100+ Free ABPN NDD Practice Questions

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Question 1

Score: 0/0

At what age does a typically developing child first sit independently without support?

9 months

3 months

6 months

12 months

to track

2026 Statistics

Key Facts: ABPN NDD Exam

~200

Total MCQ Items

ABPN NDD Subspecialty Certification Examination

1 day

Exam Duration

Computer-based test at Pearson VUE

~15-18%

ASD Weight

Among the largest domains on the 2026 ABPN NDD content outline

$2,200

2026 Subspecialty Fee

ABPN initial NDD subspecialty certification

2 yr

NDD Fellowship

ACGME-accredited (peds pathway); Child Neurology pathway alternative

Pearson VUE

Test Delivery

Computer-based testing at authorized centers

The ABPN NDD exam is a 1-day computer-based test at Pearson VUE with approximately 200 single-best-answer MCQs. The 2026 content outline emphasizes autism spectrum disorder (~15-18%), genetic syndromes (~15-18%), cerebral palsy (~12-15%), normal development & assessment (~12-15%), intellectual disability (~10-12%), pediatric neuromuscular/IEMs (~10-12%), ADHD (~8-10%), epilepsy with DD (~6-8%), mental health in NDD (~5-7%), sleep/feeding/growth (~4-6%), and transition/ethics (~4-6%). Subspecialty fee is ~$2,200; requires ABPN Child Neurology or ABP Pediatrics plus NDD fellowship.

Sample ABPN NDD Practice Questions

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

1At what age does a typically developing child first sit independently without support?

A.9 months

B.3 months

C.6 months

D.12 months

Explanation: Independent sitting emerges around 6 months (range 4-8 months). Head control by 4 months, sitting 6 months, crawling 9 months, walking by 12-15 months are core AAP Bright Futures motor milestones. Absence of independent sitting by 9 months warrants developmental evaluation.

2A typically developing toddler begins combining two words into short phrases (for example, 'more juice') at approximately what age?

A.30-36 months

B.9-12 months

C.12-15 months

D.18-24 months

Explanation: Two-word phrases emerge at 18-24 months, 3-word sentences by 3 years. Babbling begins 6 months, first true words 12 months. Absence of 2-word phrases by 24 months is a red flag for language delay and warrants ASD screening with M-CHAT-R/F (which is also routinely done at 18 and 24 months per AAP 2020).

3According to Piaget's stages of cognitive development, a 4-year-old demonstrating egocentric thinking and lacking conservation is in which stage?

A.Formal operational

B.Sensorimotor

C.Concrete operational

D.Preoperational

Explanation: Piaget stages: sensorimotor (0-2 y), preoperational (2-7 y — symbolic thought, egocentrism, lack of conservation), concrete operational (7-11 y — conservation, reversibility), formal operational (12+ y — abstract/hypothetical reasoning). A 4-year-old without conservation fits preoperational.

4The AAP recommends universal autism screening with the M-CHAT-R/F at which well-child visits?

A.15 months and 30 months

B.9 months and 12 months

C.24 months only

D.18 months and 24 months

Explanation: AAP recommends universal ASD-specific screening with the M-CHAT-R/F at 18 and 24 month well-child visits (in addition to general developmental screening at 9, 18, and 30 months with a tool such as ASQ-3). The AAP 2020 clinical report reaffirmed this dual-age screening strategy because autism can manifest between 18 and 24 months.

5Which standardized tool is the gold-standard semi-structured observational assessment for autism spectrum disorder?

A.Bayley Scales of Infant Development, Fourth Edition

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

C.Vineland Adaptive Behavior Scales, Third Edition

D.Child Behavior Checklist (CBCL)

Explanation: The ADOS-2 is the gold-standard observational assessment for ASD, paired with the parent-report ADI-R as a 'best-practice' diagnostic combination. Bayley-4 assesses overall development (birth-42 mo). Vineland-3 measures adaptive behavior. CBCL is a broadband behavioral/emotional screener, not specific to ASD.

6Which adaptive behavior measure is most commonly used to document deficits required for a diagnosis of intellectual disability?

A.Vineland Adaptive Behavior Scales, Third Edition (Vineland-3)

B.Stanford-Binet Intelligence Scales, Fifth Edition

C.Peabody Picture Vocabulary Test

D.Leiter-3 International Performance Scale

Explanation: The Vineland-3 is the most widely used standardized adaptive behavior assessment in the U.S., covering communication, daily living skills, socialization, and motor skills. Intellectual disability diagnosis requires BOTH a cognitive score approximately 2 SD below the mean AND adaptive deficits approximately 2 SD below the mean (DSM-5-TR, AAIDD 12th ed).

