ETS Form 3

Elisions and transpositions are referred to as phoneme A.additions B.blending C.deletions D.manipulations

Option (D) is correct. Phoneme manipulations change or modify the individual sounds in words. Elisions are the omissions of sounds in spoken words, and transpositions occur when the order of sounds in a word is switched.

An SLPS L P works at a hospital with the adult acute-care inpatient team. During a clinical bedside swallow evaluation, a patient asks the SLPS L P how common it is for adults to experience a swallowing disorder. The SLPS L P tells the patient that recent research indicates the prevalence of adults with swallowing problems each year is A.1 in 25 B.1 in 50 C.1 in 100 D.1 in 200

Option (A) is correct because recent research indicates that 1 in 25 adults are affected by a swallowing problem per year.

After completing an evaluation of a 5-year-old patient, an SLPS L P finds that the child's speech contains numerous phonological error patterns. If the SLPS L P follows a developmental sequence in planning intervention, which of the following is most appropriate to target first? A.Consonant assimilation B.Gliding C.Deaffrication D.Cluster reduction

Option (A) is correct. Consonant assimilation processes rarely persist beyond 3 years of age.

An endoscopic examination of swallowing is the best instrumental assessment when the SLPS L P wishes to evaluate the A.volume of and patient's response to pharyngeal secretions B.duration and extent of hyolaryngeal elevation C.penetration of material into the laryngeal vestibule during the swallow D.efficiency of lingual manipulation during bolus formation and anterior-posterior bolus transit

Option (A) is correct. Endoscopic viewing is superior to other examinations when the primary goal is to evaluate the volume of and the patient's response to pharyngeal secretions.

Which of the following statements best represents a syntactic structure characteristic of Spanish-influenced English? A."She no do laundry today." B."He is going?" C."Lady her shoes." D."She be runnin' fast."

Option (A) is correct. "No" may be used in Spanish-influenced English as a negative marker instead of "not."

An SLPS L P in a public school will be seeing a student who is returning to school after experiencing a traumatic brain injury (TBIT B I). The student has dysphagia, and the SLPS L P will provide dysphagia therapy as part of the student's IEPI E P. The clinician seeks evidence to help develop the intervention. Which of the following is the best resource? A.Reading a published case study of a 15 year old who received dysphagia therapy after a car accident B.Listening to the school principal's experience with another student who experienced a similar TBIT B I C.Incorporating the parents' request that the student eat in the cafeteria with peers D.Reviewing

Option (A) is correct. A case study provides the SLPS L P with information about external scientific research that may be helpful in answering the PICOP I C O question.

An SLPS L P will be working with a new mother to evaluate a term infant's feeding and swallowing skills to determine the infant's readiness for oral feeding. The infant has been diagnosed with a unilateral, complete cleft lip without cleft palate. The mother asks the SLP about what caused the infant's cleft lip. The SLPS L P explains that while we know that both genetic and environmental factors are likely involved with this congenital birth abnormality, there is no consensus in research about a single cause of cleft lip. The SLP completes a comprehensive oral sensorimotor and behavioral observation examination prior to initiating an oral-feeding trial. The following is documented in the SLP'sS L P's assessment notes: Right-sided complete cleft lip; otherwise unremarkable oral peripheral mechanism examination; medical chart notes no associated neurological difficulties or diagnosed syndromes; primitive reflexes present (e.g.for example, rooting); normal observation of posture, positioning, tone, and motor activity; infant presents awake, alert, and calm; baseline vital signs at rest are normal and no changes in respiratory rate, heart rate, or oxygen saturation noted with nonnutritive sucking; no respiratory stridor noted; mild external support needed to increase lip closure at introduction of pacifier nipple, and mother with strong desire to breastfeed. The mother expressed some anxiety and concern surrounding feeding an infant with a cleft lip. During which of the following weeks of pregnancy did the infant's craniofacial structures not develop completely? A. 4-to7 B. 8-to11 C. 12-to15 D. 16-to19

Option (A) is correct. A cleft lip results from incomplete closure of lip tissues as the lips form early in pregnancy, between weeks four and seven. Both genetic and environmental factors likely contribute to a cleft lip, a congenital birth defect; however, a singular cause has not been identified.

A 28-year-old female self-refers for a voice evaluation. She exhibits a variable dysphonia (it is present in some sentences but not in others) which presents as mild-to-moderate roughness. The SLPS L P desires more objective data about the patient's voice quality. Based on the information obtained so far, which of the following assessments best complements the perceptual assessment to help the SLPS L P determine the underlying physiological impairment(s)? A. Performing acoustic assessment B. Obtaining history of the problem C. Using the Consensus Auditory-Perceptual Evaluation of Voice (CAPEC A P E-V) D. Administering the Voice Handicap Index (VHIV H I)

Option (A) is correct. Acoustic measures can support a perceptual judgement of voice quality and have been found in several studies to differentiate normal from pathologic conditions of the voice.

Brennan, a 50-year-old senior corporate executive, is referred to an SLPS L P with a diagnosis of chronic traumatic encephalopathy (CTEC T E). His presenting complaints are increasing forgetfulness, difficulties learning new material, and managing money. Onset of these problems was gradual, beginning an undetermined number of years prior to the evaluation. Brennan is a college graduate who attended school on a football scholarship, after which he played professionally for two years. Although a cooperative patient, Brennan's initial assessment was incomplete due in largely to his slow responses to stimuli. Still, mild deficits in problem solving, short-term memory, and deductive reasoning were noted. Further assessment is recommended, to be followed by treatment. After hearing the SLP'sS L P's recommendation, Brennan's wife is concerned that Brennan will soon be unable to care for himself. She stated she is willing to bring him back as often as necessary in hopes of improving his condition Which of the following statements is true regarding the recommendation for Brennan's additional assessment? A.Given the likelihood of further cognitive deficits and Brennan's delayed responses, diagnostic tasks should be prioritized so that Brennan's cognitive skills are tested first. B.Given that Brennan is a professional in a high-pressure occupation, it is important that further testing not be stressful to his speech-language system. C.Given the likelihood of Brennan becoming frustrated, additional assessment should be limited to family reports. D.Given Brennan's history, further evaluation should be completed only after he receives a head CTC T scan.

Option (A) is correct. All the deficits noted to this point are cognitive.

