Testing: From Birth to COVID

The Apgar test for newborns wasn’t developed until after I was born. I’m sure if it were in use at that time, I would have worried that I might not do well.

I always worried about how I would do on tests. Throughout my school career I studied hard, often cramming the night before an important exam. And I generally did very well … but that never reduced my anxiety about the next test. I scored high on achievement and IQ tests taken in the 4th grade and since the school had no programming for “gifted” children, this led to my skipping a whole grade. This was probably not the best thing for my emotional development, since I was now in a class where I didn’t know anyone, and all the other students were older than me.  I learned that doing well on tests would not necessarily put me in a place where I was happier.

As I moved along in my school career, tests started having greater importance. Achievement tests determined that I got into a Special Progress class in junior high school, meaning that I did the three years, 7^th-9^th grades, in only two (skipping another year!). A little later, the SAT score influenced my college admission and the GRE was needed for graduate school.  I prepared and did well on these tests, even with the angst that surrounded them for me. I looked forward to a time when I would no longer have to take tests.

But other types of tests played important roles in my academic career. A Spanish language placement test determined which language class I would take in my college freshman year. I was ambivalent about how well I wanted to do on this one; in addition to my general need to do as well as I could on any test, I knew that if I did really well, I might be in a class with students who I couldn’t keep up with. As it turned out, I scored well on this test and was placed in a class focusing on Spanish literature, including reading Cervantes’ Don Quixote in Spanish. Too bad- I think an advanced Spanish conversation class would have been more useful. This was another time that doing well may not have gotten me the best outcome.

Throughout my student years I had various kinds of written tests- multiple choice, fill-in, true/false, essay, open-book and take home. I preferred multiple choice as I could often recognize the correct answer to difficult questions, and I usually knew how well I did by the end of the exam. My most important oral test was my dissertation defense. I was so well-prepared for that one, once it was over I felt I wanted them to ask me more questions. I knew I would likely never again be called upon to draw on that knowledge. It was the only time I ever wanted the testing to continue.

And there have been other kinds of tests I became familiar with. I needed to take a licensure test to get my driving license- written and road tests. I studied and prepared for these, but the angst was minimal, as I knew I could simply take them again if needed. And when I sought counseling, I was given psychological tests, including personality tests and even a projective test.  As a behavioral research scientist I also administered tests to study participants, including attitude tests and scales to measure psychological status. These were all helpful in trying to understand participants’ behaviors and views. It seemed that tests were part of my everyday life.

When I became pregnant, a new set of tests were needed after the actual pregnancy test. There was amniocentesis for genetic defects, ultrasound to help monitor the pregnancy and frequent blood tests to screen for potential conditions harmful to the fetus. In addition, since my husband and I are both Ashkenazi Jews, we were tested for Tay Sachs, as we were at higher risk for this genetic disease. Although this is now detected through a blood test, at that time the test required the collection of tears. These pregnancy/fetal tests all raised new concerns, especially since I had no control over the outcomes. There was no way to study or prepare to have a good outcome and the potential impact was not just for me- it could have profound impact on the child I was carrying and my family.

As I got older and began having an annual physical, other kinds of testing became important in my life – diagnostic tests to identify any health problems. These included regular blood tests and procedures such as mammograms.

I am now reaching the age where some of this testing is no longer recommended.  As I have no family history of cancer- mammograms, colonoscopy and pap smears are not considered necessary for my age group. I think this is because if these cancers are first detected later in life, chances are they will progress slowly and are not likely to be fatal. In other words, I am likely to die of something else and the benefits of testing no longer outweigh the risks.

So, although vision and hearing tests continue as I age, since acuity of these senses have begun to decline, I thought my testing needs were diminishing. But I was wrong. First – any testing now seems to involve referral for further testing or assessment. Vision testing led to the need to evaluate me for cataract surgery, and blood testing identified the need for monitoring my cholesterol and for treatment of a rare bone condition (Paget’s disease). It’s clear that my testing days will continue.  And COVID has introduced a whole new level of testing needs. The recommendations and requirements for COVID testing mean that I now test before and after going on plane trips and prior to doctors’ appointment. The recent surge in COVID omicron variant infections has led to requests for testing prior to going to events with family and friends. I even keep a stash of home testing kits for easy access.

I have concluded that there are several major categories of testing: for academic and achievement-related aspects of life it is a way of bringing some objectivity to assessments and can assist in progress; for health purposes it can help in diagnosis and to monitor the impact of treatment; and for aging folks it can provide early identification of declining health needs. And as for COVID testing – at least for now – it appears to have become a unique category: on a population level it provides a tool to monitor the overall progression of the pandemic, and on the individual level, it can help identify when to isolate and when it is safe to be with others.  

My anxiety about tests has finally declined. I am glad that I no longer have to take tests to provide measures and judgments of my competence, as they did in school. Nor do I have to study or even do all-nighters for the tests I now take. And I am grateful that many of the tests I take exist, as they can provide important information about my health.  But sometimes I feel annoyed at the frequency needed and the number of appointments to be made. I guess I get a little testy.