Free Practice Questions for CMSA Cert Dev Paed(SA)

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Sample CMSA Cert Dev Paed(SA) Practice Questions

Try these sample questions to review concepts for the CMSA Cert Dev Paed(SA) exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 9-month-old infant is brought to the clinic for a developmental assessment. On examination, the infant sits independently without support, transfers a block from one hand to the other, uses a raking grasp to pick up a small raisin, babbles multisyllabic sounds ('ba-ba-da-da'), and demonstrates stranger anxiety. How should the developmental paediatrician classify this infant's gross motor, fine motor, and language development?

A.Gross motor: delayed; Fine motor: advanced; Language: advanced

B.Gross motor: appropriate (6-7m); Fine motor: slightly delayed (immature raking at 9m); Language: appropriate (6-9m)

C.Gross motor: advanced; Fine motor: appropriate; Language: delayed

D.Gross motor: appropriate; Fine motor: delayed; Language: advanced

Explanation: Sitting without support emerges around 6-7 months and is well established by 9 months. Hand-to-hand transfer occurs around 6-7 months. Raking grasp (using all fingers together) is typical for 7-8 months; a neat pincer grasp normally develops between 9 and 12 months. Multisyllabic babbling and stranger anxiety are typical 6-9 month milestones. Thus, gross motor and language are age-appropriate, while fine motor shows a slight lag if a neat pincer grasp has not yet begun to emerge, though raking is still acceptable at 9 months.

2At what age does the asymmetric tonic neck reflex (ATNR, or 'fencer's posture') normally disappear, and what is the clinical significance if it persists beyond 6 months of age?

A.Disappears at 18 months; persistence is associated with early walking

B.Disappears at 12 months; persistence indicates isolated peripheral nerve injury

C.Disappears at 4-6 months; persistence prevents rolling and signifies upper motor neuron dysfunction / cerebral palsy

D.Disappears at 2 months; persistence indicates normal variation

Explanation: The asymmetric tonic neck reflex (ATNR) is present at birth, peaks around 2 months, and normally obligatorily disappears by 4 to 6 months as cortical inhibition matures. Persistence of an obligatory ATNR beyond 6 months is a major red flag for upper motor neuron damage (spastic cerebral palsy), as it prevents midline hand play, rolling, and voluntary motor control.

3A mother brings her 18-month-old son for a routine check-up. The toddler walks well, builds a tower of 3 cubes, speaks 4 clear single words, points to request desired objects, but does not point to show interest (proto-declarative pointing) or bring objects to show his mother. Which aspect of development is most concerning?

A.Fine motor skills

B.Social-communicative joint attention (proto-declarative pointing)

C.Expressive vocabulary count for age

D.Gross motor skills

Explanation: Proto-declarative pointing (pointing to share interest or enjoyment with another person) and showing objects normally emerge between 9 and 14 months and are key markers of joint attention. Absence of proto-declarative pointing by 18 months is a prominent early red flag for Autism Spectrum Disorder (ASD), even if proto-imperative (requesting) pointing is present.

4At what age should a child typically be able to copy a cross (+), copy a square, and copy a triangle, respectively, during fine-motor developmental testing?

A.Cross: 5 years; Square: 6 years; Triangle: 7 years

B.Cross: 2.5 years; Square: 3 years; Triangle: 4 years

C.Cross: 3 years; Square: 4 years; Triangle: 5 years

D.Cross: 4 years; Square: 4.5 years; Triangle: 5 years

Explanation: The developmental sequence for copying shapes is: vertical/horizontal line (2 years), circle (3 years), cross '+' (4 years), square (4.5 years), diagonals/X (5 years), and triangle (5 years). This sequence reflects visual-motor integration and parietal-frontal cortical maturation.

5Which of the following protective postural reactions normally appears last in infant development, at approximately 8 to 9 months of age, and is essential for independent sitting and standing balance?

A.Forward protective extension

B.Backward protective extension

C.Anterior parachute reflex (downward thrust extension)

D.Sideways protective extension

Explanation: Protective postural reactions develop in a strict chronological order: forward protective extension (parachute) appears at 6-7 months, sideways protective extension at 7-8 months, and backward protective extension at 9-10 months. Downward protective extension appears at 4-5 months.

