The troubles with testing

English: School children doing exams inside a classroom, 1940. Children sitting at their school desks in a classroom doing scholarship examinations, 16 April 1940. (Photo credit: Wikipedia)

Few of us have fond memories of taking tests when we were in school.  I can still remember completely blanking out on one of my final exams in university – one look at the test paper and I totally forgot everything I had studied.  I recall passing the course but just barely.  I still have dreams about failing an exam.

As a general rule, M’s school doesn’t rely on formal testing to evaluate students.  The teachers tend to use more informal methods of assessment.  There are standard tests that are administered in a couple of the grades, but by in large, testing isn’t a focus in the  school.

For a child with ADHD and anxiety, this approach works.  M’s performance is assessed but he isn’t required to sit at a desk and answer questions on a particular subject.   But this week, his teacher has been using a formalized evaluation tool to determine the student’s progress in reading comprehension against standardized norms for his grade.   M’s EA sends us a progress every couple of days, so we knew he was struggling with the evaluation.    We didn’t know how much until M burst into tears at supper.  

According to M, everyone else in the class had finished the questions except him.  He didn’t understand the questions and neither the teacher nor the EA were allowed to help him.   It was clear to us that he was very stressed about the evaluation.  We  tried to help him identify what it was about the process that was distressing him, but after a few minutes of tearful declarations about how dumb the test was, how he didn;t understand the questions and how stupid he was, he decided he didn’t want to talk about it anymore.

This is pretty typical for M – he will get to a certain stage in the discussion and then shut down.  If it is a difficult or upsetting topic, the shut down point will come sooner in the conversation, rather than later.   So it wasn’t surprising when he closed the door on the conversation.

Like most parents, we are not so easily put off.  We also understand that when M gets anxious, even simple things become seemingly impossible.  He is a strong reader and understands most of what he is reading.   Writing, however, is not his strength.  On one level, he probably did understand the questions, but his anxiety about having to write down an answer got in his way.  Since he didn’t even feel he understood what he was being asked to do, he felt doubly inadequate.

Given his exceptionalities, M has an individualized learning plan.  We have had a number of discussions with the school about what sorts of supports and modifications M needs to succeed.  He has a computer in class but apparently he wasn’t using it in this instance.  Why, we aren’t entirely sure.  We haven’t discussed putting in place specific accommodations for tests – more time, a quiet place to do the test, etc – because us until now it hasn’t been an issue.

Interestingly, it was M who identified what he needed – practice at doing tests.  He knows that he will have to do more tests in middle school.  We aren’t exactly sure how we are going to ensure he gets more experience in this area.  First step is identifying the issue.   We need M’s cooperation to come up with a solution, which may take some time.  We need to get beyond the stress and the tears so we can strategize on the best way to tackle the problem.  That will have to wait for another day.

Anxiety? What anxiety?

Image via Wikipedia

A couple of months ago, at the request of the school board, we had M assessed by a psychiatrist. 

Initially, we were told that she was accepting patients into her private practice and depending on her assessment, he might be able to see her for follow-up care. But within the first few minutes of meeting with the psychiatrist, she made it clean that her only role was to provide the assessment, as requested by the board.  If M needed any follow-up, we would need to seek out these services in the community.  Since we have been trying to find a child psychiatrist for a couple of years, this wasn’t terribly helpful.

But we kept an open mind about the process and did our best to answer the psychiatrist’s questions.  As part of the assessment, she also spoke to M and to the principal at his school.

It took a while for the report to arrive.  When it finally did come, it contained a number of recommendations, the most puzzling of which related to his anxiety.  The recommendation began “the parents see the child as anxious” and went on to conclude that once found a medication that better managed his ADHD, any anxiety could be expected to diminish.

The recommendation was supported in the body of the report by the following observations: “the principal did not see M as anxious”  and “M didn’t see himself as anxious”.  Even though we raised it during the interview, the report did not mention that both the psychiatrists in the treatment program M was in a couple of years ago had diagnosed him with anxiety.  Nor was there any reference to the fact that the psychologist M has been seeing since September definitely sees him as anxious. 

The principal’s statement made no sense to us.  She sees M every day and we’ve had numerous discussions about how to help him manage his anxiety.   

But even more confounding was the fact that the psychiatrist appeared to give more weight to M’s perceptions than ours.  He doesn’t think he suffers from anxiety?  He’s 10.  When he gets angry, he punches other kids.  And sometimes he thinks he’s a cat.  I’m all for taking the child’s perception into account, but wouldn’t we, as his parents, have a pretty good idea of whether or not our child is anxious?   

It turns out the that the principal was misquoted – she did tell the psychiatrist that M was anxious but that she wasn’t always certain how much his anxiety played into some of his interactions with his peers. This is a fair observation, because when he lashes out at other kids, it isn’t always obvious to us that he’s anxious, as opposed to pissed off. 

I prepared a long letter back to the psychiatrist and highlighted a number of factual errors and other areas that were problematic for us. To her credit, she responded promptly and made the requested revisions, including a reference to the previous diagnoses of anxiety.

