Developmental Disabilities in Physical Therapy
Exam Questions
Course Introduction
This course explores the role of physical therapy in supporting individuals with developmental disabilities across the lifespan. Students will examine the etiology, clinical presentation, and impact of common developmental disabilities such as cerebral palsy, Down syndrome, and autism spectrum disorder. Emphasis is placed on evidence-based assessment strategies, intervention planning, and therapeutic techniques that promote functional mobility, independence, and participation in daily activities. The course also covers interdisciplinary collaboration, family-centered care, and ethical considerations, preparing future physical therapists to deliver holistic and inclusive services to this diverse population.
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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Q1) If you suspect child abuse of a child you are serving,
A) you can say nothing because your professional code of conduct requires confidentiality.
B) you must report the abuse using your state's procedures.
C) you should speak to the child's parent.
D) you must write a report and share it with the child's physician.
Answer: B
Q2) 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
Q3) When possible, an examination should
A) start with tests and measures in the clinical setting.
B) start with observation done in the natural environment.
C) never be done in the waiting room.
D) start with determining the child's strengths and weaknesses.
Answer: B
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Chapter 2: Child Development
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Q1) By 24 months of age, a toddler should
A) have at least a 50-word vocabulary, use two-word combinations, and scribble using a palmar-supinate grasp.
B) have at least a 300-word vocabulary and scribble using a static tripod.
C) have a mature running pattern and use plurals in speech.
D) All of the above
Answer: A
Q2) An infant demonstrates the asymmetrical tonic neck reflex has integrated by
A) turning his head to either side.
B) turning his head to one side and looking at the extended arm on that side.
C) turning his head and bringing his hand to the mouth on the same side.
D) turning his head to one side and bringing the opposite hand toward his mouth.
Answer: C
Q3) The most serious disorders and usually death are seen in infants having chromosomal
A) trisomies.
B) monosomy.
C) gene deletions.
D) translocations.
Answer: B
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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) 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
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Chapter 4: Family-Centered Care
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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) It is appropriate for the physical, occupational, and speech therapists to collaboratively decide on the child's mode of communication.
A)True
B)False
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Chapter 5: Musculoskeletal System: Structure, Function,
and Evaluation
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Sample Questions
Q1) 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
Q2) Cartilage provides the initial prenatal structure for the development of bone.
A)True
B)False
Q3) 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
Q4) Variability in joint angle or kinematic patterns during gait is most common in A) young independent walkers.
B) toddlers.
C) adolescents.
D) running.
Page 7
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Chapter 6: Musculoskeletal System: Considerations and
Interventions for Specific Pediatric Pathologies
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Sample Questions
Q1) 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.
Q2) Which of the following is an unlikely cause of a leg length discrepancy?
A) Inflammatory hyperemia
B) Hemimelia
C) Joint contracture
D) Stress fracture of bone diaphysis
Q3) Which of the following conditions can present as toe-walking?
A) Cerebral palsy
B) Duchenne muscular dystrophy
C) Idiopathic toe walking
D) All of the above
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Chapter 7: Neuromuscular System: Examination, Evaluation, and Diagnoses
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Sample Questions
Q1) What postural control problem would best explain a decreased ability to lift heavy objects, lean over to retrieve things from the floor, step up onto surfaces without support, step forward, or maintain stance stability with rotation of head and trunk?
A) Adaptive control
B) Proactive control
C) Reactive control
D) Steady-state balance
Q2) 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
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) There is emerging evidence that increased intensity of physical therapy interventions can improve physical therapy outcomes.
A)True
B)False
Q2) 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
Q3) 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
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Chapter 9: Cardiovascular and Pulmonary Systems
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Sample Questions
Q1) When learning a new motor skill, the novice learner may
A) engage all possible degrees of freedom, resulting in uncoordinated movements.
B) incorporate the motion-dependent forces from the leg and trunk movements and gravity, resulting in smoother movements.
C) selectively limit the degrees of freedom, resulting in "stiffer" movement patterns.
D) increase the number of synergies used, resulting in smoother movement patterns.
Q2) Which of the following best describes the activity-focused interventions model for children with neurological diagnoses?
A) The primary emphasis in the plan of care is on impairments that limit the performance of functional activity.
B) The single focus of physical therapy interventions is on practice of functional activities.
C) The emphasis is on practice of functional activities that lead to participation changes, but interventions that address impairments in body functions and structures are also integreated into the plan of care.
D) None of the above
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Chapter 10: Integumentary System
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Sample Questions
Q1) _________exercises are the exercises of choice for pediatric patients with thermal injuries.
