Week 10 - Disorders of childhood

Question 1

According to the Australian National Survey of Mental Health and Wellbeing, what proportion of 4–17-year-olds met criteria for a mental disorder?

a) Approximately 10 percent

b) Approximately 13 percent

c) Approximately 15 percent

d) Approximately 25 percent

Answer 1

c) Approximately 15 percent

Question 2

According to worldwide rates, what percentage of children and adolescents are affected by some form of mental disorder?

a) Approximately 5 percent

b) Approximately 10 percent

c) Approximately 13 percent

d) Approximately 20 percent

Answer 2

c) Approximately 13 percent

Question 3

Based on the study among New Zealand secondary school students, which gender reported higher clinical levels of depression and serious thoughts about suicide?

a) Boys

b) Girls

c) Both genders equally

d) Neither gender

Answer 3

b) Girls

Question 4

What is the primary focus of research traditionally concerning psychological and behavioral problems in children?

a) Protective factors

b) Risk factors

c) Parenting styles

d) Cultural contexts

Answer 4

b) Risk factors

Question 5

According to the text, what role do nurturing environments play in child development?

a) They increase the likelihood of toxic events occurring.

b) They decrease the child’s resilience and adaptability.

c) They minimize toxic events, promote necessary skills, and foster psychological flexibility.

d) They focus solely on limiting opportunities for problem behavior.

Answer 5

c) They minimize toxic events, promote necessary skills, and foster psychological flexibility.

Question 6

What does the ‘dose–response’ relationship refer to in the context of adverse childhood experiences?

a) The number of adverse experiences a child has and the extent of their positive outcomes.

b) The frequency of adverse experiences and their likelihood to be repeated.

c) The greater the number of adverse experiences a child has, the worse their health and mental wellbeing in adulthood.

d) The duration of adverse experiences and their immediate impact on a child’s behavior.

Answer 6

c) The greater the number of adverse experiences a child has, the worse their health and mental wellbeing in adulthood.

Question 7

What does the differential susceptibility hypothesis suggest about certain genes and environmental effects?

a) Genes associated with mental health problems make individuals less susceptible to environmental effects.

b) Genes increase vulnerability to negative environmental effects but have no impact on positive effects.

c) Genes previously seen as increasing risk operate more like ‘plasticity genes,’ making individuals more susceptible to both positive and negative environmental effects.

d) Genes affect susceptibility only if environmental conditions are extremely negative.

Answer 7

c) Genes previously seen as increasing risk operate more like ‘plasticity genes,’ making individuals more susceptible to both positive and negative environmental effects.

Question 8

Prior to the twentieth century, how were childhood mental illnesses or behavioral disorders generally perceived?

a) As a result of genetic factors

b) As a consequence of negative spiritual influences

c) As conditions requiring advanced medical treatments

d) As inevitable and unavoidable

Answer 8

b) As a consequence of negative spiritual influences

Question 9

When did specific childhood diagnoses begin to be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM)?

a) DSM-I

b) DSM-II

c) DSM-III

d) DSM-IV

Answer 9

c) DSM-III

Question 10

What major change did the DSM-5 introduce regarding the categorization of childhood disorders?

a) Introduction of new disorders exclusively for children

b) Removal of the category ‘Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence’

c) Combining childhood and adult disorders into one new category

d) Addition of a specific section for childhood disorders

Answer 10

b) Removal of the category ‘Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence’

Question 11

What approach does the DSM-5 use to address childhood disorders?

a) A categorical approach focusing only on childhood conditions

b) A purely diagnostic approach with no consideration of developmental factors

c) A developmental lifespan approach that considers how development affects diagnosis and symptoms

d) A retrospective approach based on historical diagnoses

Answer 11

c) A developmental lifespan approach that considers how development affects diagnosis and symptoms

Question 12

Which early twentieth-century researchers contributed to the increased interest in child psychopathology?

a) Sigmund Freud, Carl Rogers, and Ivan Pavlov

b) Jean Piaget, Alfred Binet, and Sigmund Freud

c) Erik Erikson, John Bowlby, and Abraham Maslow

d) B.F. Skinner, Melanie Klein, and Lev Vygotsky

Answer 12

b) Jean Piaget, Alfred Binet, and Sigmund Freud

Question 13

What is the primary focus of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R)?

a) Diagnosing adult mental health disorders

b) Examining very early difficulties and focusing on parent–infant relationships

c) Addressing only externalising disorders in children

d) Providing a universal diagnostic tool for all age groups

Answer 13

b) Examining very early difficulties and focusing on parent–infant relationships

Question 14

How do the diagnostic criteria for internalising disorders in children generally compare to those for adults?

a) They are different and more complex for children.

b) They are the same as for adults, with only minor modifications.

c) They are less rigorous than those for adults.

d) They are specifically designed for infants and toddlers.

Answer 14

b) They are the same as for adults, with only minor modifications.

Question 15

What is one of the main criticisms of the DSM-5 in relation to childhood conditions?

a) It lacks empirical support for its diagnostic criteria.

b) It does not consider the dimensional nature of many childhood conditions.

c) It does not focus on parent–infant relationships.

d) It includes too many categories for childhood disorders.

Answer 15

b) It does not consider the dimensional nature of many childhood conditions.

Question 16

What approach did developmental psychopathology emphasize when it emerged in the mid-1980s?

a) A static approach to child behavior

b) A lifespan approach combining data from both normal and clinical samples

c) A focus solely on abnormal development

d) An exclusive focus on environmental influences

Answer 16

b) A lifespan approach combining data from both normal and clinical samples

Question 17

What is the primary characteristic of the disorders classified under the ‘neurodevelopmental disorders’ category in the DSM-5?

a) They emerge during adolescence and affect social functioning.

b) They are characterized by their onset in the early developmental period, often before the child starts school.

c) They primarily affect adults and involve changes in cognitive functioning.

d) They are exclusively related to psychological trauma and stress.

Answer 17

b) They are characterized by their onset in the early developmental period, often before the child starts school.

Question 18

Which of the following disorders is included in the DSM-5’s ‘neurodevelopmental disorders’ category?

a) Major depressive disorder

b) Schizophrenia

c) Autism spectrum disorder

d) Generalized anxiety disorder

Answer 18

c) Autism spectrum disorder

Question 19

Which of the following best describes Attention-Deficit/Hyperactivity Disorder (ADHD)?

a) A disorder marked by excessive activity and a lack of social skills.

b) A disorder characterized by deficits in attention, controlling impulses, and regulating activity levels.

c) A condition where individuals primarily struggle with social interactions and emotional regulation.

d) A disorder related to memory loss and cognitive decline.

Answer 19

b) A disorder characterized by deficits in attention, controlling impulses, and regulating activity levels.

Question 20

Which symptoms are associated with inattention in Attention-Deficit/Hyperactivity Disorder (ADHD)?

a) Fidgeting and excessive movement

b) Difficulty sustaining attention, being easily distracted, and making careless mistakes

c) Impulsivity and blurting out answers

d) Not being able to stay seated and interrupting others

Answer 20

b) Difficulty sustaining attention, being easily distracted, and making careless mistakes

Question 21

How can ADHD be classified according to the DSM-5?

a) Combined presentation, predominantly inattentive presentation, or predominantly hyperactive/impulsive presentation

b) Mild, moderate, or severe presentation

c) Externalising or internalising presentation

d) Acute or chronic presentation

Answer 21

a) Combined presentation, predominantly inattentive presentation, or predominantly hyperactive/impulsive presentation

Question 22

Why is it important to consider the child’s developmental stage when diagnosing ADHD?

a) Developmental stage affects the ability to focus and restrain impulses, which develop with age

b) It determines the need for medication

c) It influences the severity of hyperactivity and impulsivity

d) It helps in identifying the specific type of ADHD

Answer 22

a) Developmental stage affects the ability to focus and restrain impulses, which develop with age

Question 23

What gender differences are observed in ADHD symptomatology according to the text?

a) Boys show more intellectual impairments and internalising problems than girls

b) Girls show less hyperactivity, inattention, impulsivity, and externalising problems, but more intellectual impairments and internalising problems

c) Boys show less intellectual impairments and more internalising problems than girls

d) There are no significant gender differences in ADHD symptoms

Answer 23

b) Girls show less hyperactivity, inattention, impulsivity, and externalising problems, but more intellectual impairments and internalising problems

Question 24

What did the meta-analysis by Polanczyk et al. (2014) reveal about the variability in ADHD prevalence rates?

a) Variability in prevalence rates is due to genetic factors.

b) There has been a significant increase in ADHD rates over time.

c) Variability in prevalence rates is largely due to methodological features of the studies.

d) Prevalence rates vary significantly between different age groups.

Answer 24

c) Variability in prevalence rates is largely due to methodological features of the studies.

Question 25

According to the meta-analysis by Thomas et al. (2015), what is the pooled prevalence estimate of ADHD across populations?

a) 3.5%

b) 5.0%

c) 7.2%

d) 9.8%

Answer 25

c) 7.2%

Question 26

Which of the following is a symptom of ADHD in adults that differs from the typical symptoms seen in children?

a) Difficulty staying seated and fidgeting

b) Having difficulty completing mundane tasks and procrastination

c) Difficulty sustaining attention over time

d) Impulsivity and blurting out answers

Answer 26

b) Having difficulty completing mundane tasks and procrastination

Question 27

What is a common comorbid condition with ADHD mentioned in the text?

a) Major depressive disorder

b) Generalized anxiety disorder

c) Oppositional defiant disorder

d) Autism spectrum disorder

Answer 27

c) Oppositional defiant disorder

Question 28

When does ADHD usually begin, and how does it generally change with age?

a) ADHD usually begins in adolescence and worsens with age.

b) ADHD usually begins in early childhood and tends to diminish with increasing age, but symptoms can continue into adulthood.

c) ADHD usually begins in early childhood and remains stable throughout life.

d) ADHD begins in early adulthood and shows significant improvement over time.

