100+ Free ABP Developmental-Behavioral Pediatrics Practice Questions

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Question 1

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A 3-year-old has persistent deficits in social-emotional reciprocity, nonverbal communicative behaviors, and developing/maintaining relationships, along with restricted/repetitive behaviors. Per DSM-5-TR, which additional criterion is required for an autism spectrum disorder (ASD) diagnosis?

Symptoms present in the early developmental period and cause clinically significant impairment

IQ below 70 on standardized testing

Age at diagnosis before 3 years

Regression in language after 18 months

to track

2026 Statistics

Key Facts: ABP Developmental-Behavioral Pediatrics Exam

~200

Total MCQ Items

Single-best-answer, 4-5 options

~7 hr

Exam Time

1-day CBT at Pearson VUE

180

Passing Score

1-300 scale; criterion-referenced

$2,992

2026 Regular Fee

Includes $750 processing fee

3 yr

Required Fellowship

ACGME-accredited DBP fellowship

MOCA-Peds

Continuing Certification

5-year longitudinal assessment cycle

The ABP Developmental-Behavioral Pediatrics certifying exam is a 1-day computer-based test of approximately 200 single-best-answer MCQs delivered at Pearson VUE. Scored on a 1-300 scale with 180 passing (criterion-referenced, modified Angoff). The 2026 fee is $2,992 regular ($750 processing), $3,337 late. Highest-yield domains: ASD (~12%), ADHD/externalizing (~12%), cerebral palsy/motor (~8%), intellectual disability (~8%), developmental screening/testing (~8%), pediatric psychopharmacology (~8%), learning disabilities/school issues (~7%), anxiety/depression/OCD (~7%), ACEs/trauma (~5%), sleep (~4%), feeding (~4%), Tourette (~4%), adolescence (~4%), systems/advocacy (~4%), plus research methods and genetic syndromes.

Sample ABP Developmental-Behavioral Pediatrics Practice Questions

Try these sample questions to test your ABP Developmental-Behavioral Pediatrics exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 3-year-old has persistent deficits in social-emotional reciprocity, nonverbal communicative behaviors, and developing/maintaining relationships, along with restricted/repetitive behaviors. Per DSM-5-TR, which additional criterion is required for an autism spectrum disorder (ASD) diagnosis?

A.Symptoms present in the early developmental period and cause clinically significant impairment

B.IQ below 70 on standardized testing

C.Age at diagnosis before 3 years

D.Regression in language after 18 months

Explanation: DSM-5-TR requires persistent deficits in social communication (A), restricted/repetitive behaviors (B), symptoms in the early developmental period (C), clinically significant impairment (D), and that findings are not better explained by ID/GDD (E). Symptoms may become apparent later when social demands exceed capacity. Regression and IQ are not required.

2Per AAP 2020 surveillance and screening guidelines, at which well-child visits should universal ASD-specific screening be performed?

A.24 and 36 months

B.9 and 18 months

C.12 and 30 months

D.18 and 24 months

Explanation: AAP recommends ASD-specific screening (e.g., M-CHAT-R/F) at the 18- and 24-month well-child visits, in addition to developmental surveillance at every well visit and general developmental screening at 9, 18, and 30 months. Early identification enables timely referral to early intervention.

3A 20-month-old scores 8 on the M-CHAT-R. Per scoring guidance, what is the next step?

A.Reassure parents the score is low risk

B.Repeat M-CHAT-R at the 24-month visit

C.Refer immediately for diagnostic evaluation and early intervention without follow-up interview

D.Order brain MRI

Explanation: M-CHAT-R scores 0-2 are low risk, 3-7 medium risk (administer follow-up interview), and 8-20 high risk — refer immediately for diagnostic evaluation AND early intervention without requiring the follow-up interview. Do not delay referral.

4Which instrument is considered the gold-standard direct observational assessment for autism spectrum disorder?

