IACAM Course “Module A” Assessment -Batch 6

Question 1 of 50

1. Question

2 point(s)

A decline in cognitive functioning after 18 years of age suggests:

Intellectual Disability
Neurocognitive disorder
Autism spectrum disorder
Learning disability

Question 2 of 50

2. Question

2 point(s)

A 9-year-old child reads fluently but fails to understand the meaning of passages and cannot answer inferential questions. Which of the following best explains this presentation?

Primary visual deficit
Deficit in phonological decoding
Deficit in higher-order language processing
Lack of motivation

Question 3 of 50

3. Question

2 point(s)

The ‘liability threshold model’ in ASD genetics proposes which of the following?

A single high-penetrance gene mutation crosses the threshold and causes ASD
ASD emerges only when environmental factors exceed a biological threshold, independent of genetics
Multiple genetic and environmental risk factors accumulate until a clinical threshold is crossed, at which point ASD is expressed
The liability threshold is fixed and identical across sexes and populations

Question 4 of 50

4. Question

2 point(s)

The theory of multiple intelligences was proposed by:

Charles Spearman
Howard Gardner
Robert Sternberg
Alfred Binet

Question 5 of 50

5. Question

2 point(s)

A child continues to show difficulty in reading despite 7 months of targeted intervention. Academic skills are 1.6 SD below mean, IQ is normal, and vision/hearing are intact. What is the most appropriate interpretation?

Diagnosis cannot be made yet
Specific Learning Disorder is likely
Intellectual disability
Normal variation

Question 6 of 50

6. Question

2 point(s)

Which of the following best describes the ‘Broad Autism Phenotype’ (BAP)?

A severe form of ASD with intellectual disability and no language
Subclinical autism-related traits in first-degree relatives that do not meet diagnostic threshold
A DSM-5 specifier for individuals with ASD and above-average intelligence
The full range of ASD presentations from mild to severe on the diagnostic spectrum

Question 7 of 50

7. Question

2 point(s)

Which of the following best differentiates accommodation from modification?

Accommodations change the content or instructional level; modifications don’t
Modification reduces task demands; accommodation facilitates access
Modifications assume the student can meet the same grade-level standards; accommodation imply the student is not expected to meet the same standards.
Modifications remove barriers to access; accomodation adjust the workload to be more achievable

Question 8 of 50

8. Question

2 point(s)

Which intelligence is most closely associated with parietal lobe functioning?

Spatial intelligence
Linguistic intelligence
Interpersonal intelligence
Naturalistic

Question 9 of 50

9. Question

2 point(s)

Which of the following best explains why SLD may not be evident until later school years?

Gradual accumulation of neurological deficits
Academic demands exceeding the child's capacity
Academic demands exceeding parents’ ability to supervise
Academic demands exceeding the social capital

Question 10 of 50

10. Question

2 point(s)

A 2-year-old boy is referred for speech delay. He does not point to share interest, rarely makes eye contact, and lines up toys repetitively. Which developmental milestone deficit is most diagnostically significant for ASD?

Absence of single words by 18 months
Absence of proto-declarative pointing (joint attention), pointing to shared interest rather than to request
Failure to walk independently by 18 months
Absence of parallel play by age 2

Question 11 of 50

11. Question

2 point(s)

Which of the following best illustrates diagnostic overshadowing?

Missing an anxiety disorder in the background of psychosis
Missing a developmental disorder in a child with history of preterm birth
Missing an emotional disorder in a child with autism
Missing an emotional disorder in a child with history of trauma

Question 12 of 50

12. Question

2 point(s)

Which of the following is a core component of Individuals with Disabilities Education Act (IDEA) services?

IQ testing annually
Individualized Education Program (IEP)
Medication compliance monitoring
Court-appointed disability guardian

Question 13 of 50

13. Question

2 point(s)

A child frequently reverses letters (b/d, p/q), reads slowly, and avoids reading tasks. Which of the following is the most accurate underlying deficit?

Visual acuity impairment
Motor coordination deficit
Phonological processing deficit
Attention deficit alone

Question 14 of 50

14. Question

2 point(s)

Which of the following statements about ADHD comorbidity in ASD is most accurate?

ADHD and ASD cannot be diagnosed concurrently under DSM-5
Approximately 45% of autistic individuals have comorbid ADHD, and the two conditions share overlapping genetic risk
ADHD in ASD always presents with hyperactivity and is easily distinguished from ASD inattention
Treating ADHD with stimulants is contraindicated in the presence of ASD

Question 15 of 50

15. Question

2 point(s)

Referrals to child and adolescent psychiatry services are

Commonly associated with background psychotic disorders
Most commonly for disruptive disorders
Most commonly for internalizing disorders
Commonly associated with background neurodevelopmental vulnerabilities

Question 16 of 50

16. Question

2 point(s)

In individuals with mild intellectual disability, the most frequently diagnosed comorbid disorder is:

Autism Spectrum Disorder
ADHD
Major depressive disorder
Tic disorder

Question 17 of 50

17. Question

2 point(s)

A child is provided with extra time in exams, use of a calculator, and audiobooks. This intervention is best categorized as:

Remediation
Modification
Accommodation
Rehabilitation

Question 18 of 50

18. Question

2 point(s)

Which of the following types of statements should be avoided in a child psychiatry assessment?