During a speech-language evaluation at a preschool, a child has difficulty with receptive language tasks and responds with only one-word utterances to expressive language items. The child's eye contact is poor throughout the session. When observed with the other children in class, the child does not engage with peers but prefers self-stimulating behaviors such as flapping arms and throwing papers up in the air. According to the child's teacher, these are typical behaviors for the child. Given the data obtained, which of the following steps is most appropriate for the SLPS L P to take next? A.Engaging in an interprofessional practice (IPPI P P) to determine the appropriate diagnosis of ASDA S D B.Conducting the full evaluation when the child is more cooperative so that accurate recommendations can be made C.Initiating expressive language therapy to focus on expanding conversational utterances D.Training the teacher to deliver language stimulation tasks because the child does not respond well to the SLP

Option (A) is correct. Although it is in the SLP'sS L P's scope of practice to diagnose ASDA S D, it is stated that best practice suggests a team approach when making this determination.

An SLPS L P plans cognitive treatment for a patient with right-hemisphere disorder due to a stroke. Which of the following patient characteristics is most likely to have an impact on the patient's engagement in treatment and outcomes? A.Moderate anosognosia for identified deficits B.Hemiparesis of the left arm and hand C.Mild word-finding difficulties D.Moderate expressive aprosodia

Option (A) is correct. Anosognosia is likely to have the greatest impact on treatment engagement and outcomes, because if patients do not acknowledge their impairments, they are not likely to see the need for treatment or to engage meaningfully in it.

Which of the following must a child first be able to do before the child can produce narratives? A.Produce several utterances on the same topic B.Use past and future tenses C.Express a sequence using "then" or "next" D.Produce compound sentences using "and"

Option (A) is correct. As a first step toward the production of a cohesive narrative, a child must be able to connect a collection of ideas together.

Which of the following should a typically developing 9-month-old child begin to demonstrate? A.Canonical babbling B.Cooing C.Vocatives D.Differentiated cries

Option (A) is correct. Canonical babbling involves reduplicated sounds containing alternations of vowels and consonants and is a stage of language development that is typical in a 9-month-old child.

Which of the following is characteristic of child‑directed speech? A.Exaggerated pitch contours B.Imprecise articulation C.Increased speech rate D.Shortening the pauses between words

Option (A) is correct. Child-directed speech refers to the way adults speak to young children and is characterized by exaggerated pitch contours, such as using a higher pitch than normal, and overly dramatic facial expressions.

A 75-year-old man presents with conversational speech characterized by prolonged silent intervals and hypophonia. Resonance is normal, but voice quality is rough and tremulous. Pitch is relatively unaffected. There is no evidence of speech deterioration over time. Which of the following diagnoses is the most reasonable based on the patient's data? A.Hypokinetic dysarthria B.Ataxic dysarthria C.Hyperkinetic dysarthria D.Flaccid dysarthria

Option (A) is correct. Inappropriate silences, imprecise consonants, variable rate, short rushes of speech, increased rate in segments, and hoarse and tremulous voice quality are common characteristics of hypokinetic dysarthria. Speech deterioration over time and resonance are not typically affected.

Christel and Sharon are 14-month-old fraternal twins. Christel has more intelligible words than her sister, although she talks far less frequently. Sharon speaks almost exclusively in running jargon that nobody understands. Their parents are worried about Sharon's development because her language skills appear to be behind those of her sister. Which of the following is an SLP'sS L P's best response to the parents' concern? A.At Sharon's age, jargon is normal and may even continue for another three to four months. B.Christel's language development is more abnormal because she should be beyond single words. C.Both girls were exposed to the same language environments, so the relative lack of intelligible words indicates a language delay. D.Jargon should not persist past the age of 12 months and thus Sharon may be presenting a language disorder.

Option (A) is correct. Jargon typically continues until around 18 months of age.

Which of the following methods will best measure Sophia's progress on her language goals and objectives? A.Completing a language sample analysis B.Administering a standardized receptive and expressive language battery C.Administering a vocabulary assessment tool D.

Option (A) is correct. Language sample analysis is an appropriate measure to assess progress toward meeting intervention goals and objectives because it is a naturalistic approach to measurement, whereas standardized measures and the scores derived from them are invalid for treatment progress monitoring purposes.

Which of the following will most effectively increase the fundamental frequency of the voice? A.Lengthening the vocal folds B.Decreasing the stiffness of the vocal folds C.Decreasing subglottal pressure D.Decreasing cricothyroid muscle activity

Option (A) is correct. Lengthening the vocal folds causes the thyroarytenoid muscle to thin, which allows fundamental frequency to increase.

Which of the following is the minimal contrast approach most appropriately used to treat? A.Phonological disorders B.Dysphagia C.Dysarthria D.Global aphasia

Option (A) is correct. Minimal contrast approach was one of the first approaches designed to adhere to phonological principles of intervention.

Which of the following statements best reflects the role of stimulability in generating a prognosis for remediation of gliding in a 9-year-old child? A. A child who is not stimulable for /r/r, as in the word run will require treatment for the sound to be acquired. B. Even if the child is not stimulable for /r/r, as in the word run, the sound will still develop without treatment. C. If the child is stimulable for /l/l, as in the word last, the SLPS L P can expect the /r/r, as in the word run to improve at the same rate. D. Stimulability does not play a role in determining a prognosis for remediation of speech sound disorders.

Option (A) is correct. Nonstimulable sounds do not typically develop without intervention or treatment. The child's prognosis for acquisition is poor without treatment.

Alicia is a fourth-grade student with a language impairment that interferes with her academic performance and social communication. On a standardized test of expressive language ability, she received an overall score of 97.5, placing her in the 65thsixty fifth percentile. Alicia's test result indicates that she A.performed as well as or better than 65% of the individuals on whom the norms were developed B.responded correctly to 65% of the 150 items included in the expressive-language test C.performed as well as or better than 65% of the other fourth graders who took the same test D.responded correctly to 97.5% of the test items, as did 65% of the other children taking the test

Option (A) is correct. Percentile rank is the percentage of the scores within the norm range that are equal to or lower than the score gained by the student.

Which of the following statements best explains why thickened liquids for adult patients with dysphagia should be used with caution? A.Patients dislike thickened liquids and therefore do not drink enough, resulting in dehydration. B.The thickened liquid becomes thinner as it sits at the bedside, negating the liquid's benefit as a compensatory diet modification. C.Patients need twice as much thickened liquid because it provides half the hydration that thin liquid provides. D.Thickened liquids are aspirated more frequently than thin liquids.

Option (A) is correct. Research indicates that patients do not like thick liquids, and there is evidence that this leads to dehydration. A beginning clinician should be well aware of this and use caution when recommending thickened liquids to adult patients with dysphagia.

