SLP Praxis Practice (Form 1)

A client exhibits weakness, atrophy, and fasciculations of the right side of the tongue and lower face. The client also has right vocal-fold weakness and nasal regurgitation of fluid when swallowing. These problems are the result of damage to which part of the nervous system? A.Brain stem B.Cerebellum C.Left cerebral cortex D.Right cerebral cortex

A.Brain stem ***Why? -- Weakness, atrophy, fasciculations, and the other described symptoms are all consistent with a lower motor neuron locus and suspected cranial nerve abnormalities (primarily CN X and XII). These cranial nerves emerge directly from the brain stem and help mediate the transfer of messages from the brain to the brain stem and to the structures of the head and neck.

Which of the following views make up a standard videofluoroscopic swallow study? A.Frontal B.Lateral C.Transverse D.Anterior-posterior

Lateral & Posterior/Anterior--- A lateral view is best for seeing all stages of a swallow, and an anterior-posterior view shows the symmetry (or asymmetry) of the swallow.

When counseling the parents of a child who has an articulation disorder, the SLP can cite developmental norms to show which of the following? A.The child's misarticulation will interfere with reading skills. B.A certain percentage of children of a certain age can correctly articulate the misarticulated sound. C.The misarticulation is caused by faulty learning. D.The misarticulation is not physically based.

B.A certain percentage of children of a certain age can correctly articulate the misarticulated sound. --- Developmental norms demonstrate that a certain percentage of children of a given age can correctly articulate certain sounds.

The figure above shows the oral, pharyngeal, and esophageal structures involved in swallowing. Which of the following best describes the transit of the bolus at the moment depicted in the figure?

B.The bolus is being propelled from the oral cavity by the tongue and has entered the pharynx.

Which of the following constitutes the major component of an audiologic rehabilitation program for infants with a moderate sensorineural hearing loss? A.Development of cognitive skills B.Development of social skills C.Parent-mediated auditory stimulation D.Gestural stimulation

C.Parent-mediated auditory stimulation ***Why?-- For an infant known to have a hearing loss, parents are in the best position to provide consistent auditory stimulation, which the infant needs in order to develop an awareness of sound.

According to research on the development of Brown's morphemes in young children, which of the following is a determinant of acquisition order? A.Phonological ease of production B.Figurative-language ability C.Semantic and syntactic complexity D.Sequencing and segmentation strategies

C.Semantic and syntactic complexity ---Brown's morphemes are acquired by children in an order that is determined by semantic and syntactic complexity, with the simplest forms acquired first. The order of acquisition is typically followed by all children.

Primary motor innervation to the larynx and velum is provided by which cranial nerve?

IX- Vagus Nerve

Successful use of an alternative and augmentative communication system is based on such factors as selecting appropriate vocabulary, seating and positioning, and having a reliable method of controlling the system. To facilitate the most effective use of the system, clinicians most often advocate which of the following approaches? A.Unimodal B.Multimodal C.Bimodal D.Gestural

Multi--- A multimodal approach offers more communicative options than any other of the approaches listed.

Which of the following factors contributes to UES opening? Select all that apply. A.Partial relaxation of the cricopharyngeal portion of the inferior constrictor muscle B.Superior and anterior hyolaryngeal excursion C.Velopharyngeal closure D.Posterior and inferior hyolaryngeal excursion

Options (A) and (B) are correct. Partial relaxation of the cricopharyngeal portion of the inferior constrictor muscle is part of the neurological sequence. Superior and anterior hyolaryngeal excursion provides a mechanical opening.

Which of the following should be the primary focus of early language intervention for at-risk infants? A.Establishing object permanence through play activities B.Training primary caregivers to facilitate language learning C.Creating readiness activities in the context of play D.Enhancing social communication through play activities

Training primary caregivers to facilitate language learning

Language intervention for a child at the one-word stage should be most strongly influenced by a consideration of the child's A.motor skills B.cognitive skills C.syntactic skills D.articulation skills

cognitive--- The cognitive skills of a child at the one-word stage will most strongly influence the child's speech-language responses, so language intervention for the child should take into account the child's cognitive skills.

John is a 4 1/2 year old whose consonantal inventory includes word-initial [ w ], [ m ], [ n ], [ p ], [ b ], [ t ], [ d ], and [ f ]. He uses [ t ] for /k/, [ d ] for /ɡ/, [ b ] for /v/, and [ f ] for /θ/. He produces no consonant clusters. His word-final consonantal inventory consists of [m] and [n]. His word shape inventory includes V, CV, CVC, and CVCV. The information given most strongly indicates that the child has A.childhood apraxia of speech B.an oral motor impairment C.delayed phonological development D.a significant high-frequency hearing loss

delay phono. dev.---The pattern describes the phonological pattern of a younger child. The errors are consistent, unlike childhood apraxia of speech, which has an inconsistent error pattern. Children at this age typically have mastered consonant clusters and use word-final consonants.

Which of the following, if observed in the speech of an African American child, is most likely to represent a dialectical variation rather than an articulation error? A./f/ for /θ/ in postvocalic position B./θ/ for /s/ in all positions C.Affricates for fricatives in word-final position D.Dentals for velars in word-initial position

/f/ for /θ/ in postvocalic position---The use of voiceless labiodental fricatives for voiceless interdental fricatives is a feature of African American Vernacular English (AAVE).

A child exhibits the following production errors. w/r θ/s t/ʃ t/tʃ z/dʒ t/k d/g If a target sound for initial intervention is to be selected on the basis of established developmental norms, then that sound will be A./s/ B./ʃ/ C./k/ D./tʃ/

/k/--- According to developmental norms, /k/ is the target phoneme that should be selected for intervention.

Michael is a 32-month-old boy who has been receiving early intervention services over the past ten months for delayed speech and expressive-language development. Although his birth was reportedly unremarkable, Michael does have a history of recurrent otitis media with effusion. His parents described him as having been a "well-behaved and quiet baby." When Michael began receiving services, he communicated mainly through gestures and crude vocalizations. An open resting mouth position with slight tongue protrusion was sometimes noted. However, his receptive-language skills were found to be age appropriate and he showed no oral motor deficits during feeding. Michael's expressive-language skills have shown some progress since he began working with the speech-language pathologist, but he remains poorly intelligible. Michael's imitation of tongue, lip, and jaw movements is characterized by inconsistent groping and errors of sequencing not observed in his spontaneous oral movements. Michael has an age-appropriate vocabulary and produces utterances of up to five words. Articulation errors, especially metathesis of phones and syllables, increase as his utterance length increases. Michael's intelligibility is greatest at the single-word level. Automatic speech and highly familiar utterances are much more intelligible than his imitated productions. 1- As part of ongoing assessment, the SLP's most appropriate action is to have Michael's parents consult with his primary-care provider for referral to A.a special educator B.a neurologist C.a psychologist D.an otolaryngologist 2-Michael demonstrates speech behaviors that are typical of children diagnosed with which of the following? A.Childhood apraxia of speech B.Conductive hearing loss C.Hyperkinetic dysarthria D.Autism spectrum disorder 3-Based on Michael's case history, the SLP would most appropriately provide activities to A.stabilize muscle tone to improve gross motor support of speech movement B.improve receptive-language ability C.strengthen tongue, lip, and jaw muscles D.increase the accuracy of CV, VC, and CVC syllable sequences 4-1- Given Michael's age, which of the following is likely to be the most effective strategy for speech and language intervention? A.Using structured play to address short-term goals B.Facilitating Michael's ability to self-monitor his speech C.Instructing Michael's parents in structured home exercises for their son D.Introducing augmentative and alternative communication devices

1- Option (D) is correct. Michael's history of recurrent middle ear infections, an otolarygologist would be able to clinically manage otitis media and make provisions to obtain an audiological assessment. 2-Option (A) is correct. Articulation characterized by groping, inconsistency, and errors of sound and syllable sequencing strongly suggests developmental apraxia of speech. 3-Option (D) is correct. Michael's case history suggests that his poor intelligibility is tied to his inconsistent sequencing of speech sounds and syllables. 4-1- Option (A) is correct. Toddlers and preschoolers respond better to games and play activities than to structured exercises.

A public-school-based speech-language pathologist is employed in a state that sets the maximum caseload at 65. However, the clinician's caseload is currently at 64 with a waiting list of 10 additional students. The school principal insists that the speech-language pathologist enroll the 10 students immediately, because the district cannot locate another clinician to assist with the caseload. Which of the following is the most appropriate way for the speech-language pathologist to address the situation? A.Enroll 1 of the 10 students and provide the principal with a written statement of caseload needs, mentioning the amount, type, and frequency of treatment B.Refer the 10 students to a speech-language pathologist working in a private setting C.Suggest that the principal ask a school speech-language pathologist from another school district to take the 10 students D.Maintain current caseload until an additional speech-language pathologist is hired

A.Enroll 1 of the 10 students and provide the principal with a written statement of caseload needs, mentioning the amount, type, and frequency of treatment **Why?--It provides the principal with a statement detailing the needs of the students awaiting treatment but also observes the state's caseload limit.