7A 30-month-old who is nonverbal is referred for cognitive testing. Which instrument is most appropriate to measure nonverbal cognitive ability?

A.Peabody Picture Vocabulary Test

B.Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V)

C.Leiter-3 International Performance Scale

D.Stanford-Binet, Fifth Edition verbal subtests

Explanation: The Leiter-3 is a fully nonverbal cognitive assessment ideal for children with expressive language delay, hearing impairment, or non-English language backgrounds. WISC-V requires verbal comprehension and is for ages 6-16. Peabody measures receptive vocabulary. Verbal Stanford-Binet subtests require expressive language.

8Under IDEA, children with developmental delay or disability from birth through age 2 receive services under which part of the law?

A.Part C (Early Intervention)

B.Part B (Preschool and School-Age)

C.Part A (General Provisions)

D.Section 504

Explanation: IDEA Part C provides early intervention services from birth through age 2, organized via an Individualized Family Service Plan (IFSP). Part B covers ages 3-21 via an Individualized Education Program (IEP). Section 504 of the Rehabilitation Act provides accommodations for qualifying students in general education.

9A 5-year-old with spastic diplegic cerebral palsy walks with a walker for household distances and uses a manual wheelchair in the community. Which GMFCS level best describes his function?

A.GMFCS I

B.GMFCS III

C.GMFCS II

D.GMFCS V

Explanation: GMFCS levels: I walks without limitations; II walks with limitations (eg, reduced balance on uneven surfaces); III walks using a handheld mobility device (walker, crutches); IV self-mobility limited, may use powered mobility; V transported in manual wheelchair. This child uses a walker for ambulation (III).

10Which physiologic subtype of cerebral palsy is the most common?

A.Spastic

B.Dyskinetic

C.Ataxic

D.Mixed

Explanation: Spastic CP accounts for approximately 75% of cases. Subtypes include spastic hemiplegia, diplegia, and quadriplegia. Dyskinetic (dystonic or athetoid) CP is typically associated with basal ganglia injury (eg, kernicterus, term HIE). Ataxic CP is least common and involves cerebellum.

About the ABPN NDD Exam

The ABPN Neurodevelopmental Disabilities (NDD) Subspecialty Certification Examination is administered by the American Board of Psychiatry and Neurology for physicians specializing in the evaluation and management of children and adults with neurodevelopmental conditions. The computer-based test contains approximately 200 single-best-answer MCQs covering normal development and screening (AAP Bright Futures, ASQ-3, M-CHAT-R/F, Bayley-4, ADOS-2, Vineland), cerebral palsy (GMFCS, MACS, hip surveillance, botulinum toxin, ITB, SDR), intellectual disability (DSM-5-TR, AAIDD, chromosomal microarray, WES, Down syndrome surveillance), autism spectrum disorder (DSM-5-TR, EIBI/ESDM, risperidone/aripiprazole), ADHD (DSM-5-TR, AAP 2019 algorithm, stimulants/non-stimulants), genetic syndromes (fragile X, Rett, Angelman, Prader-Willi, Williams, 22q11, Smith-Magenis, TSC, NF1, Turner, Klinefelter), epileptic encephalopathies (infantile spasms/West, Lennox-Gastaut, Dravet), pediatric neuromuscular (SMA, DMD), inborn errors of metabolism (PKU, urea cycle, lysosomal, peroxisomal), sleep/feeding/growth in NDD, and transition/ethics (IDEA, ADA, Olmstead, guardianship). Eligibility requires prior ABPN Child Neurology certification OR ABP Pediatrics certification plus a 2-year ACGME-accredited NDD fellowship.

Questions

200 scored questions

Time Limit

1-day CBT at Pearson VUE

Passing Score

Criterion-referenced scaled score set by ABPN (modified Angoff)

Exam Fee

~$2,200 subspecialty certification fee (ABPN 2026) (American Board of Psychiatry and Neurology (ABPN) / Pearson VUE)

ABPN NDD Exam Content Outline

~15-18%

Autism Spectrum Disorder

DSM-5-TR criteria (persistent social communication deficits + restricted/repetitive behaviors + early developmental period + impairment; severity levels 1-3). AAP 2020 guideline — M-CHAT-R/F at 18 and 24 mo. Evidence-based interventions (EIBI/ABA, Early Start Denver Model, pivotal response, DIR Floortime, AAC). Pharmacology for irritability (risperidone 5-16 y, aripiprazole 6-17 y — both FDA approved). Comorbidities (epilepsy 20-30%, ID 30%, ADHD 30-50%, GI, sleep 50%).