Answer 28

b) ADHD usually begins in early childhood and tends to diminish with increasing age, but symptoms can continue into adulthood.

Question 29

What concern is expressed by international scientists regarding media portrayals of ADHD?

a) Media reports are too supportive of ADHD and its treatments.

b) Media reports often inaccurately portray ADHD, potentially leading people to believe it is not a real disorder.

c) Media reports are primarily focused on the effectiveness of ADHD medications.

d) Media reports emphasize the genetic causes of ADHD.

Answer 29

b) Media reports often inaccurately portray ADHD, potentially leading people to believe it is not a real disorder.

Question 30

According to the international consensus statement, why might inaccurate media portrayals of ADHD be harmful?

a) They might lead to increased medication costs for families.

b) They could cause sufferers to avoid seeking treatment and undermine the legitimacy of the disorder.

c) They may cause a reduction in ADHD research funding.

d) They might improve public understanding of ADHD.

Answer 30

b) They could cause sufferers to avoid seeking treatment and undermine the legitimacy of the disorder.

Question 31

What is the position of major medical associations and government health agencies regarding ADHD, according to the international consensus statement?

a) ADHD is considered a myth with no scientific support.

b) ADHD is acknowledged as a genuine disorder supported by overwhelming scientific evidence.

c) ADHD is a minor condition that does not require medical attention.

d) ADHD is only recognized in certain countries and not internationally.

Answer 31

b) ADHD is acknowledged as a genuine disorder supported by overwhelming scientific evidence.

Question 32

What is suggested as a key factor underlying ADHD according to the research mentioned?

a) Neuropsychological impairment

b) Diet and nutrition

c) Lack of parental involvement

d) Environmental stressors

Answer 32

a) Neuropsychological impairment

Question 33

What do executive functions encompass in the context of ADHD?

a) The ability to recall past events and emotional experiences

b) Skills related to goal-setting, planning, and monitoring behavior

c) Proficiency in visual and auditory processing tasks

d) Understanding and interpreting social cues and emotions

Answer 33

b) Skills related to goal-setting, planning, and monitoring behavior

Question 34

How do executive function deficits in children with ADHD compare to those with conduct disorder?

a) Executive function deficits are found to be more severe in children with conduct disorder.

b) Executive function deficits are specific to ADHD and not observed in children with conduct disorder.

c) Executive function deficits are equally prevalent in both ADHD and conduct disorder.

d) Children with conduct disorder show less impairment in executive functions compared to children with ADHD.

Answer 34

b) Executive function deficits are specific to ADHD and not observed in children with conduct disorder.

Question 35

Which of the following cognitive tests are commonly used to assess executive functions in children with ADHD?

a) Tests measuring emotional intelligence

b) Tests evaluating language development

c) Tests assessing goal-setting, planning, and monitoring behavior

d) Tests of sensory processing

Answer 35

c) Tests assessing goal-setting, planning, and monitoring behavior

Question 36

What does Brown (2006) suggest is a key issue for individuals with ADHD regarding executive functions?

a) They have difficulty performing complex calculations.

b) They struggle with initiating and stopping behaviors as required by the task.

c) They lack the ability to engage in multitasking effectively.

d) They show persistent problems with understanding abstract concepts.

Answer 36

b) They struggle with initiating and stopping behaviors as required by the task

Question 37

Which cognitive tests are commonly used to assess executive functions in children with ADHD?

a) Stop task, Trailmaking, Mazes

b) IQ test, Memory recall, Spatial reasoning

c) Personality inventory, Emotional regulation scale, Behavior observation

d) Reaction time test, Visual acuity test, Verbal fluency test

Answer 37

a) Stop task, Trailmaking, Mazes

Question 38

What is the primary purpose of the Stop task in assessing executive functions?

a) To measure a child’s speed of processing visual stimuli

b) To evaluate how well a child can inhibit a pre-planned response upon receiving a signal

c) To assess a child’s ability to connect sequentially ordered letters

d) To determine a child’s planning ability through maze navigation

Answer 38

b) To evaluate how well a child can inhibit a pre-planned response upon receiving a signal

Question 39

In the Trails B version of the Trailmaking task, what cognitive ability is specifically measured?

a) Speed of processing simple sequences

b) Ability to inhibit responses based on signals

c) Ability to shift between different types of sequences (letters and numbers)

d) Skill in drawing a line through a maze without errors

Answer 39

c) Ability to shift between different types of sequences (letters and numbers)

Question 40

How does Trails A differ from Trails B in the Trailmaking task?

a) Trails A involves alternating between letters and numbers, while Trails B involves connecting letters in sequence.

b) Trails A measures the child’s speed of processing, while Trails B measures the ability to shift between tasks.

c) Trails A evaluates planning ability, while Trails B assesses inhibition control.

d) Trails A includes a maze-solving component, whereas Trails B involves simple key-pressing tasks.

Answer 40

b) Trails A measures the child’s speed of processing, while Trails B measures the ability to shift between tasks.

Question 41

What cognitive ability is primarily assessed by the Mazes task?

a) Speed of visual processing

b) Ability to alternate between tasks

c) Planning ability and the use of foresight to choose appropriate options

d) Inhibition control in response to external signals

Answer 41

c) Planning ability and the use of foresight to choose appropriate options

Question 42

What underlying family and parenting variables contribute to oppositional defiant disorder, conduct disorder, and ADHD?

a) High levels of parental warmth and consistency

b) Strong biological factors with minimal environmental influence

c) Parental inconsistency and lack of involvement

d) Consistent academic support and discipline

Answer 42

c) Parental inconsistency and lack of involvement

Question 43

According to research, what approach tends to be more effective in managing ADHD?

a) Interventions focusing solely on biological factors

b) Interventions targeting only academic skills

c) Interventions that address both biological and parenting factors

d) Interventions emphasizing peer relationships alone

Answer 43

c) Interventions that address both biological and parenting factors

Question 44

What dietary approach is associated with treating symptoms of hyperactivity in children with ADHD?

a) The Mediterranean diet

b) The Feingold diet

c) The ketogenic diet

d) The low-carb diet

Answer 44

b) The Feingold diet

(the Feingold diet is a food-elimination
program developed by the paediatrician Benjamin Feingold to treat symptoms of hyperactivity.
The diet consists of eliminating a number of artificial colours and flavours, aspartame (an artificial
sweetener), some preservatives and certain salicylates (found in a wide range of foods and beverages).

Question 45

What did a recent meta-analysis find regarding dietary interventions for ADHD?

a) There is substantial support for dietary interventions with large effects

b) Artificial food color exclusion diets and fatty acid supplementation have some support, but effects are generally small

c) Dietary interventions have no support or effects on ADHD symptoms

d) All dietary interventions for ADHD have proven to be ineffective

Answer 45

b) Artificial food color exclusion diets and fatty acid supplementation have some support, but effects are generally small

Question 46

According to research, what is the general conclusion about the impact of artificial food colorings and preservatives on ADHD symptoms?

a) They have a significant impact on ADHD symptoms, as shown by clinical assessments

b) They have no specific effect on ADHD symptoms based on objective clinical assessments

c) They are proven to improve ADHD symptoms significantly

d) They are the sole cause of ADHD symptoms in children

Answer 46

b) They have no specific effect on ADHD symptoms based on objective clinical assessments

Question 47

What type of medication is commonly used in the treatment of ADHD?

a) Antidepressants

b) Antipsychotics

c) Psychostimulants

d) Antianxiety medications

Answer 47

c) Psychostimulants

Question 48

What has research found about the effectiveness of stimulant medications like Ritalin and Dexedrine for ADHD?

a) They are ineffective in treating ADHD symptoms.

b) They increase the availability of serotonin but have little impact on ADHD symptoms.

c) They increase the availability of dopamine and have been found effective in reducing overactivity, impulsivity, and inattention.

d) They are only effective for improving academic performance, not other ADHD symptoms.

Answer 48

c) They increase the availability of dopamine and have been found effective in reducing overactivity, impulsivity, and inattention.

Question 49

According to prevailing opinions, how should medication be used in the treatment of ADHD?

a) Medication should be used alone without any additional interventions.

b) Medication should be used only in combination with psychosocial treatments, such as behavioral parenting and classroom management.

c) Medication should be used only in combination with alternative medicine practices.

d) Medication is not recommended for children with ADHD.

Answer 49

b) Medication should be used only in combination with psychosocial treatments, such as behavioral parenting and classroom management.

Question 50

What is the primary criterion for diagnosing a specific learning disorder in a child?

a) The child’s academic achievement is below what is expected given their chronological age and is not due to intellectual disability.

b) The child’s academic achievement is above what is expected for their chronological age.

c) The child shows symptoms of ADHD but their academic performance is average.

d) The child has a physical disability that affects their academic performance.

Answer 50

a) The child’s academic achievement is below what is expected given their chronological age and is not due to intellectual disability.

