Child Development for Physical Therapists
Solved Exam Questions
Course Introduction
This course explores the principles of child development with an emphasis on their application to pediatric physical therapy. Students will examine typical and atypical patterns of physical, cognitive, and psychosocial growth from infancy through adolescence. Through the integration of developmental theories and milestones, students will gain an understanding of how movement, motor control, and functional skills progress and how these factors inform assessment and intervention strategies in pediatric rehabilitation settings. The course also addresses the role of family dynamics, play, and cultural influences on development, preparing future physical therapists to support children and families across diverse backgrounds and clinical 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) External factors may affect a child's function such as
A) cognitive ability, emotional stability, motivation, and language ability.
B) impairments of body structures and functions and limitations in activities.
C) family support, access to health care, financial resources, and accessible schools.
D) family and child's goals and objectives.
Answer: C
Q2) Reinforcing behaviors/skills that are increasingly closer to the desired behavior/skill is called
A) negative reinforcement.
B) behavioral programming.
C) positive reinforcement.
D) shaping.
Answer: D
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 "sensitive period" is a
A) period when there is the least neuroplasticity.
B) period of reduced responsivity.
C) time when normal development is most sensitive to abnormal environmental conditions and the brain is particularly responsive to experience.
D) sharply defined time when the impact of experience gradually declines.
Answer: C
Q2) 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
Q3) Anticipatory postural control in sitting occurs once the infant is able to walk.
A)True
B)False
Answer: False
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Page 4
Chapter 3: Child Appraisal: Examination and Evaluation
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Sample Questions
Q1) Common criteria referenced tests include which of the following?
A) The Peabody Developmental Motor Scales and Gross Motor Function Measure.
B) The Pediatric Inventory of Disability and Functional Independence Measure for Children.
C) The Bayley Scales of Infant Development and Computer Adaptive Testing.
D) The Canadian Occupational Performance Measure and Peabody Developmental Motor Scales.
Answer: B
Q2) When documenting services for children,
A) the term "patient" or "client" should be used.
B) the Health Insurance Portability and Accountability Act does not apply.
C) the term "infant" or "child" should be used.
D) there is no need to document physical therapy services because the team writes a joint report.
Answer: C
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Chapter 4: Family-Centered Care
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Sample Questions
Q1) John is a 4-year-old child with global developmental delay. His gross motor skills are approximately at the 8-month-old level and he does not have expressive communication. He attends a special preschool program. John has three older siblings. His parents both work. The mother has primary responsibility for John's caregiving and expresses concerns about stress and fatigue. The family is anxious for John to learn to walk. Based on this scenario, which statement least reflects a family-centered philosophy for physical therapy intervention?
A) Offer family options regarding social services including respite care.
B) Prescribe a daily home exercise program to improve John's muscle strength for preparation for ambulation.
C) Identify with the family their caregiving routines and provide consultation to assist family members and John.
D) Discuss with the family play activities in supported standing that could provide opportunities for some sibling interactions.
Q2) 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) Select the factor(s) that contributes to neonatal hip instability.
A) Synovial viscosity
B) High neck shaft angle of inclination
C) 30 degrees of retrotorsion
D) Spherical femoral head
Q2) 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
Q3) It is common to see the most significant genu valgum posture (knock-kneed) in children around ______year(s) of age.
A) 1
B) 19
C) 4
D) 12
Q4) It is typical for a 24-month old to have a hip flexion contracture of about 10 degrees.
A)True
B)False
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Chapter 6: Musculoskeletal System: Considerations and Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) 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.
Q2) Select the most accurate statement about exercise and children.
A) Children with Duchenne muscular dystrophy should participate in intense regular exercise to improve muscle bulk and slow the progression of the disease.
B) Children with juvenile idiopathic arthritis should only perform non-weight-bearing exercises to avoid increasing joint pain.
C) Children with cerebral palsy typically have poor aerobic and muscular endurance.
D) Children with Ehler's Danlos syndrome should not participate in sports due to risk of joint damage.
Q3) Which type of juvenile idiopathic arthritis involves the most joints and is the most debilitating?
Q4) Name two diagnoses where heightened reaction to trauma is common.