The speech reception threshold (SRT) is a basic component of an evaluation of hearing function. Which of the following statements about the SRT is most accurate? A.It is measured in decibels and corresponds to the intensity level at which spondaic words can be recognized approximately 50% of the time. B.It makes use of test materials that are limited to monosyllabic words. C.It provides information on how well speech is understood at conversational levels. D.It is useful in validating acoustic intermittence measures

A.It is measured in decibels and corresponds to the intensity level at which spondaic words can be recognized approximately 50% of the time.

A single exposure of several hours duration to continuous music with an overall level of 100 dB SPL will most likely produce A.tinnitus and a temporary threshold shift in high frequencies B.tinnitus and a distortion of speech perception C.a temporary threshold shift in the low frequencies D.a permanent threshold shift

A.tinnitus and a temporary threshold shift in high frequencies ---A single exposure of several hours duration to continuous music at a level of about 100 dB SPL will most likely produce tinnitus and a temporary threshold shift in the high frequencies.

A 70-year-old female has dysphagia characterized by poor posterior oral containment of the bolus during the oral preparatory stage, causing aspiration before the swallow. Cognition and the pharyngeal stage of the swallow are intact. Which of the following is the most appropriate treatment approach for the client? A.Providing a puree diet with thickened liquids B.Having the client flex her head forward (perform the chin-down posture) during oral preparation and transit stages of the swallow C.Having the client turn (rotate) her head to the right when swallowing D.Providing a diet that consists of thin liquids

B.Having the client flex her head forward (perform the chin-down posture) during oral preparation and transit stages of the swallow --- This treatment alters oral configuration to place the base of the tongue superior to the bolus inside the oral cavity. Since liquid cannot flow uphill against gravity, this intervention compensates for impaired palatoglossus contraction, which is causing impaired posterior oral containment.

Federal laws regarding freedom of access to information stipulate that client records kept or written by health care professionals can be A.reviewed only by other health-care professionals B.reviewed only by the clients themselves unless the client provides written permission to share with others C.reviewed by anyone who submits a formal written request D.released only by subpoena

B.reviewed only by the clients themselves unless the client provides written permission to share with others

This investigation was motivated by observations that when persons with dysarthria increase loudness, their speech improves. Some studies have indicated that this improvement may be related to an increase of prosodic variation. Studies have reported an increase of fundamental frequency (F0) variation with increased loudness, but there has been no examination of the relation of loudness manipulation to specific prosodic variables that are known to aid a listener in parsing out meaningful information. This study examined the relation of vocal loudness production to selected acoustic variables known to inform listeners of phrase and sentence boundaries: specifically, F0 declination and final-word lengthening. Ten young, healthy women were audio-recorded while they read aloud a paragraph at what each considered normal loudness, twice-normal loudness, and half-normal loudness. Results showed that there was a statistically significant increase of F0 declination, brought about by a higher resetting of F0 at the beginning of a sentence and an increase of final-word lengthening from the half-normal loudness condition to the twice-normal loudness condition. These results suggest that when some persons with dysarthria increase loudness, variables related to prosody may change, which in turn contributes to improvement in communicative effectiveness. However, until this procedure is tested with individuals who have dysarthria, it is uncertain whether a similar effect would be observed. From: Watson, P.J., & Hughes, D. (2006). The relationship of vocal loudness manipulation to prosodic F0 and durational variables in healthy adults. Journal of Speech, Language, and Hearing Research, 49, 636-644. ***Which of the following represent(s) the independent variable or variables used in the Watson and Hughes study?*** ***Watson and Hughes are cautious when suggesting that the speech of some persons with dysarthria improves because of the prosodic changes that result from increasing vocal loudness. Of the following, which is the most likely reason for this caution?*** ***Which of the following best describes the experimental design of the Watson and Hughes study?

C.Vocal loudness B.The prosody of persons with dysarthria may not show similar loudness effects. C.A within-subjects design

Which of the following is most important for an SLP to do when assessing a child who has an acquired brain injury? A.Evaluate pragmatics through a structured language test B.Compare premorbid performance with present performance C.Ensure administration of an intelligence test D.Compare nonverbal performance with verbal performance

Compare premorbid performance with present performance----- An SLP needs to know what skills the child attained prior to the brain injury in order to select appropriate treatment goals.

Before an SLP initiates voice intervention, it is most important that the SLP gather information about the A.cause of the client's voice problem B.client's breathing patterns C.client's oral motor skills D.fundamental frequency of the client's laryngeal tone

It is essential to know the cause of a voice problem prior to commencing voice intervention, because some voice problems are symptoms of diseases/disorders (e.g., laryngeal cancer) that do not respond to the types of voice interventions that an SLP typically provides, and can only be treated through medical intervention.

An SLP receives a referral regarding a 4-year-old boy who uses two words spontaneously and functionally, who began walking at 3 years of age, and who responds to his name inconsistently. On the basis of the information alone, the SLP can legitimately conclude that the child's communication profile reflects .a developmental delay B.autism spectrum disorder C.a chromosomal anomaly D.a metabolic disorder

Developmental Delay--- A 4-year-old typically developing child would have 4 word utterances and would respond to his name consistently. Most children start to walk around age 1. Therefore, the delay in walking, along with the delay in language, indicates a general developmental delay.

Which of the following is the most important acoustic cue that distinguishes between an unreleased final /p/ and an unreleased final /b/, as in "cap" versus "cab"? A.Locus frequency of burst B.Voice onset time C.Vocal fundamental frequency D.Duration of the preceding vowel

Duration of the preceding vowel---Research shows that vowel duration influences a listener's perception of voicing. Vowels that precede unreleased voiced stop consonants are as much as 1.5 times as long as vowels that precede voiceless stops.

Hearing loss in infants who are born with a cleft palate is usually related to which of the following? A.The infant's inability to create positive pressure in the oral cavity B.Malformation of the middle-ear ossicles associated with malformation of the palate C.Eustachian tube dysfunction D.Cochlear dysfunction

Eustachian tube dysfunction--- a major factor contributing to middle-ear disease and conductive hearing loss, is nearly universal in infants with cleft palate.

A 5-year-old girl with a repaired cleft palate has recently undergone a pharyngeal flap operation to correct velopharyngeal incompetence, but she continues to use glottal stops, pharyngeal fricatives, and mid-dorsum palatal stops. Which of the following is the most appropriate action for the SLP to take? A.Recommending that the child be examined by a cleft palate team to determine the cause of the persistent articular errors B.Referring the child back to the surgeon to determine the need for a revision of the pharyngeal flap C.Initiating articulation treatment to teach the correct placement for the stops and fricatives D.Initiating articulation treatment to teach correct production of nonpressure consonant sounds

Initiating articulation treatment to teach the correct placement for the stops and fricatives--- This child is using compensatory glottal stops, mid-dorsum palatal stops, and pharyngeal fricatives for standard American English stops and fricatives. She has had surgical management to correct velopharyngeal incompetence. She now needs to learn to produce the stops and fricatives for which she is making compensations. Therefore, articulation treatment is appropriate.

A clinician who employs active listening is doing which of the following? A.Responding to both the content and the affect of the client's remarks B.Listening very carefully and taking extensive notes C.Conducting a clinician-directed interview D.Directing the client to specific answers to questions

Option (A) is correct. A clinician who employs active listening responds to both the content (the denotative message) and the affect (the emotional content) of a client's remarks.

Which of the following types of cerebral palsy is characterized by slow, arrhythmic writhing and involuntary movements of the extremities? A.Athetosis B.Spasticity C.Hypotonia D.Bulbar palsy

Option (A) is correct. Athetosis is a type of cerebral palsy that is characterized by slow, arrhythmic writhing and involuntary movements of the extremities.

For which of the following reasons would the therapy for a client whose language loss is due to brain injury differ from the therapy for a client whose language loss is due to a progressive disorder? A.There is a much higher chance of spontaneous recovery for the client with brain injury. B.There is a much higher chance of spontaneous recovery for the client with a progressive disorder. C.The client with brain injury typically has problems with fatigue and mental confusion, whereas the client with a progressive disorder does not. D.The client with a progressive disorder typically has problems with attention and memory, whereas the client with brain injury typically does not.