Question 51

Which subtype of specific learning disorder is the most common?

a) Written expression

b) Mathematics

c) Reading

d) Social skills

Answer 51

c) Reading

Question 52

What is a reading disorder?

a) A learning disorder involving deficits in reading ability.

b) A condition characterized by general developmental delays affecting multiple cognitive domains.

c) A behavioral issue stemming from poor educational access and social opportunities.

d) An emotional or psychological disorder that impacts a child’s ability to engage in reading activities.

Answer 52

a) A learning disorder involving deficits in reading ability.

Question 53

What must be ruled out for a diagnosis of reading disorder?

a) General developmental disability, intellectual disability, sensory impairment, and lack of access to appropriate education or sociocultural opportunities.

b) ADHD, anxiety disorders, and sensory processing disorders.

c) Social skills deficits and emotional disturbances.

d) Physical disabilities and learning disabilities in other areas.

Answer 53

a) General developmental disability, intellectual disability, sensory impairment, and lack of access to appropriate education or sociocultural opportunities.

Question 54

What is the prevalence rate of reading disorder in children?

a) 1–3 percent

b) 4–7 percent

c) 8–12 percent

d) 15–20 percent

Answer 54

b) 4–7 percent

Question 55

According to the study by Smart, Sanson, and Prior (1996), what did they find regarding the stability of reading disorder in 7–8-year-old children over a two-year period?

a) High rates of spontaneous recovery.

b) Significant improvement with standard educational interventions.

c) Little evidence of spontaneous recovery.

d) Complete resolution of symptoms without intervention.

Answer: c) Little evidence of spontaneous recovery.

Answer 55

c) Little evidence of spontaneous recovery.

Question 56

What is the degree of comorbidity between reading disorder and ADHD?

a) 5 to 10 percent

b) 10 to 20 percent

c) 15 to 45 percent

d) 50 to 75 percent

Answer 56

c) 15 to 45 percent

Question 57

What defines a specific learning disorder?

a) A disorder characterized by lower than expected performance in a particular area of learning relative to the child’s chronological age and intellectual ability.

b) A condition where a child has generalized developmental delays across multiple domains.

c) A behavioral disorder where performance issues are primarily due to environmental factors rather than individual cognitive abilities.

d) An emotional disturbance leading to difficulties in achieving expected academic performance.

Answer 57

a) A disorder characterized by lower than expected performance in a particular area of learning relative to the child’s chronological age and intellectual ability.

Question 58

What percentage probability is there that a boy will have a reading disability if his father had a reading disability?

a) 30%
b) 40%
c) 50%
d) 60%

Answer 58

c) 50%

Question 59

Which cognitive deficits have been suggested to contribute to the development of reading disorder?

a) General cognitive ability and language skills
b) Phonological awareness, working memory, and speed of processing written language
c) Emotional and behavioral regulation
d) Sensory impairments and lack of educational access

Answer 59

b) Phonological awareness, working memory, and speed of processing written language

Question 60

According to research, what aspect of reading disorder treatment has been found to lead to significantly improved outcomes?

a) General cognitive skills training
b) Behavioral interventions and counseling
c) Phonological approaches (i.e., sounding out words)
d) Medication and neuropsychological therapy

Answer 60

c) Phonological approaches (i.e., sounding out words)

Question 61

What major change did the DSM-5 introduce regarding the classification of autism spectrum disorders?

a) It separated autism into multiple distinct disorders.
b) It merged previously separate disorders into a single category.
c) It removed autism spectrum disorders from the DSM altogether.
d) It added new diagnostic criteria unrelated to previous disorders.

Answer 61

b) It merged previously separate disorders into a single category.

(DSM-5 consolidated four previously separate disorders (autistic
disorder, Asperger’s syndrome, childhood disintegrative disorder and pervasive developmental
disorder not otherwise specified) into a single disorder, labelled autism spectrum disorder).

Question 62

Which of the following characteristics is not specifically mentioned as a hallmark of autism spectrum disorder in the DSM-5?

a) Marked impairments in social communication
b) Repetitive behaviours, interests, and activities
c) Significant deficits in verbal intelligence
d) Difficulties in social interaction

Answer 62

c) Significant deficits in verbal intelligence

Question 63

Which of the following is a characteristic of autism spectrum disorder (ASD) according to the DSM-5?

a) Impairments in social communication and interaction as well as repetitive behaviours, interests and activities
b) Severe physical disabilities
c) High levels of verbal intelligence
d) Frequent mood swings

Answer 63

a) Impairments in social communication and interaction as well as repetitive behaviours, interests and activities

Question 64

How are the severity levels of autism spectrum disorder (ASD) classified in the DSM-5?

a) Mild, Moderate, Severe: Based on the overall impact on daily functioning.

b) High, Medium, Low: Determined by the intensity of social and communication deficits.

c) Level 1, Level 2, Level 3: Reflecting the required level of support, ranging from minimal to substantial.

d) Emergent, Moderate, Advanced: Based on developmental stages and treatment progress.

Answer 64

c) Level 1, Level 2, Level 3: Reflecting the required level of support, ranging from minimal to substantial.

Question 65

What are the characteristics of Level 3 autism spectrum disorder as defined in the DSM-5?

a) Requiring very substantial support: Severe deficits in social communication and interaction, with minimal initiation or response to social approaches. Extreme inflexibility of behavior and repetitive behaviors that significantly impair functioning in all areas.

b) Requiring moderate support: Marked deficits in social communication with some difficulty initiating and responding to social interactions. Noticeable inflexibility and repetitive behaviors that impact daily functioning.

c) Requiring minimal support: Mild deficits in social communication and some difficulties with social interactions. Limited inflexibility and repetitive behaviors that cause slight disruptions in functioning.

d) Requiring no support: No significant deficits in social communication; minimal inflexibility and repetitive behaviors that do not affect functioning.

Answer 65

a) Requiring very substantial support: Severe deficits in social communication and interaction, with minimal initiation or response to social approaches. Extreme inflexibility of behavior and repetitive behaviors that significantly impair functioning in all areas.

Question 66

What are the characteristics of Level 2 autism spectrum disorder as defined in the DSM-5?

a) Requiring substantial support: Marked deficits in verbal and non-verbal social communication skills, noticeable even with supports in place; limited initiation of social interactions, with reduced or abnormal responses to social overtures. Frequent inflexibility of behavior and repetitive behaviors that interfere with functioning across various contexts.

b) Requiring minimal support: Mild deficits in social communication with some difficulty initiating and responding to social interactions. Inflexibility and repetitive behaviors present but not significantly impacting daily functioning.

c) Requiring no support: No significant deficits in social communication or behavior; interactions are generally appropriate and functioning is not affected.

d) Requiring very substantial support: Severe deficits in social communication with minimal initiation and response to social approaches; extreme inflexibility and repetitive behaviors significantly impair all areas of functioning.

Answer 66

a) Requiring substantial support: Marked deficits in verbal and non-verbal social communication skills, noticeable even with supports in place; limited initiation of social interactions, with reduced or abnormal responses to social overtures. Frequent inflexibility of behavior and repetitive behaviors that interfere with functioning across various contexts.

Question 67

What are the characteristics of Level 1 autism spectrum disorder as defined in the DSM-5?

a) Requiring substantial support: Marked deficits in social communication skills with limited initiation of social interactions and reduced responses to social overtures; frequent inflexibility of behavior and repetitive behaviors that interfere with functioning in various contexts.

b) Requiring very substantial support: Severe deficits in verbal and non-verbal social communication skills causing severe impairments, very limited social interaction, and minimal response to social approaches; extreme inflexibility and repetitive behaviors.

c) Requiring support: Noticeable deficits in social communication without supports; difficulties initiating social interactions with atypical or unsuccessful responses; decreased interest in social interactions; inflexibility and problems with organization and planning.

d) Requiring no support: No significant social communication or behavioral deficits; interactions are generally appropriate and functioning is not affected.

Answer 67

c) Requiring support: Noticeable deficits in social communication without supports; difficulties initiating social interactions with atypical or unsuccessful responses; decreased interest in social interactions; inflexibility and problems with organization and planning.

Question 68

What are the core deficits in autism spectrum disorder (ASD) that lead to difficulties in social interaction?

a) Deficits in social-emotional reciprocity and difficulty comprehending non-verbal communication.

b) Difficulty with motor skills and sensory processing issues.

c) Deficits in language development and memory.

d) Problems with attention and hyperactivity.

Answer 68

a) Deficits in social-emotional reciprocity and difficulty comprehending non-verbal communication.

Question 69

What does the concept of ‘theory of mind’ refer to in the context of autism spectrum disorder?

a) Understanding that others have a perspective that differs from one’s own.

b) The ability to process sensory information accurately.

c) Developing complex language skills and vocabulary.

d) Mastering motor coordination and physical tasks.

Answer 69

a) Understanding that others have a perspective that differs from one’s own.

Question 70

What is the most likely reason for the observed rise in the prevalence of autism spectrum disorder (ASD) according to recent studies?

a) Increased exposure to environmental toxins.

b) A real increase in the incidence of the disorder.

c) Changes in diagnostic criteria, more consistent diagnoses, and greater awareness.

d) Increased rates of food allergies and sensitivities.

Answer 70

c) Changes in diagnostic criteria, more consistent diagnoses, and greater awareness.

Question 71

What is the approximate prevalence of autism spectrum disorder?

