Physical Therapy for Children
Test Questions
Course Introduction
Physical Therapy for Children is a course that explores the principles, assessment techniques, and interventions used by physical therapists to support the development, mobility, and functional abilities of pediatric patients. The course covers normal and atypical motor development, common pediatric conditions such as cerebral palsy, spina bifida, and muscular dystrophy, and the impact of these conditions on movement and daily life. Students learn to design and implement individualized treatment plans, use evidence-based therapeutic exercises, adaptive equipment, and play-based strategies, as well as collaborate with families and interdisciplinary teams to optimize outcomes for children in various environments.
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) 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
Q2) 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
Q3) Collaborative teamwork does not include
A) role release.
B) consensus decision making.
C) motor and communication skills embedded throughout the interventions.
D) professionals working in isolation.
E) equal participation on the team by the family.
Answer: D
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Chapter 2: Child Development
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Q1) When an adolescent with a disability is delayed from going through the stages of psychosocial development, all of the following might occur except
A) problems with self-concept.
B) delayed establishment of identity.
C) increased independence.
D) influences on social behavior in adulthood.
Answer: C
Q2) Fetal limb movements
A) change the most during the second trimester.
B) follow a proximal to distal sequence.
C) increase during the first trimester.
D) change little during gestation.
Answer: C
Q3) 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
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Chapter 3: Child Appraisal: Examination and Evaluation
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Sample Questions
Q1) What type of measure distinguishes children with or without a specific characteristic or impairment?
A) Criterion Referenced
B) Discriminative
C) Evaluative
D) Reliable
Answer: B
Q2) When possible, the best place for examination of a child is which of the following?
A) A natural environment
B) A pediatric outpatient clinic setting
C) A pediatric hospital setting
D) The Health Department
Answer: A
Q3) Which of the following statements is false?
A) Likelihood ratio indicates the probability of the existence of the diagnosis.
B) Sensitivity is the ability of a measure to detect dysfunction.
C) Specificity indicates the absence of a disorder.
D) Reliable measures measure what they are supposed to measure.
Answer: D
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Page 5
Chapter 4: Family-Centered Care
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Sample Questions
Q1) Which of the following concepts is integral to a family system's theory, transactional model of development, and ecological model of development?
A) Task-oriented approach to motor control
B) Relationship between a person and their social environment
C) Relationship between neuromaturation and function
D) Cultural of disability
Q2) Which of the following statements does not reflect a family-centered approach to a pediatric physical therapy examination?
A) Develop a strict format for the examination to ensure standardization.
B) Respect the family's knowledge regarding their child.
C) Emphasize the child's abilities.
D) Be sensitive to the child's temperament and interests.
Q3) 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.
Q4) What are three common stresses associated with raising a child with a disability?
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Page 6
Chapter 5: Musculoskeletal System: Structure, Function, and
Evaluation
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Sample Questions
Q1) Cartilage provides the initial prenatal structure for the development of bone.
A)True
B)False
Q2) The clavicle, mandible, and facial and cranial flat bones develop directly in vascularized mesenchyme through a process called
A) endochondral ossification.
B) mesodermal outgrowth.
C) differentiating chondroblasts.
D) intramembranous ossification.
Q3) A flexible flat foot in a typically developing 3 \( 1 / 2 \) -year-old is a concerning finding and should be referred to an orthopedic physician for further evaluation.
A)True
B)False
Q4) The spine of a newborn infant is initially in a A) scolotic position.
B) kyphotic position.
C) straight position.
D) lordotic position.
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Chapter 6: Musculoskeletal System: Considerations and Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) Which type of juvenile idiopathic arthritis involves the most joints and is the most debilitating?
Q2) Why should children with arthrogryposis be evaluated for an early intervention program?
A) Arthrogryposis is generally associated with intellectual impairment.
B) Arthrogryposis is a progressive, debilitating condition.
C) Weakness and contractures at birth may delay motor milestone acquisition and lead to disuse weakness.
D) Physical therapy intervention can correct the deformities.
Q3) Select the correct statement(s) regarding Duchenne muscular dystrophy (DMD). Children with DMD
A) develop hypertrophy of the gastrocnemius as a method to compensate for progressive weakness.
B) should avoid resistive activities and eccentric contractions as this can cause further muscle breakdown.
C) require use of ankle foot orthoses to maintain walking past 12 years of age.
D) will not get muscle contractures if parents perform passive stretches weekly.
Q4) Name two pediatric diagnoses where limitation in range of motion is a common characteristic.
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Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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Sample Questions
Q1) Which of the following would best describe a typical posture for a child with Down syndrome?
A) Ankle plantar flexion, hip internal rotation, and hip adduction
B) Flat feet, wide base of support, and hyperextended knees
C) Hip external rotation, knee flexion, and ankle dorsiflexion
D) Narrow base of support, hip internal rotation anterior pelvic tilt
Q2) Which of the following activities would be more difficult for a 6-year-old child with developmental coordination disorder at school?
