Developmental and Behavioral Pediatrics Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Developmental and Behavioral Pediatrics. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Developmental and Behavioral Pediatrics Indian Medical PG Question 1: All of the following are dashboard indicators used for monitoring of India Newborn Action Plan (INAP). Which one of them is an impact level indicator ?
- A. Neonatal mortality rate (Correct Answer)
- B. Caesarean section rate
- C. Percentage of preterm births
- D. Exclusive breastfeeding rate
Developmental and Behavioral Pediatrics Explanation: ***Neonatal mortality rate***
- This is a key **impact indicator** because it directly measures the ultimate outcome of newborn health interventions: the reduction of deaths in the neonatal period.
- Changes in the neonatal mortality rate reflect the overall effectiveness of programs aimed at improving newborn survival.
*Caesarean section rate*
- This is typically an **outcome or process indicator**, reflecting healthcare service delivery and utilization rather than the direct impact on newborn survival.
- While relevant to maternal and newborn health, it doesn't directly measure newborn mortality or morbidity as an outcome.
*Percentage of preterm births*
- This is an **intermediate outcome indicator** or a **risk factor indicator**, as preterm birth is a major cause of neonatal mortality and morbidity.
- While crucial for monitoring, it is a determinant of neonatal mortality rather than the direct impact itself.
*Exclusive breastfeeding rate*
- This is generally a **process indicator** or a **behavioral indicator**, reflecting the adoption of a recommended practice that supports newborn health.
- While exclusive breastfeeding positively impacts newborn survival, the rate itself is not an impact measure of mortality reduction.
Developmental and Behavioral Pediatrics Indian Medical PG Question 2: Which of the following is NOT a milestone typically expected at 1 year of age?
- A. Playing a simple ball game
- B. Using 2 words that are meaningful
- C. Spontaneous scribbling
- D. Walking upstairs independently (Correct Answer)
Developmental and Behavioral Pediatrics Explanation: ***Walking upstairs independently***
- **Walking upstairs independently** is a gross motor skill that typically develops much later, around **24-36 months of age**, as it requires advanced balance, coordination, and bilateral leg strength.
- At 1 year, an infant might be able to *pull to stand*, *cruise* (walk while holding onto furniture), or take a few independent steps, but independent stair climbing is well beyond their developmental capacity.
*Playing a simple ball game*
- By 1 year, many infants can participate in simple interactive games like rolling a ball back and forth, demonstrating early **social reciprocity and motor coordination**.
- This activity involves basic object manipulation and understanding of turn-taking, which are typical **social-adaptive milestones** at this age.
*Using 2 words that are meaningful*
- Most 1-year-olds can say 1-2 meaningful words besides "mama" and "dada" (e.g., "ball", "dog", "bye"), showing emerging **expressive language skills**.
- This milestone is indicative of vocabulary development and the child's ability to associate words with objects or actions.
*Spontaneous scribbling*
- Around 12 months, children typically make **imitative scribbles** when shown how to use a crayon, demonstrating early **fine motor control**.
- While some advanced 1-year-olds may begin spontaneous scribbling, this skill is more consistently achieved around **15-18 months**, making it an age-appropriate milestone for most infants at 1 year.
- The key distinction is that at 1 year, scribbling is usually *prompted* rather than truly spontaneous.
Developmental and Behavioral Pediatrics Indian Medical PG Question 3: Which of the following is a CORE diagnostic criterion of autistic spectrum disorder according to DSM-5?
- A. Impaired communication (Correct Answer)
- B. Impaired imagination
- C. Language developmental delay
- D. Vision problems
Developmental and Behavioral Pediatrics Explanation: ***Impaired communication***
- Deficits in **social communication and social interaction** are one of the two core diagnostic criteria for Autism Spectrum Disorder (ASD) in DSM-5.
- This includes deficits in social-emotional reciprocity, nonverbal communicative behaviors, and developing/maintaining relationships.
- Communication impairments are essential for diagnosis and must be present across multiple contexts.
*Impaired imagination*
- While restricted, repetitive patterns of behavior (which can include rigid thinking patterns) are the second core criterion, "impaired imagination" is not specifically listed as a core diagnostic criterion in DSM-5.
- Imaginative play deficits may be present but fall under the broader category of restricted/repetitive behaviors, not as a standalone core criterion.
*Language developmental delay*
- Language delay is **not a core diagnostic criterion** in DSM-5 for ASD.
- DSM-5 explicitly states that ASD can occur with or without accompanying language impairment.
- When present, language delay is noted as a specifier, not a required criterion.
*Vision problems*
- Vision problems are not a characteristic feature of Autism Spectrum Disorder.
- Any vision issues in individuals with ASD are co-occurring conditions unrelated to the core diagnostic features.
Developmental and Behavioral Pediatrics Indian Medical PG Question 4: 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)
Developmental and Behavioral Pediatrics 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.
Developmental and Behavioral Pediatrics Indian Medical PG Question 5: What is the significance of the persistence of the asymmetric tonic neck reflex in a 9-month-old infant?
- A. Decreased muscle tone
- B. Increased muscle tone (Correct Answer)
- C. Normal phenomenon
- D. None of the options
Developmental and Behavioral Pediatrics Explanation: ***Increased muscle tone***
- The **asymmetric tonic neck reflex (ATNR)** should integrate by **6 months of age**, and its persistence beyond this period is a sign of **neurological dysfunction**.
- Persistent primitive reflexes, including ATNR, are often associated with **upper motor neuron lesions** and can manifest as increased muscle tone or **spasticity**.
*Decreased muscle tone*
- **Decreased muscle tone**, or **hypotonia**, is typically associated with **lower motor neuron lesions** or certain genetic conditions, not the persistence of primitive reflexes.
- While some neurological conditions can cause hypotonia, persistent ATNR is a hallmark of problems leading to **hypertonia**.
*Normal phenomenon*
- The persistence of the ATNR beyond **6 months of age** is considered abnormal and indicates a potential developmental delay or neurological issue.
- In a **9-month-old**, the reflex should have fully integrated, and its presence warrants further investigation.
*None of the options*
- As the persistence of the ATNR is indeed a significant finding, associated with increased muscle tone, this option is incorrect.
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