A) 0.5%
B) 1%
C) 2%
D) 5%

Answer 71

B) 1%

Question 72

What is the ratio of boys to girls diagnosed with autism spectrum disorder?

a) 1:1

b) 2:1

c) 3:1

d) 4:1

Answer 72

b) 2:1

Question 73

Which of the following is a predictor of a good outcome for children with autism spectrum disorder?

a) The presence of significant intellectual disability.

b) Acquisition of language skills before age 6.

c) Absence of any specific skills or strengths.

d) Poor social skills and interaction.

Answer 73

b) Acquisition of language skills before age 6.

Question 74

What is the concordance rate for autism in monozygotic twins, indicating the likelihood that if one twin is affected, the other will also show symptoms?

A) 30%
B) 45%
C) 60%
D) 75%

Answer 74

C) 60%

(concordance rate is
probability that both members of a twin pair will develop the same
disorder)

Question 75

What was the outcome of the 1998 study linking the measles-mumps-rubella combination vaccine to autism?

A) The study was supported by subsequent research
B) The study was later retracted by The Lancet
C) The study was confirmed by other large-scale studies
D) The study led to a widespread adoption of vaccine-free policies

Answer 75

B) The study was later retracted by The Lancet

Question 76

Which study found a higher than expected prevalence rate of autism spectrum disorder among children exposed to severe social deprivation?

A) A study of children with mitochondrial dysfunction
B) A study of children with limited dietary exposure
C) A study of Romanian orphans adopted in the United Kingdom
D) A study examining the effects of vaccination on autism

Answer 76

C) A study of Romanian orphans adopted in the United Kingdom

Question 77

What type of deprivation did the Romanian orphans experience in the study conducted by O’Connor, Bredenkamp, and Rutter (1999)?

A) Severe dietary deprivation
B) Extreme social and emotional deprivation
C) Prolonged exposure to toxins
D) High levels of physical exercise and activity

Answer 77

B) Extreme social and emotional deprivation

Question 78

What is one of the primary aims of early intervention for children with autism spectrum disorder?

A) To increase the child’s exposure to toxins
B) To help the child develop better social and emotional relationships
C) To decrease the child’s physical activity levels
D) To avoid the use of any behavioral modification programs

Answer 78

B) To help the child develop better social and emotional relationships

Question 79

Which approach is commonly used in behavior modification programs for children with autism spectrum disorder?

A) Environmental enrichment without any specific interventions
B) Positive reinforcement such as praise or tangible rewards
C) Complete avoidance of any form of reinforcement
D) Focus solely on medication without behavioral interventions

Answer 79

B) Positive reinforcement such as praise or tangible rewards

Question 80

What role does pharmacotherapy play in the treatment of autism spectrum disorder according to the text?

A) It is the primary treatment method used alone without behavioral interventions
B) It is used to target specific problems such as aggression, irritability, and hyperactivity
C) It focuses exclusively on improving social skills
D) It is used to prevent the development of autism spectrum disorder

Answer 80

B) It is used to target specific problems such as aggression, irritability, and hyperactivity

Question 81

Which of the following accurately describes intellectual disability?

A) It involves deficits primarily in social interactions and emotional regulation.

B) It is a single disorder with a clear, singular cause and no variability in presentation.

C) It comprises a heterogeneous group of disorders with multiple causes, all of which involve deficits in intellectual functioning and adaptive functioning.

D) It is characterized by temporary cognitive impairments due to environmental factors.

Answer 81

C) It comprises a heterogeneous group of disorders with multiple causes, all of which involve deficits in intellectual functioning and adaptive functioning.

Question 82

In the DSM-5, intellectual disability was previously referred to as which term in the earlier edition of the DSM?

A) Cognitive Impairment
B) Mental Retardation
C) Developmental Delay
D) Intellectual Dysfunction

Answer 82

B) Mental Retardation

Question 83

According to the DSM-5, which of the following criteria are used to diagnose intellectual disability?

A) Deficits in intellectual functioning and adaptive functioning with onset in adulthood.
B) Deficits in intellectual functioning, deficits in adaptive functioning, and onset in childhood.
C) Deficits in intellectual functioning only, without considering adaptive functioning.
D) Deficits in adaptive functioning with onset in adolescence and no specific intellectual functioning criteria.

Answer 83

B) Deficits in intellectual functioning, deficits in adaptive functioning, and onset in childhood.

Question 84

Which instrument is most commonly used to assess adaptive functioning skills in individuals with intellectual disability?

A) Wechsler Intelligence Scale for Children (WISC)
B) Stanford-Binet Intelligence Scales
C) Vineland Adaptive Behavior Scale
D) Kaufman Assessment Battery for Children (KABC)

Answer 84

C) Vineland Adaptive Behavior Scale

Question 85

What score range on an intelligence test typically indicates intellectual disability according to the DSM-5?

A) Scores above 85
B) Scores between 70 and 85
C) Scores below 65–75
D) Scores between 80 and 90

Answer 85

C) Scores below 65–75

Question 86

The Vineland Adaptive Behavior Scale assesses adaptive functioning in individuals with intellectual disability. Which of the following domains is NOT included in this assessment?

A) Communication
B) Daily-living skills
C) Socialisation
D) Memory

Answer 86

D) Memory

Question 87

What is the estimated prevalence of intellectual impairment?

A) 5%
B) 10%
C) 1%
D) 0.5%

Answer 87

C) 1%

Question 88

What percentage of individuals with intellectual impairment have an IQ within the mild range?

A) 50%
B) 70%
C) 85%
D) 90%

Answer 88

C) 85%

Question 89

Which of the following disorders is NOT commonly associated with intellectual impairment?

A) Epilepsy
B) Cerebral palsy
C) Sensory deficits
D) Schizophrenia
E) Pervasive developmental disorder

Answer 89

D) Schizophrenia

Question 90

What are pervasive developmental disorders characterized by?

A) Severe and persisting impairment in several areas of development
B) Temporary and specific impairments in cognitive functions
C) Mild difficulties in academic performance
D) Short-term behavioral issues related to environmental factors

Answer 90

A) Severe and persisting impairment in several areas of development

Question 91

Which gender is more frequently diagnosed with intellectual impairment?

A) Boys
B) Girls
C) Both genders equally
D) No significant difference

Answer 91

A) Boys

Question 92

According to the DSM-5 diagnostic criteria for intellectual disability, when must the onset occur?

A) In early adulthood
B) During the developmental period (childhood or adolescence)
C) During late adolescence or early adulthood
D) At any point in life

Answer 92

B) During the developmental period (childhood or adolescence)

Question 93

What factors influence the course and outcome of intellectual disability according to the DSM-5 diagnostic criteria?

A) Only genetic factors
B) Only psychosocial factors
C) Both biomedical and psychosocial factors
D) Environmental factors only

Answer 93

C) Both biomedical and psychosocial factors

Question 94

What is a crucial component of early intervention for individuals with intellectual disability?

A) Only behavioral therapy
B) Early treatment of underlying conditions
C) Just academic support
D) Only family counseling

Answer 94

B) Early treatment of underlying conditions

Question 95

What types of therapies are important in early intervention for individuals with intellectual disability?

A) Physical therapy, occupational therapy, and speech therapy
B) Only academic tutoring and social skills training
C) Only family therapy
D) Recreational activities and extracurricular enrichment

Answer 95

A) Physical therapy, occupational therapy, and speech therapy

Question 96

What do externalising disorders broadly encompass?

A) Disorders characterized by internal emotional struggles, such as anxiety and depression
B) Disorders characterized by problems of over-control, where behaviors are directed at oneself
C) Disorders characterized by problems of under-control, where behaviors are directed at others
D) Disorders related to cognitive deficits and learning difficulties

Answer 96

C) Disorders characterized by problems of under-control, where behaviors are directed at others

Question 97

Which disorders are included under the category of externalising disorders as classified in the DSM-5?

A) Oppositional defiant disorder and conduct disorder
B) Autism spectrum disorder and intellectual disability
C) Generalized anxiety disorder and major depressive disorder
D) Specific learning disorders and ADHD

Answer 97

A) Oppositional defiant disorder and conduct disorder

Question 98

Under which heading are externalising disorders classified in the DSM-5?

A) Mood Disorders
B) Neurodevelopmental Disorders
C) Disruptive, Impulse-Control, and Conduct Disorders
D) Anxiety Disorders

Answer 98

C) Disruptive, Impulse-Control, and Conduct Disorders

Question 99

What characterizes oppositional defiant disorder in children?

A) Chronic misbehaviour marked by belligerence, irritability, and defiance.

B) Persistent anxiety and avoidance of social situations.

C) Severe mood swings and excessive impulsivity.

D) Difficulty with attention and hyperactivity.

Answer 99

A) Chronic misbehaviour marked by belligerence, irritability, and defiance.

Question 100

Which of the following best describes oppositional defiant disorder?

A) A disorder characterized by a persistent pattern of angry/irritable mood, argumentative/defiant behavior, and vindictiveness, involving difficulty regulating emotions and a negative affective style.

B) A disorder involving chronic disregard for the rights of others, including behaviors such as stealing, lying, and engaging in acts of violence.

C) A condition marked by intense mood swings, impulsivity, and difficulty focusing on tasks.

D) A disorder defined by persistent feelings of excessive worry, fear of social situations, and avoidance behaviors.

Answer 100

A) A disorder characterized by a persistent pattern of angry/irritable mood, argumentative/defiant behavior, and vindictiveness, involving difficulty regulating emotions and a negative affective style.

Question 101

When diagnosing oppositional defiant disorder (ODD), why is it important to consider the child’s developmental stage and gender?