Although the process was a bit frustrating, it was highly instructive.  Perhaps the most important thing we learned is that we know our son better than anyone else.  While the principal may not always see a casual relationship between M’s behaviour and his anxiety, his dad and I know that anxiety is at the root of most of M’s issues, particularly at school and daycare.  But connecting the dots isn’t always easy –  it’s rarely a straight line from point A to point B.  More like start at point P and veer off to point T and then swing back to point F.

The connection between M’s anxiety and how he interacts with the rest of the world was brought back to me earlier in the week when we had to go in and speak to the daycare about his behaviour.  It was clear to me  that M was increasingly anxious about his recent difficulties with a group of boys at daycare (admittedly, totally of his own making).  As a result, the daycare was seeing an escalation in M’s behaviour – he was starting to react  negatively to things the other were saying and jumping to conclusions that weren’t based on any observable evidence, to the point where he was striking out and being verbally and physically aggressive.  After M punched another child earlier this week, for no apparent reason (that they could observe), the daycare staff decided he couldn’t participate in active games for the next couple of weeks.  At first, M was upset, but he didn’t have any additional conflicts this week at the daycare.  By sitting out the active games, he hasn’t had much contact with the group of boys he’s having difficulties with, significantly reducing his anxiety.  It isn’t just his relations with the other kids, it’s the fact that the games are mostly unstructured and a free-for-all.  Not an ideal situation for M, who finds this sort of mass chaos really stressful.  He won’t tell us this, but the fact that he hasn’t yelled rude words or punched anyone since Monday is pretty strong evidence that this is the case.  Plus, the school was starting to see some escalation in his behaviour late last week and early in the week, but things were back to normal (M’s normal) by mid-week.  I did get a call from the school today, but as the principal hastened to tell me, M was not feeling well.  The fact that he was coming down with a cold may also have played a part in some of his struggles this week – we know from experience that M often starts to act out a few days before he actually falls ill.

So the next time someone tries to tell me that M isn’t anxious, I will be as polite as I can and suggest to them what I already know – just because they can figure out what’s causing the anxiety, doesn’t mean it isn’t there.  We just have to look harder and dig a little deeper.

A bump in the road?

Today was not a good day. 

M got into a fight with another child at daycare today.  Apparently, it was unprovoked and M hit the other child several times in the face.  M’s story is different – he accidentally bumped into the boy while playing a game and the other child responded by pushing him and bending his fingers back. It is hard to know what really happened. But as far as the daycare is concerned, M’s is the one whose behaviour is the problem.  

All this stems from the incident a few weeks ago when M used a racial insult in a moment of anger with a group of boys. One of the boys is very hurt and refuses to talk to M, even to let him apologize. For his part, M has not handled the situation well – he continues to follow the other boy around and call him names. He may say he’s sorry, but from the other child’s perspective, M doesn’t seem like he is. He is certainly not walking the talk.

As we explained to the program coordinator and the head councilor today, M is clearly stressed and anxious about this situation.  It doesn’t justify what he is doing, but this has been his pattern for the last several years – M gets anxious about something and starts lashing out.  The program wanted to suspend M but I suggested to them that based on our experiences with the school, this would only add to his anxiety.

In the end, we agreed that M would not be permitted to play active games inside or outside for a couple of weeks. March Break is coming and that may be enough of a break for all the kids.  We have suggested to M that instead of trying to verbally apologize to the child who isn’t speaking to him, he write him a note. M also admitted to us later that he hadn’t eaten his bagel today.  we know from experience that the days when he has the most trouble with other children are the days when he hasn’t eaten his lunch.  So we also suggested that one of the staff check in with him when he arrives to ensure he eats.  We will be reminding him every morning.

I am trying very hard not to be discouraged about the situation.  I told the daycare staff that it was a bump in the road; we had encountered similar hurdles in the past and gotten over them.  But I am not sure I even believe myself.  What if M can’t pull himself together and gets suspended from the program or worse, asked to leave?  I know I am getting ahead of myself, but I certainly got the sense from the program coordinator today that M was on pretty thin ice with the daycare. 

Part of me wonders why my kid can’t do more to help himself.  We have explained to him over and over that he crossed a major line and he can’t force these boys to forgive him.  That he should just leave the boy who is still angry at him alone.  Find another group of kids to hang around with at the daycare. But he is his own worst enemy.  

So at the moment, I am feeling helpless and anxious.  It doesn’t help that I had a multiple migraines in the last few days and feel physically worn out.  I want to crawl back into bed and eat potato chips – not the most mature response.  Rationally, I know we will get through this.  Despite the program coordinator’s view if his recent behaviour, M has gone through much worse.  Emotionally,  however, it is another story.  I know we are doing all the right things for M:  medication, therapy, advocating for him.  But right now, it doesn’t seem like it is making much of a difference.

I know that i will feel better tomorrow morning.  I also know that M is basically a good kid – his aggression comes from fear and anxiety, not an inherent character flaw. But that doesn’t mean I won’t be watching the phone every afternoon for the next 2 weeks, just in case the daycare calls.