A.Childhood Autism Rating Scale (CARS-2)

B.Autism Diagnostic Interview-Revised (ADI-R)

C.Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)

D.Social Communication Questionnaire (SCQ)

Explanation: ADOS-2 is a semi-structured, standardized observation of social-communication behaviors and restricted/repetitive behaviors; it is considered the gold-standard direct assessment across ages/language levels. ADI-R is the complementary parent interview. CARS-2 and SCQ are additional tools but not gold standard for direct observation.

5A 4-year-old boy is newly diagnosed with ASD and moderate ID. Which genetic test is recommended as first-tier by ACMG for etiologic evaluation?

A.Whole-genome sequencing

B.Karyotype

C.Chromosomal microarray analysis (CMA)

D.FISH for 22q11.2

Explanation: ACMG and AAP recommend chromosomal microarray as first-tier testing in unexplained ASD/ID/GDD — diagnostic yield ~10-20%. Fragile X testing (FMR1 CGG repeat) is also recommended, particularly in males. Whole-exome sequencing is increasingly used as second-tier or parallel first-tier in some centers.

6A 6-year-old with ASD has macrocephaly (head circumference >2.5 SD above mean). Which additional genetic test is most specifically indicated?

A.UBE3A methylation

B.MECP2 sequencing

C.PTEN sequencing

D.SNRPN methylation

Explanation: PTEN hamartoma tumor syndrome (Cowden/Bannayan-Riley-Ruvalcaba) is associated with macrocephaly (commonly >2 SD) plus ASD or developmental delay; PTEN sequencing is recommended in this phenotype. MECP2 → Rett, UBE3A → Angelman, SNRPN → Prader-Willi.

7A 7-year-old girl with ASD has severe irritability and self-injurious behavior unresponsive to behavioral therapy. Which medication has FDA approval for irritability associated with ASD in children?

A.Lithium

B.Fluoxetine

C.Methylphenidate

D.Risperidone

Explanation: Risperidone (ages 5-16) and aripiprazole (ages 6-17) are the two FDA-approved medications for irritability/aggression/self-injury associated with ASD. Monitor weight, BMI, fasting glucose/lipids, prolactin, and extrapyramidal/tardive symptoms.

8Which intervention for young children with ASD has the strongest evidence base per systematic reviews and is typically delivered 20-40 hours/week?

A.Facilitated communication

B.Early intensive behavioral intervention (EIBI) based on applied behavior analysis (ABA)

C.Hyperbaric oxygen therapy

D.Chelation therapy

Explanation: Early intensive behavioral intervention (EIBI), rooted in ABA (e.g., Lovaas model, Early Start Denver Model), typically delivered 20-40 hours/week starting before age 4, has the strongest evidence for improving cognitive, language, and adaptive outcomes. Facilitated communication, HBOT, and chelation are not evidence-based and may be harmful.

9A nonverbal 5-year-old with ASD demonstrates frustration during requests. Which evidence-based approach supports communication access?

A.Delay speech therapy until age 7

B.Augmentative and alternative communication (AAC), including picture exchange or speech-generating devices

C.Require verbal speech before using any AAC

D.Facilitated communication

Explanation: AAC (low-tech PECS/picture symbols, high-tech speech-generating devices) supports communication in nonverbal or minimally verbal children with ASD. Research shows AAC does not inhibit speech development and often supports it. Facilitated communication is pseudoscientific and contraindicated.

10DSM-5-TR specifies severity levels 1-3 for ASD based on what dimension?

A.Level of support required for social communication and restricted/repetitive behaviors

B.IQ score

C.Age at diagnosis

D.Presence of comorbid epilepsy

Explanation: DSM-5-TR rates ASD severity separately for the social-communication and restricted/repetitive behavior domains by support needs: Level 1 'requiring support,' Level 2 'requiring substantial support,' Level 3 'requiring very substantial support.' IQ is specified as a 'with/without intellectual impairment' specifier, not a severity level.