Option (A) is correct. Brain injury is typically characterized by some degree of spontaneous improvement over a period of several days to weeks, which may be evidenced through gradual improvement in language abilities, whereas a progressive disorder is characterized by gradual loss/reduction in language skills.

Which of the following would be most likely to help a client who has aphonia? A.Development of phonation through coughing or throat clearing B.Pairing the production of /s/ and /z/ C.Respiratory exercises D.Easy initiation of phonation

Option (A) is correct. Development of phonation through coughing or throat clearing is an effective technique in the treatment of aphonia.

A correct-response rate of 51 percent on a two-choice picture-pointing task would most likely indicate which of the following? A.A random pointing response B.Successful intervention C.Development of crucial discrimination skills by the client D.Readiness to progress to a three-picture point task

Option (A) is correct. If an individual is responding randomly on a two-choice task, then there should be no significant preponderance of correct responses over incorrect responses. A result of 51 percent represents such an expected pattern of random responses.

A 9-month-old child was observed during a speech-language evaluation. To express herself, the child occasionally touched her mother, gained eye contact, and then gestured toward an object. If the child's development is normal, within the next month or so the child will begin to A.use consistent sound and intonation patterns as signals for specific intentions B.reach for objects that she desires C.establish joint reference with her caretaker D.use recognizable words and phrases to express her intentions

Option (A) is correct. In normal development, a child begins to use vocalizations to express specific intentions at around 10 months of age.

Naturalistic teaching chiefly involves which of the following? A.Establishing successful and useful communication B.Using multiple trials and training techniques C.Using more adult-initiated interactions than child-initiated interactions D.Using differential reinforcement, fading, and modeling

Option (A) is correct. Naturalistic teaching focuses on the successful production of utterances that are useful in context for communicating.

Which of the following treatment goals related to pragmatics best addresses a young child's use of language? A.In a play situation, the child will request a turn, either verbally or through gestures, 90 percent of the time. B.In a treatment session, the child will produce a two-word combination 90 percent of the time. C.In conversation, the child will produce correct velars 90 percent of the time. D.When telling a story, the child will use the standard dialect's irregular past tense forms of five specific verbs 90 percent of the time.

Option (A) is correct. Pragmatics is the study of language in realistic contexts, and the treatment goal describes a real-life, naturalistic use of communication skills.

Which of the following indicates the goal of the Health Insurance Portability and Accountability Act (HIPAA) ? A.To ensure a patient's privacy and confidentiality of health-care information B.To maximize health insurance coverage for speech-language pathology services C.To ensure a free and appropriate education D.To ensure a patient's knowledge of health insurance

Option (A) is correct. Protecting patient privacy and the confidentially of health-care information is the main purpose of HIPAA.

A client with anomic aphasia is a native speaker of Spanish with fair proficiency in English. Production of the word "shoes" as [tʃuz] on a repetition task is most likely due to which of the following factors? A.Phonological interference from the speaker's native language B.Semantic interference from the speaker's native language C.Semantic paraphasia due to the aphasia D.Phonemic paraphasia due to the aphasia

Option (A) is correct. The Spanish language does not have /f/ in its phonemic inventory, and native speakers of Spanish typically substitute the affricate /t∫/ / t ∫ / when producing English words with that phoneme. A native speaker of Spanish would most likely have made the substitution before acquiring an anomic aphasia.

Immediately following removal of a benign tumor from the base of the brain, a 76-year-old client exhibits severe nasalization and a weak, breathy voice. A four-month postsurgical assessment reveals no improvement. At this time, the remediation strategy for this client should focus on A.evaluation for prosthetic or surgical intervention B.strengthening exercises for the oral articulators C.a trial period using the yawn-sign technique D.complete vocal rest

Option (A) is correct. The client has a resonance and phonation disorder indicative of velopharyngeal and laryngeal problems. The velopharyngeal problem could be assisted by prosthetic or surgical intervention.

The most serious limitation of employing imitation as an intervention strategy for children with a language impairment is that imitation A.lacks communicative intention B.relies on semantic knowledge C.is clinician controlled D.is contextualized speech

Option (A) is correct. The most serious shortcoming of imitation as an intervention strategy is that imitation is not an intentionally communicative act.

Linguistic approaches to the treatment of sound-production errors in children are based on the notion that the errors are systematic and rule-based and that the goal of treatment is to modify a child's rule system to approximate the rule system used by adults. Which of the following is a treatment objective that reflects a linguistic approach to treatment? A.The child will contrast alveolar stops with velar stops in meaningful word pairs. B.The child will produce voiceless alveolar sibilants correctly in unstructured conversation. C.The child will coarticulate stop plus liquid clusters as easily as other children of the same age. D.The child will recognize and identify phonetic distortions of his or her error sound

Option (A) is correct. The objective refers to speech sounds in terms of general distinctive-feature classes, rather than in terms of isolated phonemes or overly specific classifications.

Which of the following is a typical symptom of cerebellar involvement? A.Overshooting or undershooting an intended target B.Rigidity during voluntary motions C.Spasticity during involuntary action D.Word-finding difficulty

Option (A) is correct. The overshooting or undershooting of an intended target is typical of individuals with deficits related to a lesion of the cerebellum.

Cognitive therapy for stuttering focuses on which of the following? A.Extinguishing the overt, dysfluent speech behavior by withholding positive reinforcement B.Changing distorted beliefs about self-efficacy and the need to speak with complete fluency C.Providing positive reinforcement during periods of fluent speech D.Reducing dysfluent speech behavior by using visual imaging

Option (B) is correct. Changing distorted beliefs about self-efficacy and the need to speak with complete fluency represents the only answer choice that is cognitive in nature.

Which of the following muscles is primarily responsible for vocal fold abduction? A.Posterior cricoarytenoid B.Cricothyroid C.Interarytenoid D.Lateral cricoarytenoid

Option (A) is correct. The posterior cricoarytenoid muscle has its origin on the posterior wall of the cricoid lamina, and courses anterolaterally and then anteriorly to insert onto the lateral aspect of the arytenoid cartilage. Given the anatomy of the cricoarytenoid joint, posterior cricoarytenoid contraction (shortening) can only produce rotation of the arytenoid cartilages such that the vocal processes are displaced laterally, abducting the true vocal folds.

An adult client exhibits visuospatial disorganization, an inability to initiate interactions, left-side neglect, and lack of facial expression. This combination of symptoms is most likely associated with which of the following? A.Right-hemisphere traumatic brain injury B.Left-hemisphere cerebrovascular accident C.Bilateral traumatic brain injury D.Alzheimer's dementia

Option (A) is correct. The symptoms listed are indicative of deficits that are generally associated with right-hemisphere dysfunction.

Native speakers of a language possess several capacities or abilities that provide insight into their language competence. Sentences such as "Visiting friends can be a nuisance" are especially useful to test a person's ability to A.recognize syntactic ambiguity B.interpret metaphoric language C.distinguish homophones by means of syntactic cues D.recognize a semantically anomalous sentence

Option (A) is correct. There are two ways to parse or interpret the structure of the sentence "Visiting friends can be a nuisance." One interpretation is that it is bothersome to visit friends; the other is that friends who have come for a visit are bothersome. Therefore, this sentence would be appropriate as part of a test of a person's ability to recognize syntactic ambiguity.

Language impairment in a child with Down syndrome is often determined by comparing performance on one or more standardized language tests with the child's mental age, rather than with the child's chronological age. Although mental age should not be used to specify the need for treatment, mental age can legitimately be used as a performance criterion because A.using chronological age would overidentify language disorders B.using chronological age would underidentify language disorders C.mental age always correlates with verbal performance D.language performance is expected to exceed mental age

Option (A) is correct. Using chronological age as a performance criterion for a child with Down syndrome would make the child's language disorders seem more pronounced than they are.

In the treatment of acute Wernicke's aphasia, the initial focus should be on A.encouraging self-monitoring of the adequacy of verbal output B.increasing the rate of speech C.improving the client's ability to elaborate verbally D.increasing the complexity of sentence structures

Option (A) is correct. Wernicke's aphasia results in deficits related to the ability to recognize the adequacy of one's verbal production.

Which of the following is the most reasonable standard to apply when judging whether a client has achieved generalization of a targeted skill? A.The client uses the targeted skill under stimulus conditions that were not present during the training process and without reinforcement. B.The client maintains the correct production of the targeted skill when the reinforcement schedule is changed. C.The client correctly produces the targeted skill effortlessly and without hesitation. D.The client is able to monitor errors and correct them with only a minimal number of cues from the clinician.

Option (A) is correct. When judging whether a client has achieved generalization of a targeted skill it is a reasonable standard to apply. It shows that the client is exhibiting the skill independently in situations not covered during training.

