Language and Speech Disorders — MCQs

10 questions

A patient with schizophrenia demonstrates significant difficulty in maintaining meaningful social interactions. The most appropriate initial management approach is:

Absence of which of the given milestones in a 3 year old child should be called delayed development?

A 7-year-old girl presents with difficulties in writing and spelling, while her overall intelligence is normal. What is the most likely diagnosis?

A child is suspected of having an autistic disorder. All areTRUE about autism, EXCEPT:

A child with pervasive developmental disorder will have all of the following except:

Best therapy suited to teach daily life skill to a mentally challenged child:

A two year old girl child is brought to the out patient with features of hand wringing stereotype movements, impaired language and communication development, breath holding spells, poor social skills and deceleration of head growth after 6 months of age. The most likely diagnosis is –

Which of the following statements about development milestones at 6 months of age is incorrect?

At what age do children typically begin to use past and present tense in their speech?

Q10

Most reliable predictor of autism in 18-month-olds is:

Language and Speech Disorders Indian Medical PG Practice Questions and MCQs

Question 1: A patient with schizophrenia demonstrates significant difficulty in maintaining meaningful social interactions. The most appropriate initial management approach is:

A. Individual psychotherapy
B. Social skills training (Correct Answer)
C. Family psychoeducation
D. Cognitive remediation therapy

Explanation: ***Social skills training*** - **Social skills training (SST)** is the most appropriate initial management because it directly addresses the patient's difficulty in maintaining meaningful social interactions by teaching specific social behaviors and communication skills. - SST helps individuals with schizophrenia learn to interpret social cues, engage in conversations, and build relationships, which are key areas of deficit in their social functioning. *Individual psychotherapy* - While individual psychotherapy can be beneficial for managing symptoms and coping strategies, it may not be the most effective initial approach for directly improving concrete **social interaction skills** in schizophrenia. - Psychotherapy often focuses on internal processes, whereas the primary problem here is external social engagement. *Family psychoeducation* - **Family psychoeducation** is crucial for supporting the family and providing them with information about schizophrenia, reducing relapse rates, and improving family coping. - However, it does not directly teach the patient the necessary skills to improve their own **social interactions**. *Cognitive remediation therapy* - **Cognitive remediation therapy (CRT)** aims to improve cognitive functions such as attention, memory, and executive function, which can indirectly impact social functioning. - While beneficial, CRT does not directly teach specific **social interaction behaviors** and would typically be used in conjunction with, or after, more direct social skill interventions.

Question 2: Absence of which of the given milestones in a 3 year old child should be called delayed development?

A. Hopping on one leg
B. Catching a ball reliably
C. Drawing a square
D. Feeding by spoon (Correct Answer)

Explanation: ***Feeding by spoon*** - The ability to **feed oneself with a spoon** is typically achieved by **15 to 18 months of age**, making its absence in a 3-year-old a sign of delayed development. - This milestone reflects both **fine motor coordination** and **self-help skills**. *Hopping on one leg* - **Hopping on one leg** is a gross motor skill usually developed between **4 and 5 years of age**, so a 3-year-old not yet doing this is within the normal developmental range. - This skill requires advanced **balance** and **coordination**. *Catching a ball reliably* - **Catching a ball reliably** typically emerges around **4 to 5 years of age**, as it requires good **hand-eye coordination** and **anticipation skills**. - A 3-year-old's inability to catch a ball reliably is not considered delayed. *Drawing a square* - The ability to **draw a square** is usually achieved by **4 to 5 years of age**, requiring fine motor precision and visuomotor integration. - At 3 years, children are more likely to be able to copy a **circle** or **vertical line**.

Question 3: A 7-year-old girl presents with difficulties in writing and spelling, while her overall intelligence is normal. What is the most likely diagnosis?

A. Dyslexia
B. Intellectual disability
C. Dysphonia
D. Specific learning disorder affecting writing (Correct Answer)

Explanation: ***Specific learning disorder affecting writing*** - This diagnosis aligns with documented difficulties in **writing and spelling** despite **normal overall intelligence**. - Formerly known as **dysgraphia**, it specifically impacts the motor and cognitive aspects of written expression. *Dyslexia* - Primarily affects **reading abilities**, with challenges in **decoding and phonological processing**. - While it can co-occur with writing difficulties, the primary presentation here emphasizes writing and spelling. *Intellectual disability* - Characterized by significant limitations in both **intellectual functioning** and **adaptive behavior**. - The descriptor "normal overall intelligence" directly rules out intellectual disability. *Dysphonia* - Refers to a **disorder of the voice**, affecting its quality, pitch, or loudness. - This condition is related to speech production and has no direct involvement with difficulties in writing or spelling.