Which of the following approaches would be the most direct way to address the patient's fear of how coworkers might react to his disfluent speech? A.Application of principles from cognitive behavioral therapy B.Fluency-shaping therapy based on prolonged speech C.Pharmacological management D.Application of progressive relaxation therapy principles

Option (A) is correct. Research supports the idea that Cognitive Behavioral Therapy (CBTC B T) can change the communication-related attitudes of people who stutter.

Joe, an 18-year-old male, sustained a severe traumatic brain injury following a motorcycle accident. He was in a coma for approximately four weeks before being transferred to a rehabilitation program. Joe demonstrates severe attention deficits, anomia, disorientation, and poor short-term memory. Which of the following should be the initial target area in the treatment plan? A.Retraining attention as a discrete cognitive process B.Using declarative memory as an active learning strategy C.Using implicit memory as a passive learning strategy D.Reality orientation training

Option (A) is correct. Retraining attention is the most appropriate initial target area in this situation; all the other responses require attention as a prerequisite.

Based on Sofia's case history and presenting problem, which of the following is most likely the etiology of her suspected language disorder? A.A developmental disorder B.A psychogenic disorder C.An auditory processing disorder D.An acquired disorder

Option (A) is correct. Sofia's history is unremarkable for any sensory impairment or neurological disorder. There is no history of an emotional disorder or mention of intellectual disability. With most language disorders the cause is not known.

Which of the following statements regarding statistical significance is true? A.A statistically significant difference can occur between experimental groups and control groups even if the magnitude of difference between the groups is quite small. B.If a statistically significant difference between groups occurs, it means that large and important change occurs in at least one of the groups. C.Statistically significant findings in a clinical research study suggest that the treatment is successful and highly recommended. D.The terms "statistically significant" and "clinically significant" are interchangeable.

Option (A) is correct. Statistical significance is a measure of how likely it would be to get the produced results by chance, not necessarily an indicator that the change or the difference was large.

A kindergarten teacher requests a speech screening for a student who is 5 years, 2 months old. The teacher observes that the student has a lisp during conversation and reading activities. Results of the screening note an interdental sound production for /s/s, as in the word sit and /z/z, as in the word zebra in all positions of words. The oral peripheral screening appears unremarkable and adequate for speech production. Which of the following summary recommendations is most appropriate based on the student's screening results? A. Interdental production of /s/s, as in the word sit and /z/z, as in the word zebra sounds are within range of typical development. Continue to monitor and reassess in one year. B.Interdental production of /s/s, as in the word sit and /z/z, as in the word zebra sounds are not within the range of typical development. An evaluation is recommended. C. Interdental production of the /s/s, as in the word sit sound is within the range of typical development, while /z/z, as in the word zebra sound errors are not. RTIR T I intervention is recommended. D.Correct production of /s/s, as in the word sit and /z/z, as in the word zebra sounds is emerging, and the student should be rescreened in three months.

Option (A) is correct. The /s/s, as in the word sit and /z/z, as in the word zebra sounds are not mastered until age 7 or later.

At the start of a speech-language evaluation, James, a 3-year-old patient, fails a hearing screening. There is no reported hearing deficit, and the child appears to easily understand instructions from the SLPS L P. Which of the following is the most appropriate next step for the evaluating SLPS L P? A.Completing the speech-language evaluation and referring James for an audiologic evaluation B.Stopping the speech-language evaluation and referring James for an audiologic evaluation C.Continuing with the speech-language evaluation and noting that the screening was failed likely because of poor cooperation D.Interviewing the parents, reading any available outside reports, and basing a diagnosis on those data

Option (A) is correct. The child understands the instructions and the hearing is not impacting the results, so it is appropriate to continue the speech-language evaluation and refer the child for a hearing evaluation.

A child has been demonstrating significant progress in producing the targeted responses in the therapy room; however, observation in the classroom indicates little mastery of the targeted responses. Which of the following would be the most appropriate revision to the treatment plan? A.Delivering treatment in the classroom B.Increasing the frequency of treatment in the therapy room C.Increasing the duration of treatment in the therapy room D.Changing the IEPI E P goals

Option (A) is correct. The child's treatment plan should now focus on generalizing the production of the targeted responses outside of the therapy room. Generalization of the targeted response must be systematic with implementation of classroom-based intervention; this revision to the therapy plan represents an integration of therapy services.

Researchers are conducting an experiment that depends on the use of professional judgments of the speech produced by 30 research subjects. Which of the following actions should the researchers take to determine interjudge reliability? A. Asking two SLPsS L Ps to each independently rate the 30 subjects B. Asking an SLPS L P to rate the 30 subjects C. Asking one SLPS L P to rate the 30 subjects before treatment and another SLPS L P to rate them after treatment D. Asking an SLPS L P to rate the 30 subjects and then rate them again two weeks later

Option (A) is correct. The definition of interjudge (or interrater) reliability is the level of agreement in scoring between two or more judges scoring the same observation.

An SLPS L P developed a new approach to the treatment of school-age children with specific language impairment. To determine whether this approach is effective, the language abilities of these children following treatment should be compared with the language abilities of A.similar children who did not receive treatment B.similar children who received a different treatment with known efficacy C.similar children who also received this treatment D.these children one year after the termination of treatment

Option (A) is correct. The use of a control group, a group not receiving the treatment, allows the SLPS L P to measure only one variable at a time and test its effectiveness.

Which of the following strategies best demonstrates an SLPS L P working as a Response to Intervention (RTIR T I) team member to provide a student Tier 2 language supports? A.Assisting the teacher with Individualized Education Program referral paperwork B.Collaborating with the teacher to provide small-group instruction C.Enrolling the student in language therapy to address language needs D.Evaluating the student's speech and language skills

Option (B) is correct. Tier 2 services are provided in the general education classroom in collaboration with the SLPS L P, usually in small groups.

An SLPS L P works at a voice clinic and learns that a patient, who has arrived for an initial voice evaluation, has not received medical evaluation by a laryngologist. Which of the following actions is the best plan for referring the patient to a laryngologist for a medical evaluation? A.Completing the voice evaluation and referring the patient to a laryngologist for a medical evaluation prior to initiating therapeutic intervention B.Completing the voice evaluation and treatment plan, as the SLPS L P is not required to obtain medical information from a physician and can diagnose and treat voice disorders without referring the patient C.Completing the voice evaluation and referring the patient to a laryngologist while initiating therapeutic intervention, knowing that the patient will see the laryngologist soon D.Deferring the voice evaluation until after the patient has seen a laryngologist for a medical evaluation

Option (A) is correct. When voice evaluation by an SLPS L P occurs before a physician's evaluation, the SLPS L P should defer SLPS L P treatment planning to after the medical evaluation information is received and reviewed.