Which of the following is the ratio of reinforcement that will most quickly cause a newly acquired behavior to be habituated? A.A random ratio of tokens to correct responses B.A ratio of 1 token to 1 correct response C.A ratio of 1 token to 4 correct responses only D.A ratio of 1 token to 10 correct responses only

Option (A) is correct. When the goal is to reinforce a behavior that has already been acquired, a random ratio of tokens to correct responses creates an intermittent reinforcement schedule and is the most effective. Such a reinforcement schedule decreases the client's dependence on the token reward.

Which of the following provides the most important diagnostic information to an SLP making a differential diagnosis between childhood apraxia of speech and flaccid dysarthria in a child? A.The child's articulation performance at the sentence level B.A history of the child's development of chewing, eating, and swallowing C.A history of the child's language development D.The child's willingness to function in sociocommunicative events

Option (B) is correct. A child with childhood apraxia of speech does not have difficulties with chewing, eating, and swallowing, whereas a child with flaccid dysarthria is likely to have such difficulties.

Establishment of which of the following is most important in ensuring that the results of any diagnostic test of speech or language are replicable? A.Content validity B.Interjudge reliability C.Split-half reliability D.Face validity

Option (B) is correct. A test that has interjudge reliability is one whose results are replicable, even if different people administer the test.

Doing which of the following would likely yield the most useful information about the effectiveness of an intervention strategy? A.Reviewing the results of standardized assessment instruments B.Utilizing a single-subject design (ABAB) or a reversal procedure (ABA) C.Utilizing the subjective, objective, assessment, and plan (SOAP) format D.Requesting that a colleague reevaluate the client

Option (B) is correct. An ABAB or ABA design shows changes when intervention is applied. Single-subject design using ABAB or ABA design is the best method to determine whether intervention has succeeded.

Which of the following is the best action to take initially with a client who presents with poor oral control of liquids and solids, coughing and choking while eating and drinking, and a history of hospitalizations associated with pneumonia? A.Thickening liquids so that the client will be better able to control oral movements for swallowing B.Obtaining a modified barium-swallow study to determine appropriate interventions C.Evaluating the client's ability to eat a variety of foods in order to determine which foods are safest D.Prescribing that the client be NPO, since aspiration is present

Option (B) is correct. An assessment of the problem must be undertaken before treatment is provided, and the best way to do this is to obtain a modified barium-swallow study.

Which of the following errors is likely to persist the longest in the speech of children who are learning Standard American English (SAE) as a first language and are following the normal developmental course for speech and language acquisition? A.Assimilation B.Consonant cluster reduction C.Final-consonant deletion D.Velar fronting

Option (B) is correct. Consonant cluster reduction is the most persistent of the normal developmental processes listed.

Individuals diagnosed as having hemifacial microsomia are also most likely to have A.laryngeal dysfunction B.ear malformation C.webbed fingers and toes D.widely spaced eyes

Option (B) is correct. Ear malformation is the only symptom of those listed that is typical of hemifacial microsomia, a genetic diagnosis within the oculo-auricular-vertebral (OAV) spectrum.

An SLP sees a college-educated 22-year-old man who has sustained a brain injury as a result of a motor vehicle accident eighteen months earlier. The man was unconscious for five days and had posttraumatic amnesia for three months. In the last year he has held three unskilled jobs, from which he was released for unspecified reasons. Based on the information given, the man's most pervasive condition is most likely impaired A.visual construction B.attention and memory C.speech D.language

Option (B) is correct. Impaired attention and impaired memory are consistent with the brain injury sustained by the client. There is no evidence for any of the other areas of potential deficit listed in the other choices.

Six months ago, an SLP evaluated 4-year-old Molly's speech fluency during conversation. At that time, she displayed physically relaxed repetitions of words and phrases (occurring at a frequency of 2 per 100 words), and interjections such as "um" (occurring at a frequency of 1 per 100 words). She did not display any sound prolongations or facial grimaces; she did not produce any pitch rises or phonatory breaks; and she did not appear to avoid any sounds or words. Results from several formal tests suggested that her articulation and language development were within normal limits. Molly reportedly began producing repetitions and interjections at age 24 months, and the frequency of these disfluency types reportedly has remained stable since then. The SLP did not recommend speech-language intervention following the previous evaluation; however, she did provide the parents with information about fluency development, symptoms of stuttering, and general suggestions for how to facilitate children's fluency. A reevaluation is scheduled for next week. Which of the following is most appropriate for the SLP to do if Molly's speech fluency has remained the same since the previous evaluation? A.Recommend that Molly immediately begin fluency therapy, in which the focus is on reducing the frequency of repetitions and interjections in her conversational speech B.Recommend that Molly be released from the SLP's active caseload C.Recommend that Molly be referred for psychological counseling, with a focus on on helping Molly improve speech fluency by learning how to manage anxiety more effectively D.Recommend monthly evaluations of Molly's speech fluency until she is five years old

Option (B) is correct. Molly's fluency development was within normal limits at the previous evaluation, and, based on the parents' report, it also seemed to be within normal limits at age 2. Further, no other concerns about Molly's communication development were mentioned in the scenario. Thus, it appears that Molly has never stuttered and her communication skills have been and continue to be within normal limits. Therefore, it is unnecessary to reevaluate her speech or enroll her in fluency therapy.

A client has been determined to have poor upper esophageal sphincter opening secondary to decreased hyolaryngeal excursion, following a lateral medullary stroke. Cognitive functions are within normal limits. Which of the following interventions would be the most appropriate recommendation for this client as an initial course of treatment for the underlying disorder? A.Thermotactile stimulation B.Mendelsohn maneuver C.Thickened liquids D.Chin-down posture (head/neck flexion)

Option (B) is correct. The Mendelsohn maneuver is the only one of the listed interventions designed and shown in research to prolong the duration and diameter of upper esophageal sphincter opening.

A speech-and-hearing clinic has recently opened, but referrals are slow in coming. Which of the following would be most appropriate and effective for the clinic's director to do first? A.Ask local hospitals to provide names of recent clients likely to need speech-language services B.Identify and define the major consumer groups and referral sources, and develop a plan to reach them C.Identify the weaknesses in the competition, and inform consumer groups and referral sources of the weaknesses D.Wait for demand to increase on its own, because marketing speech-language services is against the ASHA Code of Ethics

Option (B) is correct. The clinical director of a new speech-and-hearing clinic would most appropriately prospect for referrals by identifying major consumer groups and creating a plan to contact them.

Of the following sentences, which represents the greatest degree of syntactic complexity? A.Is John helping Bill? B.Why isn't John helping Bill? C.John isn't helping Bill. D.Why is John helping Bill?

Option (B) is correct. The sentence involves inversion, adding negation, and adding a question word, so with three transformations, this option has the greatest degree of syntactic complexity.

The sensorimotor integration of the muscles of the lower face depends on which two of the cranial nerves? A.The accessory and hypoglossal B.The trigeminal and facial C.The vagus and glossopharyngeal D.The phrenic and facial

Option (B) is correct. The trigeminal nerve has a motor component which is involved in mastication (and thus the lower face) and a sensory component, which provides sensory information from the entire face (including the lower face). The facial nerve provides motor innervation to several muscles that are found in the lower face, including the orbicularis oris and the buccinator.

"Book read me." "Me TV see." The utterances above, spoken by a 3-year-old monolingual English-speaking child, indicate that the child most likely has a problem with which of the following? A.Semantic redundancy B.Syntactic relationships C.Morphological relationships D.Pragmatics

Option (B) is correct. The utterances are not in the correct order, which is characteristic of a syntactic error.

For which individual would a recommendation for an augmentative and alternative communication (AAC) intervention be least appropriate? A.A preschool child with a language-learning disorder and highly unintelligible speech B.A teenager with a repaired cleft palate who continues to experience hypernasality C.A young adult with severe cerebral palsy precluding functional oral communication D.A 55-year-old man who has had a laryngectomy

Option (B) is correct. This is correct because someone with hypernasality would still be intelligible, and an AAC device would not be needed.

Which of the following is an accurate statement about whispered speech? A.It is produced by approximating the arytenoid cartilages so that their medial surfaces are in direct contact. B.It is composed largely of aperiodic sounds. C.Spectrographic analysis of it reveals no discernible formants for the vowels. D.Most people can produce longer utterances per breath using it than they can using conventional phonation.

Option (B) is correct. Whispered speech is composed largely of aperiodic sounds, as the vocal folds do not vibrate while whispering is taking place.