Question 4: A child is suspected of having an autistic disorder. All areTRUE about autism, EXCEPT:

A. Repetitive behavior is seen
B. Language is not well developed
C. Child is able to interact (Correct Answer)
D. Symptoms appear between 18-24 months

Explanation: ***Child is able to interact*** - Autism Spectrum Disorder (ASD) is characterized by **persistent deficits in social communication and social interaction**. - Children with autism typically have difficulty with **social reciprocity**, such as initiating or responding to social interactions, and often show limited interest in interacting with peers. - This statement is **FALSE** about autism, making it the correct answer to this EXCEPT question. *Repetitive behavior is seen* - **Restricted, repetitive patterns of behavior, interests, or activities** are a core diagnostic criterion for ASD. - This can manifest as **stereotyped or repetitive motor movements**, use of objects, or speech, as well as insistence on sameness or highly restricted, fixed interests. *Language is not well developed* - Many individuals with ASD experience **delays or difficulties in language development**, ranging from a complete lack of spoken language to difficulties with conversational skills and understanding nuances of speech. - While some may develop advanced vocabulary, their **pragmatic language skills** (social use of language) are often impaired. *Symptoms appear between 18-24 months* - Symptoms of ASD often become noticeable between **12 and 24 months** of age, though this can vary. - Early signs can sometimes be observed before 12 months, and in some cases, symptoms may not become clear until **social demands exceed limited capacities** in later childhood. - The typical age of symptom recognition is indeed in this developmental period.

Question 5: A child with pervasive developmental disorder will have all of the following except:

A. Stereotyped behaviour
B. Reduced social interaction
C. Poor language skills
D. Impaired cognition (Correct Answer)

Explanation: ***Impaired cognition*** - While some individuals with **pervasive developmental disorders (PDDs)** may have comorbid intellectual disability, **impaired cognition is not a universal or defining characteristic** of PDDs. - Many individuals with PDDs, particularly those with **Asperger's syndrome**, have **average or above-average intelligence**. - Intelligence quotient (IQ) varies widely across the autism spectrum, making cognitive impairment a non-essential feature. *Stereotyped behaviour* - **Stereotyped and repetitive behaviors** (e.g., hand flapping, rocking, rigid adherence to routines) are a **core diagnostic criterion** for PDDs, including autism spectrum disorder. - These behaviors are part of the **restricted, repetitive patterns of behavior, interests, or activities** domain in diagnostic criteria. *Reduced social interaction* - Significant **deficits in social interaction and communication** are a **hallmark feature** of PDDs. - This manifests as difficulty with reciprocal social communication, impaired ability to interpret social cues, and challenges in forming age-appropriate peer relationships. *Poor language skills* - **Communication impairments**, including poor language skills, are a **common feature** of PDDs, especially in classical autism. - This can include delayed speech development, unusual language patterns (e.g., **echolalia**, pronoun reversal), or complete absence of verbal communication in severe cases.

Question 6: Best therapy suited to teach daily life skill to a mentally challenged child:

A. Contingency management (Correct Answer)
B. Cognitive reconstruction
C. Self instruction
D. CBT (Cognitive behavior therapy)

Explanation: ***Contingency management*** - This therapy involves consistently **rewarding desired behaviors** and withholding rewards for undesirable ones, which is highly effective for teaching new skills to individuals with intellectual disabilities. - It uses principles of **operant conditioning** to shape behavior through positive reinforcement, making it suitable for acquiring daily living skills. *Cognitive reconstruction* - This technique focuses on identifying and changing **maladaptive thought patterns**, which typically requires a higher level of cognitive function. - It is generally not the primary or most effective approach for teaching concrete daily life skills to individuals with significant **cognitive limitations**. *Self instruction* - This involves teaching individuals to guide their own behavior using **internal verbal cues** or self-talk. - While beneficial for some, it often requires a certain degree of **abstract thinking** and memory, making it less suitable as a standalone method for those with profound cognitive challenges in acquiring basic skills. *CBT (Cognitive behavior therapy)* - CBT integrates cognitive and behavioral strategies to address emotional and behavioral problems by modifying **thoughts, feelings, and behaviors**. - While beneficial for a range of psychological issues, its emphasis on **cognitive restructuring** makes it less directly applicable or the most effective first-line therapy for teaching concrete, functional daily living skills to mentally challenged children.