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Page 8
Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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Sample Questions
Q1) Which of the following home exercise programs would be most effective for children with Down syndrome and developmental coordination disorder to prevent secondary conditions including type 2 diabetes and cardiovascular disease?
A) Baseball
B) Gymnastics
C) Soccer
D) Swimming
Q2) When working with a child with myelomeningocele, you need to remember that there is an increased prevalence of allergy to which of the following items?
A) Latex
B) Milk
C) Peanut
D) Pollen
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
Page 9
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Chapter 8: Neuromuscular System: the Plan of Care
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Sample Questions
Q1) According to the information processing perspective, memory
A) can interfere with creating new movement patterns.
B) enables a person to benefit from prior experience.
C) must be embedded within a task.
D) does not impact on performance, but is important in learning.
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 statement regarding the concept of "constraints on action" is not true?
A) They are factors that limit or "constrain" the possible movement outcomes as a child performs a functional action.
B) They can relate to the performer, the task, or the environment.
C) They are theoretical concepts that have yet to be applied to the clinical environment.
D) They can be linked to the concept of control parameter from the Dynamic Systems Perspective on motor learning.
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Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) The objective for generalization of stair climbing for a child with spastic diplegia is that the child will climb stairs at school independently using his crutches and a step-by-step pattern. What is your plan for generalization?
A) Train and hope
B) Start with relaxation and range of motion exercises
C) Whole practice in different environments
D) Part practice in the clinic
Q2) You are treating a 13-month-old child who is not yet sitting independently. He requires support at the hips to sit on the floor, and your goal for him is to sit indendently.
Focusing on function, which intervention strageties would be most appropriate?
A) Playing in prone to strengthen his trunk muscles and floor sitting activities while playing with toys with decreasing amounts of physical assistance provided
B) Strengthening activities, such as having the child perform assisted sit-ups and sitting on a therapy ball
C) Using pillows around the hips and trunk to completely prop the child into a supported poistion in sitting to play
D) Reducing tone and active range of motion
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Chapter 10: Integumentary System
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Sample Questions
Q1) Skin necrosis from chronic pressure is likely to occur after _____hours of continuous pressure.
Q2) Superficial partial-thickness burns, without infection, should heal within ______days.
Q3) The self-reporting pain scale utilized for children aged 3 to 7 years is the _____scale.
Q4) In young children and adults, the body area for estimation of burns is relativity similar except for significant differences in the__________area.
Q5) A pressure ulcer that presents as a partial-thickness skin loss and can be a blister or shallow crater is a stage ________ulcer.
Q6) 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.
Q7) _________exercises are the exercises of choice for pediatric patients with thermal injuries.
Q8) Wound drainage that is infected and malodorous is called _____________.
Q9) ___________is the process of laying down of collagen matrix.
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Chapter 11: Early Intervention
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Sample Questions
Q1) 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
Q2) Evidence-based guidelines regarding motor prognosis for children with cerebral palsy are available.
A)True
B)False
Q3) Early intervention, as defined by the Individuals with Disabilities Education Act, refers to children ages
A) birth through 2 years of age.
B) birth to 5 years of age.
C) 3 to 5 years of age.
D) 3 to 8 years of age.
Q4) Role release allows all therapists to complete the duties of all disciplines.
A)True
B)False
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Chapter 12: Schools
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Sample Questions
Q1) A child with a disability that substantially limits life activities, but who does NOT require special education, might be eligible for physical therapy in the schools through A) PL 94-142.
B) Section 504 of the Rehabilitation Act.
C) Individuals with Disabilities Education Improvement Act.
D) No Child Left Behind.
E) PL 101-336, Americans with Disabilities Act.
Q2) 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.
Q3) A common problem of working in school-based settings is
A) working school hours.
B) that pediatric clinical specialization PCS is required.
C) working with a team of professionals.
D) professional isolation.
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Page 14
Chapter 13: Sports Settings for the School-Aged Child
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Sample Questions
Q1) Which factors should be monitored to assess hydration needs?
A) Humidity
B) Temperature
C) Age of athletes
D) All of the above
Q2) What should be the emphasis of training programs for children?
