Developmental Milestones — MCQs
A normally growing child smiles back (social smile) at around what age?
A 3-year-old child with delayed speech development, prefers to play alone and is not making friends. The likely diagnosis is
Absence of which of the given milestones in a 3 year old child should be called delayed development?
A child of 4 years can do all of the following except:
A child with pervasive developmental disorder will have all of the following except:
Which of the following statements about development milestones at 6 months of age is incorrect?
A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is
Bilateral grasp is seen at what age?
At what age do most children reach a height of 100 cm?
At what month does a baby typically sit in the tripod position?
Developmental Milestones Indian Medical PG Practice Questions and MCQs
Question 1: A normally growing child smiles back (social smile) at around what age?
- A. 2-4 weeks
- B. 4-6 weeks
- C. 6-8 weeks (Correct Answer)
- D. 8-10 weeks
Explanation: ***6-8 weeks*** - A **social smile** is a significant developmental milestone indicating emotional and social development, typically appearing around **2 months of age** (6-8 weeks). - It signifies the infant's ability to recognize and respond to human faces, fostering early parent-child bonding. *2-4 weeks* - At this age, infants typically exhibit **reflexive smiles**, which are not true social smiles as they do not respond to external stimuli. - Their primary focus is on basic physiological needs like feeding and sleeping. *4-6 weeks* - While infants may show some early signs of engagement, a consistent and clear **social smile** is usually not fully established yet. - They are more focused on tracking objects and showing early visual preferences. *8-10 weeks* - By this age, the **social smile** should already be well-established, as it typically appears by 6-8 weeks. - If a social smile has not appeared by 10 weeks, developmental assessment and monitoring for other milestones would be warranted.
Question 2: A 3-year-old child with delayed speech development, prefers to play alone and is not making friends. The likely diagnosis is
- A. Autism (Correct Answer)
- B. Specific learning disability
- C. Rett's syndrome
- D. ADHD
Explanation: ***Autism*** - **Delayed speech development**, a preference for playing alone, and difficulty making friends are classic diagnostic criteria for **Autism Spectrum Disorder (ASD)**. - ASD is characterized by persistent deficits in **social communication and social interaction** across multiple contexts, along with restricted, repetitive patterns of behavior, interests, or activities. *Specific learning disability* - A specific learning disability primarily affects academic skills (e.g., **reading, writing, arithmetic**) in individuals with otherwise average intelligence. - While it can impact social interactions due to frustration or self-esteem issues, its core features are not primarily related to delayed speech or intrinsic difficulties in social engagement. *Rett's syndrome* - Rett's syndrome is a rare **neurodevelopmental disorder** that almost exclusively affects females and is caused by mutations in the MECP2 gene. - It is characterized by initial normal development followed by a regression of skills, including **purposeful hand movements**, speech, and gait, often presenting with stereotypic hand-wringing. - The clinical presentation here shows early developmental concerns without regression, making ASD more likely. *ADHD* - **Attention-deficit/hyperactivity disorder (ADHD)** is characterized by symptoms of **inattention, hyperactivity, and impulsivity**. - While children with ADHD may have difficulty with social interactions due to impulsivity or inattention, delayed speech development and a consistent preference for solitary play are not primary diagnostic features.
Question 3: 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 4: A child of 4 years can do all of the following except:
- A. Copies triangle (Correct Answer)
- B. Skips
- C. Tell a story
- D. Goes down stairs one foot per step
Explanation: ***Copies triangle*** - Drawing a **triangle** typically develops around **5 to 6 years of age** as it requires more advanced fine motor and visual-motor integration skills. - At 4 years, a child can usually copy simpler shapes like a **square** or a **cross**, but not a triangle. *Skips* - **Skipping** is a gross motor skill that often emerges around **4 to 5 years of age**. - Many 4-year-olds can coordinate the reciprocal motion required to skip, even if not perfectly. *Tell a story* - By 4 years, children have developed sufficient language skills to **recount events** and **create simple narratives**, often with imaginative elements. - They can use several sentences to tell a story and understand the concept of a beginning, middle, and end. *Goes down stairs one foot per step* - Descending stairs with one foot per step is a typical gross motor milestone achieved by most children around **3 to 4 years of age**. - This shows improved balance and coordination compared to using both feet on each step.