A 4-year-old child presents with general speech patterns that include liquid gliding, stridency deletion, final-consonant deletion, and consonant-cluster reduction. Which of the following is the speech-language pathologist's most appropriate recommendation for the child? A.Treatment is not needed, because the child's speech will improve during the next year. B.Treatment should focus on the production of /p/, because /p/ is one of the earliest acquired phonemes. C.Treatment should use a phonological approach and focus initially on the production of final consonants. D.Formal treatment is not needed not, but the parents should be counseled to read aloud to the child, correct the child's errors, elicit correct repetitions, and, when needed, interpret to other people what the child is trying to say.

Option (C) is correct. A 4-year-old child should have already developed final consonants.

Compared with children who do not have language disorders, children with language disorders tend to A.take more conversational turns B.initiate topics and direct the flow of conversation more C.ask fewer open-ended questions D.initiate more indirect requests

Option (C) is correct. Children with language disorders tend to ask fewer open-ended questions than do children who are developing normally.

Computer software that has been developed to facilitate speech and language treatment can best be used A.in group sessions when the SLP's caseload precludes working individually with clients B.by clients in place of services that would otherwise be provided by an SLP C.by clients under the direction of SLPs D.when SLPs are unavailable

Option (C) is correct. Computer software and other aids are intended not to replace treatment sessions provided by an SLP but rather to enhance clients' opportunities to improve their skills in relation to goals established by the clinician.

For which of the following conditions is it most appropriate for the SLP to recommend that the patient's primary-care physician refer the patient to a prosthodontist for construction of a palatal-lift appliance? A.Submucous cleft palate B.Unrepaired cleft of the secondary palate C.Flaccid paralysis of the soft palate D.Congenitally short palate

Option (C) is correct. Construction of a palatal-lift appliance is appropriate for a patient with flaccid paralysis characterized by an intact palate that does not function.

Which of the following describes an important diagnostic distinction between apraxia of speech and dysarthria? A.Apraxia of speech is a result of lower motor neuron lesions, whereas dysarthria is the result of upper motor neuron lesions. B.Clients with apraxia of speech lack the ability to monitor reactive speech, whereas clients with dysarthria lack the ability to sequence volitional speech movements. C.Strength and coordination of the speech musculature are intact in clients with apraxia of speech, whereas slowness, weakness, incoordination, or altered tone of the speech musculature are associated with dysarthria. D.Apraxia of speech is characterized by distortions, omissions, and substitutions, whereas dysarthria is characterized by inconsistent, highly variable misarticulations.

Option (C) is correct. Dysarthria is a motor speech disorder characterized by slowness, weakness, incoordination, or altered tone of the speech production mechanism. The definition of apraxia includes the absence of any deficits in strength, tone, or coordination and rather is characterized by deficits in motor planning and/or programming of speech.

A 55-year-old woman, recently hospitalized for probable cerebrovascular accident (CVA), is referred for evaluation of stuttering speech. The initial conversation with the client indicates that speech is characterized by frequent initial-phoneme repetitions and prolongations as well as associated mildly effortful eye blinking. Which of the following pieces of information is crucial to accurate speech diagnosis and decisions regarding management of the speech problem? A.The site and extent of the lesion associated with the suspected CVA B.Whether the client has any associated dysphagia or dysphonia C.Whether the dysfluencies began before or after the suspected CVA D.Whether the client feels frustrated by the dysfluencies

Option (C) is correct. Dysfluent speech may or may not be directly caused by the patient's suspected CVA.

Which of the following communication disorders is most frequently associated with significant dysphagia? A.Aphasia B.Ataxic dysarthria C.Flaccid dysarthria D.Organic voice tremor

Option (C) is correct. Flaccid dysarthria and dysphagia are both disorders likely to be characterized by flaccidity or weakness of the oromotor and laryngeal mechanisms that results from cranial nerve damage. These two disorders frequently coexist.

To provide greater independence for a client who has a brain injury and is in a late stage of speech-language treatment, which of the following techniques is most appropriate? A.Increasing memory-retention span B.Using word-repetition drills C.Teaching compensatory strategies D.Training visual-perceptual skills

Option (C) is correct. Functional independence is a main goal for a client shortly before dismissal from treatment. It can be achieved by teaching compensatory strategies to minimize any remaining deficits.

A physician told the spouse of a client that melodic intonation therapy (MIT) would improve the client's speech considerably. The most appropriate next action by the SLP would be to A.provide MIT, as recommended B.tell the physician that it is inappropriate for the physician to make recommendations for a speech treatment C.consider the potential value of incorporating MIT into the client's treatment D.explain MIT to the client's spouse to assist in the decision-making process about the type of therapy to use

Option (C) is correct. MIT is a procedure appropriately used by SLPs to promote certain results. The SLP has responsibility for determining the value of this procedure in relation to the objectives of the speech-language treatment program.

Which of the following procedures would be effective in remediating a falsetto voice for an adult male with a severe bilateral hearing loss? A.Development of phonation from coughing B.Pushing exercises C.Manual depression of the larynx D.Manual elevation of the larynx

Option (C) is correct. Manual depression of the larynx will serve to lengthen the vocal folds, allowing them to vibrate at a lower frequency.

An otolaryngologist has referred a 45-year-old man for voice treatment following medialization thyroplasty for a paralyzed vocal fold. Which of the following is the most appropriate therapeutic strategy for the SLP to use? A.Assisting the patient to produce a soft glottal attack B.Digitally manipulation of the patient's neck to reduce strap-muscle tension C.Assisting the patient to produce a hard glottal attack D.Employing techniques aimed at increasing airflow

Option (C) is correct. Medialization thyroplasty moves the paralyzed vocal fold closer to the mid-glottis to allow better compensation by the unaffected fold. Only the production of a hard glottal attack addresses the compensatory behavior.

A number of research reports have described poor auditory memory in children with language impairments. Which of the following can most appropriately be concluded from these studies? A.Poor auditory memory can be improved by language-intervention programs that focus on teaching vocabulary and word meanings. B.Poor auditory memory is a reflection of a language impairment, and clinicians and researchers cannot effect improvement. C.Poor auditory memory could be a reflection or a cause of a language impairment or could be related to some other factor, and further research is needed to determine which is the case. D.Children with language impairments normally do not have well-developed representational skills.

Option (C) is correct. Research reports are restricted to the variables examined in the studies on which they are based. A relationship between poor auditory memory and language impairment has been found in some research studies. Other factors could be involved, however, suggesting that further research is needed. Conclusions about treatment or the effects of the impairment must be made through additional research studies.

A 412 4 1 2 -year-old boy has significant speech and language difficulties exemplified by poor oral-motor control, slight difficulty in swallowing, high palate, poor tongue mobility, and fasciculation on protrusion. During an evaluation, the speech-language pathologist notes very poor paper-and-pencil grasp, poor posture, and an inability to complete performance tasks requiring fine motor control. To which of the following should the child be referred in order to obtain additional diagnostic information? A.An otolaryngologist B.A physical therapist C.A neurologist D.A physiologist

Option (C) is correct. The boy's deficits as noted are most indicative of a neurological disorder, and a neurologist can best provide the additional diagnostic information needed.

A teacher asks the speech-language pathologist for advice regarding a child who talks excessively during class, rarely listens to instructions, and does work only intermittently. Attempts at alternative seating for the child have not been successful. Of the following, which is the most appropriate recommendation that the speech-language pathologist can provide to the teacher? A.Have the school counselor consider working with the child and the parents on self-control and discipline B.Put the child on a management system for classroom behavior C.Refer the child for evaluation by members of the child-study team D.Suggest remedial speech-language services for the child to improve the child's interactive communication

Option (C) is correct. The child has a behavioral problem that should be evaluated for the purposes of identification and management planning.

A 60-year-old man says that he has "trouble thinking of names and words" and that it is interfering with his job performance. The problem began three months ago after he had a minor cerebrovascular accident. He does not report any other problems. His conversation is characterized by some hesitancies, latencies, repetitions, interjections, and self-corrections. On the basis of an interview and the results of an aphasia battery, it is concluded that he has a mild aphasia. The most appropriate course of action is to A.advise the client to wait for three more months in order to allow spontaneous recovery to take place B.begin a treatment program designed to decrease dysfluencies in his speech C.offer a treatment program designed to improve word-retrieval skills D.encourage the client to increase his reading of information related to his profession in order to facilitate recall of professional terminology

Option (C) is correct. The client's language reflects the word-finding difficulties of an individual with aphasia. Treatment to remediate his difficulties is appropriate.

Control over the fundamental frequency of the laryngeal tone is most closely related to the activity of which of the following muscles? A.Posterior cricoarytenoid B.Lateral cricoarytenoid C.Cricothyroid D.Sternocleidomastoid

Option (C) is correct. The cricothyroid muscle has the greatest control over the fundamental frequency of the laryngeal tone by lengthening or tensing the vocal folds.

