It’s been in the news this morning that a rising number of children are contacting Childline to seek help with exam stress. The children’s charity says it conducted 3,077 counselling sessions about exam stress in the last year, up 9% on 2014/15. It’s an issue that worries me and my children are only 4 and 5 years old. It seems to me that pressure starts at such a young age these days, from what I remember of my school days it was really only when we hit GCSE stage that the heat was on, but I’m finding even very young children are freaking out over spelling tests. We’ve asked psychiatrist Dr Ramya Mohan for her advice.  

In a competitive and relentless world, today’s children and their families are under increasing amounts of pressure to achieve academically. It is understandable that parents and the education systems prioritise this topic, large sums of money are spent to prepare children in the best possible way for exams that could potentially play a key role in their future.

The expectations of parents and society are always rising, which may help some children to reach their full potential. However it may have opposite effect on more emotionally vulnerable children, who may not handle the stress as well.

It is key to identify the signs of exam stress as quickly as possible. Anxiety manifests itself in a number of noticeable ways, sleep disturbances, poor eating, bad mood, increased amounts of worry, lack of confidence and a fear of failing all lead to a premature burnout. The consequences of which can be severe, causing conditions such as depression and eating/sleep disorders.

Small children may experience nightmares or start to show unusually difficult behaviours. For example, a child might suddenly refuse to go to school, or have difficulty in concentrating when they are in school. A loss of enthusiasm for previously enjoyed tasks and hobbies can result in withdrawal and social isolation.

Such behaviour can affect those around the child. Parents, carers and siblings for example may find themselves living in a household with increased tension and emotion, which may lead them to look to the potentially dangerous world of social media for support. This leads to further problems when a lack of support and understanding from family members leads isolation and a real lack of self-confidence.

It is important to recognise and be realistic with a child’s ability and potential. Setting unrealistic expectations can affect a child’s overall development. The role of a parent helps and aids in a child’s progress, but aiming too high can add further pressure on an already pressured child, which causes stress and anxiety. Children manage these emotions in differing ways, but there is potential to cause damage.

The management of exam stress is possible and there are definitive steps that can be taken. One way is to identify from the very beginning the abilities and strengths of a child, along with their temperament and mind-set, to set realistic goals and expectations. Understand your child’s strengths and interests but recognise that the child also has limitations. These limitations can be identified by communicating closely with schools and the parents of other children.

The key is to begin from the very start to create an enjoyable learning environment, where education can be viewed as a joy and not a chore. The learning process can be enhanced and supported by regular communication, practical tasks and a regular, recognised learning environment where the child is permitted to ask questions and be curious.

New research by the American Psychological Association (2012) shows that children may perform better if they are taught that failure is an unavoidable part of learning, rather than being pressured to succeed at all costs.


Around the exam season, pre-planning, being prepared and making organised lists can all greatly help in preventing stress. Good organisation and communication during periods of stress are essential within families and may require frank conversations within the family with clearly agreed actin points before the exam season begins. Obvious but forgettable considerations like reassuring your child that you will drive them to school in time for the exam, or that the office room is always available to them should they need space to study.

The role of creative exercises such as music and art play a key and underestimated part in supporting relaxation, emotional processing, and managing stress during pressured times. Neuro-scientific reviews on the brain, the arts and therapeutic techniques emphasise the role and use of the creative arts in managing emotions in times of stress.

For children with special needs or conditions like ADHD may require access to a quiet space in preparation for, or during exams. It is important to ensure all these factors are prepare long before the time of the exams

Although academic success and the attainment of degrees are viewed as a pass to financial success, ensuring the education of the mind and supporting children’s social and spiritual health will go a long way in their immediate and future lives.

By Dr Ramya Mohan

Dr Ramya Mohan, MRCPsych, is a Senior Consultant Psychiatrist and Medical Educator with the National Health Service UK (NHS) since 2008. Trained and qualified at world-renowned tertiary centres of excellence, Dr Mohan specialises in Child and Adolescent Psychiatry and is an expert within Neurodevelopmental disorders, Developmental Neuropsychiatry and Psychopharmacology.

 Ramya is running a solo art exhibition and a community Art Mosaic project (16-20 May 2016) and launching her novel music-based therapeutic technique CAPE: Creative Arts for Processing Emotions (19th May) during this year’s Mental Health Week.

 Details of the events and her work are on Ramya on Twitter @DrRamyaMohan and Facebook on @Dr Ramya Ramesh Mohan for updates.