Special Topics in Pediatric Physical Therapy
Exam Questions
Course Introduction
This course explores advanced and emerging topics in pediatric physical therapy, focusing on the assessment and management of movement disorders and functional limitations in children and adolescents. It covers contemporary evidence-based interventions, specialized treatment techniques, and the impact of developmental, neurological, musculoskeletal, and genetic conditions on pediatric populations. Students will engage with case studies, current research, and practical applications to address the unique needs of infants, children, and teenagers in various healthcare settings. Emphasis is placed on multidisciplinary collaboration, family-centered care, ethical considerations, and the integration of technology and innovation in pediatric rehabilitation.
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) Which statement least reflects a family-centered philosophy of physical therapy intervention?
A) Asking the family what their concerns are.
B) Providing the family a daily home exercise program to improve the child's muscle strength in preparation for ambulation.
C) Identifying family caregiving routines and providing consultation to assist family members.
D) Preparing for ambulation; discussing with the family play activities for supported standing that could provide opportunities for some sibling participation.
Answer: B
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Chapter 2: Child Development
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Q1) Which of the following are "red flags" as possible indications of atypical motor development in an infant?
A) He is extremely floppy.
B) He is a very quiet baby.
C) He has oral feeding difficulties.
D) He demonstrates unilateral reaching.
E) All of the above
Answer: E
Q2) Maternal tobacco smoking during pregnancy might cause the infant to
A) die in the first year of life.
B) be born early and have a low birth weight.
C) have craniofacial abnormalities.
D) have a seizure disorder.
Answer: B
Q3) What factors have been shown to correlate with positive child development?
Answer: Adequate socioeconomic status, higher parent educational level, and availability of play toys.
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4
Chapter 3: Child Appraisal: Examination and Evaluation
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Sample Questions
Q1) Quality of life
A) measures include a normal range and standard mean.
B) cannot be measured directly and is determined by a group of questions calculating the underlying dimension.
C) measures detect subtle facets of specific disorders.
D) is an assessment of well-being across one domain.
Answer: B
Q2) As part of an Early Intervention grant focused on identifying babies/young children in the community who have developmental delays or are at risk for delay, you are going with the rest of your pediatric team (occupational therapist, speech pathologist, social worker, teacher, etc.) to several area day care centers. Which of the following assessment tools would be most appropriate to use?
A) The Peabody Developmental Motor Scales
B) WeeFIM: Functional Independence Measure for Children
C) Alberta Infant Motor Scale
D) Denver Developmental Screening Test II
E) Miller Assessment of Preschoolers
Answer: D
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Chapter 4: Family-Centered Care
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Sample Questions
Q1) It is appropriate for the physical, occupational, and speech therapists to collaboratively decide on the child's mode of communication.
A)True
B)False
Q2) 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
Q3) Family-centered care precludes providing direct service in a hospital-based clinic.
A)True
B)False
Q4) Which of the following approaches is not representative of family-centered care?
A) Strength based
B) Directive
C) Supportive
D) Responsive
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Chapter 5: Musculoskeletal System: Structure, Function,
and Evaluation
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Sample Questions
Q1) The spine of a newborn infant is initially in a A) scolotic position.
B) kyphotic position.
C) straight position.
D) lordotic position.
Q2) A tape measure is a more accurate method to measure an actual leg length discrepancy than the block method.
A)True
B)False
Q3) The kinematics of a child's gait are generally mature by which age?
A) 2 years
B) 4 years
C) 7 years
D) 9 years
Q4) Reciprocal arm swing
A) starts to emerge at age 4 years.
B) is correlated with decreased base of support.
C) is common with hand high guard.
D) is common in early walkers.
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Chapter 6: Musculoskeletal System: Considerations and Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) Select the correct statement regarding congenital muscular torticollis.
A) It can be associated with developmental dysplasia of the hip.
B) The muscle tightness will spontaneously resolve by 12 months of age.
