Developmental Disabilities in Physical Therapy
Solved Exam Questions
Course Introduction
This course explores the nature, causes, and implications of developmental disabilities as they relate to physical therapy practice. Students will examine common conditions such as cerebral palsy, Down syndrome, autism spectrum disorder, and spina bifida, focusing on the physical, cognitive, and social challenges that impact motor development and function. The course covers assessment techniques, evidence-based intervention strategies, and interdisciplinary collaboration to enhance participation and quality of life for individuals across the lifespan. Emphasis is placed on family-centered care, ethical considerations, and adapting therapeutic approaches to meet diverse developmental needs in clinical and community settings.
Recommended Textbook
Meeting the Physical Therapy Needs of Children 1st Edition by Susan K. Effgen PhD PT
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Chapter 1: Serving the Needs of Children and Their Families
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Sample Questions
Q1) Physical therapists first started to work with children
A) in the 1940s for the treatment of children with cerebral palsy.
B) when Sister Kenny came to the United States to meet the needs of children with polio.
C) when Berta Bobath introduced a treatment for children with cerebral palsy.
D) during the polio epidemic in the early part of the 20th century.
Answer: D
Q2) The legislation that preceded the Americans with Disabilities Act in providing protection and access for individuals with disabilities is
A) Section 504 of the Rehabilitation Act
B) Social Security Amendments of 1965
C) Economic Opportunity Act of 1963
D) State Children's Health Insurance Plan
Answer: A
Q3) Evidenced-based practice should include
A) expert opinion, continuing education, and personal experience.
B) intuition, unsystematic clinical experience.
C) explanations based on pathophysiology.
D) awareness, consultation, judgment, and creativity.
Answer: D
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Page 3
Chapter 2: Child Development
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Sample Questions
Q1) A child typically uses two- to three-word phrases by
A) 8 months.
B) 12 months.
C) 2 years.
D) 3 years.
E) preschool.
Answer: C
Q2) Smoking during pregnancy increases the risk of the infant being
A) large for gestational age and having a cleft lip.
B) born postterm and having a clubfoot.
C) born early and having a low birth weight.
D) irritable and lethargic and having a large frontal lobe.
Answer: C
Q3) When does successful goal-directed reaching typically first occur in infants?
A) 1 month of age
B) 4 months of age
C) 6 months of age
D) 8 months of age
Answer: B
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Page 4
Chapter 3: Child Appraisal: Examination and Evaluation
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Sample Questions
Q1) If you want to assess the level of caregiver assistance or the types of modifications that a 4-year-old child with arthrogryposis needs to perform functional motor activities, your best choice for an assessment tool is which of the following?
A) Peabody Developmental Motor Scales
B) Gross Motor Function Measure
C) Bruininks-Oseretsky Test of Motor Proficiency
D) Bayley Scales of Infant Development
E) Pediatric Evaluation of Disability Inventory
Answer: E
Q2) Select the most important consideration when choosing a pain assessment scale.
A) Degree and cause of pain
B) Age and cognitive ability of child
C) Quality of life
D) All of the above
Answer: B
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Chapter 4: Family-Centered Care
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Sample Questions
Q1) Which of the following approaches is not representative of family-centered care?
A) Strength based
B) Directive
C) Supportive
D) Responsive
Q2) Which of the following strategies is not representative of family-centered care?
A) Help families establish connections with community agencies.
B) Listen and learn from the family.
C) Encourage active participation of the child and family.
D) Set PT goals from items not passed on a motor assessment.
Q3) Respite care is defined as
A) home-based care for respiratory or pulmonary problems to minimize hospital admissions.
B) care for a patient who is terminally ill.
C) temporary care for a child with a disability so the primary caregiver can rest.
D) home-based medical care that allows the family to focus on the emotional well-being of the child rather than the medical condition.
Q4) What are three common stresses associated with raising a child with a disability?
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Chapter 5: Musculoskeletal System: Structure, Function, and
Evaluation
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Sample Questions
Q1) When performing the hip prone extension test, you should
A) stabilize the pelvis prior to measuring.
B) allow the "non-testing" foot to rest gently on the floor.
C) position the child with one hip on the edge of the plinth and the other securely on the plinth.