“Can you tell me about your school?”
“Does your father not take you to school every day?”
“What happened after you left school?”
“How do you feel getting back home from school?”

Question 19 of 50

19. Question

2 point(s)

The overall rate of psychiatric comorbidity in intellectual disability compared to the general population is:

Same
Lower
2-4 times higher
10 times higher

Question 20 of 50

20. Question

2 point(s)

A child spells words based on sound (e.g., “enough” as “enuf”) and has poor handwriting and disorganized written expression. Which diagnosis is most appropriate?

Dyslexia
Dysgraphia
Dyscalculia
ADHD

Question 21 of 50

21. Question

2 point(s)

Determinants of therapeutic alliance include all except:

Clinician’s age
Child’s motivation
Child’s age
Clinician’s non-verbal communication

Question 22 of 50

22. Question

2 point(s)

The concept of “secure base” in attachment theory primarily facilitates development of:

Disinhibited social attachment issues
Behavioral inhibition
Exploration and autonomy
Reactive attachment issues

Question 23 of 50

23. Question

2 point(s)

Which of the following best supports the multi-deficit theory of dyslexia?

All children with phonological deficits develop dyslexia
Dyslexia is caused by a more than 3 genetic mutations
Multiple interacting risk and protective factors determine outcome
Environmental factors have a causal role

Question 24 of 50

24. Question

2 point(s)

The “double chair” technique can be useful in assessing:

Neuromuscular disorders
Neurodevelopmental disorders
Emotional disorders
Psychotic disorders

Question 25 of 50

25. Question

2 point(s)

A child with early psychosocial deprivation showing quasi-autistic features best illustrates interaction between attachment disruption and:

Epigenetic determinism
Formal operational delay
Operant conditioning principles
Critical periods in neurodevelopment

Question 26 of 50

26. Question

2 point(s)

Which of the following is a requirement for SLD certification in India?

IQ less than 70
IQ of 100 or above
IQ of 85 or above
IQ deficit documented before age 5

Question 27 of 50

27. Question

2 point(s)

A case formulation is

Listing of all the relevant biological, social and psychological factors
A synthesis of bio-psycho-social factors, how they interact and co-determine symptoms
Multi-axial diagnosis with identification of good and bad prognostic factors
A summary of case management plan

Question 28 of 50

28. Question

2 point(s)

In specific learning disorder affecting reading (dyslexia), neuroimaging studies most consistently demonstrate dysfunction in:

Right parietal cortex
Left temporo-parietal regions
Bilateral occipital poles
Basal ganglia

Question 29 of 50

29. Question

2 point(s)

Which of the following best explains why autism prevalence figures have risen from under 0.4% to 1–2% over four decades?

A true biological increase due to environmental toxins alone
Broadened diagnostic criteria, increased awareness, and improved case ascertainment – with possible true increase
Reclassification of intellectual disability as autism
Improved genetic testing identifying previously missed cases

Question 30 of 50

30. Question

2 point(s)

Alcohol use disorders arising in the background of attention deficit hyperactivity is an example of

Homotypic continuity
Isotypic continuity
Monotypic continuity
Heterotypic continuity

Question 31 of 50

31. Question

2 point(s)

In children with attention-deficit/hyperactivity disorder, deficits in inhibitory control are most closely linked to dysfunction in:

Limbic system
Prefrontal-striatal circuits
Occipital cortex
Primary motor cortex

Question 32 of 50

32. Question

2 point(s)

According to DSM-5, the diagnostic criteria for ASD are based on which of the following?

A triad of impairments: social communication, repetitive behaviours, and language delay
A dyad of impairments: social communication deficits AND restricted/repetitive behaviours
A dyad of impairments: intellectual disability AND social withdrawal
A triad: sensory processing disorder, language delay, and emotional dysregulation

Question 33 of 50

33. Question

2 point(s)

Structured assessment tools are least useful for

Diagnostic confirmation
Outcome assessment
Preliminary assessment
Eliciting side effects of treatment

Question 34 of 50

34. Question

2 point(s)

A child with autism spectrum disorder who shows difficulty with theory of mind tasks most directly reflects impairment in which theoretical construct?

Mentalization
Egocentrism (Piagetian)
Object permanence
Classical conditioning

Question 35 of 50

35. Question

2 point(s)

A 14-year-old girl is referred for anxiety and social difficulties. She performs well academically and has a wide social network, but reports exhaustion after social interactions. Which phenomenon best explains her late presentation?