An SLPS L P designs a study to examine the effect of a new therapy technique in comparison to the effect of the current standard approach. Patients are recruited and randomly assigned to either a control group or an experimental group. The outcomes of each group will then be compared. Which of the following best describes the SLP'sS L P's research project? A.Cohort study B.Controlled trial C.Cross-sectional study D.Case-Control study

Option (B) is correct. A controlled trial is the only study design option that involves experimental manipulation; one group would be provided a treatment or intervention, and the other would receive a placebo, a sham treatment, or some other form of control.

An SLPS L P just completed an aphasia evaluation with an aphasia battery. The results of the battery show that the patient with aphasia produces very fluent speech but makes many phonemic errors. When producing phonemic errors, the patient stops to try and get the word right with multiple attempts (e.g.for example., for the word screwdriver, the patient said "Cewdriver, dewdiver, screwdriver."). The patient also had relatively good comprehension but a pronounced repetition impairment. The patient's results are most consistent with which of the following type of aphasia? A.Broca's aphasia B.Conduction aphasia C.Wernicke's aphasia D.Anomic aphasia

Option (B) is correct. All the symptoms listed are classic symptoms of conduction aphasia and are distinguishable from other aphasia types.

An SLPS L P collects a play-based language sample from a 3-year-old patient, who uses mostly single words with a few two-word combinations. Which of the following analyses should the SLPS L P plan to apply to obtain the most helpful and appropriate information when forming treatment goals from the sample? A.Analyzing the percentage of correct consonants B.Calculating the mean length of utterance in morphemes C.Listing narrative cohesion markers used by the patient D. Identifying types of "whw h" questions that the patient uses

Option (B) is correct. At this age, morphological development is expected to explode in typically developing children learning English, and should be reflected in the mean length of utterance (MLUM L U). MLUM L U is a good snapshot of language development in children age 3.

Based on the long-term prognosis for CTEC T E, which of the following interventions by the SLPS L P is most likely to benefit Brennan? A.Word retrieval strategies B.Patient/family counseling C.Executive function retraining D.Spaced retrieval training

Option (B) is correct. Because CTEC T E is a progressive neurological illness with limited empirical evidence of most effective treatments, the first step for SLPsS L Ps is to provide counseling and supports.

A child with developmental apraxia of speech is not making progress in a school setting. The parents wish to schedule additional therapy. An SLPS L P in a local clinic evaluates and determines that a more individualized treatment plan is warranted. Which of the following actions is most appropriate for the SLPS L P at the local clinic to take to ensure the child receives necessary treatment? A.Recommending the parents stop school treatment given the lack of progress B.Contacting the child's school SLPS L P to coordinate treatment plans C.Encouraging private SLPS L P treatment using a smaller group setting D.Suggesting additional treatment at the local SLPS L P clinic using the same tasks used by the school SLP

Option (B) is correct. Coordinating with the school's SLPS L P potentially allows the patient the most practice of the same tasks.

An SLP evaluates a 5-year-old child who produces several sounds in error. The SLPS L P wants to determine the consistency of the child's errors by conducting stimulability testing. The most appropriate next step for the SLPS L P is to ask the child to produce each misarticulated sound in A.a novel word using real objects as stimuli B.isolation after watching and listening to the SLPS L P produce the sounds correctly C.isolation after listening to recorded samples of correctly produced sounds D.connected speech after listening to the SLP'sS L P's production of the erroneous sounds

Option (B) is correct. In stimulability testing, the patient first attempts an isolated sound, then uses the sound in a syllable, then in a word. Prior to producing the sound, the SLPS L P asks the patient to watch and listen to what the clinician is going to say, then asks the patient to repeat it.

Which of the following conditions is primarily associated with a short lingual frenulum, heart-shaped tongue tip, and a failure to elevate the tongue tip beyond the mandibular incisors, as revealed during oral-facial examination? A.Bulbar palsy B.Ankyloglossia C.Glossoptosis D.Congenital lip pits

Option (B) is correct. Limited tongue mobility, heart-shaped tongue tip and a failure to elevate the tongue tip beyond the mandibular incisors are all characteristics of ankyloglossia (tongue-tied/short lingual frenulum).

A 9-year-old child is one year post tonsillectomy and adenoidectomy and presents with moderate hypernasality and consistent nasal emission. The child was referred for assessment, and velopharyngeal incompetency was identified. Which of the following would be the next appropriate step for the SLPS L P to take? A.Continue to monitor resonance as the child still may spontaneously improve B.Discuss surgical management options with the craniofacial team C.Initiate therapy to discriminate between hypernasal speech and oral speech D.Slow down rate of speech to help velopharyngeal closure

Option (B) is correct. Nasopharyngoscopy will be conducted to visualize the velopharyngeal mechanism and provide information for possible surgical management.

An evaluation is performed on a 5 year old with frequent hoarseness. Which of the following measures is primarily included in the endoscopic examination? A.Amplitude perturbation B.Laryngeal visualization C.Laryngeal airway resistance D.Perceptual judgment

Option (B) is correct. Observing the larynx is part of an endoscopic examination.

Kelli is a 10-year-old patient with velopharyngeal dysfunction. She presents with hypernasality, audible nasal emission, and weak pressure for oral consonants. She also displays glottal stops and pharyngeal fricatives. She is in speech therapy, and her parents would like to know what to expect after she has pharyngeal flap surgery next week. Which of the following outcomes is most appropriate for the SLPS L P to counsel Kelli's parents to expect? A.Surgery should eliminate the glottal stops but not the pharyngeal factors. B.Surgery should decrease the hypernasality and audible nasal emission. C.Surgery should eliminate the need for ongoing speech therapy. D.Surgery should decrease hypernasality and nasal emission and eliminate articulation errors.

Option (B) is correct. Only speech therapy would correct the articulation errors, and only surgery would improve resonance and audible nasal emission.

During videofluoroscopic evaluation of an adult patient, the SLPS L P notices material in both pyriform sinuses after the patient swallows. Upon review, the SLPS L P sees that both pyriform sinuses clear during the pharyngeal swallow but then refill quickly as the structures return to rest. Which of the following statements best explains this observation? A.Pharyngeal stripping was not adequate to fully clear the pyriform sinuses, so there was material in the pyriform sinuses after each swallow. B.The patient had small pharyngeal pouches (pharyngoceles) that filled with barium during the swallow and then emptied into the pyriform sinuses after each swallow. C.Hyolaryngeal elevation was not sufficient, leaving material in the pyriform sinuses after each swallow. D.The patient had a tracheoesophageal fistula, and contrast was deposited in the pyriform sinuses after each swallow.