About the ABP Developmental-Behavioral Pediatrics Exam

The ABP Developmental-Behavioral Pediatrics (DBP) subspecialty certifying exam validates expert-level knowledge of autism spectrum disorder (DSM-5-TR, M-CHAT-R, ADOS-2, ABA), ADHD (DSM-5-TR, Vanderbilt, AAP 2019 guideline, stimulant and non-stimulant pharmacology), cerebral palsy (GMFCS), intellectual disability (chromosomal microarray workup, Fragile X), learning disabilities (IDEA, IEP/504), developmental screening (ASQ-3, Bayley-4, WISC-V, Vineland-3), pediatric anxiety/depression/OCD, pediatric psychopharmacology (SSRI black box, antipsychotic metabolic monitoring), ACEs and trauma-informed care, Tourette syndrome, sleep disorders, feeding disorders, and adolescent developmental issues. 1-day CBT of ~200 MCQs. Requires ABP General Pediatrics certification plus a 3-year ACGME-accredited DBP fellowship.

Questions

200 scored questions

Time Limit

1-day CBT (~7 hours with breaks)

Passing Score

Scaled score of 180 on a 1-300 scale (criterion-referenced, modified Angoff)

Exam Fee

$2,992 regular ($750 processing fee); $3,337 with late fee (American Board of Pediatrics (ABP) / Pearson VUE)

ABP Developmental-Behavioral Pediatrics Exam Content Outline

~12%

Autism Spectrum Disorder (ASD)

DSM-5-TR criteria (social communication + restricted/repetitive behaviors, severity 1-3), M-CHAT-R/F at 18/24 mo, ADOS-2, ADI-R, etiology (Fragile X FMR1, Rett MECP2, TSC, 15q/16p CNVs), genetic workup (CMA + Fragile X first-line), EIBI/ABA, Early Start Denver, risperidone/aripiprazole for irritability.

~12%

ADHD and Externalizing Behaviors

DSM-5-TR (inattentive, hyperactive-impulsive, combined; symptoms <12y), Vanderbilt/Conners-3/SNAP-IV, AAP 2019 guideline, stimulants (methylphenidate, amphetamine — cardiac screen), non-stimulants (atomoxetine, guanfacine ER, clonidine ER), ODD/CD/DMDD.

~8%

Cerebral Palsy and Motor Disorders

Spastic (diplegia, hemiplegia, quadriplegia), dyskinetic, ataxic; GMFCS I-V; etiology (prematurity+PVL, HIE, stroke, kernicterus); comorbidities (ID, epilepsy, hip dysplasia, scoliosis); baclofen, botulinum toxin A, SDR; Duchenne DMD, SMA SMN1.

~8%

Intellectual Disability and GDD

DSM-5-TR ID (intellectual + adaptive, severity by adaptive), GDD <5y, workup (CMA, Fragile X FMR1, thyroid, CK, metabolic, MRI), syndromes (Down T21, Williams 7q11.23, 22q11.2, Rett MECP2, Angelman, PWS, Smith-Magenis).

~8%

Developmental Screening and Testing

AAP Bright Futures surveillance + 9/18/30 mo screening, ASQ-3, ASQ-SE-2, PEDS, SWYC, Bayley-4 (1-42 mo), WPPSI-IV (2.5-7y), WISC-V (6-16y), WIAT-4, Vineland-3 adaptive.

~8%

Pediatric Psychopharmacology

SSRI black box (6-24y, monitor 2-4w), atypical antipsychotic monitoring (weight, BMI%, HbA1c, lipids, prolactin; EPS, TD, metabolic syndrome), lithium (renal/thyroid), valproate (hepatotoxicity, teratogen, hyperammonemia), α2-agonists (rebound HTN), melatonin.

~7%

Learning Disabilities and School Issues

Specific learning disorder DSM-5-TR (reading/dyslexia, written, mathematics), Orton-Gillingham, IEP vs 504 (IDEA vs Section 504), LRE, RTI/MTSS, twice-exceptional, school refusal.

~7%

Anxiety, Depression, OCD

GAD, SAD, social anxiety, selective mutism, specific phobias, PTSD, OCD (DSM-5-TR); MDD, persistent depressive, DMDD; PHQ-A, ASQ; CBT first-line; fluoxetine ≥8y for MDD; fluoxetine/sertraline/fluvoxamine for OCD; TF-CBT.