A) Interacting with peers
B) Jumping jacks in physical education class
C) Putting on a coat
D) Sitting in a chair
Q3) Which component of the International Classification of Functioning, Disability, and Health would include the assessment of ROM, motor function, and sensation?
A) Activities
B) Body functions and structures
C) Health condition
D) Participation
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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) For which activity is part practice most likely to be beneficial?
A) Walking
B) Sit-to-stand transitions
C) Crawling
D) Putting on a shirt
Q3) In addition to procedural interventions by the physical therapist, what other categories of intervention, as outlined by the Guide to Physical Therapist Practice, should be integrated into the plan of care?
A) Communication with parents
B) Communication with other members of the interdisciplinary team
C) Instruction to family, classroom staff, and child in many areas
D) All of the above
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Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) 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.
Q2) 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
Q3) 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.
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11
Chapter 10: Integumentary System
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Sample Questions
Q1) In young children and adults, the body area for estimation of burns is relativity similar except for significant differences in the__________area.
Q2) ____________are the cells responsible for pulling the epidermal layer toward the center of the wound.
Q3) ___________is the process of laying down of collagen matrix.
Q4) Superficial partial-thickness burns, without infection, should heal within ______days.
Q5) The prognosis for a wound for a specific child will depend on what factors?
Q6) _________exercises are the exercises of choice for pediatric patients with thermal injuries.
Q7) 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.
Q8) A pressure ulcer that presents as a partial-thickness skin loss and can be a blister or shallow crater is a stage ________ulcer.
Page 12
Q9) Wound drainage that is infected and malodorous is called _____________.
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Chapter 11: Early Intervention
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Sample Questions
Q1) To increase the likelihood of a young child achieving a functional task,
A) the intensity of physical therapy should be increased.
B) everyone should focus on just the motor goal.
C) intervention should be discipline specific.
D) everyone must help find opportunities for high-volume, task-specific practice.
Q2) Which technique(s) assist the therapist and family in integrating therapeutic objectives into the family's daily lives?
A) Intervention in the child's natural environment
B) Activity-based instruction
C) Use of catalogs and matrixes
D) All of the above
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
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13
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) A child with developmental delay in all domains entering an early intervention program under IDEA Part B would be provided all of the following except
A) a case manager or primary service coordinator who coordinates service delivery.
B) development of educationally relevant annual goals.
C) development of an individual family service plan.
D) objectives regarding function in the motor domain.
E) family-centered care.
Q3) All of the statements are true except which of the following?
A) Cognitive ability has no basis in determining the need for physical therapy.
B) An individualized education program (IEP) should include a behavioral management plan for children with behavior problems.
C) Child must be educated to the maximum extent possible with children who do not have disabilities.
D) Assistive technology may include electric wheelchairs.
E) Specific intervention methodologies should be included in the IEP document.
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Chapter 13: Sports Settings for the School-Aged Child
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Q1) Adolescents (ages 14 to 18 years) need increased amounts (beyond adult recommendations) for which of the following?
A) Vitamin C
B) Protein
C) Calcium
D) All of the above
Q2) 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
Q3) Which factors should be monitored to assess hydration needs?
A) Humidity
B) Temperature
C) Age of athletes
D) All of the above
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15
Chapter 14: Pediatric Acute Care Hospital
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Q1) Supports mechanical ventilation
A)Arterial line
B)Broviac
C)Chest tube
D)Endotracheal tube
E)Foley
F)Gastric tube
G)Jackson Pratt drain
Q2) Removes fluid from the pleural cavity
A)Arterial line
B)Broviac
C)Chest tube
D)Endotracheal tube
E)Foley
F)Gastric tube
G)Jackson Pratt drain
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Page 16
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) When making recommendations about the infant's active movement, the physical therapist should generally recommend
A) encouraging the infant to have several periods of active movement during the day to build body strength and endurance.
B) allowing active movement when the infant is awake and quietly alert, but helping the infant to avoid excessive, frequent movements.
C) avoiding all active movement to conserve energy, including using restraints if needed.
D) encouraging any active movement as long as the infant is not crying.
Q3) Name three neonatal methods of self-calming.
Q4) Describe the behavioral state of "quiet alertness."
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17
Chapter 16: Rehabilitation Settings
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Sample Questions
Q1) Which of the following is not usually an ethical issue for a therapist to consider?
A) Parental control versus the right of a child to make choices about care
B) Eligibility criteria for therapy
C) How to manage education regarding sexuality
D) Family-centered care
Q2) In planning for transition to school, which of the following statements is true?
A) School therapists can continue to provide the same level of rehabilitation therapy when the child is back in school.
B) School therapists provide therapy deemed necessary for the child's educational goals as outlined on the IEP.
C) Children should return to school when they no longer have any rehabilitation therapy needs.
D) Coordination between school and rehabilitation therapists is not necessary if the family is able to relay information.
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18
Chapter 17: Assistive Technology: Positioning and Mobility
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Q1) Assistive technology involves
A) the assistive technology device only.
B) the services necessary to obtain assistive technology devices only.
C) both the assistive technology device and services.