A) Because the severity of ODD symptoms decreases with age.

B) Because normative behavior varies with age and gender, influencing how symptoms present.

C) Because gender and age have no impact on the presentation of ODD symptoms.

D) Because treatment strategies for ODD differ based on age and gender.

Answer 101

B) Because normative behavior varies with age and gender, influencing how symptoms present.

Question 102

For a diagnosis of oppositional defiant disorder (ODD), why must the behaviors occur across different settings and situations such as home, school and community?

A) To ensure that the behaviors are a result of specific environmental factors rather than a general pattern.

B) To confirm that the behaviors are not isolated incidents but part of a persistent pattern affecting various aspects of the child’s life.

C) To distinguish ODD from other disorders that only manifest in one setting.

D) To validate that the child’s symptoms are not influenced by external interventions.

Answer 102

B) To confirm that the behaviors are not isolated incidents but part of a persistent pattern affecting various aspects of the child’s life.

Question 103

Which of the following is true about the behaviors indicative of oppositional defiant disorder in different age groups?

A) Preschoolers with ODD typically exhibit more passive behaviors compared to older children.

B) Older children with ODD are more likely to exhibit behaviors such as stealing money or video games compared to preschoolers.

C) The type of disturbed behavior in ODD is consistent across all age groups.

D) Younger children with ODD are less likely to engage in temper tantrums than older children.

Answer 103

B) Older children with ODD are more likely to exhibit behaviors such as stealing money or video games compared to preschoolers.

Question 104

What is essential for a comprehensive assessment of oppositional defiant disorder (ODD)?

A) Relying solely on parent reports of the child’s behavior.

B) Using multiple forms of assessment and gathering information from various sources, including the child, parent, and teacher.

C) Focusing only on direct observations of the child’s behavior in a single setting.

D) Administering only standardized questionnaires without additional interviews.

Answer 104

B) Using multiple forms of assessment and gathering information from various sources, including the child, parent, and teacher.

Question 105

What is the approximate prevalence of oppositional defiant disorder (ODD) among all children?

A) 1 per cent
B) 3 per cent
C) 5 per cent
D) 8 per cent

Answer 105

B) 3 per cent

Question 106

Oppositional defiant disorder (ODD) is more common in boys compared to girls. What is the approximate ratio of boys to girls diagnosed with ODD?

A) 1:1
B) 1.6:1
C) 2:1
D) 3:1

Answer 106

B) 1.6:1

Question 107

At what stage of childhood is oppositional defiant disorder (ODD) most commonly diagnosed?

A) Early childhood
B) Preschool
C) Middle childhood
D) Adolescence

Answer 107

C) Middle childhood

Question 108

The longer oppositional defiant disorder (ODD) persists, the more likely a child is to develop other conditions, including:

A) Autism spectrum disorder
B) Schizophrenia
C) Attention-deficit/hyperactivity disorder and anxiety disorders
D) Obsessive-compulsive disorder and eating disorders

Answer 108

C) Attention-deficit/hyperactivity disorder and anxiety disorders

Question 109

A broad array of risk factors for oppositional defiant disorder (ODD) includes:

A) Only biological factors such as genetics and neurodevelopmental abnormalities
B) Only social factors such as family environment and peer relationships
C) Biological, psychological, and social factors
D) Only psychological factors such as cognitive distortions and emotional regulation

Answer 109

C) Biological, psychological, and social factors

Question 110

What biological factor related to aggressiveness has been found to show alterations in children with oppositional defiant disorder?
A) Cortisol levels
B) Estrogen levels
C) Androgen levels
D) Serotonin levels

Answer 110

C) Androgen levels

(Substance such as
testosterone producing male characteristics)

Question 111

According to research, what difference in brain function is associated with a negative affective style in children with oppositional defiant disorder?
A) Altered cerebellum activation
B) Differences in patterns of frontal brain activation
C) Increased occipital lobe activity
D) Reduced temporal lobe function

Answer 111

B) Differences in patterns of frontal brain activation

Question 112

What physiological characteristic has been observed in preschoolers with oppositional defiant disorder that may contribute to their problem behaviors?
A) Increased heart rate variability
B) Autonomic under-arousal
C) Elevated blood pressure
D) Enhanced sweat gland activity

Answer 112

B) Autonomic under-arousal

Question 113

What condition has been associated with the development of oppositional defiant disorder symptomatology?
A) Chronic migraines
B) Traumatic brain injury
C) Epileptic seizures
D) Hydrocephalus

Answer 113

B) Traumatic brain injury

Question 114

What characteristic is commonly found in parents of non-compliant, aggressive children compared to parents of non-problem children?
A) High levels of warmth and support
B) Greater use of positive reinforcement
C) Highly punitive and critical attitudes, and attributing misbehaviour to stable, dispositional traits
D) Increased involvement in children’s extracurricular activities

Answer 114

C) Highly punitive and critical attitudes, and attributing misbehaviour to stable, dispositional traits

Question 115

What type of parental behaviour, associated with externalising behaviour problems, involves giving negative instructions and punishing the child?
A) Authoritative parenting
B) Permissive parenting
C) Restrictive control
D) Supportive parenting

Answer 115

C) Restrictive control

Question 116

According to Patterson’s (1982) coercive processes model, which of the following best describes the cycle of interactions between parents and children?

A) Parents use consistent and non-reinforcing responses to child misbehavior, leading to improved behavior over time.
B) Children learn to cooperate with parents through positive reinforcement and supportive interactions.
C) Parents and children engage in progressively more coercive interactions with each other through learning processes, where each party reinforces the other’s negative behavior, creating a cycle of increasing conflict.
D) The model suggests that parental influence is minimized, and children’s behavior is shaped primarily by external social factors.

Answer 116

C) Parents and children engage in progressively more coercive interactions with each other through learning processes, where each party reinforces the other’s negative behavior, creating a cycle of increasing conflict.

Question 117

Which of the following best describes Conduct Disorder?
A) A disorder characterized by mood swings and emotional instability.
B) A disorder marked by chronic disregard for the rights of others, including behaviours such as stealing, lying, and engaging in acts of violence.
C) A disorder involving difficulty with social interactions and communication, as seen in Autism Spectrum Disorder.
D) A disorder defined by excessive worry and anxiety about various aspects of life.

Answer 117

B) A disorder marked by chronic disregard for the rights of others, including behaviours such as stealing, lying, and engaging in acts of violence.

Question 118

Which of the following behaviours is commonly associated with Conduct Disorder?
A) Difficulty following instructions and frequent temper tantrums.
B) Engaging in acts of violence, stealing, and lying.
C) Persistent sadness and loss of interest in activities.
D) Avoidance of social interactions and difficulty with non-verbal communication.

Answer 118

B) Engaging in acts of violence, stealing, and lying.

Question 119

Which of the following statements accurately reflects the gender differences in the prevalence of conduct disorder?

A) Conduct disorder is equally common in boys and girls across all age groups.
B) Conduct disorder is more common in girls than boys throughout childhood.
C) Conduct disorder is more common in boys than girls, with a higher prevalence rate in adolescence.
D) Conduct disorder is equally prevalent in boys and girls in adolescence but more common in girls in childhood.

Answer 119

C) Conduct disorder is more common in boys than girls, with a higher prevalence rate in adolescence.

Question 120

What is the approximate prevalence rate of conduct disorder across childhood, and how does it change during adolescence?

A) Approximately 1 per cent in childhood, rising to 4 per cent in adolescence.
B) Approximately 3 per cent in childhood, rising to 6 per cent in adolescence.
C) Approximately 3 per cent in childhood, remaining stable through adolescence.
D) Approximately 6 per cent in childhood, decreasing to 3 per cent in adolescence.

Answer 120

B) Approximately 3 per cent in childhood, rising to 6 per cent in adolescence.

Question 121

According to the DSM-5, what are the two
subtypes of conduct disorder, and how do they differ in terms of age of onset?

A) Early onset (before age 10) and late onset (11 years or older), with early onset being more characteristic of girls.
B) Early onset (before age 10) and late onset (11 years or older), with early onset being more characteristic of boys.
C) Early onset (before age 5) and late onset (10 years or older), with late onset being more characteristic of boys.
D) Early onset (before age 10) and late onset (11 years or older), with late onset being more characteristic of girls.

Answer 121

B) Early onset (before age 10) and late onset (11 years or older), with early onset being more characteristic of boys.

Question 122

How does the course of conduct disorder typically differ between boys and girls?

A) Boys commonly show late onset conduct disorder, while girls typically show early onset.
B) Both boys and girls show similar patterns of onset and progression for conduct disorder.
C) Boys are more likely to show early onset conduct disorder, while girls are more likely to show late onset.
D) Girls show early onset conduct disorder, while boys show late onset

Answer 122

C) Boys are more likely to show early onset conduct disorder, while girls are more likely to show late onset.

Question 123

n longitudinal studies like the Dunedin Study and the Australian Temperament Project, how are children with persistent antisocial behaviour differentiated from those with late-onset antisocial behaviour?

A) Persistent antisocial behaviour is seen from early childhood, while late-onset behaviour starts in early adolescence.
B) Persistent antisocial behaviour is identified based on substance use during adolescence, while late-onset behaviour is based on temperamental traits.
C) Persistent antisocial behaviour starts in late adolescence, while late-onset behaviour starts in early childhood.
D) Persistent antisocial behaviour is marked by social competence issues, while late-onset behaviour is marked by parental conflict.