~15-18%

Genetic Syndromes

Fragile X (FMR1 CGG >200 full mutation — long face, large ears, macroorchidism, autism, ID; premutation → FXTAS/POI). Rett (MECP2 — regression 6-18 mo, hand stereotypies, respiratory dysrhythmias, acquired microcephaly). Angelman (UBE3A 15q11-q13 maternal — happy demeanor, ataxia, epilepsy, severe ID). Prader-Willi (paternal 15q11-q13 — neonatal hypotonia, hyperphagia, obesity, GH/setmelanotide). Williams (ELN 7q11.23 — SVAS, hypercalcemia, cocktail personality). 22q11.2 DS (DiGeorge — conotruncal, hypocalcemia, palate, schizophrenia risk). Smith-Magenis, Noonan, Turner, Klinefelter. TSC1/2 (infantile spasms, SEGAs, autism 50%). NF1 (OPG, LD 50%).

~12-15%

Cerebral Palsy

Definition — nonprogressive posture/movement disorder from developmental brain insult. GMFCS I-V (I walks without limitations; V transported). MACS manual ability, CFCS communication, EDACS eating/drinking. Topographic (hemi/di/quad) and physiologic (spastic 75%, dyskinetic, ataxic, mixed). Etiology mostly antenatal; term HIE ~10%; preterm PVL; perinatal arterial ischemic stroke. Associated — epilepsy 30-50%, ID, vision/hearing, hip surveillance AACPDM, scoliosis, drooling (glycopyrrolate/scopolamine/botox salivary), feeding/G-tube, AAC. Treatment — PT/OT/SLP, AFO, onabotulinumtoxinA focal, ITB generalized, selective dorsal rhizotomy.

~12-15%

Normal Development & Assessment

Motor milestones (sits 6 mo, walks 12 mo, runs 18 mo, jumps 24 mo, tricycle 3 y). Language (babble 6 mo, first words 12 mo, 2-word phrases 18-24 mo, 3-word sentences 3 y). Social-emotional, cognitive Piaget stages (sensorimotor, preoperational, concrete operational, formal operational). Bowlby/Ainsworth attachment. AAP Bright Futures surveillance/screening, ASQ-3, M-CHAT-R/F at 18 and 24 mo, Bayley-4 (birth-42 mo), Denver II, PEDS, Vineland adaptive, ADOS-2, ADI-R, CBCL, SCQ. Cognitive testing — Stanford-Binet, WISC-V/WPPSI, Leiter (nonverbal).

~10-12%

Intellectual Disability

DSM-5-TR (significant intellectual + adaptive deficits, developmental onset), AAIDD 12th edition. FSIQ <70 plus >2 SD adaptive deficits; severity by adaptive functioning (mild/moderate/severe/profound). Etiologic workup — chromosomal microarray first-tier (10-20% yield), fragile X FMR1, MECP2 in girls, PTEN if macrocephaly; whole-exome sequencing 25-30% yield when above negative. Down syndrome (T21 — universal ID, AVSD, duodenal atresia, hypothyroidism, AMKL infants/ALL, AD risk after 40). IDEA Part C <3 y; Part B 3-21 y.

~10-12%

Pediatric Neuromuscular & IEMs

SMA (types I-IV, SMN1, newborn screening, nusinersen intrathecal, onasemnogene abeparvovec gene therapy <2 y, risdiplam oral). DMD (Xp21 dystrophinopathy, Gower sign, corticosteroids prednisone/deflazacort, exon-skipping eteplirsen/golodirsen, delandistrogene moxeparvovec 2023 gene therapy). Congenital myotonic dystrophy, Pompe (ERT), CMT. IEMs — PKU (NBS, phenylalanine-restricted diet), MSUD, urea cycle (OTC most common — Ravicti, phenylbutyrate), organic acidurias, mitochondrial (Leigh, MELAS), lysosomal (MPS I Hurler, Fabry, Gaucher, Tay-Sachs, Krabbe), peroxisomal (Zellweger, X-ALD → HSCT).

~8-10%

ADHD

DSM-5-TR (inattentive/hyperactive-impulsive/combined; <12 y onset; ≥2 settings; 6+ symptoms persistent ≥6 mo with impairment). Vanderbilt/Conners rating scales. AAP 2019 guideline — behavioral first <6 y, stimulants + behavioral 6-12, combined 12-18. Stimulants (methylphenidate, amphetamine). Non-stimulants (atomoxetine, guanfacine ER, clonidine ER, viloxazine FDA-approved 2022). Monitoring — height/weight q6 mo, BP/HR, cardiac history. Comorbidities (LD, anxiety, depression, ODD, Tourette, SUD).