D) the assistive technology device and the acquisition of the device.
Q2) During a physical examination for a seating system, physical therapists should begin by examining the child's
A) pelvic position.
B) hip range of motion.
C) trunk position.
D) knee range of motion.
Q3) Planar seating systems are most appropriate for a child with
A) moderate postural problems or flexible postural asymmetries.
B) mild postural problems, symmetrical posture, and no structural deformities.
C) fixed structural deformities.
D) severe postural problems resulting in asymmetrical posture.
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19
Chapter 18: Assistive Technology: Augmentative
Communication and Other Technologies
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Q1) For a child with serious limitations in activity, play can be facilitated with which of the following technologies?
A) Switches
B) Battery adaptors
C) Latch timers
D) Environmental control units
E) All of the above
Q2) Environmental control units consist of which of the following components?
A) Input device, switch, and the appliance
B) Output device, switch, and the appliance
C) Input device, control unit, and the appliance
D) Output device, control unit, and the switch
Q3) Factors associated with successful long-term use of assistive technology include all of the following except
A) The level of detail included in the evaluation report written by the evaluation team
B) Child and family satisfaction
C) Continued maintenance of the device
D) Adequate training
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Chapter 19: Cerebral Palsy
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Q1) A 13-year-old child with spastic diplegic cerebral palsy has decreased dorsiflexion range of motion bilaterally. An appropriate activity to include in his home program to increase dorsiflexion range of motion is
A) passive range of motion of the ankle.
B) wear orthotics for at least 3 to 4 hrs daily.
C) strength training of the dorsiflexors.
D) heel lift exercises.
Q2) To measure a 6-year-old child's level of participation in life activities, the best standardized measurement tool to use is the
A) Gross Motor Function Measure, 88.
B) Peabody Developmental Motor Scale-2nd edition.
C) School Function Assessment.
D) Times Up and Go Test.
Q3) When assessing the lower extremity range of motion of a child with spastic diplegic cerebral palsy, accuracy of the measurement is
A) not achieved because of the changes in muscle tone.
B) easily achieved using a standard goniometer.
C) enhanced by averaging two consecutive measurements.
D) supported by high intersession reliability of goniometry.
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Page 21
Chapter 20: Cystic Fibrosis
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Q1) Cystic fibrosis involves the exocrine mucous glands and typically affects the A) genitourinary tract.
B) pancreas.
C) sweat glands.
D) All of the above
Q2) An 8-year-old child with cystic fibrosis presents to the clinic with a 1-wk history of persistent cough, increased sputum production, increased work of breathing, and weight loss. What steps should be taken next?
A) He should be sent to the emergency room of a local hospital for critical care.
B) He should most likely be admitted to the hospital for treatment of a pulmonary exacerbation.
C) He should be sent home on extra multivitamins and be seen for his next routine clinic visit in 6 months.
D) He should be sent home, his pulmonary hygiene program should be stopped, and his parents/caregivers should be instructed to focus on his nutrition for a few weeks.
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Chapter 21: Down Syndrome
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Sample Questions
Q1) 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
Q2) An individual with Down syndrome typically has ___muscle tone.
A) normal
B) hypertonic
C) hypotonic
D) rigid
Q3) 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.
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23
Chapter 22: Leukemia
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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) Intrathecal chemotherapy is administered directly into what area?
A) Muscle
B) Mouth
C) Vein
D) Cerebral spinal fluid
Q3) 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%.
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Chapter 23: Duchenne Muscular Dystrophy
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Q1) Duchenne muscular dystrophy is an
A) autosomal recessive disorder.
B) autosomal dominant disorder.
C) X-linked recessive disorder.
D) acquired disorder.
Q2) Ambulation can be prolonged for boys with Duchenne muscular dystrophy through the use of knee-ankle-foot orthoses and contracture-release surgery, augmented by daily stretching, functional activities, and swimming.
A)True
B)False
Q3) Some boys who are delayed in their development of ambulation and speech are later diagnosed with Duchenne muscular dystrophy.
A)True
B)False
Q4) Surgical correction of scoliosis and spinal stabilization are considered cosmetic procedures that do not improve function or longevity for boys with Duchenne muscular dystrophy.
A)True
B)False
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Chapter 24: Developmental Coordination Disorder
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Q1) Adults with developmental coordination disorder commonly have participation issues due to
A) the inability to walk independently.
B) the inability to communicate wants and needs.
C) decreased strength and endurance.
D) decreased muscle tone.
Q2) Developmental coordination disorder is a condition occurring in A) less than 5% of grade-school children.
B) predominantly teenage girls.
C) 6% to 13% of grade-school children.
D) children with cerebral palsy.
Q3) Neuromotor task training incorporates motor learning concepts with A) motor task analysis.
B) problem-solving.
C) sensory processing activities.
D) kinesthetic input.
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Chapter 25: Myelodysplasia
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Q1) 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
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) 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.
Q4) Discuss what a child must learn when using a manual wheelchair in a natural school environment.
Q5) List five common complications of myelodysplasia.
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