Answer 123

A) Persistent antisocial behaviour is seen from early childhood, while late-onset behaviour starts in early adolescence.

Question 124

What is the relationship between oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) during childhood and the development of conduct disorder (CD)?

A) Children with ODD and ADHD are less likely to develop CD compared to children with only one of these disorders.
B) The presence of ODD and ADHD during childhood is often a precursor to CD, though not all children with these conditions develop CD.
C) ODD and ADHD are directly responsible for the development of CD in all cases.
D) CD always develops from ODD and ADHD without the influence of additional variables.

Answer 124

B) The presence of ODD and ADHD during childhood is often a precursor to CD, though not all children with these conditions develop CD.

Question 125

What role do modifiable variables play in the development of conduct disorder in children with oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD)?

A) Modifiable variables have no impact on the development of conduct disorder in these children.
B) Modifiable variables, similar to those for ODD, can influence the likelihood of developing conduct disorder and can be targeted through intervention.
C) Only non-modifiable variables affect the transition from ODD and ADHD to conduct disorder.
D) Modifiable variables are irrelevant to conduct disorder, which is solely determined by genetic factors.

Answer 125

B) Modifiable variables, similar to those for ODD, can influence the likelihood of developing conduct disorder and can be targeted through intervention.

Question 126

What evidence suggests a genetic link between conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder?

A) High levels of cortisol in affected individuals

B) Shared genetic elements among these disorders

C) Increased androgen hormone levels

D) Presence of callous-unemotional traits

Answer 126

B) Shared genetic elements among these disorders

Question 127

How might low cortisol levels be related to conduct disorder in boys?

A) They are linked to increased impulsivity

B) They are associated with higher aggression levels

C) They predict higher academic performance

D) They reduce the likelihood of developing conduct disorder

Answer 127

B) They are associated with higher aggression levels

Question 128

What role do androgen hormones play in conduct disorder?

A) They are unrelated to conduct disorder

B) Higher levels are associated with conduct disorder

C) They reduce aggressive behavior

D) They increase empathy and remorse

Answer 128

B) Higher levels are associated with conduct disorder

Question 129

What temperamental traits in young children are associated with an increased risk of developing conduct disorder?

A) Calm and persistent behavior

B) Negativity, volatility, and low persistence

C) High empathy and cooperation

D) Stable mood and high social competence

Answer 129

B) Negativity, volatility, and low persistence

Question 130

Which social factor is a significant predictor of conduct disorder in children?

A) High levels of parental warmth

B) Associating with antisocial peers

C) Positive family relationships

D) High academic achievement

Answer 130

B) Associating with antisocial peers

Question 131

What family-related factors are associated with an increased risk of conduct disorder?

A) Single parent families, low marital conflict, and high parental supervision

B) High parental warmth, supportive family relationships, and consistent discipline

C) Single parent families, marital conflict, and harsh parenting practices

D) Dual parent families, minimal marital conflict, and positive parenting practices

Answer 131

C) Single parent families, marital conflict, and harsh parenting practices

Question 132

Which of the following types of interventions has been shown to be effective in reducing externalising problems in children?

A) School-based interventions designed to improve classroom and playground behaviour

B) Interventions aimed solely at enhancing academic performance

C) Pharmacological approaches without any additional psychosocial support

D) Solely attachment-based approaches without involving parenting interventions

Answer 132

A) School-based interventions designed to improve classroom and playground behaviour

Question 133

Which of the following best describes the primary approach used in parent management training for treating problem behaviors in children?

A) Training parents to use a variety of positive parenting strategies and consistent consequences for problem behaviors.

B) Emphasizing only punitive parenting practices without using positive reinforcement.

C) Providing pharmacological treatments to parents to manage their children’s behavior.

D) Focusing exclusively on improving academic performance without addressing behavioral issues.

Answer 133

A) Training parents to use a variety of positive parenting strategies and consistent consequences for problem behaviors

Question 134

Which of the following interventions is specifically designed to improve parenting skills and family relationships?

A) School-based behavioral programs
B) Pharmacological treatments
C) Parenting management training and family therapy
D) Social skills training for children

Answer 134

C) Parenting management training and family therapy

Question 135

What is the primary focus of the Triple P-Positive Parenting Program?

A) Improving children’s academic performance
B) Enhancing parenting skills and family relationships
C) Increasing children’s physical fitness
D) Addressing specific learning disabilities

Answer 135

B) Enhancing parenting skills and family relationships

Question 136

Which of the following is a key component of the Triple P-Positive Parenting Program?

A) Teaching children advanced academic skills
B) Implementing pharmacological treatments for behavioral issues
C) Using positive reinforcement strategies such as praise and rewards
D) Conducting intensive individual therapy for children

Answer 136

C) Using positive reinforcement strategies such as praise and rewards

Question 137

Which of the following techniques is NOT typically emphasized in the Triple P-Positive Parenting Program?

A) Praise and attention for desired behavior
B) Response cost and planned ignoring
C) Medication for behavioral issues
D) Clear and calm instructions with consistent consequences

Answer 137

C) Medication for behavioral issues

Question 138

What is a primary focus of attachment-based approaches to parenting?

A) Teaching specific academic skills to children
B) Enhancing the parent’s ability to perceive and respond to the child’s emotional cues
C) Implementing strict disciplinary measures for behavioral problems
D) Providing medication to manage conduct problems

Answer 138

B) Enhancing the parent’s ability to perceive and respond to the child’s emotional cues

Question 139

According to current research, how effective are attachment-based approaches when used in isolation for treating conduct problems?

A) They are highly effective in changing behavior on their own
B) There is significant evidence showing they are the best standalone treatment
C) They have shown limited effectiveness and are often integrated with behavioral interventions
D) They are only effective for children with secure attachments

Answer 139

C) They have shown limited effectiveness and are often integrated with behavioral interventions

Question 140

Which of the following best describes Functional Family Therapy?

A) A long-term individual therapy focusing exclusively on the youth
B) A short-term family therapy intervention aimed at improving family communication and reducing negativity
C) A medication-based treatment for delinquent youth
D) A behavioral therapy focusing on classroom management for school-aged children

Answer 140

B) A short-term family therapy intervention aimed at improving family communication and reducing negativity

Question 141

Which of the following best describes the approach used in social problem-solving training for children with conduct problems?

A) Teaching children to avoid conflict by using passive avoidance strategies
B) Training children in identifying problems, generating solutions, selecting the best solution, and evaluating its success through modeling, rehearsal, feedback, and reinforcement
C) Encouraging children to solve problems through physical aggression and retaliation
D) Providing medication to manage symptoms of aggression and impulsivity

Answer 141

B) Training children in identifying problems, generating solutions, selecting the best solution, and evaluating its success through modeling, rehearsal, feedback, and reinforcement

Question 142

Which of the following best describes the approach used by the ‘FAST TRACK’ program for managing conduct problems?

A) Targeting only home-based interventions without involving schools or peers
B) Focusing solely on medication management for children with conduct problems
C) Concurrently addressing risk and protective factors at home and school, involving parents, teachers, peers, and the curriculum
D) Emphasizing individual therapy for children without involving family or school environments

Answer 142

C) Concurrently addressing risk and protective factors at home and school, involving parents, teachers, peers, and the curriculum

Question 143

What is a primary criticism of Disruptive Mood Dysregulation Disorder (DMDD) as introduced in the DSM-5?

A) It is too similar to Attention-Deficit/Hyperactivity Disorder.
B) It lacks empirical support for its validity and is seen as pathologizing normal temper tantrums.
C) It is too narrowly defined and excludes children with significant emotional symptoms.
D) It is only applicable to adults and not children.

Answer 143

B) It lacks empirical support for its validity and is seen as pathologizing normal temper tantrums.

Question 144

What is a significant issue concerning the diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in relation to other disorders?

A) It is rarely diagnosed alongside any other disorders.
B) It has very low comorbidity rates compared to other disorders.
C) It has a very high comorbidity rate with Oppositional Defiant Disorder, making it difficult to distinguish between the two.
D) It is easily differentiated from Conduct Disorder due to distinct symptom patterns.

Answer 144

C) It has a very high comorbidity rate with Oppositional Defiant Disorder, making it difficult to distinguish between the two.

Question 145

Which of the following best describes Separation Anxiety Disorder?

A) A disorder characterized by excessive worry about academic performance and fear of failure
B) A disorder where children exhibit uncontrollable temper tantrums and defiant behavior
C) A disorder marked by abnormal fear or worry about becoming separated from one’s caregivers, and clinging behavior in their presence
D) A disorder involving persistent worry about health and frequent physical complaints

Answer 145

C) A disorder marked by abnormal fear or worry about becoming separated from one’s caregivers, and clinging behavior in their presence

Question 146

What distinguishes Separation Anxiety Disorder from normative separation anxiety in young children?

A) Separation Anxiety Disorder is only observed in children under 13 months.
B) Separation Anxiety Disorder is characterized by fears and worries unrelated to separation and is not alleviated by the presence of attachment figures.
C) Separation Anxiety Disorder is expressed through distress specifically related to separation from an attachment figure, and the fear is greatly reduced in the presence of the attachment figure.
D) Separation Anxiety Disorder typically involves generalized anxiety about various concerns, not specifically related to separation.

Answer 146

C) Separation Anxiety Disorder is expressed through distress specifically related to separation from an attachment figure, and the fear is greatly reduced in the presence of the attachment figure.

Question 147

Which of the following symptoms is most characteristic of Separation Anxiety Disorder in older children?