Option (B) is correct. Pharyngoceles emptying into the sinuses after each swallow could be diagnosed by analyzing slow-motion videofluoroscopic images.

A 12-year-old phonology patient responds very well to continuous verbal reinforcement. The SLPS L P wishes to increase the task level for sibilant production to conversational speech, but is concerned that the accuracy of the patient's productions will diminish without continuous reinforcement. Which of the following adjustments is most logical for the patient's treatment plan? A.Increase task level to conversation and continue with continuous reinforcement for correct productions B.Changing the reinforcement schedule to variable-interval C.Discontinuing reinforcement and providing a performance summary at the end of the conversation D.Shifting the feedback to punishment

Option (B) is correct. Reinforcement is still needed, but a continuous schedule would be awkward and unnecessary for the described task.

An SLPS L P works with a 4-year-old patient diagnosed with autism spectrum disorder. The patient is nonverbal, does not have a functional communication system, and does not follow simple directions. Which of the following communicative target goals is most appropriate for the SLPS L P to prioritize for the patient? A.Matching identical pictures in an array of pictures B.Requesting wants in any modality C.Labeling of common items verbally D.Imitating a sequence of two actions

Option (B) is correct. Requests (mands) are very important for the early development of language and for day-to-day verbal interactions with others. Requests (mands) are usually the first type of communication acquired by an infant.

According to current research, which of the following is most contributing to a rise in oropharyngeal cancers in the United States? A.Cigarettes B.Human papillomavirus (HPVH P V) C.Alcohol D.Smokeless tobacco

Option (B) is correct. Research shows that oropharyngeal cancer caused by HPVH P V is increasing.

A speech language pathologist evaluated Sophia Allen, a 6-year-old girl. The SLPS L P completed a case history with Sophia's mother and conducted a comprehensive speech and language assessment. During the case study the SLPS L P learned that Sophia has had a normal developmental history and is currently healthy with no known neurological deficits. Sophia's mother first became concerned when Sophia could not describe her school day. Sophia's sentences lacked detail or were composed of very basic words and consisted of simple sentence structures. Sophia's first-grade teacher reported that her speech sounds immature compared to that of her classmates and that she frequently does not follow directions. During the assessment Sophia passed the oral mechanism examination and hearing screening. Sophia received a standard score of 99, placing her in the 47thforty seventh percentile on a commonly used receptive vocabulary test. To obtain the most valuable information related to Sophia's future reading skills, the SLPS L P should assess which of the following? A.Receptive vocabulary B.Morphological awareness C.Articulation skills D.Comprehension of one-step directions

Option (B) is correct. Researchers have documented that morphological awareness skills significantly contribute to literacy development and are positively related to successful vocabulary, sight-word reading, decoding, reading comprehension, and spelling abilities.

A typically developing child who is 4 years and 5 months old was referred to a school-based SLPS L P for an evaluation because of poor speech intelligibility. Assessment results indicated a moderate phonological impairment with receptive language skills developing as expected for the child's age. Based on the assessment, eligibility for speech-language services was determined. In accordance with the Individuals with Disabilities Education Act (IDEAI D E A), which of the following service plans is most appropriate for the SLPS L P to recommend? A.Services will be provided by the SLPS L P when the student enters kindergarten. B.Services will be provided by the SLPS L P in the least restrictive environment. C.Services will be provided by the school's intensive-needs preschool staff. D.Services will be provided by a private SLPS L P with consultation from the school SLPS L P.

Option (B) is correct. Services must be provided in the least restrictive environment (LREL R E), according to the Free Appropriate Public Education (FAPEF A P E) component of IDEAI D E A.

Which of the following procedures is most important for an SLPS L P to consider when assessing the social aspect of a school-age child's communication skills? A.Collecting a language sample to assess narrative skills B.Assessing expressive vocabulary used by the child on a picture vocabulary test C.Observing the child interacting with peers in natural settings, such as during recess D.Looking for a discrepancy between the child's IQI Q and communication skills to determine eligibility

Option (C) is correct. Informal observation of a student in a natural setting is part of a comprehensive assessment. A determination of eligibility for SLPS L P services in a school must be made from more than one source and should include authentic assessment in an informal setting.

The parents of an 8-year-old boy who stutters are upset because their child was placed in the lowest reading group at school because of his poor performance on an oral reading fluency assessment in the classroom. The parents are very sure that their child is reading at an average to above-average level compared to his classmates. The SLP'sS L P's informal observations of the boy's reading performance during fluency therapy sessions are consistent with the parents' report. Which of the following is the most appropriate way for the SLPS L P to advocate for the boy? A.Offer to conduct a reading assessment with the boy and report the score to the boy's teacher. B.Recommend that the teacher reassess the child's reading level with an assessment that uses silent reading. C.Wait until the child's speech improves in therapy, and then ask the child's teacher to readminister the oral reading assessment. D.Encourage the child to continue practicing oral reading to demonstrate to his teacher that individuals who stutter can read as well as other people.

Option (B) is correct. The boy's stuttering is affecting his fluency during oral reading, so an assessment of his silent reading fluency will provide more valid results.

As part of a routine preschool screening, an SLPS L P tests a 4 year old whose speech is characterized by sound omissions, hypernasality, nasal emission, and weak consonants. Which of the following would be most appropriately evaluated initially? A.Oral-motor behavior B.Velopharyngeal function C.Laryngeal function D.Phonological awareness

Option (B) is correct. The characteristics described are consistent with a resonance disorder, hence velopharyngeal function would be evaluated initially.

A 42-year-old male teacher is referred for a voice evaluation. History and perceptual voice assessments reveal an eight-month history of progressive dysphonia, which is currently characterized by a rough and breathy voice. Acoustic and aerodynamic assessments reveal aperiodic voice signal, reduced frequency range, increased subglottal air pressure, and increased transglottal airflow. The patient complains of voice fatigue at the end of the day and pain during phonation. The patient reports moderate alcohol use but is not currently a smoker. He has no previous history of chronic voice problems, surgery, or neurological disease. Based on the patient's history, which of the following assessments will best allow the SLP to assess vocal fold vibratory dynamics during phonation? A.Videofluoroscopic assessment B.Laryngeal videostroboscopy C.Nasoendoscopy D.Ultrasound

Option (B) is correct. The patient's history does not lead to a clinical hypothesis of a specific etiology, and the vocal folds must always be visualized as part of the process of differential diagnosis. Vocal fold vibration is occurring too quickly for the human eye to perceive individual cycles of vibration and the vibratory dynamics of the vocal fold tissue during vibration. A stroboscopic light source is needed in conjunction with the endoscope to visualize vocal fold vibration. If vibration and the vibratory dynamics are not of interest for the assessment, laryngeal videostroboscopy is not needed.

