are essential for your teen to thrive and succeed!
 

With the right balance of structure, encouragement and perspective, teens can learn to manage anxiety not just for tests, but for future challenges as well.
 

Veronica Dang, DO

Residente de pediatría

Dr. Veronica Dang is a California native who comes to Valley Children's from California Health Sciences University in Clovis and is in her second year of Postgraduate Residency. Dr. Dang is an advocate for improving mental healthcare access and supporting the emotional and psychological needs of developing children. Learn more about Dr. Dang here

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