A) Fear of loud noises and public speaking.
B) Preoccupation with harm coming to an attachment figure and extreme homesickness.
C) Generalized anxiety about a range of everyday activities.
D) Persistent fears about physical health unrelated to separation experiences.

Answer 147

B) Preoccupation with harm coming to an attachment figure and extreme homesickness.

Question 148

What is the estimated prevalence of Separation Anxiety Disorder in children, according to available studies?

A) Approximately 1 per cent
B) Approximately 4 per cent
C) Approximately 10 per cent
D) Approximately 15 per cent

Answer 148

B) Approximately 4 per cent

(more common in girls)

Question 149

Separation Anxiety Disorder is most commonly observed in which age group?

A) Preschoolers (under 5 years old)
B) Early adolescents (10–12 years old)
C) Middle childhood (7–9 years old)
D) Teenagers (13–18 years old)

Answer 149

C) Middle childhood (7–9 years old)

Question 150

What is a common outcome for cases of Separation Anxiety Disorder in young children?

A) They always resolve by early adolescence
B) They typically worsen in adolescence
C) They remain stable without significant changes
D) They improve over time but may worsen again in adolescence

Answer 150

D) They improve over time but may worsen again in adolescence

Question 151

What is a significant concern for children with persistent Separation Anxiety Disorder?

A) They are less likely to develop any other disorders
B) They may experience high levels of impairment and comorbidity with other disorders
C) They do not show any comorbid conditions
D) They are always diagnosed with conduct disorder

Answer 151

B) They may experience high levels of impairment and comorbidity with other disorders

Question 152

Which of the following is a common comorbidity with Separation Anxiety Disorder in children?

A) Obsessive-Compulsive Disorder
B) Oppositional Defiant Disorder
C) Schizophrenia
D) Attention-Deficit/Hyperactivity Disorder

Answer 152

B) Oppositional Defiant Disorder

Question 153

How does Separation Anxiety Disorder in childhood relate to later mental health outcomes?

A) It is unlikely to affect mental health in adulthood.
B) It is strongly linked to the development of other anxiety disorders in adulthood.
C) It prevents the development of other mental health disorders later in life.
D) It leads directly to the development of personality disorders.

Answer 153

B) It is strongly linked to the development of other anxiety disorders in adulthood.

Question 154

Which of the following factors is believed to contribute to the development and maintenance of Separation Anxiety Disorder?

A) Only genetic predisposition
B) Exclusively parental anxiety
C) Genetic components, parental anxiety modeling, parenting behaviors, and environmental factors
D) Lack of academic achievement

Answer 154

C) Genetic components, parental anxiety modeling, parenting behaviors, and environmental factors

Question 155

What is the genetic vulnerability associated with Separation Anxiety Disorder that is characterized by a predisposition to anxiety in general?

A) Behavioral inhibition
B) Cognitive dissonance
C) Emotional dysregulation
D) Impulse control
Answer: A) Behavioral inhibition

Answer 155

A) Behavioral inhibition

(genetic vulnerability characterised by a tendency to display anxiety and to withdraw in unfamiliar situations)

Question 156

What role does observational learning play in the development of Separation Anxiety Disorder in children with anxious parents?

A) Children learn to respond to anxiety-provoking situations by adopting their parents’ coping strategies.
B) Children develop a strong sense of independence by observing their parents handle fear without showing anxiety.
C) Children are less likely to develop anxiety if they see their parents remain calm.
D) Children do not learn from their parents’ behavior but from external sources.

Answer 156

A) Children learn to respond to anxiety-provoking situations by adopting their parents’ coping strategies.

Question 157

In CBT for Separation Anxiety Disorder, which coping strategy might a child be taught to manage anxiety-provoking thoughts?

A) Ignoring all negative thoughts completely
B) Using positive coping statements like “Even though I’ll be away from home, I’ll be with friends who care about me”
C) Avoiding all situations that might trigger anxiety
D) Replacing anxiety-provoking thoughts with random, unrelated thoughts

Answer 157

B) Using positive coping statements like “Even though I’ll be away from home, I’ll be with friends who care about me”

Question 157

Which of the following is a key component of CBT for treating Separation Anxiety Disorder?

A) Psychoeducation about anxiety and its maintenance
B) Medication to alter brain chemistry
C) Social skills training to enhance peer interactions
D) Creative arts therapy to express emotions

Answer 157

A) Psychoeducation about anxiety and its maintenance

Question 158

Which of the following is an unsupported but commonly believed cause of selective mutism?

A) Early psychological or physical trauma
B) Genetic predisposition
C) Environmental stressors
D) Neurological disorders

Answer 158

A) Early psychological or physical trauma

Question 158

Which of the following best describes selective mutism?

A) A disorder characterized by an inability to speak in all situations, including at home and at school.
B) A disorder marked by a persistent failure to speak in certain settings despite having the ability to speak.
C) A condition where an individual experiences a temporary loss of speech due to a traumatic event.
D) A speech disorder involving difficulty pronouncing certain sounds.

Answer 158

B) A disorder marked by a persistent failure to speak in certain settings despite having the ability to speak.

(may respond or make their needs known by nodding their heads, pointing or by remaining emotionless or expressionless until
someone guesses what they want)

Question 158

What is the primary aim of the ‘Friends Program’ developed in Australia?

A) To specifically target separation anxiety disorder in children
B) To provide a school-wide intervention to reduce overall childhood anxiety, including separation anxiety
C) To offer medication-based treatments for anxiety
D) To focus solely on individual therapy for children with severe anxiety

Answer 158

B) To provide a school-wide intervention to reduce overall childhood anxiety, including separation anxiety

(Psychoeducation and CBT strategies for anxiety)

Question 159

Which of the following statements about the prevalence of selective mutism is accurate?

A) Selective mutism occurs in more than 5% of children.
B) The prevalence rate of selective mutism is estimated to be less than 1%, but this rate might be an underestimate due to the condition’s subtle nature.
C) Selective mutism is observed in 2-3% of children, based on recent studies.
D) The prevalence of selective mutism is widely recognized as 10% of children.

Answer 159

B) The prevalence rate of selective mutism is estimated to be less than 1%, but this rate might be an underestimate due to the condition’s subtle nature.

(more common in girls)

Question 160

Selective mutism is typically diagnosed when a child fails to speak in certain settings for how long?

A) Less than one month
B) At least one month
C) Six months
D) One year

Answer 160

B) At least one month

Question 161

Which of the following is the most common comorbid condition in children with selective mutism?

A) Attention-deficit/hyperactivity disorder (ADHD)
B) Oppositional defiant disorder (ODD)
C) Anxiety disorders, such as separation anxiety disorder and social phobia
D) Autism spectrum disorder

Answer 161

C) Anxiety disorders, such as separation anxiety disorder and social phobia

(75% anxiety)
(40% elimination and speech disorder)

Question 161

What is a key characteristic of selective mutism regarding its onset and duration?

A) Selective mutism typically begins suddenly and has a high rate of remission within a few months.
B) The onset of selective mutism is usually gradual, with some children experiencing it for only a short period, while others may have it for many years. Even after remission, individuals often still feel discomfort in speaking situations.
C) Selective mutism commonly resolves within a few weeks without any discomfort in future speaking situations.
D) The disorder usually starts abruptly and resolves quickly without ongoing effects.

Answer 161

B) The onset of selective mutism is usually gradual, with some children experiencing it for only a short period, while others may have it for many years. Even after remission, individuals often still feel discomfort in speaking situations.

Question 162

In more recent accounts, what factors are considered to contribute to the development of selective mutism?

A) Only environmental stressors
B) Biological, temperamental, and anxiety components
C) Educational deficiencies
D) Cultural influences

Answer 162

B) Biological, temperamental, and anxiety components

Question 163

How is selective mutism classified in the DSM-5?

A) As a mood disorder
B) As a neurodevelopmental disorder
C) As an anxiety disorder
D) As a dissociative disorder

Answer 163

C) As an anxiety disorder

Question 164

What is the primary focus of behavioural interventions for treating selective mutism?

A) Enhancing academic performance
B) Eliminating reinforcement for mutism while increasing self-confidence and decreasing anxiety
C) Increasing verbal communication with family members only
D) Encouraging pharmacotherapy as the main treatment approach

Answer 164

B) Eliminating reinforcement for mutism while increasing self-confidence and decreasing anxiety

Question 164

ccording to Dow and colleagues (1995), what temperament is suggested to contribute to the development of selective mutism?

A) Extroverted and sociable
B) Shy and inhibited
C) Highly active and impulsive
D) Emotionally stable and confident

Answer 164

B) Shy and inhibited

Question 165

What percentage of children with selective mutism in Black and Udhe’s (1994) study met the diagnostic criteria for social phobia?

A) 50%
B) 75%
C) 97%
D) 30%

Answer 165

C) 97%

Question 166

Which technique involves using auditory and video recordings to help a child with selective mutism?

A) Graduated exposure therapy
B) Self-modelling of appropriate actions
C) Pharmacotherapy
D) Parental guidance sessions

Answer 166

B) Self-modelling of appropriate actions

Question 167

Which of the following best describes enuresis (elimination disorder)?

A) Repetitive soiling in inappropriate places
B) Involuntary emptying of the bladder
C) Persistent fear of separation from a caregiver
D) Failure to speak in certain settings

Answer 167

B) Involuntary emptying of the bladder

Question 168

What is the main criterion for diagnosing nocturnal enuresis?