Which of the following areas needs to be evaluated first for a 5 year old who says [pun] for "spoon" and [top] for "soap"? A.Auditory discrimination B.Dialectal differences C.Phonological system D.Receptive language

Option (C) is correct. The error patterns described are phonological in nature (cluster reduction and stopping, specifically) and are not consistent with a deficit in language comprehension (receptive language), dialectal differences, or problems with auditory discrimination.

Which of the following most accurately represents the etiology of cleft palate? A.Genetic factors alone B.Environmental influences alone C.Genetic factors interacting with environmental influences D.Medications taken by the mother during pregnancy

Option (C) is correct. The interaction of genetic factors and environmental influences represents the etiology of cleft palate.

A 67-year-old male patient with no history of swallowing problems has undergone a cardiothoracic surgical procedure. Postoperatively, he is found to be aspirating while swallowing and is diagnosed with a left vocal-fold paralysis and left pharyngeal paresis. Which of the following is the most likely etiology? A.An intraoperative CVA in the right pons B.Damage to the right recurrent laryngeal nerve C.Damage to the left recurrent laryngeal nerve D.A left hemispheric stroke

Option (C) is correct. The left recurrent laryngeal nerve courses under the aortic arch in its course back to innervate the left larynx and the inferior pharynx. The nerve can be damaged in cardiothoracic operations including aortic arch or valve repairs. Only the left (and not the right) recurrent laryngeal nerve has this course.

The figure shows a midsagittal view of the oral and pharyngeal structures. The top and bottom lip are located one above the other, with a small opening in between. The top central incisors and lower central incisors are both tipped forward labially; however, the lower central incisors appear to rest behind the top central incisors. The tongue is not in contact with the hard or soft palate. The soft palate is not in contact with the posterior pharyngeal wall. An individual attempting to sustain /f/ is shown in the midsagittal view above. The most important reason why this speaker will not produce an acceptable /f/ is that A.the upper central incisors are tipped too far labially B.the lower central incisors tipped too far labially C.intraoral air pressure will be insufficient D.lip placement is inadequate

Option (C) is correct. The midsagittal section shows that the speaker's velopharyngeal port is open, allowing a flow of air into the nasal cavity; the resulting intraoral air pressure would be insufficient to sustain normal production of the phoneme.

A disfluent 4-year-old child is referred to an SLP for assessment. Which of the following is most important for the SLP to consider in deciding whether the child is developmentally nonfluent or stuttering? A.The length of time the child has been disfluent B.The rate at which the child talks C.The nature and frequency of the child's disfluencies D.The child's comments to the clinician about the disfluencies

Option (C) is correct. The nature and frequency of the child's repetitions will help distinguish between normal disfluency and the type of stuttering for which remediation is indicated.

When treating a client who is using an electronic augmentative-communication device, the speech-language pathologist's primary goal should be to A.ensure that the client develops skill in using every technical aspect of the aid B.ensure that the client's caregivers learn how to modify the aid's hardware and any applicable software to meet the client's communication needs C.train the client to use the aid as independently and interactively as possible in a variety of settings D.help the client develop the skills necessary for moving on to a more sophisticated device

Option (C) is correct. The primary goal of any intervention is to effect the best functional outcome for the client. Generalization with respect to the environments in which the augmentative device is used effectively would help accomplish this goal.

A 6-year-old child produces [t] for /s/, [d] for /z/, [p] for /f/, and [b] for /v/. Intervention for this problem would target language at the level of A.morphology B.syntax C.phonology D.semantics

Option (C) is correct. The speech patterns described in the question stem all pertain to speech sound production. Phonology is the aspect of language that deals with speech sound production.

Ms. Brown, a 70-year-old retired female, was admitted to the hospital following a CVA. The SLP conducted a comprehensive evaluation that revealed the presence of left-side neglect, anosognosia (denial of impairment), and visuospatial problems, including prosopagnosia (difficulty recognizing familiar faces). Although her auditory comprehension and repetition skills were good, she experienced difficulty with topic maintenance and turn taking. Based on the clinical features described, Ms. Brown's diagnostic classification would most likely be A.Wernicke's aphasia B.Conduction aphasia C.Cognitive-communicative disorder consistent with right hemisphere damage D.Cognitive-communicative disorder consistent with left hemisphere damage

Option (C) is correct. The symptoms described in the scenario are consistent with damage to the right hemisphere.

A videofluoroscopic study of a client with dysphagia revealed post-swallow vallecular residue occupying more than 50 percent vallecular height. Which of the following is the most likely overt symptom that the client will experience? A.Watery eyes during swallowing B.Oral pocketing of foods C.Coughing after swallowing D.Esophageal reflux

Option (C) is correct. The valleculae are depressions that lie lateral to the median epiglottal folds. Pooling of liquids in the valleculae gives a person the feeling that there is material remaining in the respiratory pathway, so coughing would be a natural reaction to expect in this case.

A third-party reimburser asks the speech-language pathologist to demonstrate in a diagnostic statement that a child's communication problems have a physiological cause. Which of the following observations, if included in the statement, would best satisfy the request? A.The child's dentition is not yet fully developed but is within normal limits for a child of that age. B.The child has developmental delay, exhibiting speech that is not appropriate for a child of that age. C.The child demonstrates a motor-speech disorder and is unable to perform voluntarily the oral movements required for speech production. D.The child exhibits stridency deletion, consonant cluster reduction, stopping, and fronting.

Option (C) is correct. The wording represents a well-written diagnostic statement for a child with communication problems that are physiological, or functional, in nature. None of the other answer choices demonstrates the presence of a physiological problem.

Treatment for apraxia of speech most appropriately emphasizes A.coordination of respiration with phonation and articulation B.auditory discrimination, resonance, and respiration C.auditory-visual stimulation, oral-motor repetition, and phonetic placement D.rate of speech, range of movement, strength, and coordination of the oral mechanism

Option (C) is correct. Treatment for apraxia of speech appropriately emphasizes auditory-visual stimulation, oral-motor repetition, and phonetic placement.

Which of the following muscles produces the opposing action to those that produce velopharyngeal closure? A.Musculus uvulae B.Levator veli palatini C.Palatoglossus D.Stylopharyngeus

Option (C) is correct. Velopharyngeal closure is largely produced by soft palate elevation, and the only muscle in the list that produces soft palate depression (the opposite of soft palate elevation) is the palatoglossus.

To justify providing individual treatment for a 2½ year old with apraxia of speech, which of the following would be LEAST important for the SLP to include in the evaluation report? A.A description of the child's typical interaction with peers B.Relevant prognostic data C.Information about apraxia of speech D.A description of the language development of the child's older siblings

Option (D) is correct. A description of the child's older siblings' language development does not provide the objective, documented evidence required to justify provision of treatment for a child of an age at which some unintelligibility would be typical.

In terms of communication impairment, an adult with Alzheimer's-type dementia tends to differ from an adult with aphasia associated with a CVA in that A.repetition abilities are typically more seriously impaired in the adult with dementia B.the adult with dementia generally experiences greater dysfluency C.the adult with dementia is generally more aware of any disruptions in communication D.the capacity of the adult with aphasia to make appropriate comments about recent events is generally better

Option (D) is correct. Adults with dementia typically have impaired short-term memory abilities. Adults with aphasia are more likely to recall recent events and consequently would be more likely to make appropriate comments about recent events when compared to those with dementia.

Following anoxic encephalopathy, clients are likely to experience the most significant long-term impairments in the area of A.prosody B.resonance C.aphonia D.memory

Option (D) is correct. Anoxic encephalopathy, or brain damage resulting from oxygen deprivation, typically leads to global impairment that affects memory. It is difficult to reverse the effects of memory loss, so the impairment is usually long-term.

A child with discourse problems is most likely to need remediation directed at which of the following? A.Morphology B.An initial lexicon C.Gestural communication D.Cohesive devices

Option (D) is correct. Cohesive devices, such as prenominal references, coordinating conjunctions, and conjunctive adverbs, are used to link clausal and sentential elements to form a coherent and unified message.

Research regarding the use of intensive phonemic-awareness treatment for children who have difficulty learning to read has demonstrated that the treatment A.is effective only for children from 4 to 8 years old B.is effective mainly with children who have remediated all phonological process errors C.is effective only when combined with a supplemental literacy program D.might have no direct relationship to improvement in reading abilities

Option (D) is correct. Intensive phonemic-awareness treatment programs are thought to improve reading by training children to better differentiate and process speech sounds. However, to date, research has not successfully separated the effects of intensive intervention, so no direct relationship has yet been proved.