An aphasia evaluation of a 68-year-old retired woman reveals utterances of one to two words, no apraxia of speech, and relatively good comprehension. When the patient makes production errors, they are typically semantic errors and she attempts to correct them, often with success. Her goal is to use more words to convey ideas using complete sentences. She is active and wants to communicate in various settings, such as at her volunteer job, with her family, and when traveling. Which of the following treatments best prioritizes the patient's language needs and personal goals? A.Providing a script for the patient to recite that allows her to tell people about her stroke B.Starting Verb Network Strengthening Treatment (VNeSTV N e S T) to increase word retrieval in untrained discourse C.Engaging the patient in semantic feature analysis (SFAS F A) to teach her self-cuing techniques and aid with word retrieval D.Having the patient use melodic intonation treatment (MITM I T) to increase fluency of commonly uttered phrases

Option (B) is correct. The patient's language impairment is related to word-retrieval impairments that affect the ability to produce complete utterances. VNeSTV N e S T has been shown to increase word-retrieval abilities in untrained tasks, which could potentially aid in various functional scenarios.

MsMiss. Malone, a 65-year-old retired attorney, presents with severe nonfluent aphasia secondary to a stroke that occurred more than a year ago. Speech-language intervention helped her regain the ability to answer simple questions but not initiate speech. Citing MsMiss. Malone's frustration at her limitations, her family requests that she be evaluated for an augmentative and alternative communication (AACA A C) device. During MsMiss. Malone's assessment, the SLPS L P determines that she could potentially benefit from AACA A C services and initiates discussion of intervention goals. Once goals are established and MsMiss. Malone has her device, she begins to learn how to operate her device to produce common spoken messages. Over the course of intervention, MsMiss. Malone is ultimately able to produce novel sentences. Regarding MsMiss. Malone's proposed AACA A C assessment, which of the following statements is true? A.Her choice of devices will be severely limited by her difficulties with speech onset. B.Her family should be involved in the AACA A C assessment as well as any subsequent therapy. C.Given her advanced level of education, only high-tech devices should be considered. D.Given the severity of her impairment, only low-tech devices should be considered.

Option (B) is correct. The success of AAC intervention success is largely dependent upon the support of people close to the patient.

Which of the following is the most appropriate response the SLPS L P can give Brennan's wife to address her concerns? A. Brennan's cognitive functioning will continue to deteriorate, but the process is gradual and any severe deficits are unlikely to manifest for at least twenty years. B. It is difficult to predict the pattern of Brennan's deteriorating cognitive function because the progression of CTEC T E varies from person to person. C. There is doubt that Brennan has CTEC T E, given that he played professional football for only a short period. D. The progression of CTEC T E is reversible if Brennan undergoes therapy during its initial phase.

Option (B) is correct. There is no uniform progression of CTEC T E, and little is known regarding how it progresses.

Which of the following treatments is most appropriate to promote expressive and receptive language performance in conversation for an individual with aphasia? A.Melodic intonation therapy B.Promoting Aphasics' Communication Effectiveness C.Response elaboration training D.Semantic feature analysis

Option (B) is correct. This therapy approach targets communication using any means necessary (talking, gestures, pointing, vocalizations, drawing) as opposed to targeting a specific language modality such as written expression, verbal expression, reading comprehension, or auditory comprehension.

An SLP conducts a videofluoroscopic swallowing study (VFSS) for a patient referred for suspected dysphagia secondary to stroke. The SLP finds that the patient has dysphagia characterized by delayed onset of the pharyngeal response, limited lingual retraction, limited oropharyngeal propulsion, and the need to swallow two or more times to clear boluses. Some aspiration of hypopharyngeal residue occurs after the swallow from the pyriform sinuses. During the VFSS, several compensatory maneuvers (chin-down posture) were attempted to test their efficacy. The SLP is developing a treatment plan to eliminate aspiration and to improve lingual strength, retraction, and oropharyngeal propulsion through a combined strategy using compensatory and restorative maneuvers, including a progressive resistive exercise program of isometric tongue-press exercises using an instrument that measures the pressure of tongue contact with the hard palate (IOPI or SwallowStrong). The SLP measures the patient's baseline maximum tongue-press pressure generation with the instrument and begins treatment. When the patient attempted the chin-down posture during the VFSSV F S S, which of the following observations was the SLPS L P most likely to make? A.Aspiration from the pyriform sinuses was eliminated. B.Aspiration from the pyriform sinuses was not eliminated. C.The space between the tongue base and posterior pharyngeal wall increased. D.The vallecular space became more narrow, preventing aspiration.

Option (B) is correct. Using the chin-down posture eliminated aspiration in 50% of patients with stroke who aspirated due to a pharyngeal onset delay. All patients (50%) who continued to aspirate did so from the pyriform sinuses—the chin-down posture empties the pyriform sinuses into the airway.

A mother reports that her three-year-old son's speech seems normal at school, but at home his speech is either loud or fast, or he stops talking altogether. The mother further reports that she, her husband, and their two older children speak quickly and interrupt each other frequently. She is concerned that her son is not developing the speech and language skills to keep up. Which of the following statements is most accurate with respect to the mother's concern? A.Based on the child's age, speech is typically intermittent and thus he is very likely developing language skills normally. B.The child's speech neuromotor system can keep up with the language systems of children his own age but not with the more advanced systems in his household. C.The child's situational lack of language is more consistent with a cognitive delay than a speech or language deficit. D.The child is employing compensatory speech production techniques at school but not at home.

Option (B) is correct. Young children, particularly those with frequent disfluency, often have difficulty competing with more advanced speech systems.

Question: One treatment option for adductor spasmodic dysphonia involves the percutaneous injection of which of the following into the thyroarytenoid muscle? A.Gelfoam B.Collagen C.Botulinum toxin D.Autologous fat

Option (C) is correct. Adductor spasmodic dysphonia is a neurological voice disorder. Botulinum toxin is the only treatment listed that acts on the neuronal end plate, thereby treating a neurological deficit.

Which of the following approaches most accurately helps an SLPS L P know if a treatment plan for an adolescent with language disorders is having an impact on academic learning? A. Reviewing the results of state standards-based assessments B. Administering the Peabody Picture Vocabulary Test (PPVTP P V T) C. Analyzing performance on classroom-based assessments D. Using the Clinical Evaluation of Language Fundamentals (CELFC E L F-5) assessment

Option (C) is correct. An adolescent with language disorders would best show academic progress through performance on classroom assessments.