A) The child must be aged five years or older.
B) The child must experience involuntary emptying of the bladder during the day.
C) The child must have a history of physical trauma.
D) The child must have never experienced bladder control.

Answer 168

A) The child must be aged five years or older

Question 169

Which of the following best describes primary enuresis?

A) Occurs when a child has been dry for at least six months and then begins wetting the bed again.
B) Occurs when a child has never been dry.
C) Involves involuntary emptying of the bladder during the day.
D) Is characterized by a significant increase in bladder control.

Answer 169

B) Occurs when a child has never been dry.

Question 170

Which statement best describes secondary enuresis?

A) It occurs when a child has never been dry.
B) It occurs when a child has had a period of dryness for at least six months before starting to wet the bed again.
C) It involves involuntary emptying of the bladder during the day.
D) It is a type of enuresis that only occurs at night.

Answer 170

B) It occurs when a child has had a period of dryness for at least six months before starting to wet the bed again.

Question 171

What is the typical prevalence rate of nocturnal enuresis in 7-year-old boys and girls?

A) 5-10% in boys and 2-5% in girls
B) 15-22% in boys and 7-15% in girls
C) 25-30% in boys and 10-20% in girls
D) 10-15% in boys and 5-10% in girls

Answer 171

B) 15-22% in boys and 7-15% in girls

Question 172

What are the key reasons for the importance of early intervention in treating nocturnal enuresis?

A) Most children with enuresis resolve the problem without treatment
B) Enuresis is rare in adulthood and typically resolves on its own
C) Children with enuresis often face embarrassment, social isolation, and low self-esteem that may lead to ongoing difficulties in adulthood
D) Enuresis is only a minor issue that does not impact long-term functioning

Answer 172

C) Children with enuresis often face embarrassment, social isolation, and low self-esteem that may lead to ongoing difficulties in adulthood

Question 173

What is a common comorbid condition associated with nocturnal enuresis?

A) Social Anxiety Disorder
B) Attention-Deficit/Hyperactivity Disorder (ADHD)
C) Generalized Anxiety Disorder
D) Obsessive-Compulsive Disorder

Answer 173

B) Attention-Deficit/Hyperactivity Disorder (ADHD)

Question 174

Why is it important to address comorbidity in children with nocturnal enuresis?

A) Comorbidity with other conditions can complicate treatment and exacerbate issues such as behavioral problems and social difficulties.
B) Comorbid conditions are unrelated and do not impact the treatment of enuresis.
C) Addressing comorbidity is not necessary as it has no effect on enuresis.
D) Comorbid conditions always resolve on their own without intervention.

Answer 174

A) Comorbidity with other conditions can complicate treatment and exacerbate issues such as behavioral problems and social difficulties.

Question 175

Psychological factors rarely contribute to the development of primary enuresis, whereas specific psychosocial events are much more common in secondary enuresis. True/False

Answer 175

True

(e.g. stressful life events such as parental divorce, the death of a loved one or other trauma can lead to the development of secondary enuresis)

Question 176

What factor is thought to play a substantial role in the development of enuresis?

A) Environmental stressors
B) Inherited factors
C) Nutritional deficiencies
D) School-related issues

Answer 176

B) Inherited factors

Question 177

How does having an enuretic parent affect a child’s likelihood of developing enuresis?

A) It decreases the likelihood of enuresis.
B) It has no impact on the likelihood of developing enuresis.
C) It increases the likelihood of enuresis.
D) It is only relevant if both parents are enuretic.

Answer 177

C) It increases the likelihood of enuresis.

(44% if one parent had it and 77% if both parents had it)

Question 177

What general developmental factor is associated with children who have enuresis?

A) Higher than average height
B) Delayed development of milestones
C) Advanced motor skills
D) Early developmental milestones

Answer 177

B) Delayed development of milestones

Question 178

Which of the following is a possible specific factor contributing to enuresis?

A) Reduced height
B) Increased sensitivity to bladder sensations
C) Reduced functional bladder capacity
D) Enhanced bladder control

Answer 178

C) Reduced functional bladder capacity, hyperactivity of the parasympathetic
nervous system; abnormal sleep patterns and arousability (i.e., reduced waking from sleep in response to
the sensation of a full bladder);

Question 179

What is the most successful treatment for enuresis, based on the success rates?

A) Medication
B) Conditioning approach
C) Dietary changes
D) Increased fluid intake

Answer 179

B) Conditioning approach

(more successful
than medication)

Question 180

How does the effectiveness of desmopressin compare to conditioning interventions in treating enuresis?

A) Desmopressin is more effective than conditioning interventions.
B) Desmopressin and conditioning interventions have similar success rates.
C) Conditioning interventions are generally more successful than desmopressin.
D) Desmopressin has a higher rate of complete dryness compared to conditioning interventions.

Answer 180

C) Conditioning interventions are generally more successful than desmopressin.

(an antidiuretic that leads to decreased urine production and increased urine concentration)

Question 181

How does the bell and pad method work for treating nocturnal enuresis?

A) It involves the use of medication to reduce urine production.
B) It uses a urine-sensitive pad connected to an alarm that activates when the child wets the bed.
C) It requires increasing fluid intake to manage enuresis.
D) It employs dietary changes to manage bladder control.

Answer 181

B) It uses a urine-sensitive pad connected to an alarm that activates when the child wets the bed.

Question 181

What is the most effective intervention for nocturnal enuresis based on conditioning principles?

A) Medication
B) Behavioral therapy
C) The bell and pad method
D) Dietary changes

Answer 181

C) The bell and pad method

Question 182

What is the definition of encopresis?

A) Frequent urination in inappropriate places
B) Repetitive soiling in inappropriate places in a child at least four years old
C) Difficulty controlling bowel movements but not occurring in inappropriate places
D) Frequent vomiting in inappropriate places

Answer 182

B) Repetitive soiling in inappropriate places in a child at least four years old

Question 182

To meet the criteria for encopresis, how often must a child exhibit soiling behavior?

A) Once a week
B) At least once a month
C) Once a year
D) Daily

Answer 182

B) At least once a month

Question 183

What are the two main types of encopresis?

A) Stress-related and non-stress-related
B) Organic and functional
C) Retentive and non-retentive
D) Acute and chronic

Answer 183

C) Retentive and non-retentive

(retentive, where the child tends to hold on for as long as possible, or non-retentive, where soiling is intermittent and there is no evidence of constipation)

Question 184

Despite its decline with age, what are some of the difficulties children with encopresis may experience?

A) Better social interactions
B) Fewer academic challenges
C) Increased anxiety, depressive symptoms, and social problems
D) Improved behavioral and attention skills

Answer 184

C) Increased anxiety, depressive symptoms, and social problems

Question 184

At what age is encopresis typically not diagnosed due to the lack of physical control over anal functioning?

A) Before two years
B) Before three years
C) Before four years
D) Before five years

Answer 184

C) Before four years

Question 185

According to Cox, Sutphen, Ling, and Quillian’s aetiological model, what is the initial event that triggers the development of encopresis?

A) Diarrhea
B) Constipation
C) Urinary tract infection
D) Emotional trauma

Answer 185

B) Constipation

Question 186

What consequence follows the child’s avoidance of toilet use due to painful experiences with large, hard stools?

A) Decreased faecal impaction
B) Chronic constipation with overflow incontinence
C) Improved toilet habits
D) Increased frequency of bowel movements

Answer 186

B) Chronic constipation with overflow incontinence

Question 187

How does parent–child conflict contribute to the development of encopresis according to the model?

A) It decreases the child’s anxiety about using the toilet.
B) It leads to increased frequency of successful toilet use.
C) It results in resistance to toilet use and further soiling.
D) It improves the child’s ability to manage bowel movements.

Answer 187

C) It results in resistance to toilet use and further soiling.

Question 188

What psychological effects can occur as a result of encopresis according to the model?

A) Increased confidence and self-esteem
B) Enhanced social interactions
C) Shame and rejection leading to hiding or lying about dirty underwear
D) Improved academic performance

Answer 188

C) Shame and rejection leading to hiding or lying about dirty underwear

Question 189

Why is combining medical management with behavioral treatment generally more effective than using medical management alone for encopresis?

A) Medical management alone addresses both the physical and psychological aspects of the disorder.
B) Behavioral treatment complements medical management by addressing the behavioral and psychological components.
C) Behavioral treatment alone is sufficient for managing encopresis.
D) Medical management alone is more effective than combined approaches.

Answer 189

B) Behavioral treatment complements medical management by addressing the behavioral and psychological components.

Question 190

How do behavioral interventions help manage encopresis?

A) By focusing only on dietary changes
B) By providing psychoeducation, implementing a reinforcement schedule, and reducing accidental reinforcement
C) By exclusively using laxatives
D) By avoiding any interaction with the child’s toileting habits

Answer 190

B) By providing psychoeducation, implementing a reinforcement schedule, and reducing accidental reinforcement

Question 191

What is one challenge highlighted by follow-up studies on encopresis treatment?

A) The treatments are effective immediately and require no follow-up.
B) All children fully resolve their symptoms with initial treatment.
What is one challenge highlighted by follow-up studies on encopresis treatment?

A) The treatments are effective immediately and require no follow-up.
B) All children fully resolve their symptoms with initial treatment.
C) A significant percentage of children continue to soil even after treatment.
D) Follow-up studies are not necessary for evaluating treatment effectiveness

Answer 191

C) A significant percentage of children continue to soil even after treatment.