~6-8%

Epilepsy with DD

Infantile spasms/West syndrome — hypsarrhythmia; first-line ACTH or vigabatrin (vigabatrin preferred in TSC). Lennox-Gastaut — slow spike-wave, multiple seizure types; rufinamide, clobazam, cannabidiol, felbamate. Dravet syndrome (SCN1A) — fenfluramine, cannabidiol, stiripentol; AVOID sodium channel blockers. Rett-associated seizures. Epileptic encephalopathies. ESES/CSWS (electrical status epilepticus in slow-wave sleep).

~5-7%

Mental Health & Behavior in NDD

Anxiety, depression, OCD, psychosis, aggression, self-injurious behavior. Functional behavior assessment (FBA) identifies function of behavior; ABC (antecedent-behavior-consequence) framework; positive behavior support as first-line. DBT adapted for ID. Pharmacology individualized — risperidone/aripiprazole for irritability in ASD, SSRIs for anxiety, judicious use with monitoring.

~4-6%

Sleep, Feeding, Growth

Behavioral insomnia — melatonin for sleep onset (ASD, ADHD, NDD). Obstructive sleep apnea prevalent in Down syndrome, Prader-Willi, neuromuscular conditions. Dysphagia (VFSS modified barium swallow), GERD, constipation, pica, ARFID/selective eating. Precocious/delayed puberty in NDD, GH in Turner/Prader-Willi/SHOX, universal thyroid screening in Down syndrome.

~4-6%

Transition & Ethics

Transition planning begins age 14 in many states (16 federal minimum) through 21 (IDEA). Adult services, legal guardianship vs supported decision-making, vocational rehabilitation, postsecondary, independent living, health care transition. Informed consent and assent in ID, surrogate decision-making, abuse/neglect vulnerability, sterilization history (Buck v Bell legacy), Olmstead v LC 1999 community integration, IDEA/ADA, research ethics with vulnerable populations.

How to Pass the ABPN NDD Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPN (modified Angoff)
Exam length: 200 questions
Time limit: 1-day CBT at Pearson VUE
Exam fee: ~$2,200 subspecialty certification fee (ABPN 2026)

Keys to Passing

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

ABPN NDD Study Tips from Top Performers

1DSM-5-TR ASD criteria require BOTH persistent deficits in social communication/interaction AND restricted/repetitive behaviors, interests, or activities. Symptoms must be present in the early developmental period and cause clinically significant impairment. Severity is specified by support needed (Level 1 requiring support; Level 2 requiring substantial support; Level 3 requiring very substantial support). AAP 2020 recommends universal screening with M-CHAT-R/F at 18 and 24 months. FDA-approved irritability treatments: risperidone ages 5-16 and aripiprazole ages 6-17.

2GMFCS is a 5-level classification of gross motor function in cerebral palsy that is stable over time (especially after age 2): Level I walks without limitations; II walks with limitations; III walks using a handheld mobility device; IV self-mobility with limitations, may use powered mobility; V transported in manual wheelchair. Hip surveillance by GMFCS level per AACPDM care pathway — children at GMFCS III-V need more frequent hip radiographs due to high risk of hip displacement.

3Intellectual disability workup sequence: chromosomal microarray (CMA) is FIRST-TIER in unexplained developmental delay/ID/ASD (10-20% diagnostic yield), followed by fragile X FMR1 testing in all patients, MECP2 in girls with regression/Rett features, PTEN if macrocephaly. If all above are negative, whole-exome sequencing (WES) provides an additional 25-30% diagnostic yield. Metabolic testing only if features suggest IEM (regression, episodic decompensation, multisystem).

4Infantile spasms (West syndrome) — triad of epileptic spasms, hypsarrhythmia on EEG, and developmental regression. First-line therapy: ACTH or oral prednisolone; vigabatrin is first-line specifically in tuberous sclerosis complex. Early treatment improves developmental outcomes. Lennox-Gastaut (slow spike-wave, tonic/atonic/atypical absence, cognitive impairment) — rufinamide, clobazam, cannabidiol, felbamate. Dravet (SCN1A, febrile-onset hemiclonic) — fenfluramine, cannabidiol, stiripentol; AVOID sodium channel blockers (lamotrigine, carbamazepine, phenytoin) which worsen seizures.