Female protective effect leading to milder phenotype
Social masking/camouflaging suppressing diagnostic features in clinical settings
Comorbid generalised anxiety disorder masking ASD
Higher intelligence compensating for all autistic traits

Question 36 of 50

36. Question

2 point(s)

Child-friendly spaces should

Restrict the availability of toys to the play therapy room
Have trained staff
Have directions for nearest transport services
Restrict the availability of open space because of possibility of falls

Question 37 of 50

37. Question

2 point(s)

Mirror neuron systems, implicated in imitation and social cognition, are primarily located in:

Primary visual cortex
Inferior frontal gyrus
Hippocampus
Hypothalamus

Question 38 of 50

38. Question

2 point(s)

Twin studies in ASD show monozygotic concordance rates of 70–90%. Which of the following conclusions is most accurate based on this finding?

ASD is entirely genetically determined with no environmental contribution
ASD is highly heritable but no single gene accounts for more than 1–2% of cases
Dizygotic twins have equal concordance rates, confirming shared environment as the primary driver
High heritability implies that genetic testing will identify the cause in most cases

Question 39 of 50

39. Question

2 point(s)

The most common inherited cause of intellectual disability is:

Down syndrome
Fragile X syndrome
Phenylketonuria
Tuberous sclerosis

Question 40 of 50

40. Question

2 point(s)

In cognitive neuroscience, executive functions are most strongly associated with which brain region?

Occipital cortex
Cerebellum
Temporal lobe
Prefrontal cortex

Question 41 of 50

41. Question

2 point(s)

Which of the following is the most appropriate first-line screening tool for autism in a 20-month-old child presenting to a general paediatric clinic?

ADOS-2 (Autism Diagnostic Observation Schedule)
ISAA (Indian Scale for Assessment of Autism)
M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up)
Vineland Adaptive Behaviour Scales (VABS)

Question 42 of 50

42. Question

2 point(s)

Hyperphagia and obesity in a child with intellectual disability are most characteristic of:

William’s syndrome
Fragile X syndrome
Prader–Willi syndrome
Smith-Lemli-Opitz syndrome

Question 43 of 50

43. Question

2 point(s)

According to Albert Bandura’s social learning theory, which factor is most critical for observational learning?

Classical conditioning
Insight learning
Vicarious reinforcement
Maturation

Question 44 of 50

44. Question

2 point(s)

An autistic adult presents with social withdrawal, blunted affect, and odd fragmented speech. Which feature would most strongly support a diagnosis of superimposed psychosis rather than ASD alone?

Ego-syntonic, stable unusual beliefs present since childhood
Literal misinterpretation of social cues without distress
A definable onset of new positive symptoms with deterioration from a previous baseline
Flat affect and reduced speech output consistent with longstanding ASD

Question 45 of 50

45. Question

2 point(s)

All of the following criteria can be used to define intellectual disabilities, EXCEPT:

Significantly below average intellectual functioning
Impairments in adaptive functioning generally
These deficits should be manifest before the age of 18-years
Impairments in instrumental activities of daily living

Question 46 of 50

46. Question

2 point(s)

In the “Strange Situation” paradigm developed by Mary Ainsworth, which behavior is most characteristic of insecure-ambivalent attachment?

Avoidance of caregiver on reunion
No distress on separation
Distress on separation but resistance on reunion
Indifference to stranger and caregiver

Question 47 of 50

47. Question

2 point(s)

What proportion of autistic individuals are estimated to experience suicidal ideation, and what is the most important clinical implication?

~10%; suicidality in ASD is rare and does not require routine screening
~35–40%; clinicians should ask directly using plain language as autistic individuals often answer honestly when asked plainly
~20%; suicidality should only be assessed via standardised questionnaires, not direct questioning
~50%; all autistic adults should be admitted for inpatient psychiatric assessment

Question 48 of 50

48. Question

2 point(s)

Which prenatal factor is strongly associated with intellectual disability?

Maternal hypothyroidism
Fetal alcohol exposure
Maternal anemia
Hyperemesis gravidarum

Question 49 of 50

49. Question

2 point(s)

In John Bowlby’s attachment theory, prolonged early maternal deprivation is hypothesized to primarily affect:

Language acquisition
Executive function
Internal working models of relationships
Sensorimotor development

Question 50 of 50

50. Question

2 point(s)

Regarding pharmacological treatment in ASD, which of the following statements is most accurate?

Risperidone is FDA-approved for the core social communication deficits of ASD
SSRIs are first-line treatment for repetitive behaviours in all autistic individuals
No medication is approved for core ASD features; pharmacotherapy targets comorbid conditions and associated behaviours
Methylphenidate is contraindicated in ASD due to risk of psychosis