Pediatrics Study Guide – Key Concepts & Disorders

A comprehensive set of Question-and-Answer flashcards covering core theories, developmental milestones, neonatal and pediatric conditions, orthopedic and neuromotor impairments, legislation, and intervention principles from the Pediatric Study Guide lectures.

What are Wessel’s “rules of threes” for diagnosing infant colic?

Crying ≥3 hours per day, ≥3 days per week, in infants aged 3 weeks to 4 months.

According to Rome IV, what two criteria must be present for infant colic?

Long periods of irritability/crying in infants <5 months with no failure to thrive, fever, or illness.

Neural-Maturationist Theory states that motor skills unfold primarily because of _ maturation.

Central nervous system

In the Neural-Maturationist hierarchical model, higher nervous-system levels control more _ behaviors.

Complex

Which pediatric PT examination tool is rooted in the Neural-Maturationist perspective?

Assessment of reflex development to predict motor function.

List Piaget’s four stages of the Developmental Cognitive Theory in order.

Sensorimotor (0-2 yr), Pre-operational (2-7 yr), Concrete Operational (7-11 yr), Formal Operational (≥11 yr).

Define ‘assimilation’ in Piagetian terms.

Integrating new experiences into an existing schema.

Define ‘accommodation’ in Piagetian terms.

Adjusting existing schemata to incorporate new experiences.

At what age is the A-not-B error typically overcome?

11–12 months.

Means-end problem solving emerges mainly in which year of life?

The first year.

Motor Learning Cognitive Theory distinguishes between closed-loop and _-loop control.

Open

What are the four elements stored in a Generalized Motor Program (GMP)?

Initial conditions, response specifications, sensory consequences, and response outcome.

Recall schema predicts parameters; recognition schema predicts expected consequences.

Motor; sensory

Dynamic Systems Theory views motor development as the interaction of multiple _ that self-organize.

Subsystems

In Dynamic Systems Theory, a ‘control parameter’ is defined as…

A variable whose change causes the entire system to transition to a new movement pattern.

A deep attractor well represents a movement pattern that is _ to change.

Stable / hard

Bernstein’s ‘degrees of freedom problem’ refers to…

The challenge of controlling the body’s many joint and muscle options during movement.

Name Bernstein’s three stages of motor learning.

Freezing DOF, Freeing DOF, Exploiting mechanics.

Gestational age is measured from the _ day of the last menstrual period.

First

Around which week post-fertilization does organogenesis begin?

Approximately 3 weeks.

Too much amniotic fluid is called ; too little is called .

Polyhydramnios; oligohydramnios

Which fetal presentation is considered ideal for birth?

Occiput anterior (head-down, face toward sacrum).

Root and Sucking reflexes normally weaken by what ages?

Root reflex ~3 months; sucking-swallowing ~5–7 months.

A positive Babinski beyond 24 months suggests damage to which tract?

Corticospinal tract.

At what age should an infant typically be able to sit without arm support?

Around 6 months.

Persistence of ATNR beyond 6 months is considered a _ flag.

Red

According to standard milestones, when do most infants walk independently?

Around 12 months.

Perception–Action theory emphasizes the concept of _, meaning perceived action possibilities.

Affordances

In perception–action research, experienced 12-month crawlers avoid cliffs whereas novice 12-month _ usually do not.

Walkers

Define ‘appropriate for gestational age’ (AGA).

Birth weight between the 10th and 90th percentiles for gestational age.

Respiratory Distress Syndrome in preterm infants is primarily due to deficiency of _.

Surfactant

Patent ductus arteriosus normally closes within _ days in full-term infants.

2–3

Stage 3 of Retinopathy of Prematurity is characterized by…

Neovascularization extending into the vitreous (threshold disease).

Grade IV intraventricular hemorrhage involves bleeding into the ventricles plus the _.

Brain parenchyma

Skin-to-skin (kangaroo) care benefits infants by reducing _ infections and improving weight gain.

Nosocomial

Wolff’s Law states that bone remodels in response to _ stress.

Mechanical

Hueter-Volkmann’s Law: Increased compressive forces on the physis _ growth.

Retard

Normal femoral anteversion decreases from ~40° at birth to about _° by adolescence.

15–20

The Pavlik harness holds the hip in flexion and abduction to treat _.

Developmental dysplasia of the hip (DDH)

Osgood-Schlatter disease involves traction apophysitis of the _.

Tibial tubercle

Osteogenesis Imperfecta stems from mutations affecting which type of collagen?

Type I collagen.

Name two hallmark features of Juvenile Idiopathic Arthritis.

Persistent joint swelling and morning stiffness.

Arthrogryposis Multiplex Congenita is characterized by at least _ severe joint contractures present at birth.

Two

Salter–Harris type V fractures carry the highest risk of…

Growth plate arrest.

Spasticity is defined as a _-dependent increase in muscle tone due to hyper-excitable stretch reflexes.

Velocity

Botulinum toxin reduces spasticity by blocking release of which neurotransmitter?

Acetylcholine

Selective Dorsal Rhizotomy works by severing selected _ rootlets.

Sensory

Erb’s palsy typically involves which spinal nerve roots?

