Common Diagnoses
Which combination of features is most commonly associated with Down syndrome in infancy and early childhood?
A) Tall stature, large hands, and early speech development
B) Short neck, hypotonia, upward slanting eyelids, and developmental delays
C) Rapid motor development, sharp facial features, and strong muscle tone
D) Irregular pigmentation, enlarged internal organs, and high-pitched voice
B) Short neck, hypotonia, upward slanting eyelids, and developmental delays
Explanation:
✅ Children with Down syndrome often present with low muscle tone (hypotonia), a short neck, distinctive facial features, and delays in speech, motor, and cognitive development.
❌ Options A, C, and D do not reflect typical early features of Down syndrome.
Which of the following is a low-tech assistive device used to support communication in non-verbal children?
A) Eye gaze tracking software
B) PECS (Picture Exchange Communication System)
C) Augmentative and Alternative Communication (AAC) app on a tablet
D) Speech-generating device with dynamic display
__________________________________________
Choose the correct option:
A) A only
B) B only
C) B and C
D) All of the above
B) B only
Explanation:
✅ B is true: PECS is a low-tech option using laminated symbols/pictures to support communication.
❌ A, C, and D are considered high-tech devices requiring electronic input/output or software.
Access to appropriate therapeutic devices at all times is considered a basic right for children with disabilities.
A) True
B) False
A) True
Explanation:
✅ Children with disabilities have the right to access assistive devices and supports that enable them to participate equally in daily life.
This includes mobility aids, communication tools, and positioning equipment, and should not be withheld or treated as optional extras.
Why can mental health conditions in children with ID be difficult to diagnose?
A. Because they are physically healthy
B. Because they always verbally express their feelings
C. Because emotional distress is often expressed through behaviour rather than language
D. Because standard diagnostic tools work better for them
✅ C. Because emotional distress is often expressed through behaviour rather than language
What is the most commonly prescribed medication(s) for irritability and aggression in children with Autism Spectrum Disorder (ASD)?
A) Ritalin
B) Carbamazepine
C) Risperidone (Risperdal)
D) Fluoxetine
__________________________________________
Choose the correct option:
A) A only
B) C only
C) C and D
D) All of the above
B) C only
Explanation:
✅ C is correct: Risperidone is the most commonly used medication for irritability, aggression, and self-injurious behaviour in children with autism.
❌ A (Ritalin) is used for ADHD, not autism specifically.
❌ B (Carbamazepine) is used for epilepsy and mood disorders.
❌ D (Fluoxetine) is sometimes used for anxiety or depression but is not the first-line treatment for core ASD symptoms.
Which of the following statements about Cerebral Palsy (CP) is TRUE?
A) CP is a progressive disorder that worsens over time
B) Hemiplegia, affecting one side of the body, is the most common type of CP
C) CP is most often caused by genetic inheritance
D) All individuals with CP are unable to walk or talk
B) Hemiplegia, affecting one side of the body, is the most common type of CP
Explanation:
✅ Hemiplegia (one side affected) and spastic diplegia (legs more affected than arms) are common forms.
❌ CP is non-progressive (damage is static, though symptoms may change).
❌ It is not typically genetic.
❌ Many people with CP can walk, talk, and participate in daily life with support.
Which of the following are true statements about ankle-foot orthoses (AFOs) used in children with motor impairments?
A) AFOs are designed to prevent foot drop and support ankle alignment.
B) AFOs must be custom-fitted to each child and reviewed regularly.
C) Children using AFOs can never walk without assistive support.
D) AFOs help improve gait patterns in children with cerebral palsy or spina bifida.
__________________________________________
Choose the correct option:
A) A and B only
B) A, B and D
C) All of the above
D) B and D only
B) A, B and D
Explanation:
✅ A: AFOs support correct ankle positioning and help prevent foot drop.
✅ B: They must be fitted to the child's growth and physical changes.
❌ C: Some children with AFOs can walk independently — this depends on their overall motor function and condition.
✅ D: AFOs improve stability and movement efficiency for walking.
Which answer lists three actual rights of children in South Africa?
A) The right to vote, the right to drive, and the right to freedom of trade
B) The right to social media, the right to travel abroad, and the right to inheritance
C) The right to be registered, the right to education, and the right to healthcare
D) The right to work, the right to choose political leaders, and the right to pay taxes
C) The right to be registered, the right to education, and the right to healthcare
Explanation:
✅ According to the South African Constitution and the Children’s Act, all children have the right to:
Birth registration (legal identity)
Basic education
Access to health services
❌ Voting, driving, and working are adult rights, not child rights.