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: 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 7: A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is
- A. 4 years
- B. 5 years
- C. 2 years
- D. 3 years (Correct Answer)
Explanation: ***3 years*** - A child who can **ride a tricycle**, **copy a circle**, and knows their **name and gender** has achieved developmental milestones typically seen around **3 years of age**. - **Riding a tricycle** demonstrates advanced gross motor skills, while **copying a circle** indicates fine motor skill development. **Knowing name and gender** points to cognitive and social-emotional understanding. *4 years* - By 4 years, a child can typically **hop on one foot**, **draw a square**, and **tell stories**. - While they might refine skills acquired at 3, the listed milestones are primary for the 3-year mark. *5 years* - A 5-year-old usually can **skip**, **draw a triangle**, and **count 10 or more objects**. - These milestones represent further advancements beyond those described in the question. *2 years* - At 2 years, a child typically starts to **kick a ball**, **draw a straight line**, and can say **two-to-four-word sentences**. - The skills described (tricycle, circle) are generally too advanced for a 2-year-old.
Question 8: Bilateral grasp is seen at what age?
- A. 6 months
- B. 3 months
- C. 9 months
- D. 5 months (Correct Answer)
Explanation: ***5 months*** - At **5 months**, infants typically develop the ability to **reach for and grasp objects with both hands**, demonstrating improved coordination and control. - This age marks a transition from reflexive grasping to more intentional and bilateral manipulation of objects. *6 months* - While fine motor skills continue to develop at 6 months, **bilateral grasp** is usually well-established by this age, having emerged earlier. - At 6 months, infants are often progressing towards **unilateral grasp** and transferring objects between hands. *3 months* - At **3 months**, infants are typically still developing head control and beginning to reach, but their grasp is often still a **reflexive palmar grasp** rather than intentional bilateral grasping. - Reaching at this age is usually more swiping or batting at objects rather than a coordinated grasp. *9 months* - By **9 months**, infants have developed more refined pincer grasp and are capable of complex manipulation of objects with a single hand. - **Bilateral grasp** is a much earlier developmental milestone than the advanced skills seen at 9 months.
Question 9: At what age do most children reach a height of 100 cm?
- A. 3 years
- B. 2 years
- C. 5 years
- D. 4 years (Correct Answer)
Explanation: **4 years** - Most children reach approximately **100 cm** in height around their fourth birthday. - This represents a doubling of their birth length, as the average birth length is around 50 cm. *2 years* - A child's height at 2 years is typically around **86-89 cm**. - While they have often doubled their birth weight by then, they haven't typically reached 100 cm in height. *3 years* - By 3 years of age, the average height for a child is usually between **94-96 cm**. - This is close, but still generally less than the 100 cm mark. *5 years* - Children aged 5 years are generally taller than **100 cm**, typically averaging around **108-110 cm**. - Reaching 100 cm would occur well before this age.
Question 10: At what month does a baby typically sit in the tripod position?
- A. 9 months
- B. 8 months
- C. 5 months
- D. 6 months (Correct Answer)
Explanation: **6 months** - Around **6 months** of age, infants typically develop sufficient **head control** and **trunk strength** to sit unsupported, often using their hands for balance in a **tripod position**. - This developmental milestone is crucial for further motor development, enabling improved visual exploration and hand use. *5 months* - At **5 months**, infants can usually **roll over** and support themselves on their forearms, but generally lack the **trunk stability** for unsupported sitting. - While they might briefly sit with support, the sustained **tripod position** is typically not achieved until later. *8 months* - By **8 months**, most infants can sit **unsupported for extended periods** and often begin to **crawl** or pull themselves to stand. - The tripod position is usually a precursor to fully unsupported sitting, which is well-established by this age. *9 months* - At **9 months**, infants are typically highly mobile, often **crawling**, **cruising** (walking while holding onto furniture), and sitting completely **independently** without needing hand support. - The need for a tripod position for stability would indicate a **developmental delay** at this age.
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