Question 7: A two year old girl child is brought to the out patient with features of hand wringing stereotype movements, impaired language and communication development, breath holding spells, poor social skills and deceleration of head growth after 6 months of age. The most likely diagnosis is –

A. Rett's syndrome (Correct Answer)
B. Asperger's syndrome
C. Fragile x–syndrome
D. Colorado syndrome

Explanation: ***Rett's syndrome*** - The constellation of **hand-wringing stereotype movements**, language impairment, poor social skills, and **deceleration of head growth** after 6 months of age in a female child is highly characteristic of Rett's syndrome. - This neurodevelopmental disorder is almost exclusively seen in girls and is caused by a mutation in the **MECP2 gene**. *Asperger's syndrome* - Asperger's syndrome (now part of **Autism Spectrum Disorder**) typically presents with difficulties in social interaction and nonverbal communication, alongside restricted and repetitive patterns of behavior and interests. - However, it does not usually involve **seizures, loss of purposeful hand use, or acquired microcephaly**, which are key features of Rett's syndrome. *Fragile x–syndrome* - Fragile X syndrome is a genetic condition causing intellectual disability, most commonly in males, characterized by a **long face, prominent jaw and ears**, and **macroorchidism** (large testicles) in post-pubertal males. - It does not specifically feature the unique hand stereotypes or decelerated head growth seen in Rett's syndrome. *Colorado syndrome* - **Colorado syndrome** is not a recognized medical diagnosis for such a clinical presentation. - The symptoms described do not align with any known neurological or developmental disorder named "Colorado syndrome."

Question 8: Which of the following statements about development milestones at 6 months of age is incorrect?

A. Watching self in mirror
B. Pincer grasp (Correct Answer)
C. Sitting in tripod position
D. Monosyllable sounds

Explanation: ***Pincer grasp*** - The **pincer grasp** (using the index finger and thumb to pick up small objects) typically develops much later, usually around **9-12 months** of age. - At 6 months, infants are usually developing a **palmar grasp** or raking motion, not the fine motor control required for a pincer grasp. - This milestone is **NOT expected at 6 months**, making this the incorrect statement. *Watching self in mirror* - By 6 months, infants typically show **interest in their own reflection** and will watch themselves in a mirror, often smiling or vocalizing at the image. - This is a normal social-emotional milestone at this age. *Sitting in tripod position* - Many 6-month-old infants are able to sit with support, and often begin to sit independently for short periods, frequently using their arms for stability in a **tripod position**. - This is a common and expected gross motor milestone at this age. *Monosyllable sounds* - Around 6 months, infants commonly start to produce **monosyllable sounds** like "ba-ba," "da-da," or "ma-ma," as part of their early babbling. - This is a normal and expected language development milestone.

Question 9: At what age do children typically begin to use past and present tense in their speech?

A. 18 Months
B. 1 Year
C. 2 Years
D. 30 Months (Correct Answer)

Explanation: ***30 Months*** - Around 30 months (2.5 years), children typically begin to comprehend and produce **simple past and present tense forms**. - This stage reflects an increased understanding of **time concepts** and more complex grammatical structures. *1 Year* - At 1 year, children are usually at the **single-word stage**, using vocabulary like 'mama' or 'dada'. - They are primarily focused on **naming objects and people**, with little to no grasp of verb tenses. *2 Years* - By 2 years, children are generally using **two-word phrases** and beginning to combine words into simple sentences. - While they are expanding their vocabulary, consistent use of distinct past and present tenses is still developing. *18 Months* - Children at 18 months are typically expanding their **single-word vocabulary** and may be starting to use two-word combinations. - Their language is still focused on immediate needs and objects, without the grammatical complexity of verb tenses.

Question 10: Most reliable predictor of autism in 18-month-olds is:

A. No pretend play (Correct Answer)
B. Language delay
C. Repetitive behaviors
D. Poor eye contact

Explanation: ***No pretend play*** - The absence of **symbolic play** or **pretend play** is a significant early indicator of autism spectrum disorder (ASD) in toddlers. - This reflects a core deficit in **social imagination** and understanding of others' perspectives often seen in ASD. *Language delay* - While **language delay** is a common feature in children with ASD, it is not the most specific or reliable predictor on its own at 18 months, as many children without ASD can also experience language delays. - It can also be associated with other developmental issues, making it less specific than lack of pretend play. *Repetitive behaviors* - **Repetitive behaviors**, such as hand flapping or rocking, are characteristic of ASD but often become more prominent and easier to identify at a slightly later age than 18 months. - At this early age, these behaviors may be subtle and less consistently observed compared to deficits in pretend play. *Poor eye contact* - **Poor eye contact** is a recognized symptom of ASD, reflecting difficulties in social interaction. - However, it can be variable and influenced by temperament and other factors, making it less universally reliable as the single best predictor at 18 months compared to the fundamental disruption in social communication represented by absent pretend play.

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free