D) test both sides at the same time.
Q2) A full-term, typically developing neonate will have which following range of motion?
A) Limitations in hip flexion and elbow flexion and excessive plantar flexion
B) Limitations in hip extension and elbow extension and excessive plantar flexion
C) Limitations in plantar flexion and excessive hip flexion and elbow extension
D) Limitations in hip extension and elbow extension and excessive dorsiflexion
Q3) Cadence is
A) highest in adolescence.
B) very high in 1-year-old walkers.
C) highest in toddlers.
D) stable during maturation of gait.
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Chapter 6: Musculoskeletal System: Considerations and
Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) Methods to promote bone mineralization include
A) impact exercise.
B) weight-bearing exercise.
C) upright standing frames.
D) running.
E) All of the above
Q2) Arthrogryposis
A) is characterized by an asymmetrical pattern of contractures and joint involvement.
B) typically has associated cognitive impairments.
C) may be related to a lack of fetal movement.
D) is a progressive disorder.
Q3) Young boys having Duchenne muscular dystrophy tend to use the Gower maneuver to rise from the floor because of weakness in
A) knee extensors and flexors.
B) hip extensors and flexors.
C) distal leg musculature.
D) upper extremity musculature.
Q4) Which type of juvenile idiopathic arthritis involves the most joints and is the most debilitating?
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Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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Sample Questions
Q1) Based upon the available evidence, which of the following interventions would be most effective for an 8-year-old child with developmental coordination disorder working on kicking a ball and hitting a target?
A) Kicking a ball into a goal inside, outside, and outside with peers
B) Kicking a large ball into a small goal
C) Riding a bike around the park
D) Running around obstacles
Q2) Which of the following diagnostic pediatric standardized tests would be most appropriate to administer to a 7-year-old child to assist in confirming a diagnosis of developmental coordination disorder?
A) Bruininks-Oseretsky Test of Motor Proficiency-2
B) Developmental Coordination Disorder Questionnaire
C) Movement Assessment Battery for Children
D) Peabody Developmental Motor Scales-2
Q3) Which of the following statements most accurately defines spasticity?
A) Constant resistance to passive movement
B) Hyperreflexia associated with increased resistance to passive movement
C) Upper motor neuron syndrome
D) Velocity-dependent increased resistance to passive movement
Page 9
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Chapter 8: Neuromuscular System: the Plan of Care
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Sample Questions
Q1) Physical guidance should be
A) used to achieve high-level advanced motor skill performance.
B) used when the child finds the task easy but does not want to perform the task.
C) faded out and withdrawn when the child has a general idea of the movement.
D) included in all physical therapy interventions.
Q2) Application of the information-processing perspective to pediatric physical therapy is best illustrated by
A) considering cognitive aspects of motor learning, such as attention, memory, and the processing that occurs before a movement is initiated.
B) structuring the treatment environment to eliminate distracting stimuli.
C) repeating a task multiple times to ensure motor memory.
D) understanding that many body systems come together to affect movements.
Q3) There is emerging evidence that increased intensity of physical therapy interventions can improve physical therapy outcomes.
A)True
B)False
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10
Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) When a therapist tells a child how many feet he was able to run in 10 sec, the therapist is providing which of the following?
A) Intrinsic feedback
B) Negative reinforcement
C) Attention
D) Extrinsic feedback
Q2) Select the practice scenario that is most likely to facilitate motor learning in a child with a neurological impairment.
A) Promoting error-free practice to avoid learning bad habits.
B) Practicing in the clinic setting to control external stimuli.
C) Varying the practice situation to include several versions of the task.
D) Provide a substantial amount of verbal rationale.
Q3) Which type of practice would best facilitate the generalization of motor skills?
A) Specific practice
B) Blocked practice
C) Part-task practice
D) Variable practice
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11
Chapter 10: Integumentary System
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Sample Questions
Q1) _________exercises are the exercises of choice for pediatric patients with thermal injuries.
Q2) Positioning for a patient with anterior neck burns would include all except A) neck extension.
B) neck flexion.
C) a pillow behind the shoulders.
D) neck orthosis.
Q3) Superficial partial-thickness burns, without infection, should heal within ______days.
Q4) Skin necrosis from chronic pressure is likely to occur after _____hours of continuous pressure.