Which of the following syndromes results from the presence of an extra copy of chromosome 21 ? A. 22q11.222 q 11.2 deletion syndrome B.Fragile X syndrome C.Down syndrome D.Velocardiofacial syndrome

Option (C) is correct. An extra copy of the twenty-first chromosome is trisomy 21, also known as Down syndrome. The other conditions listed are not associated with abnormalities of the twenty-first chromosome.

After an evaluation of a patient's communication needs, an SLPS L P pursues acquisition of a high-tech AACA A C device. The patient's private health insurance rejects the request, stating that the device is "not medically necessary." The SLPS L P can best advocate for the patient by immediately appealing A.to the insurance company to determine a lower-technology device that is covered by the payer B.the denial and providing a review of how the patient's quality of life is impacted by the device C.the denial and providing data regarding the medical necessity for the device D.to a member of the state government for coverage of high-tech AACA A C devices

Option (C) is correct. Appealing the denial and providing the insurance company with data indicating the device is medically necessary in advocacy for the patient is the most direct response to the denial of the claim.

A school-age patient being assessed for a language disorder listens to a short passage and is asked "whw h" questions based on the passage. The SLPS L P reviews the patient's responses, records any errors, and then teaches the patient strategies to answer "who" and "what" questions. The SLPS L P makes careful notes about how much assistance the client requires to achieve a correct response. After several sessions, the SLPS L P reassesses the patient's responses to "whw h" questions. Which of the following types of assessment is primarily exemplified in the scenario? A.Standardized assessment B.Criterion-referenced assessment C.Dynamic assessment D.Curriculum-based assessment

Option (C) is correct. Dynamic assessment employs a test-teach-retest procedure; it is not a static assessment in which the client has only one chance to select the correct answer.

Which of the following activities is an example of a metalinguistic strategy used to assist a student with language difficulties? A.Providing a definition of a word B.Placing story elements in sequential order C.Editing the writing of same-aged peers D.Discussing similarities and differences between two pictures

Option (C) is correct. Editing the writing of a same-age peer is an example of a metalinguistic activity because it involves the awareness, analysis, and control of language form, content, and use.

To best apply the multiple oppositions method for phonological errors when treating a child, an SLPS L P should use pairs of words such as A. "son" and "ton," "fun" and "pun," and "zoo" and "do" to help discriminate stops from fricatives B. "torn" and "sore," "soup" and "two," and "fast" and "pat" to help produce final consonants C. "doe" and "go," "doe" and "though," and "doe and Joe" to address using /d/d, as in the word dog for various sounds D. "key" and "tea," "cone" and "tone," and "cap" and "tap" to address the use of velar fronting

Option (C) is correct. In multiple oppositions treatment, targets are selected that will address all phonemes affected by a phoneme collapse, not just the target phoneme and the phoneme produced in substitution.

Which of the following procedures best establishes whether velopharyngeal dysfunction causing hypernasality is present in a patient with flaccid dysarthria? A.A nasopharyngoscopy B.A videofluoroscopic swallow study C.A laryngoscopy D.A manometry

Option (C) is correct. Laryngoscopy is the only procedure that allows visualization of the velopharyngeal port during speech.

An SLPS L P completes a speech and language screening of a three-and-a-half-year-old boy. He presented with the following skills. Age-appropriate articulation skills Restricted mean length of utterance of approximately 2.0 Echolalia Difficulty following directions Difficulty responding to name Minimal eye contact Based on the screening information above, which of the following diagnostic categories is the most appropriate to consider when preparing for the diagnostic evaluation? A.Social communication disorder B.Developmental speech and language disorder C.Autism spectrum disorder D.Auditory processing disorder

Option (C) is correct. Minimal eye contact and echolalia are unique hallmarks of ASD

Which of the following is most likely to occur in an infant with an unrepaired cleft palate? A.Aspiration pneumonia B.Choking C.Nasal regurgitation D.Tongue thrust

Option (C) is correct. Nasal regurgitation, the leakage of food/liquids into the nasal cavity while feeding, is a common sequela of cleft palate. After palate repair, this typically resolves because there is no longer open communication between the oral and nasal cavities during swallowing.

Joanna is a 36-month-old child who is enrolled in a treatment program for stuttering. The SLPS L P is involving Joanna's parents and 5-year-old brother in treatment activities. Every time Joanna's brother participates in a treatment activity, Joanna begins to stutter much more severely than she does when interacting with her parents. Which of the following actions is the most appropriate for the SLPS L P to take next? A.Helping the parents devise strategies for limiting how often Joanna and her brother converse with each other at home B.Engaging Joanna in a role-playing activity that seeks to identify how she would like her brother to interact with her during conversations C.Analyzing recorded conversations between Joanna and her brother to identify discourse factors that might affect the severity of Joanna's stuttering D.Teaching her brother to produce statements that support Joanna's attempts to talk

Option (C) is correct. Research has shown that external factors can precipitate stuttering or worsen its severity.

Which of the following statements regarding risk factors for developmental reading disorders is most accurate? A. There are no risk factors for developmental reading disorders that an SLPS L P can assess. B. Only those children with a family history of reading disorders are at risk for developing a reading disorder. C. Children with speech sound disorders (SSDsS S Ds ) are at increased risk of having a reading disorder. D. Children with SSDsS S Ds are only at increased risk of a reading disorder if they do not receive speech therapy.

Option (C) is correct. SSDsS S Ds are a risk factor for later reading disability in school-age children.

A 75-year-old patient with a history of chronic obstructive pulmonary disease underwent a three-vessel coronary artery bypass graft surgery. The patient needed to be intubated for three days following surgery. After extubation, the medical team requested a swallow consultation to determine if it was safe for the patient to take oral medications and initiate oral nutrition. Based on the patient's condition, which of the following assessment procedures is most appropriate for an SLPS L P to practice? A.Administering a clinical bedside swallow evaluation and recommending an oral diet as there were no clinical signs or symptoms of aspiration during the evaluation B.Deferring the evaluation for 24 hours because the patient was just extubated to allow a possible improvement in the patient's swallow function before evaluation C.Completing a clinical bedside swallow evaluation to determine patient readiness for an instrumental evaluation and then completing the instrumental evaluation if the patient is ready D.Determining any preexisting dysphagia with the patient and the patient's family; if there is no history of dysphagia, recommending to advance the patient's diet

Option (C) is correct. Several studies using instrumental assessment have concluded that some patients recover airway protection and swallow function within 24 hours of extubation and others much later than 24 hours post-extubation following prolonged endotracheal intubation, suggesting that a 24-hour "deferral time" benchmark is not particularly useful.

