Does this lament sound familiar?

Whether you are the parent of a child that is struggling in school or are a college, graduate school or professional school student, if you have ADHD, you may have difficulty in fully demonstrating your mastery of a subject when taking a test. There can be many reasons why a student may be a poor test taker.

Test taking is an anxiety-producing circumstance for many students. It can be difficult for most of us to subject ourselves to being assessed or graded on any area of ability or learning. And the higher the stakes, the higher the anxiety.

Those with ADHD, however, have a second layer of anxiety to deal with; most come into an exam knowing that their brains have been unreliable partners in the past. Most have experienced the panic of a blank page which produces extra panic for those with ADHD have difficulty organizing their thoughts into a coherent, linear argument. Many others have a long history of frustration when they “go blank” and can’t reliably retrieve information that that truly know, but can’t retrieve on cue during in exam.

For those with ADHD, good preparation for an exam is not insurance that they will do well on the exam. They will do well only if their good preparation is combined with a convergence of factors that lead their brain to function optimally during the strictly defined start and stop times of the exam.
Bright individuals with ADHD have certain cognitive styles that may make test-taking difficult. These include:

Having difficulty identifying key information
This is the “can’t see the forest for the trees” phenomenon. Many people with ADHD report that when they study for an exam they study “everything” because it’s hard for them to pick out the essential elements that are critical to learn. Likewise, essay answers may involve a frantic information “dump” rather than a thoughtful, considered and prioritized selection of information selected from a broader body of knowledge.

Difficulty shifting focus
Another common ADHD trait is a tendency to get so involved in one activity that it’s very difficult to disengage and move on to another activity. In an exam, this can play out when you spend far too much time on the first essay question you encounter and don’t leave enough time to adequately answer the other questions.

Difficulty with organization of thoughts
Essay questions, in particular, require us to not only recall information, but to organize that information into a coherent, logical response to the question being asked.

Poor time awareness 
Good test taking requires good time awareness throughout the test. Without consistent time awareness, a student can easily fail to allocate time appropriately in order to have the best chance to answer all questions.

Slow processing speed
While not a “symptom” of ADHD, many with ADHD have what is called “slow processing speed” – processing speed is a term used to describe one’s ability to do fairly rote activities quickly and accurately – something akin to efficiency.

Tendency to make careless errors
Those with ADHD are much more prone to make an accidental mistake – careless errors can include accidentally checking the wrong box or skipping a line on the answer sheet making all subsequent answers incorrect.

Creative divergent thinking patterns can lead to reasons by several choices could possibly be correct.

Working memory challenges impacting the reading of passages of text in an exam
This can make it difficult to recall information contained in complex, densely factual text well enough to answer questions on the text; such working memory problems require the student to read and re-read information, slowing down the test-taking process.

Long-term memory difficulties
Long-term memory difficulties lead to difficulty memorizing and retaining large banks of factual information. Many students with ADHD report that they are able to do well on quizzes and tests that cover a limited amount of material, but find that when several sections of material must be retained and retrieved for a final exam that their memory capacity is exceeded.

Difficulty with reliable, consistent on-cue memory retrieval
ADHD brains are generally very good at seeing the multiple relationships and associations between things, but due to these divergent thought patterns, when a question requires one and only one correct answer, retrieving that answer (a convergent thinking task) can be very difficult. For example, a divergent thinker with ADHD may be able to recount a wealth of fascinating facts about Mark Twain and his role in American literature, but have difficulty recalling, on cue, that his legal name was Samuel Clemens. Other students with ADHD report that they are not able to reliably retrieve information from long-term memory that they know, but can’t recall on cue in the context and time pressure of the exam.

Distractibility
Distractibility makes test taking in a group setting much more challenging; often the student with ADHD is hyper-aware of the noises and movements of other students and may also become distracted and preoccupied as other students complete their exam early and leave the room.

Difficulty following directions
Written directions can be misunderstood or interpreted differently than the teacher’s intentions; parts of multi-step directions can be readily overlooked; and verbal directions can become confused or only partially recalled.

Barriers to retrieval of information and written expression 
Many students with ADHD, at every level, report that they are much better at “telling” information than writing it. “If I could just sit down with the teacher, I could tell him how much I know about this subject,” is a commonly expressed sentiment among many students with ADHD. The multiple demands of spelling, grammar, and more formalized organization of ideas that is expected when writing interfere with a more natural flow of expressing facts and opinions.

Cognitive fatigue
Maintaining focus for those that struggle with internal and external distractibility requires a great deal of cognitive effort; while a student that is not easily distracted can calmly move from one test item to the next, expending relatively little mental energy, the student with ADHD is lifting much heavier “mental weights” in order to maintain his focus. This heavy lifting leads to rapid cognitive fatigue. Need for extended time on tests is not necessarily due to slow processing speed or retrieval difficulties; in many cases, extended time is a highly valid need simply to allow the student time to regularly take a break, stand up, walk around, eat a snack, and get their brain back to optimal functioning.

What can students do to optimize their performance on an exam?

First, get your brain in gear by:
• Getting a good night’s sleep before all exams – sleep deprivation tends to increase ADHD symptoms.
• Ask for extended time in a quiet, non-distracting environment – even if you believe you don’t require extended time, having extra time will help you to be more relaxed and focused and will allow you to take strategic breaks during the exam to relieve cognitive fatigue.
• Ask for afternoon exams as an accommodation – morning exams often lead to students staying up late studying and heading to the exam having had little to no sleep; afternoon exams allow the student to study late into the night and still get a reasonable amount of sleep.
• Request voice recognition software as an accommodations – if you are someone that can express yourself verbally much more easily than in writing, try using voice recognition software to get your “first draft” onto the computer screen. Once you have your ideas dictated it will be much easier to organize and edit them.
• Get an hour of vigorous exercise before your exam. Aerobic exercise changes your brain chemistry, helping your brain to be more focused and alert as well as more calm and ready to think.
• Drink lots of water during the exam.
• Be sure you are taking your stimulant medication and that it will be fully effective throughout the exam.
• As for extended time on exams, even if you think you “don’t need it.” – then set a timer and take a short break every 20 minutes.
• Eat during the exam: taking an exam is mental “heavy lifting” – this mental exertion burns rapidly through the glucose available to the brain. Recent studies show that decision-making is much more difficult for those with low blood glucose levels, so make sure you keep refilling the tank so your brain has plenty of fuel.
• Divide your exam into segments:  then set a timer on your watch to make sure that you don’t spend too much time on any one section of the exam.
• Make time to review, retrieve, and catch careless errors: Often, we can more easily catch mistakes and retrieve information that didn’t come readily to mind earlier when we leave time to go back over the exam, checking for errors.
• When you get stuck, move on. If there is a particular question that you can’t recall the answer to, the best strategy is to move on and come back later at the end when you are reviewing your test.

Bring this checklist of test-taking strategies to the exam with you as a reminder:

Test Taking Strategies Checklist
• Close your eyes, take a deep breath and relax your shoulders
• Open your exam and review it from beginning to end before you start answering questions
• Carefully review directions – re-read them as needed
• Divide the exam into 20-minute segments including an extra segment at the end for review and revision – mark the 15 minute stopping point throughout your text
• Set an alarm for 15 minutes–TAKE A BREAK!–stand up, walk around, waive your arms, stretch, drink water, eat a small snack – do this every 15 minutes during your exam.
Don’t get stuck – MOVE ON!