6A 2-year-old child is assessed for speech delay. The parents report the child says about 15 single words but no 2-word phrases, and strangers understand less than 25% of what the child says. What is the expected speech intelligibility to an unfamiliar listener at ages 2, 3, and 4 years?

A.2 years: 75%; 3 years: 90%; 4 years: 100%

B.2 years: 25%; 3 years: 50%; 4 years: 75%

C.2 years: 50%; 3 years: 75%; 4 years: 100%

D.2 years: 100%; 3 years: 100%; 4 years: 100%

Explanation: The clinical rule of thumb for speech intelligibility to unfamiliar listeners is: age in years divided by 4 (or 50% at 2 years, 75% at 3 years, and 100% at 4 years). A 2-year-old whose speech is only 25% intelligible and who lacks 2-word spontaneous phrases meets criteria for expressive speech delay.

7Which developmental screening instrument, validated for international and low-to-middle-income settings, relies on parent reporting across 5 domains (Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social) between 1 and 66 months of age?

A.Griffiths Scales of Child Development (Griffiths III)

B.Bayley Scales of Infant and Toddler Development (Bayley-IV)

C.Ages and Stages Questionnaires, Third Edition (ASQ-3)

D.Peabody Developmental Motor Scales (PDMS-2)

Explanation: The ASQ-3 is a parent-completed developmental screening tool covering 5 domains from 1 to 66 months. It is widely used in primary care and resource-limited settings because of its low cost, ease of completion, and high sensitivity and specificity.

8At what corrected gestational age should developmental milestones be adjusted for a premature infant born at 28 weeks gestation, and until what age is age adjustment standard practice?

A.Adjust by 16 weeks; adjust until 36 months of age

B.Adjust by 8 weeks; adjust until 12 months of age

C.Adjust by 12 weeks; adjust until 24 months of age

D.Adjust by 4 weeks; adjust indefinitely

Explanation: Full term is considered 40 weeks. An infant born at 28 weeks is 12 weeks (3 months) premature. Standard paediatric guidelines recommend correcting developmental milestone expectations for prematurity until 24 months of chronological age (or up to 36 months for extreme prematurity/severe motor delay).

9A 15-month-old girl is evaluated for motor delay. She can roll and sit independently but cannot pull to stand or creep on hands and knees. Neurological examination reveals persistent palmar grasp and Moro reflexes, lower limb hyperreflexia with 4 beats of ankle clonus, and scissoring posture when suspended vertically. What is the most likely diagnosis?

A.Spinal muscular atrophy type 1

B.Normal developmental variance

C.Benign congenital hypotonia

D.Spastic diplegic cerebral palsy

Explanation: The clinical picture—inability to pull to stand at 15 months, retained primitive reflexes (Moro, palmar grasp beyond 6 months), upper motor neuron signs (hyperreflexia, clonus, scissoring posture)—is diagnostic of spastic diplegic cerebral palsy.

10Which subscale of the Griffiths Scales of Child Development, Third Edition (Griffiths III) measures a child's ability to plan, organise, execute motor tasks, and solve non-verbal spatial problems?

A.Language and Communication

B.Foundations of Learning

C.Personal-Social-Emotional

D.Eye and Hand Coordination

Explanation: The Griffiths III consists of 5 subscales: Foundations of Learning (assesses cognitive planning, problem-solving, memory, and spatial reasoning), Language and Communication, Eye and Hand Coordination, Personal-Social-Emotional, and Gross Motor.

About the CMSA Cert Dev Paed(SA) Exam

The CMSA Sub-specialty Certificate in Developmental Paediatrics Cert Dev Paed(SA) is the formal sub-specialty credential awarded by the College of Paediatricians of South Africa. It verifies specialist expertise in the diagnosis, assessment, and comprehensive management of children with neurodevelopmental disabilities, behavioral disorders, cerebral palsy, intellectual disability, genetic syndromes, and complex motor or sensory impairments, within the context of the South African healthcare system and legislative framework.