Q2) A child with an upper extremity burn that crosses the anterior aspect of the antecubital fossa should A) be splinted in flexion. B) be splinted in extension. C) not be splinted and should perform PROM only. D) be measured for a compression garment.
Q3) A pressure ulcer that presents as a partial-thickness skin loss and can be a blister or shallow crater is a stage ________ulcer.
Q4) ____________are the cells responsible for pulling the epidermal layer toward the center of the wound.
Q5) All of the following are hallmark signs of the inflammatory process except A) a change in skin color. B) a loss of sensation. C) an increased temperature. D) pain.
Q6) The self-reporting pain scale utilized for children aged 3 to 7 years is the _____scale.
Page 12
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Chapter 11: Early Intervention
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Q1) Which of the following is not one of the five developmental areas required in assessment prior to IFSP development?
A) Communication
B) Cognition
C) Memory
D) Physical
E) Adaptive Skills
Q2) 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
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.
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13
Chapter 12: Schools
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Sample Questions
Q1) 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.
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 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.
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Chapter 13: Sports Settings for the School-Aged Child
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Q1) 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
Q2) The purposes of the preparticipation screening include
A) identification of sports that can be played safely.
B) detection of conditions that predispose to injury or limit participation.
C) maturity assessment.
D) All of the above.
Q3) Which of the following characterizes the physiological structure of children?
A) Adult-size heart
B) Lower glycolytic capacity
C) Complete myelination of nervous system
D) Similar stroke volume
Q4) 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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Chapter 14: Pediatric Acute Care Hospital
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Sample Questions
Q1) An 18-month-old toddler who presents in the Pediatric Intensive Care Unit presents with increased work of breathing, fever, poor feeding, and irritability. This toddler is most likely suffering from which of the following?
A) Burkholderia cepacia
B) methicillin-resistant Staphylococcus aureus
C) respiratory syncytial virus (RSV)
D) vancomycin-resistant enterococci
Q2) A 2-year-old toddler with an extensive past medical history including prematurity (33-week gestation), feeding intolerance, and global delays is admitted to the acute care setting for revision of a g-tube. The family is currently followed at home by early intervention one time a week for physical therapy services. What factors play a role in your consideration for determining acute-care physical therapy treatment frequency?
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Chapter 15: Neonatal Intensive Care Unit
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Sample Questions
Q1) 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.
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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Chapter 16: Rehabilitation Settings
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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) 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.
Q3) 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
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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) 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 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) Johanna is a 6-year-old girl with cerebral palsy who is nonverbal. Her school team wants to try a picture symbols system with her. They think she will use eye gaze as a direct selection technique when she starts using a low-tech Augmentative Alternative Communication (AAC) system. How should Johanna's communication partners interact with her when she starts learning to use the AAC? The team should
A) anticipate her needs so she never has to ask for anything.
B) attach as many pictures as realistically possible to her tray to allow her to make choices.
C) model the picture symbols by pointing to them as they talk with her.
D) begin using the AAC system only in speech therapy so she is not overwhelmed.
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Page 20
Chapter 19: Cerebral Palsy
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Q1) 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.
Q2) The Peabody Developmental Motor Scales-2nd edition is an appropriate tool for assessing the level of motor development of a child with cerebral palsy who is A) 3 years old.
B) 7 years old.
C) 13 years old.
D) 21 years old.
Q3) 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
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21
Chapter 20: Cystic Fibrosis
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Q1) The median predicted life expectancy for patients with cystic fibrosis is approximately
A) 18 years.
B) 28 years.
C) 38 years.
D) 48 years.
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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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) 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
Q3) The common gait pattern for individuals with Down syndrome can be characterized by
A) foot supination, forward head, and lordotic spinal column.
B) foot supination, forward head, and kyphotic spinal column.
C) foot pronation, forward head, and kyphotic spinal column.
D) foot pronation, forward head, and lordotic spinal column.
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Page 23
Chapter 22: Leukemia
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Q1) Children with acute lymphoblastic leukemia frequently have chemotherapy (Vincristine)-induced peripheral neuropathy, thus causing range of motion limitations in A) shoulder flexion.
B) neck rotation.
C) spinal flexion.
D) ankle dorsiflexion.
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) Intrathecal chemotherapy is administered directly into what area?
A) Muscle
B) Mouth
C) Vein
D) Cerebral spinal fluid
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Chapter 23: Duchenne Muscular Dystrophy
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Q1) 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.
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) 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
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25
Chapter 24: Developmental Coordination Disorder
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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) 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.
Q3) 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.
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26
Chapter 25: Myelodysplasia
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Q1) 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
Q2) 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
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) 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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