A child with intellectual disability begins having frequent tantrums after small changes in routine. What is the most likely interpretation of this behaviour based on the information provided?
A. The child is being manipulative and needs firmer boundaries
B. The child is spoiled and overreacts to minor issues
C. The child may be experiencing emotional overload due to anxiety
D. The tantrums are unrelated to the child’s disability and should be ignored
✅ C. The child may be experiencing emotional overload due to anxiety
What are common side effects of Ritalin (methylphenidate) in children?
A) Headaches
B) Trouble sleeping
C) Loss of appetite
__________________________________________
Choose the correct option:
A) A only
B) A and B only
C) C only
D) All of the above
D) All of the above
Explanation:
✅ Headaches, insomnia, and reduced appetite are well-documented side effects of stimulant medication like Ritalin.
These side effects often occur at the start of treatment and may lessen over time or be managed by dose adjustments.
Monitoring by a healthcare provider is essential to ensure safety and effectiveness.
Which of the following is a common characteristic of Autism Spectrum Disorder (ASD) in children?
A) Strong preference for unstructured and spontaneous routines
B) Advanced pretend play without prompting
C) Delays in self-care tasks and difficulty with hygiene due to sensory sensitivities
D) High-quality sleep with minimal behavioral impact
C) Delays in self-care tasks and difficulty with hygiene due to sensory sensitivities
Explanation:
✅ Many autistic children have sensory processing differences that affect self-care tasks like brushing teeth, haircuts, or dressing.
❌ Children with ASD usually prefer structure and routine (A is false).
❌ Pretend play is often limited or needs prompting (B is false).
❌ Sleep issues are common in ASD, not minimal (D is false).
Which of the following statements reflect best practice when supporting a child using an assistive mobility device (e.g. wheelchair, gait trainer, walker)?
A) Devices should be checked for fit, safety, and condition daily.
B) All children with mobility aids must be transferred out of them every hour regardless of ability.
C) Staff should be trained in how to assist, transfer, and position each individual child.
D) Encouraging active participation and choice is part of using the device ethically.
__________________________________________
Choose the correct option:
A) A, C and D
B) All of the above
C) A and B only
D) C and D only
A) A, C and D
Explanation:
✅ A: Daily safety checks are essential for preventing injury.
❌ B: While regular repositioning is important, it must be individualised — some children may tolerate longer sitting times, while others may need shorter intervals. There is no one-size-fits-all time rule.
✅ C: Proper training ensures safety and dignity.
✅ D: Children should be given autonomy and choice in using their devices whenever possible — it's both ethical and empowering.
Due to the right to freedom, children are permitted, according to the Constitution, to beg on the side of the road.
A) True
B) False
B) False
Explanation:
❌ While the Constitution does protect freedom, children also have the right to protection from exploitation and harm.
Begging, especially in unsafe environments like roads, violates child protection laws and exposes children to danger.
Children are entitled to care, education, and protection — not to be used to generate income through begging.
Which of the following is NOT a recommended support strategy for children with ID experiencing mental health difficulties?
A. Teaching emotional awareness using visuals
B. Ignoring behaviours to avoid reinforcing them
C. Using predictable routines and calming spaces
D. Collaborating with a multidisciplinary team
✅ B. Ignoring behaviours to avoid reinforcing them
Epilim and carbamazepine are most commonly used to treat epilepsy in children.
A. True
B. False
True
Explanation:
✅ Both Epilim and Carbamazepine are commonly prescribed antiepileptic drugs (AEDs) for managing seizures in children.
Choice of medication depends on the seizure type, age, and side-effect profile.
Epilim is often used for generalised seizures; carbamazepine is more common for focal seizures.
Which type of spina bifida involves an exposed spinal cord and nerves, often causing paralysis and brain abnormalities?
A) Occulta
B) Closed Neural Tube Defects
C) Meningocele
D) Myelomeningocele
D) Myelomeningocele
Explanation:
✅ Myelomeningocele is the most severe form of spina bifida, where the spinal canal remains open and spinal cord and nerves protrude.
❌ Occulta is the mildest form, often hidden under the skin.
❌ Meningocele involves the spinal cord coverings, but not the spinal cord itself.
❌ Closed neural tube defects are usually less severe.
Which of the following are key goals of using a properly fitted posture support device (e.g. Shonaquip wheelchair or seating system)?
A) Prevent spinal deformities and pressure sores
B) Improve speech and language development directly
C) Increase comfort and endurance during learning activities
D) Promote safe feeding and swallowing posture
__________________________________________
Choose the correct option:
A) A and C only
B) A, C and D
C) All of the above
D) B and D only
B) A, C and D
Explanation:
✅ A: Proper support helps prevent scoliosis, pelvic tilt, and pressure sores.