Q5) A Stage I pressure ulcer is described as having
A) full thickness skin loss with extensive damage to underlying tissues.
B) full thickness skin loss that presents as a deep crater but does not damage adjacent tissue.
C) partial thickness skin loss that appears as an abrasion, blister, or shallow crater.
D) nonblanchable erythema of intact skin with warmth edema and discoloration.
E) discoloration that lasts longer than 60 min.
Q6) The prognosis for a wound for a specific child will depend on what factors?
Page 12
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Chapter 11: Early Intervention
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Sample Questions
Q1) Role release allows all therapists to complete the duties of all disciplines.
A)True
B)False
Q2) How many days prior to the child's third birthday should a transition meeting be held with the receiving school program?
A) 45 days
B) 90 days
C) 4 months
D) This process is not necessary
Q3) Who should guide the focus of early intervention based on their priorities and concerns?
A) The physician
B) The family
C) The physical therapist
D) The primary service coordinator
Q4) Early intervention should occur
A) in a center-based program.
B) in a physician's office.
C) in the child's natural environment.
D) in the public school setting.
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Chapter 12: Schools
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Sample Questions
Q1) List at least four themes/issues that should be included in "best" practice in transition.
Q2) Preschool services, as defined by Individuals with Disabilities Education Improvement Act, may start as early as
A) birth.
B) 1 year of age.
C) 2 years of age.
D) 3 years of age.
E) 5 years of age.
Q3) Important provisions for parents of children with disabilities in schools include
A) availability of assistive technology, right to due process, and parent participation.
B) parent participation, athletic training, and scoliosis screening.
C) IFSP, parent participation, and right to due process.
D) primary service coordinator, transition planning, and parent participation.
Q4) There is consistency among local educational agencies regarding who receives physical therapy services.
A)True
B)False
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Chapter 13: Sports Settings for the School-Aged Child
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Sample Questions
Q1) Which of the following activities can assist with infection control?
A) Proper cleaning of equipment with disinfectant
B) Sharing of personal sporting equipment
C) Weekly cleaning of clothing
D) Use of bar soap in the showers
Q2) Indicate which of the following constitutes the greatest medical issue in children.
A) Fractures
B) Sprains and strains
C) Concussion and second impact syndrome
D) Spinal injuries
Q3) Indicate which of the following statements must be adhered to strenuously in sports for children.
A) Coaching staff should complete a certification course
B) Equipment should be properly fit to the youth
C) Playing areas should be free of obstacles and be shock-absorbing
D) All of the above
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15
Chapter 14: Pediatric Acute Care Hospital
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Sample Questions
Q1) Administers long-term medications such as chemotherapy and can be used for blood draws
A)Arterial line
B)Broviac
C)Chest tube
D)Endotracheal tube
E)Foley
F)Gastric tube
G)Jackson Pratt drain
Q2) A 15-year-old male adolescent is admitted to the emergency room with a head trauma. He now presents with an external ventriculostomy to monitor intracranial pressure. When working on bed mobility, what should the position of the drain be in relationship to the patient?
A) Above the level of the patient's head
B) Below the level of the patient's head
C) Even with the patient's head
D) The position of the drain does not impact patient care
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Chapter 15: Neonatal Intensive Care Unit
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Sample Questions
Q1) Infants born preterm and weighing less than 1,000 g at birth are at the greatest risk for cerebral palsy and other motor, cognitive, and behavioral disorders.
A)True
B)False
Q2) Infants that are small for gestational age
A) are premature.
B) are born after 40 weeks gestation.
C) weigh less than the 10th percentile.
D) weigh 1,000 g.
Q3) Name three neonatal methods of self-calming.
Q4) Behavioral signs of stress in a neonate include
A) hyperalertness and apnea.
B) finger splays and gaze aversion.
C) decreased respiratory rate and bradycardia.
D) leg extension and increased blood pressure.
Q5) Physiological signs of stress in a neonate include
A) increased heart rate and skin color changes.
B) gaze aversion and leg extension.
C) increased respiration and oxygen saturation.
D) facial grimace and finger splays.