Exam sponsor: Colleges of Medicine of South Africa (CMSA) — College of Paediatricians. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans core domains including neurodevelopmental assessment, ASD, ADHD, cerebral palsy, genetic syndromes, neuromuscular disorders, early intervention, and South African legal and policy frameworks.

Time Limit

Written short-answer papers plus an OSCE and viva component.

Passing Score

Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).

Exam / Certification Fees

R24 650

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Neurodevelopmental Assessment & Milestones

Standardised screening and diagnostic tools, motor, language, cognitive, and social trajectories, primitive reflexes, red flags, and developmental neurobiology.

25%

Autism Spectrum Disorder & ADHD

DSM-5-TR diagnostic criteria, screening/assessment tools, comorbid neurobehavioral disorders, evidence-based psychopharmacology, behavioral, and educational interventions.

20%

Cerebral Palsy, Neuromuscular & Motor Disorders

Cerebral palsy classification systems (GMFCS, MACS, EDACS), etiology, spasticity management, orthopedic management, Duchenne muscular dystrophy, and SMA.

15%

Intellectual Disability & Genetic Syndromes

Diagnostic evaluation of intellectual disability, genetic diagnostic algorithms (CMA, WES, fragile X), neurodevelopmental phenotypes of dysmorphic syndromes.

15%

Early Intervention, Rehabilitation & Special Education Law in SA

Children's Act 38 of 2005, Education White Paper 6, SASSA Care Dependency Grant, early childhood intervention, assistive technology, and multidisciplinary care in SA.

Preparing for the CMSA Cert Dev Paed(SA) Exam

What You Need to Know

Passing score: Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
Assessment: Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans core domains including neurodevelopmental assessment, ASD, ADHD, cerebral palsy, genetic syndromes, neuromuscular disorders, early intervention, and South African legal and policy frameworks.
Time limit: Written short-answer papers plus an OSCE and viva component.
Exam / certification fees: R24 650 Official sources

Using Our Practice Resources

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CMSA Cert Dev Paed(SA): Suggested Study Strategy

1Master normal and abnormal milestone trajectories, including precise ages for motor, speech-language, vision/hearing, and social-emotional milestones, primitive reflex disappearance times, and red flags.

2Review DSM-5-TR diagnostic criteria for ASD, ADHD, Developmental Coordination Disorder, and Intellectual Disability, alongside psychopharmacology (methylphenidate, atomoxetine, guanfacine, risperidone) and non-pharmacological therapies.

3Be thoroughly familiar with GMFCS levels I–V for Cerebral Palsy, motor patterns, etiologies (PVL vs HIE vs kernicterus), and tone management algorithms including oral agents, botulinum toxin A, and intrathecal baclofen.

4Learn South African specific legal and social frameworks: Education White Paper 6, Children's Act provisions regarding consent and child protection, and eligibility criteria for the SASSA Care Dependency Grant.

Frequently Asked Questions

What is the examination format for the CMSA Cert Dev Paed(SA)?

The exit examination has two components, each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Candidates must achieve an overall 50% with a 50% subminimum in each component. This free question bank provides 100 practice MCQs as a study aid and does not replicate the official format.

What key topics are covered in the Cert Dev Paed(SA) examination?

The exam is divided into five main blueprint domains: Neurodevelopmental Assessment & Milestones (25%), Autism Spectrum Disorder & ADHD (25%), Cerebral Palsy, Neuromuscular & Motor Disorders (20%), Intellectual Disability & Genetic Syndromes (15%), and Early Intervention, Rehabilitation & Special Education Law in SA (15%).

What South African laws and policies are tested on the exam?

Candidates are expected to know the Children's Act (Act 38 of 2005), National Integrated Early Childhood Development Policy, Education White Paper 6 (Special Needs Education / Inclusive Education), the Social Assistance Act governing SASSA Care Dependency Grants, and HPCSA guidelines for child protection and consent.

What is the fee and candidate eligibility for the CMSA Cert Dev Paed(SA)?

The examination fee is R24 650. Candidates must hold an FC Paed(SA) or equivalent registered specialist paediatric qualification and be enrolled in or have completed an accredited 2-year sub-specialty fellowship in Developmental Paediatrics in South Africa.