Intervention from an SLP for a nursing-home resident who is in a late stage of progressive dementia will most effectively focus on A.conversational intelligibility B.recall of salient vocabulary words C.comprehension of social discourse D.assisting in communication routines

Option (D) is correct. Intervention from an SLP for a nursing-home resident in a late stage of progressive dementia would most effectively focus on assisting the resident with daily communication functions.

If a child's language exhibits the phonological process of gliding, the child might say [wɛd] for "red." When asked, "Do you mean wed?" the child may respond, "No! [wɛd]!" Such a response demonstrates which of the following? A.Phonological development lags behind semantic development. B.Semantic development lags behind phonological development. C.Linguistic competence lags behind linguistic performance. D.Linguistic performance lags behind linguistic competence.

Option (D) is correct. Linguistic performance typically lags behind linguistic competence.

Mr. Charles, age 78, has had Alzheimer's disease for the past nine years. A recent speech and language evaluation at his nursing home indicated severe deficits in verbal reasoning, memory, word finding, discourse, pragmatics, phonology, semantics, and syntax. Which of the following should the speech-language pathologist do next? A.Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is least deficient B.Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is most deficient C.Initiate group treatment with other adults with language impairments to improve spontaneous conversational speech and pragmatic skills D.Examine his living conditions and, if necessary, educate the nursing staff concerning ways to help him communicate more effectively

Option (D) is correct. Mr. Charles has Alzheimer's disease with loss of memory and deteriorating language skills. The best that can be done for him is to help his caregivers improve the conditions related to his basic communication needs. Speech-language treatment itself is very unlikely to be effective and thus is not appropriate.

Ms. Helene, a 60-year-old woman with a suspected neurological disorder, is referred for speech-language evaluation. She achieves a score of 35/50 on a measure of confrontation object-naming ability. This score is below norms established for individuals of her age and educational level. Based on these results alone, which of the following statements can most reliably be made about Ms. Helene's disorder? A.She has anomic aphasia, which might or might not be associated with other language deficits. B.She has aphasia, but the type of aphasia cannot be specified on the basis of this test score alone. C.She does not have aphasia but probably does have a memory disturbance. D.She has difficulty with naming, but the precise nature of the deficit cannot be determined on the basis of this test score alone.

Option (D) is correct. Ms. Helene has a suspected neurological disorder and she achieves a score that is below the norms for individuals her age. Given this information alone, the most that can be said is that she has difficulty with naming; the precise nature of her deficit cannot be determined.

Ms. Lopez's articulation errors consist of the following: f/v, ʃ/ʒ, and s/z. On the basis of these errors, the SLP should begin remediation that focuses on A.manner B.place C.fricatives D.voicing

Option (D) is correct. Ms. Lopez's phonological errors are errors of voicing, as [f] is substituted for [v], [ʃ] for [ʒ], and [s] for [z].

A prospective client is described as a man in his forties who is under chronic stress. He uses his voice extensively in daily life has a hard-driving personality, and exhibits glottal fry. The client has the classic profile of a person at high risk for A.spastic dysphonia B.acute laryngitis C.vocal nodules D.contact ulcers

Option (D) is correct. The symptoms exhibited by this patient represent a classic profile of a person who has contact ulcers.

A 12-year-old native speaker of Spanish who has been studying English as a second language for three years is most likely to do which of the following when speaking English in casual conversation with teachers at school? A.Use the auxiliary "have" in place of "be" in progressive tenses B.Use incorrect word order within prepositional phrases C.Use conjunctions in place of prepositions D.Use multiple negation improperly

Option (D) is correct. Multiple negation is a grammatical feature of Spanish but not of Standard English. The contrast between the two languages can cause multiple negation to persist as a speaker attempts to learn Standard English.

Which of the following is a type of perturbation that can be measured to determine the amount of noise in the voice? A.Changes in the frequency range between F1 and F2 over time B.Changes in the frequency range between F2 and F3 over time C.F3 cycle-to-cycle variations in sound energy over time D.F0 cycle-to-cycle variations in sound energy over time

Option (D) is correct. Perturbation is a disturbance in the quality of the laryngeal tone, or fundamental frequency, of the voice.

An SLP has a consultation with a self-referred adult who has a fluency disorder. The client had been enrolled in treatment programs with the clinician three times before and had reached from 75 to 90 percent fluency before dropping out of treatment for various reasons. Thirty percent of the client's syllables are spoken disfluently. The client also exhibits signs of depression and anxiety. Which of the following is the most appropriate action for the SLP to take? A.Encouraging the client to re-enroll for remedial services B.Encouraging the client to take responsibility for maintaining fluency by using techniques learned in the previous treatment sessions C.Recommending that the client schedule a neurological evaluation D.Referring the client for psychological counseling

Option (D) is correct. Psychological counseling is most appropriate for a client who appears interested in improving speech but has not remained motivated long enough to complete the several treatment programs started. The client also does not exhibit maintenance of benefits from prior treatment. Thus, psychological counseling should precede any further remedial efforts.

Which of the following actions will most effectively control the problem of overreferral in school screening programs that use impedance/immittance measurements? A.Obtaining the measurements in a professional sound-insulated room B.Including 500 Hz in the audiometric screening procedure C.Retesting immediately those who did not pass the first screening D.Waiting three to five weeks to retest those who did not pass the first screening

Option (D) is correct. Some children may have a temporary problem due to a cold or ear infection, which may resolve in a few weeks.

In the treatment of voice disorders, the chewing technique is used to do which of the following? A.Improve control of loudness B.Increase pitch range during voice production C.Increase air supply during voice production D.Reduce tension in the laryngeal area

Option (D) is correct. The chewing technique is used to reduce muscular tension in the laryngeal area.

A 3-year-old child presents for an evaluation of communication skills. When the SLP says "Sit in your seat," the child responds by saying [tɪ ɪ ti]. When the SLP asks the child to "put the big block in the box," the child responds by saying [bɪ bɑ ɪ bɑ]. Based on the responses, the child's primary problem with communication is most likely which of the following? A.Oral-motor weakness B.Poor auditory discrimination C.A fluency disorder D.A receptive and/or expressive language impairment

Option (D) is correct. The child is imitating what the SLP is saying but not adding new information to the conversation. This may be due to difficulty comprehending what is said (receptive language) and difficulty with producing sounds and words (expressive language).

A 42-year-old client with upper-and lower-extremity weakness and a diagnosis of amyotrophic lateral sclerosis is referred for a speech-language evaluation. The evaluation reveals a progressive severe dysarthria that is characterized by imprecise articulation secondary to bilateral facial and lingual weakness, atrophy, and fasciculations; mild-to-moderate hypernasality and weak pressure consonants with associated nasal emission during speech; and strained, harsh, groaning voice quality with occasional inhalatory stridor. Speech intelligibility is poor. Which of the following will most effectively improve this client's ability to communicate? A.Teflon injection into one or both vocal cords B.Palatal-lift prosthesis C.Amplification device D.Augmentative communication system

Option (D) is correct. The client has an advanced stage of amyotrophic lateral sclerosis with consequent progressive deterioration of communication abilities. An augmentative-communication system is the best option for improving or maintaining communication for this client.

A 4-month-old-infant who has a low birth weight but passed a neonatal hearing screening was evaluated for development of communication skills. The speech-language pathologist found that the infant followed moving objects visually, showed interest in mouthing and banging objects, and began sucking in anticipation of eating, but failed to localize to environmental sounds. On the report to the infant's primary care physician, the most appropriate recommendation by the speech-language pathologist is A.consideration of auditory amplification B.hearing-loss counseling for the parents C.careful parent monitoring of the child's speech-language development D.evaluation of auditory function by an audiologist

Option (D) is correct. The infant is showing normal development except for problems in localizing environmental sounds. This symptom is indicative of a possible auditory problem, making it appropriate for the infant to be referred to an audiologist for evaluation of auditory function.

For a test of expressive morphology and syntax for speakers of African American Vernacular English (AAVE), the test item that would be considered LEAST biased against such speakers would be one requiring A.use of the auxiliary verb "be" in the present progressive tense B.use of the past-tense ending "-ed" C.use of sentences with multiple negation D.agreement of personal pronouns with their antecedents in gender and number

Option (D) is correct. The morphological feature listed is one in which African American Vernacular English (AAVE) does not differ from Standard American English (SAE).

An SLP is planning treatment for a 5-year-old child with multiple speech-production errors. The most effective strategy the clinician can use to treat the child is to A.arrange error sounds by developmental pattern and correct them sound by sound B.start with sounds the child can make and use them as bridges to error sounds C.teach sounds in isolation, then use nonsense syllables, and then build to words D.delineate phonological processes in operation and address them through minimal-contrast pairs

Option (D) is correct. The most efficient procedure for the child would be for the speech-language pathologist to define the phonological processes in operation and address them through minimal-contrast pairs.

