DPT Pediatric Physical Therapy 5 — Questions and Answers
Question 1: In the context of IDEA 2004, what distinguishes a 'related service' from 'special education' for a child receiving school-based PT?
- PT is a related service that supports the child's ability to benefit from special education (Correct answer)
- PT is considered special education when provided in the classroom
- Related services are provided only to children without IEPs
- PT qualifies as special education if the therapist holds a teaching license
Correct answer: PT is a related service that supports the child's ability to benefit from special education
Under IDEA, physical therapy is a related service — a supportive service that helps children with disabilities benefit from their special education program.
Question 2: A 2-year-old with bilateral clubfoot (talipes equinovarus) treated with the Ponseti method has achieved correction. Which intervention is critical to prevent relapse?
- Foot abduction orthosis (brace) worn 23 hours/day initially, then at night and naps until age 4 (Correct answer)
- Daily passive stretching only without bracing
- Immediate surgical tendon transfer after casting
- Orthotics worn only during standing activities
Correct answer: Foot abduction orthosis (brace) worn 23 hours/day initially, then at night and naps until age 4
Ponseti protocol requires a foot abduction orthosis after casting to maintain correction; non-compliance results in relapse in the majority of cases.
Question 3: A school-based PT writes goals for a child's IEP. According to IDEA, goals must be:
- Measurable and focused on educationally relevant functional outcomes (Correct answer)
- Written in medical terminology to ensure clinical accuracy
- Generated solely by the PT without team input
- Based on grade-level academic standards only
Correct answer: Measurable and focused on educationally relevant functional outcomes
IDEA requires IEP goals to be measurable and tied to the child's participation in the educational environment, not just clinical or medical outcomes.
Question 4: A 16-year-old with adolescent idiopathic scoliosis (AIS) has a Cobb angle of 28°. According to current evidence, what is the recommended PT approach?
- Scoliosis-specific exercises (PSSE) such as Schroth method combined with bracing monitoring (Correct answer)
- Aggressive spinal manipulation to reduce the curve
- Observation only — exercise has no effect on AIS
- Surgical referral for curves under 40°
Correct answer: Scoliosis-specific exercises (PSSE) such as Schroth method combined with bracing monitoring
Current evidence supports PSSE (particularly Schroth) for AIS curves 20-45°, often combined with bracing for curves 25-40° in skeletally immature patients.
Question 5: A child with sensory processing disorder shows gravitational insecurity. Which activity would MOST likely provoke distress for this child?
- Being tilted backward in a tilt-in-space wheelchair or on a therapy swing (Correct answer)
- Playing on the floor in prone position
- Walking on a firm, flat surface
- Pushing a heavy cart across the room
Correct answer: Being tilted backward in a tilt-in-space wheelchair or on a therapy swing
Gravitational insecurity is an excessive fear of movement relative to gravity, particularly triggered by having feet off the ground or being tilted.
Question 6: During constraint-induced movement therapy (CIMT) for a child with hemiplegic CP, what is the primary mechanism of therapeutic benefit?
- Forced use of the affected limb promotes cortical reorganization and reduces learned non-use (Correct answer)
- Immobilization of the affected limb allows it to rest and recover
- Strengthening the unaffected limb through resistance training
- Improving bilateral coordination through bimanual tasks only
Correct answer: Forced use of the affected limb promotes cortical reorganization and reduces learned non-use
CIMT restrains the unaffected limb to force use of the affected extremity, combating learned non-use and driving neuroplastic reorganization.
Question 7: A 6-week-old infant born at 28 weeks gestation is being evaluated for motor development. What corrected age should the therapist use for developmental expectations?
- Subtract weeks of prematurity from chronological age: approximately 6 weeks minus 12 weeks = -6 weeks (not yet at term) (Correct answer)
- Use the chronological age of 6 weeks without correction
- Add 6 weeks to the gestational age to correct for prematurity
- Correction for prematurity is not applied until after 6 months
Correct answer: Subtract weeks of prematurity from chronological age: approximately 6 weeks minus 12 weeks = -6 weeks (not yet at term)
Corrected age = chronological age minus weeks premature; at 6 weeks chronological age, a 28-weeker (12 weeks early) has a corrected age of approximately -6 weeks, meaning they are not yet at their due date.
DPT Pediatric Physical Therapy 5
In the context of IDEA 2004, what distinguishes a 'related service' from 'special education' for a child receiving school-based PT?