Page 17
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Chapter 16: Rehabilitation Settings
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Sample Questions
Q1) For a child with a brain injury, the rehabilitation team should consider which of the following when planning a transition back to school?
A) The child will not be able to return to school and will need to be home schooled.
B) The child will need a Section 504 plan or individualized education program.
C) The child will need to go to a different school.
D) The child will return to the same classroom without accommodations.
Q2) Discharge planning for a new patient entering the rehab unit should begin
A) the moment the child enters the rehabilitative setting.
B) when the child is reaching functional goals.
C) when the child is medically stable.
D) 1 week prior to expected discharge.
Q3) For a 7-year-old boy s/p posterior fossa tumor resection who is currently ambulating three steps in the parallel bars with maximal assistance of one, the following is the most appropriate goal for discharge from inpatient rehabilitation:
A) Ambulate 50 ft with a walker and moderate assistance
B) Ambulate 50 ft with a walker and contact guard assistance
C) Ambulate 50 ft independently without an assistive device
D) Run 50 ft independently without loss of balance
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18
Chapter 17: Assistive Technology: Positioning and Mobility
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Sample Questions
Q1) For best results regarding pelvic stability and upper extremity reaching, Kevin's pelvic belt should be placed
A) across his anterior superior iliac spines.
B) 45 degrees to the sitting surface to stop anterior pelvic mobility.
C) close to 90 degrees to the sitting surface to provide stability but allow anterior pelvic mobility.
D) across his chest at the level of the 6th rib to help stop the lateral lean and provide a stable base for shoulder girdle movement.
Q2) You are examining a 12-year-old with fixed deformities at the pelvis, trunk, and hips for a seating system. Which of the following supports would be most appropriate?
A) Firm, planar seat and custom contoured back support
B) Custom contoured seat and sling back support with knee blocks
C) Custom contoured seat and detachable lateral trunk supports on a planar back
D) Custom contoured seat and back support
E) Supine wedge for bed positioning, as the child should not be up in a wheelchair
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19
Chapter 18: Assistive Technology: Augmentative
Communication and Other Technologies
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Sample Questions
Q1) Which of the following areas are important to consider when assisting a child to use scanning to access a communication device or computer?
A) The child's movement capabilities
B) Location of the switch to be used in scanning
C) Type and size of switch to use
D) All of the above
Q2) Gloria is a 15-year-old with spinal muscular atrophy. She uses a wheelchair for mobility, which she controls using head switches. She is interested in learning to use a computer so she can apply for a job after school entering data. After completing a computer access evaluation, you determine that Gloria's best method for typing on a computer will be to use a switch and a scanning program in conjunction with an on-screen keyboard. Gloria can use row-column scanning to select letters of the alphabet consistently. This method of access is considered
A) direct selection.
B) indirect selection.
C) primary selection.
D) secondary selection.
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Page 20
Chapter 19: Cerebral Palsy
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Sample Questions
Q1) Evidence has shown that "participation" scores of children with cerebral palsy increase with
A) aerobic training programs.
B) Partial body weight-supported treadmill training.
C) Progressive resistance exercise training.
D) Passive range of motion and stretching.
Q2) Strength training programs for children with cerebral palsy have been demonstrated to
A) increase muscle strength.
B) increase muscle tone.
C) increase functional community ambulation skill.
D) increase aerobic capacity.
Q3) A physical therapist would like to assess the level of participation of a 18-year-old college student with spastic cerebral palsy. Which of the following standardized measurement tools is most appropriate?
A) Children's Assessment of Participation and Enjoyment
B) Bruininks Oseretsky Test of Moot Proficiency
C) Gross Motor Function Classification System
D) School Function Assessment
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Page 21
Chapter 20: Cystic Fibrosis
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Sample Questions
Q1) A child can have cystic fibrosis and have no pulmonary symptoms.
A)True
B)False
Q2) You are examining a 12-year-old with cystic fibrosis. His resting vitals are HR = 90 bpm; RR = 20 bpm; and SpO<sub>2</sub> = 98%. You start your exercise testing. As the test continues, the child is walking on the treadmill at 2.5 mph 2% grade for 5 min. His vital signs are as follows: HR = 120 bpm, RR = 22 bpm, SpO<sub>2</sub>, 90%; and an RPE of 14. You would
A) continue the test with the same mph and grade.