C5–C6

A ‘waiter’s tip’ posture indicates injury to the _ portion of the brachial plexus.

Upper (Erb’s)

The presence of Horner’s syndrome suggests avulsion of which nerve root?

T1

Bronchopulmonary dysplasia is a chronic obstructive lung disease most often caused by _.

Mechanical ventilation and oxygen toxicity in premature infants.

Typical croup presents with which classic radiographic sign?

Steeple sign (subglottic narrowing).

CFTR gene mutations cause thick mucus and recurrent infections in which disease?

Cystic Fibrosis

Congenital muscular torticollis involves unilateral shortening of which muscle?

Sternocleidomastoid (SCM).

Name the three clinical types of congenital muscular torticollis.

Postural, Muscular, SCM Nodule.

Deformational plagiocephaly commonly co-occurs with _.

Congenital muscular torticollis.

Attention that involves shifting focus back and forth between tasks is called ____ attention.

Alternating

In ADHD, which subtype is more common in girls?

Predominantly inattentive.

DSM-5 criterion for Developmental Coordination Disorder requires motor deficits that appear in _ development.

Early

The gold-standard motor test for DCD screening is the _.

Movement Assessment Battery for Children-2 (M-ABC-2).

Autism Spectrum Disorder is diagnosed by deficits in social communication plus ____ behaviors.

Restricted and repetitive

‘Toe-walking’ and reduced postural reflexes are early motor signs that may be seen in _.

Autism Spectrum Disorder

IDEA Part C covers which age group?

Birth to 3 years.

The document guiding services for a school-aged child under IDEA Part B is called an _.

Individualized Education Plan (IEP)

Section 504 plans are intended for students whose disability substantially limits a ____ life activity.

Major

Duchenne Muscular Dystrophy results from a mutation in the gene encoding _.

Dystrophin

Gower’s sign indicates weakness in which muscle group?

Hip and trunk extensors (proximal muscles).

Name one medication class that can slow functional decline in DMD.

Corticosteroids (e.g., prednisone, deflazacort).

At what Vignos grade does a child with DMD typically lose the ability to walk?

Grade 8 (confined to bed).

In neonatal care, which arousal state is optimal for physical therapy interventions?

Quiet Alert (state 4).

Finger splaying and yawning are considered _ signals in preterm infants.

Stress

Which NICU diagnosis is characterized by inflammatory destruction of the intestine and may require surgical resection?

Necrotizing Enterocolitis (NEC)

Sarnat Stage 2 hypoxic-ischemic encephalopathy has what prognosis if symptoms last >7 days?

Poor; likely abnormal outcomes.

Which fetal behavior typically appears around 26–28 weeks gestation?

Fetal eye opening.

List the four core concepts of the Perception–Action approach.

Contact with support, orientation to gravity, variability, adaptability.

Somites differentiate into sclerotome and _.

Dermomyotome

Primary myotubes predominantly become type _ muscle fibers.

I (slow-twitch)

Hueter-Volkmann’s principle is often applied surgically using tension band plates to modulate growth in _.

Scoliosis

In spastic cerebral palsy, which GMFCS level describes children who walk without limitations but with reduced speed and coordination?

Level I

A child who requires a power wheelchair for most mobility but may stand with support is likely GMFCS level _.

IV

What are the four lesions composing Tetralogy of Fallot?

Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.

The arterial switch operation permanently corrects which cyanotic heart defect?

Transposition of the Great Arteries.

An open neural tube defect with protrusion of meninges and neural tissue is called _.

Myelomeningocele

Hydrocephalus in spina bifida is commonly managed with placement of a _.

Ventriculoperitoneal shunt

Tethered cord syndrome may present later with progressive weakness and worsening _ control.

Bladder/Bowel

Spinal muscular atrophy type 1 is also known as ____ disease and has onset before 6 months.

Werdnig–Hoffmann

The medication Riluzole or the gene therapy onasemnogene (Zolgensma) targets which pediatric neuromuscular disorder?

Spinal Muscular Atrophy

In SMA management, standing frames are recommended primarily to improve _.

Bone density and contracture prevention.

Clonus differs from rigidity because clonus is ____ and rhythmic.

Repetitive

Baclofen is a GABA-B agonist given orally or intrathecally to reduce _.

Spasticity

Phenol neurolysis is typically used to reduce spasticity in which muscle group of the hip?

Hip adductors via obturator nerve.

The AMS (Active Movement Scale) grades muscle function in infants with _ palsy.

Brachial Plexus

Tripod positioning is instinctively adopted by children experiencing severe ____ distress.

Respiratory

SCM tightness causes head tilt toward the affected side and chin rotation toward the ____ side.

Opposite

Earliest intervention for torticollis focuses on prolonged, gentle _ stretching of the SCM.

Passive

In Dunn’s sensory processing framework, a child who actively seeks intense sensory input is classified as _.

Sensation Seeking

An IFSP is reviewed at least every _ months.

Six

FERPA grants parents the right to inspect and amend their child’s _ records.

Educational

In DMD, night splints are most often applied to prevent contracture of which muscle-tendon unit?

Gastrocnemius-soleus (ankle plantarflexors).

North Star Ambulatory Assessment is specific to what disease?

Duchenne Muscular Dystrophy