5High-yield genetic syndromes to recognize at a glance: Fragile X (long face, prominent ears, macroorchidism post-pubertal, autism, ID — FMR1 CGG >200). Rett (girls, regression 6-18 mo, hand-wringing stereotypies, acquired microcephaly — MECP2). Angelman (happy demeanor with paroxysmal laughter, ataxic gait, severe ID, epilepsy — UBE3A maternal 15q11-q13). Prader-Willi (neonatal hypotonia → hyperphagia/obesity in childhood — paternal 15q11-q13; GH therapy, setmelanotide). Williams (supravalvular AS, idiopathic infantile hypercalcemia, 'cocktail party' personality, elfin facies — ELN 7q11.23). 22q11.2 deletion (conotruncal cardiac defect, hypocalcemia, T-cell immunodeficiency, palatal anomalies, schizophrenia risk in adolescence).

Frequently Asked Questions

What is the ABPN Neurodevelopmental Disabilities exam?

The ABPN Neurodevelopmental Disabilities (NDD) Subspecialty Certification Examination is administered by the American Board of Psychiatry and Neurology for physicians specializing in the diagnosis and management of neurodevelopmental conditions across the lifespan. It is a 1-day computer-based exam at Pearson VUE test centers covering normal development, cerebral palsy, intellectual disability, autism spectrum disorder, ADHD, genetic syndromes, epileptic encephalopathies, pediatric neuromuscular disease, inborn errors of metabolism, and transition planning.

Who is eligible to take the ABPN NDD exam?

Candidates must hold prior ABPN certification in Child Neurology OR ABP Pediatrics certification plus completion of a 2-year ACGME-accredited NDD fellowship. All candidates must hold a valid unrestricted medical license and have program director attestation of satisfactory fellowship completion. Applications are submitted through the ABPN website within the designated eligibility window.

What is the format of the ABPN NDD exam?

The exam is a 1-day computer-based examination administered at Pearson VUE test centers, consisting of approximately 200 single-best-answer multiple-choice questions. Questions frequently include clinical vignettes, photographs of syndromic features, EEG tracings, neuroimaging (MRI, CT), and genetic/metabolic laboratory results. Content is distributed across the 2026 ABPN NDD content outline with the largest weight on autism spectrum disorder and genetic syndromes.

How much does the 2026 ABPN NDD exam cost?

The 2026 ABPN Neurodevelopmental Disabilities subspecialty certification fee is approximately $2,200. Cancellation and refund policies follow the ABPN schedule with decreasing refunds as the exam date approaches. Continuing Certification (MOC) includes ongoing Professionalism, Lifelong Learning and Self-Assessment, Performance in Practice, and Cognitive Expertise components over a 10-year cycle. Retakes within the eligibility window require full re-registration and fee payment.

When is the 2026 exam administered?

The ABPN NDD subspecialty exam is typically offered once per year in a testing window (historically in the fall). Applications open earlier in the year with a submission deadline prior to the testing window. Candidates schedule specific Pearson VUE appointments after application approval. Exact 2026 dates should be confirmed on the ABPN website.

How is the exam scored?

ABPN uses a criterion-referenced scaled scoring system with a passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass/fail result depends on performance relative to the fixed cut-score rather than on other test-takers. Score reports include subdomain performance to guide future study. Results are typically released several weeks after the testing window closes.

What are the highest-yield topics?

Highest-yield topics include: DSM-5-TR criteria for ASD, ID, and ADHD; M-CHAT-R/F at 18 and 24 months (AAP 2020); GMFCS I-V classification and hip surveillance in CP; ASIA-independent spasticity management (onabotulinumtoxinA, ITB, SDR); chromosomal microarray as first-tier ID workup (10-20% yield) followed by WES (25-30%); recognition of genetic syndromes (fragile X, Rett, Angelman, Prader-Willi, Williams, 22q11, TSC, NF1); infantile spasms first-line therapy (vigabatrin preferred in TSC, ACTH otherwise); SMA gene therapies (nusinersen, onasemnogene, risdiplam); DMD corticosteroid and delandistrogene moxeparvovec; PKU and urea cycle defect management; and IDEA Part C/Part B transition rules.

How should I study for the ABPN NDD exam?

Use a structured 12-18 month plan during NDD fellowship. Map to the ABPN NDD content outline: lead with normal development and screening, then CP and ID, autism and ADHD, genetic syndromes (spend heavy time on the top 10-15 high-yield syndromes), then epilepsy with DD, pediatric neuromuscular and IEMs, mental health in NDD, sleep/feeding/growth, and transition/ethics. Core resources include Swaiman's Pediatric Neurology, Volkmar's Handbook of Autism, AACPDM care pathways for CP, AAP Bright Futures, and ABPN content specifications. Drill high-volume MCQs with timed sets and complete 2-3 full-length timed mock exams.