A) Cooperation, fun, team play, and learning
B) Competitive spirit
C) Improvement of aerobic ability
D) All of the above
Q3) 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
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15
Chapter 14: Pediatric Acute Care Hospital
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Sample Questions
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 needing intensive care are very sensitive to stimulation. The NICU environment is an overwhelming setting for the infant. Which following recommendation can assist in helping the infant cope with the NICU environment?
A) Place the infant under a bright light during the daytime hours
B) Keep light and noise levels as low as possible and minimize the frequency of handling the infant
C) Group quiet infants next to each other and more active infants next to each other
D) Provide a certain level of noise often to help the infant adapt to the noise level
Q2) Which of the following can be a complication of premature birth that is often found in premature infants who have cerebral palsy?
A) Intraventicular hemorrhage
B) Periventricular leukomalacia
C) Microcephaly
D) Retinopathy of prematurity
Q3) Name three neonatal methods of self-calming.
Q4) Describe the behavioral state of "quiet alertness."
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Chapter 16: Rehabilitation Settings
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Sample Questions
Q1) 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
Q2) A child who is safe to go home but still requires intensive rehabilitation 5 days per week would most benefit from which setting?
A) Acute care
B) Inpatient rehabilitation
C) Day hospital rehabilitation
D) Home health care
Q3) 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.
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Chapter 17: Assistive Technology: Positioning and Mobility
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Sample Questions
Q1) If you are providing assistive technology as mandated under the Technology Related Assistance Act, the evaluation for this technology
A) is not considered to be a critical part of the acquisition process.
B) is necessary to establish matches between children's abilities and the features of specifically recommended technology.
C) can be conducted by any team member who happens to know the child, regardless of their knowledge and expertise in assistive technology.
D) should only be conducted by professionals in a rehabilitation hospital setting.
Q2) The use of power mobility should be considered
A) as a last resort when other forms of mobility are unsuccessful.
B) for children older than the age of 5.
C) for children who score at an age-appropriate level on a cognitive test.
D) as a means to overcome mobility limitations for any child.
Q3) 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.
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Chapter 18: Assistive Technology: Augmentative
Communication and Other Technologies
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Sample Questions
Q1) Which of the following characteristics does not describe a simple voice output device?
A) The device is activated by touch or by a switch
B) The device can carry a single or multiple messages
C) The device can only store vocabulary in levels or layers
D) The device is usually programmed by pushing a button and recording the message
Q2) 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
Q3) Children who have literacy skills below a third-grade level can benefit from a communication device that is "text-to-speech."
A)True
B)False
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Chapter 19: Cerebral Palsy
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Sample Questions
Q1) 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.
Q2) A child with cerebral palsy commonly presents with impairments of A) range of motion.
B) strength.
C) coordination.
D) soft tissue mobility.
E) All of the above
Q3) 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.
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21
Chapter 20: Cystic Fibrosis
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Sample Questions
Q1) 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.
Q2) Cystic fibrosis involves the exocrine mucous glands and typically affects the A) genitourinary tract.
B) pancreas.
C) sweat glands.
D) All of the above
Q3) A child can have cystic fibrosis and have no pulmonary symptoms. A)True
B)False
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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) There is evidence to suggest that the following intervention might be successful with infants with Down syndrome.
A) Constraint-induced movement therapy
B) Infant massage
C) Treadmill training
D) Therapy suit training
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) 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%.
Q2) 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
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Chapter 23: Duchenne Muscular Dystrophy
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Q1) As Duchenne muscular dystrophy progresses, the greatest life-threatening concerns are
A) cerebral hemorrhage and seizures.
B) pulmonary infections and cardiomyopathy.
C) cerebral thrombosis and seizures.
D) neoplasms and cardiac arrest.
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) Corticosteroids have been found to improve muscle mass and function in the short term, but prolonged use does not affect outcomes in boys with Duchenne muscular dystrophy.
A)True
B)False
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25
Chapter 24: Developmental Coordination Disorder
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Sample Questions
Q1) 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.
Q2) 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.
Q3) Which of the following characteristics are typical of children with developmental coordination disorder?
A) Spasticity
B) Hyperactivity
C) Hypotonia
D) Decreased flexibility
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26
Chapter 25: Myelodysplasia
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Q1) List five common complications of myelodysplasia.
Q2) 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
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) 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
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