❌ B: Posture support doesn’t directly improve speech/language development, although improved positioning may indirectly help communication.
✅ C: Correct posture increases attention and tolerance during seated tasks.
✅ D: Proper head/trunk alignment is crucial for safe feeding and reducing aspiration risk.
What is the main purpose of White Paper 6 (2001)?
A) To establish more private schools for children with disabilities
B) To remove children with disabilities from mainstream education and place them in special schools
C) To create an inclusive education and training system for all learners
D) To provide funding specifically for special schools
C) To create an inclusive education and training system for all learners
Explanation:
✅ White Paper 6 is South Africa’s national policy framework for inclusive education.
It promotes the idea that all children, regardless of ability, should be supported in regular schools wherever possible — with necessary accommodations.
❌ It does not advocate segregation or special school-only approaches.
What percentage of children with intellectual disability (ID) may meet the criteria for a psychiatric disorder at some point in their lives?
A. 10%
B. 25%
C. 50%
D. 70%
✅ C. 50%
Which areas of the body are commonly used for insulin injections?
A) Hands and feet
B) Abdomen, buttocks, thighs and upper arms
__________________________________________
Choose the correct option:
A) A only
B) B only
C) All of the above
D) None of the above
B) B only
Explanation:
✅ Insulin is subcutaneously injected into fatty tissue, most commonly in the abdomen, thighs, buttocks, and upper arms.
❌ Hands and feet are not suitable injection sites due to risk of nerve or blood vessel damage.
Rotating injection sites helps prevent lipodystrophy (fatty tissue changes).
Which type of cerebral palsy is characterized primarily by muscle stiffness and is the most common form, resulting from damage to the motor cortex?
A) Dyskinetic CP
B) Ataxic CP
C) Spastic CP
D) Mixed CP
C) Spastic CP
Explanation:
✅ Spastic cerebral palsy is the most common type, making up about 70–80% of cases. It involves increased muscle tone (stiffness) and limited movement.
❌ Dyskinetic CP involves involuntary, writhing movements.
❌ Ataxic CP affects balance and coordination.
❌ Mixed CP combines features of more than one type, but is not the most common.
Which of the following are benefits of using a standing frame for a child with high physical support needs?
A) Supports bone development and reduces risk of osteoporosis
B) Increases the child’s ability to walk independently
C) Improves digestion, bladder, and bowel function
D) Promotes social inclusion by allowing eye-level interaction with peers
__________________________________________
Choose the correct option:
A) A only
B) A and C only
C) A, C and D
D) All of the above
C) A, C and D
Explanation:
✅ A is true: Standing supports bone strength and reduces osteoporosis risk.
❌ B is false: Standing frames do not directly improve independent walking ability in most users because standing in a fixed frame is passive – the child isn’t learning or practicing the dynamic balance and coordinated movements required to walk.
✅ C is true: Standing supports digestive and bladder/bowel function through improved alignment and pressure.
✅ D is true: Being upright allows better peer engagement and participation.
All children in South Africa have the right to free health care at a hospital level.
A) True
B) False
B) False
Explanation:
✅ Children under 6 years old (and pregnant women) are entitled to free primary and hospital-level public health care in South Africa.
❌ After age 6, access may depend on the child's needs, service availability, ethics (e.g. distributive justice), location, and health facility and department policies. This is also a reason as to why an ethics board is so essential in health care facilities.
The right to health care is protected, but not unlimited and unconditional at every level.
Why is multidisciplinary collaboration especially important in supporting children with ID and co-occurring mental health conditions?
A. It ensures that only medical treatment is provided
B. It allows different professionals to take turns in supporting the child
C. It enables comprehensive understanding across developmental, emotional, and behavioural needs
D. It reduces the need for family involvement in care
✅ C. It enables comprehensive understanding across developmental, emotional, and behavioural needs
Sensory Processing Disorder (SPD) affects how the brain processes sensory input. What are common behaviours in children with SPD?
A) Poor balance
B) Irritation to light/sound
C) Rocking and swaying
__________________________________________
A) A only
B) B only
C) A and C only
D) All of the above
D) All of the above
Explanation:
✅ Children with SPD may be over-responsive (irritated by noise or light), under-responsive (seek strong movement like spinning), or have motor planning difficulties (leading to poor balance).
Rocking, swaying, covering ears, or avoiding textures are all common signs.
Sensory needs vary, and occupational therapists often assess and support children with these difficulties.