C) It is characterized by tightness of the sternocleidomastoid muscle resulting in decreased lateral flexion and rotation to the same side.
D) Torticollis is caused by prematurity.
Q2) Children with cerebral palsy
A) commonly retain neonatal levels of hip retroversion.
B) have atypical muscle composition so strengthening is not advocated.
C) have a higher incidence of scoliosis than the general population.
D) characteristically have intellectual disabilities.
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) Name two diagnoses where heightened reaction to trauma is common.
Page 8
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Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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Sample Questions
Q1) 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
Q2) 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
Q3) Which of the following is a higher risk for adults with Down syndrome than the normal population?
A) Bladder infections
B) Patellofemoral instability
C) Cataracts
D) Rheumatoid arthritis
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Chapter 8: Neuromuscular System: the Plan of Care
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Sample Questions
Q1) 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
Q2) The difference between learning and changes in performance is that learning is the immediate effect of practice.
A)True
B)False
Q3) 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.
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Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) 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
Q2) 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
Q3) When providing physical guidance, the instructor should consider which of the following?
A) The phase of learning a task
B) The child's frustration in achieving the movement pattern required for the task
C) Methods for reducing or fading the use of manual guidance as the child gets the general idea of how to perform the task
D) All of the above
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Chapter 10: Integumentary System
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Sample Questions
Q1) 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.
Q2) All of the following are examples of synthetic skin substitutes except A) Acticoat.
B) Aquacel Ag.
C) Biobrane.
D) CEA.
Q3) ____________are the cells responsible for pulling the epidermal layer toward the center of the wound.
Q4) ___________is the process of laying down of collagen matrix.
Q5) In young children and adults, the body area for estimation of burns is relativity similar except for significant differences in the__________area.
Q6) Wound drainage that is infected and malodorous is called _____________.
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Chapter 11: Early Intervention
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Sample Questions
Q1) 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.
Q2) Which is considered the most functional, natural form of early intervention?
A) Clinician-directed treatment
B) Activity-based instruction
C) Individual instruction with only the child and clinician present
D) None of the above
Q3) Because a therapist is able to see more children in his/her own office, it is fine to ask parents to bring the child into the office to deliver early intervention services as long as the family has transportation.
A)True
B)False
Q4) Because the physician is the first professional to see the family of a child with a disability, he/she should be the head of the intervention team and select the outcomes for the family.
A)True
B)False
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Chapter 12: Schools
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Sample Questions
Q1) A written evaluation done in a school setting before an individualized education program meeting does not include
A) indications of the child's strengths.
B) results of standardized tests and measures.
C) goals and objectives.
D) evaluation of the examination.
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) All of the following are true except
A) An individual family service program must include family input.
B) Use of a least-restrictive environment encourages generalization.
C) Specific methodologies should be included in the IEP document.
D) Assistive technology may include electric wheelchairs.
E) Children with disabilities should be educated with children who do not have disabilities.
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Chapter 13: Sports Settings for the School-Aged Child
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Sample Questions
Q1) Which of the following statements are true about strength training in the prepubescent athlete?
A) Strength training is contraindicated
B) Strength training will improve force output and increase muscle mass
C) Programs developed for adolescents can be done by prepubescent children if the repetition number is lowered
D) Strength training must be well-supervised, emphasize concentric movements with lighter weights, and avoid maximal lifts
Q2) Which of the following are public health issues in children?
A) The majority of children do not meet national physical activity recommendations
B) Children have increased computer time, contributing to decreased physical activity
C) Physical inactivity contributes to the increase in overweight and obesity in children
D) All of the above
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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) 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) Describe the behavioral state of "quiet alertness."
Q2) 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
Q3) Full-term infants are born
A) between 37 and 42 weeks gestation.
B) at 9 months gestation.
C) at 40 weeks gestation.
D) between 35 and 40 weeks gestation.
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.
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Chapter 16: Rehabilitation Settings
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Sample Questions
Q1) Pediatric rehabilitation is different from adult rehabilitation in that
A) there are no accrediting organizations to ensure safety and quality of care.