Laborious, halting, telegraphic utterances are typical of clients with which of the following types of aphasia? A.Conduction B.Anomic C.Wernicke D.Transcortical motor

Option (D) is correct. Transcortical motor aphasia is characterized by dysfluent, telegraphic utterances, and none of the distractors are characterized by this pattern of production.

For a patient with communication and swallowing disorders secondary to acquired immunodeficiency syndrome (AIDS), a speech-language pathologist will most appropriately A.serve only as a consultant to others who are directly involved in the patient's care B.provide treatment on a monthly basis C.provide treatment only as prescribed by the patient's physician D.provide treatment in consultation with the patient's primary-care physician or medical team

Option (D) is correct. Treatment in consultation with the patient's primary-care physician or medical team would provide the information needed to determine the best management of the patient.

A child repeatedly inserts an inappropriate sound in certain environments; for example, [fpɪʃ] for [fɪʃ] . Which of the following would likely be most helpful for the child as a target for treatment? A.Bisyllabic words for which a minimal-contrast pair can be easily identified B.Words containing phonemes that have distinctive features in common with the sound the child inserts inappropriately C.Repeated practice with the combinations of phonemes that the child finds particularly easy to produce D.Words that contrast the child's error pattern with the target pattern in the word

Option (D) is correct. Words that contrast the child's error pattern with the target pattern would be most helpful for this child.

Fela is a third-grade student in a public school. She is a speaker of African American Vernacular English (AAVE) who has difficulty with the Standard American English (SAE) dialect used in her classroom. Her teacher believes that Fela's language skills are affecting her academic performance and has referred her to the school's speech-language pathologist. Which of the following is an appropriate rationale for providing language intervention for Fela? A.It will likely foster better communication with Fela's linguistically and culturally diverse peers. B.It will likely improve Fela's code-switching ability with her teacher and other adult speakers of SAE. C.It may expand Fela's later academic and vocational opportunities. D.It will likely lead Fela to adopt SAE as her primary dialect.

Options (A), (B), and (C) are correct. The intervention will foster better communication because Fela and her peers will have a common dialect. Also, the intervention will provide Fela with the ability to switch easily between dialects using SAE structures. Furthermore, being able to switch codes will enable Fela to participate in more educational and vocational opportunities.

A team of SLPs is evaluating whether a new language intervention is suitable for use with children who are on their caseload. The clinicians read an article documenting research on the effect of a novel treatment on the language performance of 30 children with specific language impairment. The researchers administered a standardized language test to the children before and after the treatment program. The children's posttreatment scores on the test were significantly higher than their pretreatment scores. This led the researchers to conclude that the treatment was highly effective. Based on the preceding description, which of the following appears to be a significant limitation of the design of the study? Select all that apply. A.The use of a single-group pretest-posttest design B.The absence of a control group C.The inability to rule out the possibility that the children's language scores improved for reasons other than the treatment D.The use of random assignment to place the children into the treatment group E.The number of participants in the study

Options (A), (B), and (C) are correct. The use of a single-group pretest-posttest design is a limitation because there is inadequate control of internal and external validity without a control group. The absence of a control group is a limitation because control groups are a way of introducing control and can better isolate the effect of the treatment. Furthermore, since it is a longitudinal study, improvement based on language development cannot be ruled out.

An SLP who is treating an adolescent who stutters designs a treatment plan that includes three fluency management strategies: prolonged speech, cancellation, and pullout. Which of the following is true about the use of these treatment strategies? Select all that apply. A.Use of prolonged speech is likely to reduce the frequency of part-word repetitions and sound prolongations significantly. B.Each of the three strategies entails deliberate regulation of speech motor movements. C.The client will seek to apply cancellation whenever he feels anxious about the possibility of stuttering overtly. D.The client will seek to apply pullout during the course of part-word repetition or sound prolongation.

Options (A), (B), and (D) are correct. Prolonged speech, deliberate regulation of speech motor movements, and pullout could all be appropriately applied.

A child who is 4 years and 4 months old is referred for assessment of speech sound development, with the following results. Phonological error pattern Sounds in error Error frequency (# of errors/# of opportunities to produce error) Stopping ​Observed only on ð 85% Fronting /k/ → [t] /g/ → [d] /ng/ → [n] 90% 100% 20% Gliding /r/ → [w] 100% Final consonant deletion Obstruents à null 80% (The only phonemes the child used correctly in the word-final position were /n, m/.) Epenthesis Insertion of ə into stop /s/ clusters 10% Which of the following phonological error patterns is most appropriate to address in a treatment program? Select all that apply. A.Stopping B.Fronting C.Gliding D.Final consonant deletion E.Epenthesis

Options (B) and (D) are correct. Fronting and final consonant deletion should be suppressed earlier, as they make the biggest difference in intelligibility.

A two-year-old child produces the following utterances during a play-based conversation with her mother. Utterance Gloss/Child's Intended Meaning No kitty It's not a kitty. My doggie This toy dog is mine. No goat It's not a goat. Kitty house The cat is in the house. Big kitty It's a big cat. Doggie ball The dog pushed the ball. Which of the following semantic-syntactic constructions does the child show evidence of using? Select all that apply. A.Disappearance B.Denial C.Possessor + possession D.Attribute + entity E.Agent + action

Options (B), (C), (D), and (E) are correct. Denial is shown through the utterance of "no kitty," possessor + possession is shown through the utterance of "my doggie," attribute + entity is shown through the utterance of "big kitty," and agent + action is shown though the utterance of "doggie ball."

Fiber-optic instrumentation is appropriate for evaluation of which of the following types of disorders? A.Articulation B.Phonation C.Proprioception D.Respiration

Phonation--- Fiber-optic nasopharyngoscopy or laryngoscopy is a commonly used approach to evaluate vocal fold anatomy and physiology for voice production (phonation).

Children diagnosed as having specific language impairments are likely to exhibit the greatest deficits in which of the following? A.Production of sentences with appropriate inflectional morphology and syntax B.Acquisition of word meanings C.Comprehension of short sentences D.Motoric aspects of written expression

Production of sentences with appropriate inflectional morphology and syntax--- Children with specific language impairments typically have difficulty producing utterances that are morphologically and syntactically well formed.

Excessive nasality is associated with inadequate velopharyngeal closure. An SLP is training a client to self-monitor nasality during speech. Which of the following tactics will best allow the speaker to determine whether there is excessive nasal airflow? A.Looking in a mirror while speaking B.Being aware of vowel-sound productions C.Speaking/phonating while alternately leaving the nostrils open and pinching them closed D.Monitoring production of consonant blends

Speaking while alternately leaving the nostrils open and pinching them closed is an easy way for a speaker to determine whether inappropriate nasal airflow is occurring. This technique allows one to determine the difference in airflow pattern when speech is produced with the nostrils occluded as compared with speech produced when the nostrils are open. For a speaker with velopharyngeal incompetence, closure of the nostrils will eliminate the nasal airflow in production of /s/.

After sustaining a CVA, Ms. Williams, age 75, was referred to an SLP for a speech and language evaluation. While Ms. Williams was describing the cookie-theft picture, the SLP observed that her grammatical structure appeared to be intact and her prosody was normal but that many of her sentences were meaningless, did not fit the context, and included nonsensical paraphasic errors. Additional testing also revealed that Ms. Williams exhibited poor repetition and naming skills, did not respond appropriately to many simple commands, and had difficulty reading. Ms. Williams appeared happy and talked excessively. She did not appear to be aware of her communication deficits. What is the most likely location of the lesion? A.Left posterior superior temporal gyrus B.Left inferior frontal gyrus C.Left superior frontal gyrus D.Left inferior parietal gyrus

The symptoms that are described in the scenario are consistent with damage to the left posterior superior temporal gyrus.

Which of the following best describes the rationale for using standardized, norm-referenced instruments to assess speech-language functioning? A.They enable the clinician to generate weekly statements about a client's treatment progress. B.They provide the clinician with the information that is necessary to generate a specific and comprehensive treatment plan. C.They enable the clinician to understand and make informed statements about how a client's performance compares with the performance of other people. D.They provide the clinician with reliable information about how well a client is likely to respond to treatment.

The use of standardized normative instruments enables a clinician to compare a client's language and speech function with the average normal function for a person in the client's age range.

The major objective of auditory training in the treatment of a client with a hearing loss is to A.improve the client's awareness of position and movements of the speech mechanism B.improve the client's kinesthetic and auditory awareness C.increase the client's kinesthetic and proprioceptive discrimination D.teach the client to make discriminations among speech sounds

teach the client to make discriminations among speech sounds--- Auditory training focuses on the interpretation of auditory input and would thus teach a client to discriminate speech sounds.