Paula Throckmorton gave a science test to her fifth-graders, confident that they knew the material thoroughly. They all flunked. Then she asked them the same questions in an informal discussion, and most gave the correct answers.
Her diagnosis: test anxiety.
Her prescription: a new routine to help everyone relax. Shortly before giving an exam, Throckmorton puts on a pair of Elmo slippers, a banana nose and a funny hat. She turns on classical music and dims the lights for a few minutes to help her students clear their heads.
"I can't tell you, mathematically, that it helps them perform better, but it makes them dread the test less, and we usually do better on things when we are not afraid," Throckmorton said of the unorthodox method, which she has used for four years at Porta Central School in Petersburg, Ill.
Her experience underscores what educators have said is a growing problem at a time when students are being bombarded with exams, standardized or otherwise, whose consequences are greater than ever. And not enough teachers and parents are addressing the problem, experts have said.
Test anxiety is one aspect of "evaluation anxiety," in which mental and physical reactions are triggered in some people when they are being judged, said Mike Malmon-Berg, a clinical psychologist at the Longbrake Student Wellness Center at the College of Wooster in Ohio.
Kelsey Ninneman, 13, a seventh-grader at Belzer Middle School in Indianapolis, said her leg can't stop shaking and her mind "goes blank" when taking a test -- even when she knows the material. Her classmate, Lindsey Collins, 12, said her hands get sweaty, especially during math tests.
For some students, the effects of anxiety are so great that they can't complete standardized tests, said Dianne Campbell, director of assessment and research for the Rockingham County school district in North Carolina. "What I am seeing is that there are increased instances of kids crying during the test . . . or becoming ill," she said. "Or they have to go to the restroom more. And to me, those are symptoms of test anxiety."
Researchers estimate that 20 to 30 percent of American students feel the effects, to varying degrees. The prevalence rises in third through fifth grades and seems to peak in middle school, researchers have said.
Many people never overcome the anxiety, however, and students of all ages are affected, researchers said. Carl Clavadetscher said he sees it in the courses he teaches at National Defense University in Washington; his students are adults in the military.
Some nervousness before an exam is normal and can be helpful, with adrenaline firing up the brain synapses, Malmon-Berg said.
Amy Yelman, 10, a student in Throckmorton's class, said that her "heart starts to pound" when she takes any test, yet she said she is able to do well.
But other students move "past the point where it becomes facilitating to where it becomes inhibiting," Malmon-Berg said. The consequences can include psychological distress, poor cognitive performance, scholastic underachievement and ill health, wrote Moshe Zeider, dean of research at the University of Haifa in Israel, in his book "Test Anxiety: The State of the Art."
Bob Crittenden, executive director of Living Wages, an adult education program in the District, said many of his students working toward a high school diploma blame test anxiety in part for their previous academic failure. For those students, Living Wages offers the "external diploma" program, which involves a form of testing that is less pressure-filled than the GED program. For one thing, the word "test" is not used.
Researchers have said people who have test anxiety tend to be anxious about other things. And though many students who do not know how to study properly are more prone to experience the symptoms, plenty of well-prepared kids said they can't remember a thing when they have to take a test.
Various factors feed the problem. Some kids said they worry that tests are an accurate reflection of how smart they are, even if a test is poorly designed. Other kids said they get anxious because their parents punish them for bad grades. Donna Payton, 12, of Belzer Middle School in Indianapolis said she is grounded for a week if she gets an F.
Psychologists and educators said that learning to feel calm is a key to controlling anxiety-producing thoughts. Students should rephrase such tormenting questions as "What if I fail?" by asking instead, "So what if I fail?"
Students also should reframe their thinking about the consequences of a test, Malmon-Berg said. Even on an exam to get into graduate school, for example, young adults can remind themselves that the application has other parts.
Charles D. Spielberger, director of the University of South Florida's Center for Research in Behavioral Medicine and Health, said counseling often helps, as does learning better test-taking and study skills.
Learning time management saved Clavadetscher, who said that as a young man, he was on the verge of flunking out of the U.S. Military Academy at West Point because of test anxiety. He finished his studies at Montana State University, where a counselor told him in 1963 that he should devise a one-week study plan before tests and prepare outlines of already studied material the night before -- but never learn anything new on the eve of a test. He also started a daily activity log.
"I took control of my life," he said. "We don't teach kids to do that."
Kathleen O'Daniel, a fourth-grade teacher at Mendenhall River Community School in Juneau, Alaska, uses language to take the dread out of tests. She suffered from test anxiety herself from elementary school through college.
"I tell the kids that we won't be having any tests at all this year," she said. "Once they quit cheering, I tell them that we will, occasionally, have 'Zimbabwes' " -- a name she chose arbitrarily. "I explain to them that Zimbabwes are a way for me to know how each of them is coming along and they are not in competition with any other student in the room."
Michele Krouse, a guidance counselor at Galaxy Elementary School in Boynton Beach, Fla., said she gets on the in-house TV every morning to teach students how to meditate, do yoga breathing and "visualize success" to ease test anxiety.
Throckmorton's students said they like her approach.
"It made us less nervous because she was being funny," said Kari Allen, 11, who was a student of Throckmorton's last year. Asked whether it helped her perform better, she said, "Yeah."
Savanna Shafer, 10, a current student of Throckmorton's, said she is looking forward to the Elmo slippers because she studies hard at home but gets nervous anyway.
"It's just kind of like an instinct," she said.