B) increase the mph and grade.
C) decrease the grade but keep the mph the same.
D) stop the test and monitor vitals over the next few minutes.
E) stop the test and call a code.
Q3) You are evaluating a 16-year-old with cystic fibrosis who needs an independent method of postural drainage with percussion and vibration (PDPV). The most appropriate method for the patient is
A) percussor.
B) positive expiratory pressure and flutter.
C) a vest.
D) PDPV from his friends.
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Chapter 21: Down Syndrome
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Sample Questions
Q1) Common sitting posture for individuals with Down syndrome can be characterized by
A) internal hip rotation, knee extension, and ankle plantar flexion.
B) external hip rotation, flexed spine, and extended head.
C) external hip rotation, flexed spine, and forward head.
D) normal sitting posture.
Q2) For a preschool child with Down syndrome, which of the following would the most valid and appropriate tool to monitor the progress of gross motor skills and functional mobility?
A) Alberta Infant Motor Assessment
B) Bayley Scales of Motor Development
C) Bruinink Oseretsky Test of Motor Proficiency
D) Gross Motor Function Measure
Q3) Heart defects and cardiovascular pathology are a common complication in children with Down syndrome.
A)True
B)False
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Page 23
Chapter 22: Leukemia
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Sample Questions
Q1) You have been asked to develop an exercise program for a child who has been admitted for a stem cell transplant. Appropriate exercise choices would include
A) wheelchair basketball.
B) resistive weight training.
C) a walking program.
D) All of the above
Q2) The most common form of pediatric leukemia is acute lymphoblastic leukemia, which has a survival rate for children between the ages of 1 and 10 years of
A) 80% to 90%.
B) 50% to 60%.
C) 40%.
D) 20%.
Q3) Common physical therapy interventions for a child with acute lymphoblastic leukemia include
A) orthotics.
B) stretching exercises.
C) age-appropriate strengthening exercises.
D) age-appropriate gross motor developmental activities.
E) All of the above.
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Page 24
Chapter 23: Duchenne Muscular Dystrophy
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Q1) Among male births, the incidence of Duchenne muscular dystrophy is variably reported as 1 in:
A) 800 to 1,000.
B) 3,500 to 6,000.
C) 6,000 to 8,000.
D) 8,000 to 10,000.
Q2) Boys with Duchenne muscular dystrophy tend to use the Gowers' maneuver to rise from the floor because of weakness in
A) hip flexors, extensors, and abductors.
B) hip flexors and extensors, and knee extensors.
C) hip extensors, knee flexors, and extensors.
D) hip extensors and abductors and knee extensors.
Q3) A pharmacological intervention that can prolong ambulation for boys with Duchenne muscular dystrophy is
A) nonsteroidal anti-inflammatory medications.
B) chemotherapy.
C) antimalarials.
D) corticosteroids.
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25
Chapter 24: Developmental Coordination Disorder
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Sample Questions
Q1) A child who has developmental coordination disorder may frequently also have A) learning difficulties.
B) cerebral palsy.
C) pervasive development disorder.
D) a hearing impairment.
Q2) Interventions for children who have developmental coordination disorder are based on the top-down approach, which focuses on
A) child and family goals.
B) impairments.
C) school goals and objectives.
D) activities of daily living.
Q3) One method being used to train children on how to ride a bike without training wheels requires
A) practice riding a bike for 2 hrs each day.
B) removal of the bikes pedals.
C) placement of the bike on a stationary rack.
D) the assistance of a caregiver.
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26
Chapter 25: Myelodysplasia
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Q1) List five common complications of myelodysplasia.
Q2) In the school environment, it is nice to have a translator available to interpret at the individualized education program meetings, but it is not required.
A)True
B)False
Q3) In the natural school environment, the physical therapist relies on the classroom staff to follow through with mobility and transfer activities on a daily basis for a child with a myelomeningocele.
A)True
B)False
Q4) Discuss what a child must learn when using a manual wheelchair in a natural school environment.
Q5) All of the following are environmental adaptations that might assist a child with mid-lumbar myelomeningocele in using the bathroom except A) a sliding board.
B) grab bars.
C) a changing table.
D) a rolling stool.
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