~5%

Trauma, ACEs, Attachment

ACEs (CDC/Kaiser 10-item), toxic stress, Bruce Perry model, trauma-informed care, pediatric PTSD, attachment disorders (RAD, DSED), foster care/adoption.

~4%

Sleep Disorders

Behavioral insomnia (sleep-onset association, limit-setting), OSA (adenotonsillar hypertrophy, AT first-line, AHI ≥1), parasomnias, RLS/PLMD (ferritin <50), narcolepsy type 1 (orexin), delayed sleep phase.

~4%

Feeding Disorders and FTT

ARFID (DSM-5-TR), pediatric feeding disorder (ASPEN), FTT (organic vs nonorganic), refeeding syndrome, rumination, pica, anorexia/bulimia/binge-eating adolescents.

~4%

Tourette and Tic Disorders

DSM-5-TR Tourette (motor + vocal, >1y, <18y), comorbid ADHD + OCD, CBIT/HRT first-line, α2-agonists first-line pharmacotherapy, aripiprazole/risperidone, VMAT2 inhibitors.

~4%

Adolescence and Gender Development

Tanner staging, HEEADSSS, confidentiality, SBIRT/CRAFFT, gender identity (WPATH v8, gender-affirming care), transitions, depression/suicide screening.

~4%

Systems, Advocacy, Early Intervention

IDEA Part C (0-3), IDEA Part B (3-21), IEP process, 504 Plan, ADA, medical home, SSI for children, Medicaid waivers.

How to Pass the ABP Developmental-Behavioral Pediatrics Exam

What You Need to Know

Passing score: Scaled score of 180 on a 1-300 scale (criterion-referenced, modified Angoff)
Exam length: 200 questions
Time limit: 1-day CBT (~7 hours with breaks)
Exam fee: $2,992 regular ($750 processing fee); $3,337 with late fee

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABP Developmental-Behavioral Pediatrics Study Tips from Top Performers

1AAP M-CHAT-R/F rule: universal autism screening at 18 and 24 months. Score 0-2 low risk; 3-7 medium risk — administer the M-CHAT-R Follow-Up; 8-20 high risk — refer directly to diagnostic evaluation AND early intervention (Part C). A negative screen at 18 months does NOT rule out ASD — rescreen at 24 months because regressive ASD can present 15-30 months.

2AAP 2019 ADHD guideline by age: 4-5y → evidence-based parent training in behavior management (PTBM) FIRST; methylphenidate only if behavior therapy fails and moderate-to-severe impairment persists. 6-12y → FDA-approved stimulant PLUS evidence-based behavior therapy. 12-18y → FDA-approved medication with patient assent + behavior therapy. Obtain cardiac history (syncope, family sudden death, HCM); routine ECG NOT required unless concerning history.

3Chromosomal microarray (CMA) is first-line genetic test for unexplained ID/GDD or ASD (yield ~15-20% vs karyotype <3%). Add Fragile X FMR1 testing (>200 CGG repeats = full mutation). Add MECP2 in any girl with regression after normal early development (Rett syndrome). Consider whole exome sequencing (WES) when CMA + Fragile X negative — yield ~30%.

4Antipsychotic monitoring rule (APA/AACAP): at baseline obtain BMI, waist circumference, BP, fasting glucose/HbA1c, fasting lipids, LFTs, prolactin. Monitor weight/BMI every 3 months, HbA1c and lipids at 3 months then annually. Watch for EPS (acute dystonia, akathisia, parkinsonism, tardive dyskinesia — use AIMS). Risperidone and aripiprazole are FDA-approved for ASD irritability ages 5-17 and 6-17 respectively; aripiprazole has a lower metabolic profile but more akathisia.

