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: ### **Explanation: Autism Spectrum Disorder (ASD) Criteria**
The **DSM-5** revolutionized the diagnosis of Autism by merging several older categories (like Asperger’s and PDD-NOS) into a single spectrum. It defines ASD through two core "dyads" of impairment.
#### **Why Option A is Correct**
**Impaired communication** is a fundamental component of the first core criterion: **Persistent deficits in social communication and social interaction**. This includes:
* Deficits in **social-emotional reciprocity** (e.g., failure of normal back-and-forth conversation).
* Deficits in **non-verbal communicative behaviors** (e.g., abnormalities in eye contact or body language).
* Deficits in developing, maintaining, and understanding **relationships**.
#### **Analysis of Incorrect Options**
* **B. Impaired imagination:** While often present (lack of "make-believe" play), it is considered a subset of social-communication deficits rather than a standalone core criterion.
* **C. Language developmental delay:** Under DSM-IV, this was a primary criterion. However, **DSM-5 removed language delay** as a core requirement because many individuals on the spectrum (formerly Asperger’s) have fluent speech. Language impairment is now considered a "specifier" rather than a diagnostic requirement.
* **D. Vision problems:** These are not part of the diagnostic criteria for ASD, though sensory sensitivities (hypersensitivity to light) are common.
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### **High-Yield Clinical Pearls for NEET-PG/INI-CET**
* **The Second Core Criterion:** Restricted, repetitive patterns of behavior, interests, or activities (includes **stereotyped movements**, insistence on sameness, and **sensory hyper/hypo-reactivity**).
* **Age of Onset:** Symptoms must be present in the **early developmental period** (typically recognized by age 2).
* **M-CHAT:** The most commonly used screening tool for toddlers (16–30 months).
* **Prognosis:** The best predictors of long-term outcome are **IQ level** and **communicative language development** by age 5.
* **Pharmacotherapy:** No drug treats core symptoms. **Risperidone** and **Aripiprazole** are FDA-approved only for associated **irritability/aggression** in ASD.
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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