**Core Concept**
The APGAR score is a method to quickly assess the health of a newborn child. It evaluates five components: Appearance (colour), Pulse (heart rate), Grimace (reflexes), Activity (muscle tone), and Respiration (breathing effort).

**Why the Correct Answer is Right**
Tendon reflexes are not a component of the APGAR score. The Grimace component assesses the infant's response to stimulation, which includes a grimace or cry when the soles of the feet are pressed, but it does not evaluate tendon reflexes. The APGAR score focuses on immediate postnatal adaptation, and tendon reflexes are not a critical indicator of newborn adaptation at this stage.

**Why Each Wrong Option is Incorrect**
**Option B:** Colour is actually one of the components of the APGAR score, assessing the infant's skin colour to determine if it is blue or pink.
**Option C:** Muscle tone is also a component of the APGAR score, assessing the infant's muscle tone to determine if it is active or limp.
**Option D:** Respiratory effort is another component of the APGAR score, evaluating the infant's breathing to determine if it is strong or weak.

**Clinical Pearl / High-Yield Fact**
The APGAR score is usually performed at 1 and 5 minutes after birth, and a score of 7 or higher is generally considered normal. However, the APGAR score is not a definitive indicator of a child's health and may not accurately reflect the presence of underlying conditions.

✓ Correct Answer: A. Tendon reflexes