B) there are no standardized outcome measures for global independence in function.
C) caregivers require less training for discharge planning.
D) children often require a 1:1 staffing ratio during therapy sessions.
Q2) 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.
Q3) 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
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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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Q1) Which of the following is not an aided communication system?
A) Sign language
B) Dynamic display communication device
C) Simple picture board
D) Level-based communication device
Q2) Medicaid is an example of a funding program that is considered an entitlement because when the child meets the eligibility criteria, the child is guaranteed all services covered by the program.
A)True
B)False
Q3) 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
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Page 20
Chapter 19: Cerebral Palsy
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Q1) A 6-year-old child with cerebral palsy who walks independently in the school environment using a wheeled, rear walker, would be classified in the Gross Motor Function Classification System as
A) Level I.
B) Level II.
C) Level III.
D) Level IV.
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) 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.
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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) You are examining a 2-month-old with cystic fibrosis. The family is meeting with you to learn postural drainage percussion and vibration (PDPV). You would teach them all the PDPV positions except A) left side lying.
B) prone.
C) Trendelenberg.
D) right side lying.
Q3) During your examination of a 14-year-old with cystic fibrosis, you note moderate clubbing throughout all digits. This clubbing is caused by A) acute hypoxemia.
B) chronic hypoxemia.
C) lack of performance of fine motor skills.
D) medication side effects.
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22
Chapter 21: Down Syndrome
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Sample Questions
Q1) Under the Individuals with Disabilities Education Improvement Act, a child with an established diagnosis of Down syndrome has the right to receive educationally based services to help obtain functional independence until what age?
A) 21
B) 5
C) 3
D) 18
Q2) Outpatient physical therapy services are indicated when the individual's goals are
A) to improve high-level balance skills.
B) not educationally based.
C) focused on improving recreational skills.
D) All of the above
Q3) The Original Borg Scale
A) measures blood pressure.
B) tracks perceived exertion during exercise.
C) evaluates muscle strength.
D) assesses functional range of motion.
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Chapter 22: Leukemia
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Q1) Your patient has neutropenia. Neutropenia is the condition of a low absolute neutrophil count. Neutrophils are a type of white blood cell that fights against infection. Absolute neutrophil count (ANC) is a measure of the number of neutrophil granulocytes. When a child is receiving chemotherapy, the physician measures the patient's white blood count regularly, specifically the neutrophils. If an ANC is less than __cells/µL, then the child is considered to have neutropenia and has a significantly increased risk of infection
A) 12,000
B) 3,000
C) 2,000
D) 500
Q2) 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
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Page 24
Chapter 23: Duchenne Muscular Dystrophy
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Q1) Development of contractures in boys with Duchenne muscular dystrophy has been documented to occur in which following sequence?
A) Heel cords, IT band/TFL, hip flexors
B) Hip flexors, knee flexors, elbow flexors
C) Heel cords, knee flexors, hip flexors
D) Hip flexors, elbow flexors, wrist flexors
Q2) 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.
Q3) Duchenne muscular dystrophy affects skeletal muscle, cardiac muscle, and smooth muscle of the gastrointestinal tract but is not associated with learning disabilities.
A)True
B)False
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Chapter 24: Developmental Coordination Disorder
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Q1) Families of children who have developmental coordination disorder often express concern about their child's
A) vision.
B) social skills.
C) hearing.
D) feeding skills.
Q2) 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.
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) Improved strength and aerobic capacity in obese children with spinal cord dysfunction or myelomeningocele was found after a 16-week
A) intervention program of nutrition and fitness.
B) wheelchair training program.
C) exercise program.
D) walking intervention program.
Q2) List five common complications of myelodysplasia.
Q3) 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
Q4) What happens to the heart rate of children with low- and mid-lumbar myelomeningocele compared to nondisabled peers when walking?
A) Heart rate remains the same
B) Heart rate increases
C) Heart rate decreases
D) Heart rate varies
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