Noah Muthler took his first state standardized test in third grade at the Spring Cove Elementary School in Roaring Spring, Pa. It was a miserable experience, said his mother, Kathleen Muthler. He was a good student in a program for gifted children. But, Muthler said, “he was crying in my arms the night before the test, saying: ‘I’m not ready, Mom. They didn’t teach us everything that will be on the test.’ ” In fourth grade, he was upset the whole week before the exam. “He manifests it physically,” his mother said. “He got headaches and stomachaches. He would ask not to go to school.” Not a good sleeper anyway, Noah would slip downstairs after an hour tossing in bed and ask his mom to lie down with him until he fell asleep. In fifth grade, the anxiety lasted a solid month before the test. “Even after the test, he couldn’t let it go. He would wonder about questions he feared he misunderstood,” Muthler said.