5SSRI black box + age-specific FDA approvals: suicidal ideation warning in patients 6-24 years — monitor weekly ×4 weeks, biweekly ×4 weeks, then monthly. Fluoxetine is FDA-approved for pediatric MDD ≥8 years and pediatric OCD ≥7 years. Escitalopram is approved for adolescent MDD ≥12 years. Sertraline, fluoxetine, and fluvoxamine are approved for pediatric OCD. CBT is first-line for mild-to-moderate anxiety/OCD/depression; combined CBT + SSRI is superior to either alone in moderate-to-severe depression (TADS).

Frequently Asked Questions

What is the ABP Developmental-Behavioral Pediatrics subspecialty certification?

The ABP Developmental-Behavioral Pediatrics (DBP) certification is awarded by the American Board of Pediatrics to pediatricians who demonstrate expert knowledge in the evaluation and management of developmental, learning, and behavioral disorders in children and adolescents. It qualifies diplomates to lead developmental evaluation clinics, consult on ASD/ADHD/learning disabilities, prescribe psychopharmacology, and collaborate with schools, early intervention programs, and child welfare.

Who is eligible to take the ABP DBP exam?

Candidates must hold primary ABP General Pediatrics certification in good standing and have completed 3 years of full-time training in an ACGME-accredited Developmental-Behavioral Pediatrics fellowship. A valid unrestricted medical license is required. The fellowship includes clinical DBP, developmental testing exposure, scholarly activity meeting the ABP scholarly requirement, and integrated mental health training.

What is the format of the ABP DBP exam?

It is a 1-day computer-based exam administered at Pearson VUE Professional Testing Centers, consisting of approximately 200 single-best-answer multiple-choice questions. Questions have 4-5 options with exactly one correct answer. Items include clinical vignettes with rating scale interpretation (Vanderbilt, M-CHAT-R, ADOS, Bayley-4, WISC-V), genetic test interpretation (CMA, FMR1), psychopharmacology dosing/side effects, and school-system scenarios (IEP/504).

How much does the 2026 ABP DBP exam cost?

The 2026 regular registration fee is $2,992, which includes a $750 nonrefundable processing fee. Late registration is $3,337 (includes a $345 late fee). DBP is administered as an ABP subspecialty exam at Pearson VUE centers in 2026.

How is the exam scored?

The exam is scored on a 1-300 scale with 180 designated as the passing mark. ABP uses a criterion-referenced scoring model: a panel of practicing, board-certified DBP physicians determines the passing standard using the modified Angoff method. Results are reported as scaled scores, not percentile ranks.

What are the highest-yield topics?

ASD (~12%), ADHD (~12%), CP (~8%), ID (~8%), and developmental screening/testing (~8%) together cover roughly half the exam. Master DSM-5-TR criteria for ASD and ADHD, M-CHAT-R/F and AAP 2019 ADHD guideline, ADOS-2 and Bayley-4, CP GMFCS levels and etiology, chromosomal microarray as first-line ID workup (plus Fragile X), stimulant and non-stimulant pharmacology with cardiac screening, antipsychotic metabolic monitoring (weight, HbA1c, lipids, prolactin, EPS), and IEP/504/IDEA (Part C 0-3, Part B 3-21).

How should I study for this exam?

Use a 6-12 month structured plan. Start with ASD, ADHD, CP, and ID (highest-yield, daily practice). Move to developmental screening/testing tools and learning disabilities. Then pediatric psychopharmacology (black box warnings, metabolic monitoring), anxiety/depression/OCD, and ACEs/trauma. Finish with sleep, feeding, Tourette, adolescence, and systems/advocacy. Take 2-3 timed full-length mock exams. Integrate the SDBP Board Review Course, Voigt-Macias-Myers 'Developmental and Behavioral Pediatrics' textbook, DSM-5-TR, and AAP clinical reports.

What are my continuing certification requirements after passing?

After initial certification, diplomates maintain certification via the ABP's Maintenance of Certification Assessment for Pediatricians (MOCA-Peds) — a longitudinal assessment with quarterly questions over a 5-year cycle. Diplomates must also complete Part 2 (self-assessment CME) and Part 4 (improvement in medical practice) activities and maintain an unrestricted license.