A 65-year-old-male who is hospitalized with pneumonia completed a videofluoroscopic swallowing study. Findings showed aspiration after the swallow due to a reduced upper esophageal sphincter opening diameter separating the bolus tail, which was then retained in the pyriform sinuses. Which of the following interventions was designed to and is shown to improve upper esophageal sphincter opening? A.Effortful swallow B.Valsalva (breath hold) C.Shaker (head lift) exercise D.Lingual resistance exercise

Option (C) is correct. Shaker et aland others. (2002) showed that the head lift exercise significantly increased the diameter of the upper esophageal sphincter opening in people with dysphagia.

Questions 20-through22 refer to the following. A 24-year-old male self-refers for a fluency evaluation. His presenting complaint is stuttering. During conversation at the initial assessment, he speaks intelligibly at a typical rate and produces no overt stutter-like disfluencies. He reports that he often expects to stutter while conversing, but that he usually can prevent or conceal the occurrence of the expected fluency disruptions either by substituting a word or by inserting a pause or "um" before the word upon which he expects to be disfluent. He states that these strategies are useful and that he would like to be able to "talk without thinking about talking." He reports that he attended speech therapy from elementary school through high school and that it helped him reduce disfluency significantly during therapy activities, but his disfluency frequency did not change much during activities outside of therapy. He fears that coworkers will react negatively to hearing him stutter. Consequently, he talks as little as possible at work. The patient's assessment results are most consistent with which of the following diagnoses? A.Neurogenic stuttering B.Cluttering C.Developmental stuttering D.Specific language impairment

Option (C) is correct. Some people who stutter can prevent anticipated instances of stutter-like disfluency either by substituting words or by delaying the start of a word upon which stuttering is anticipated, e.g., by pausing or by interjecting fillers such as "um." Speech-related fear, concern about listener evaluations, and anticipated disfluency are all hallmarks of stuttering but are not typical symptoms in SLI or cluttering. Even though the SLP has not heard stuttering-like disfluency in the patient's speech, all other symptoms are consistent with a diagnosis of stuttering.

Which of the following statements accurately describes state licensure requirements that must be met for an SLPS L P to legally provide services via telepractice within the state or across state lines? A.An SLPS L P is required to hold a specialty certification to provide services via telepractice because this service delivery method requires additional skills. B.No state licensure requirements apply to individual SLPsS L Ps providing services via telepractice, as long as their employers can obtain reimbursement. C.The SLPS L P should check with all relevant state licensure boards before delivering telepractice services. D.As long as the SLPS L P has the ASHAA S H A Certificate of Clinical Competence and is licensed in the SLP'sS L P's state of residence, the SLPS L P can legally provide services via telepractice anywhere.

Option (C) is correct. States differ on licensure rules regarding telepractice at this time, and failing to know the relevant regulations is not an excuse for practicing without a license.

Kimberly, a patient who suffered a brain stem stroke and has had a fairly successful recovery, complained of food sticking in her throat and needing to swallow two to three times to clear liquid and solid boluses. She underwent a videofluoroscopic swallowing study that showed a limited duration of upper esophageal sphincter opening. The SLPS L P decides to employ an intervention plan that includes the Mendelsohn maneuver. Which of the following strategies is most likely to be effective in accomplishing this goal? A.Completing a fiberoptic endoscopic evaluation of swallowing (FEESF E E S) to determine if the patient is performing the maneuver properly B.Performing cervical auscultation (CAC A) to quantify improved swallowing with the maneuver C.Using submental surface electromyography (sEMGs E M G) as biofeedback during attempts to perform the maneuver D.Teaching the patient to use palpation of her neck and a mirror to help her master the maneuver

Option (C) is correct. Submental surface EMGE M G has been shown to improve acquisition of the Mendelsohn maneuver in some people though the maneuver itself is very difficult to learn.

Which of the following reflexive responses is primarily responsible for expelling material from the airway of healthy adult individuals? A.Rooting reflex B.Gag reflex C.Cough reflex D.Swallowing reflex

Option (C) is correct. The cough reflex occurs when the vocal folds and trachea are stimulated by the laryngeal nerves, resulting in expulsion of material from the airway.

Which of the following communication diagnoses would most likely require a treatment program that is focused on improving auditory language comprehension? A.Right-hemisphere communication impairment B.Global aphasia C.Wernicke's aphasia D.Broca's aphasia

Option (C) is correct. The hallmark of Wernicke's aphasia is deficits in auditory comprehension, because the site of lesions is most typically the left superior temporal gyrus.

According to literature on men's and women's voices, the prevalence of benign vocal fold lesions in women can best be explained by differences in A.daily dairy consumption B.speaking duration C.rates of vocal fold vibration D.neck circumference

Option (C) is correct. The increased fundamental frequency of most female voices results in an increased number of glottal contacts during a fixed period of voice use. This increased number of contacts is thought to increase the risk of development of benign vocal fold lesions.

Studies of the anatomy of human vocal folds and of mucosal behavior during phonation have led to the current cover-body characterization of the vocal fold. Which of the following is included in the vocal-fold transition? A.The epithelium and superficial lamina propria B.The epithelium and deep lamina propria C.The intermediate and deep layers of the lamina propria D.The lamina of the thyroid cartilage

Option (C) is correct. The intermediate and deep layers are considered transitional because of where they are located anatomically.

Which of the following risk factors has the highest independent predictive value for pneumonia in elderly people with dysphagia? A.Drinking more than six glasses of water per day B.Experiencing aspiration of saliva at night C.Depending on others for feeding and oral care D.Having a history of acute hemispheric stroke more than one year ago

Option (C) is correct. The landmark study done by Susan Langmore, et. aland others, showed that dependence on others for feeding and oral care was most highly correlated with pneumonia.

When completing speech sound evaluations, it is best practice for an SLPS L P to include a sample of connected speech because connected speech samples A.provide more reliable information than standardized tests B.contain a representative sample of all the phonemes in a language C.may result in different types of errors than those elicited by single-word elicitation tasks D.are easier to gloss than single-word productions

Option (C) is correct. The more complex task of producing connected speech tends to increase the types and numbers of errors, allowing for an accurate reflection of the patient's speech ability.

Which of the following muscles opposes lip retraction (spreading) ? A.Risorius B.Levator labii superioris C.Orbicularis oris D.Zygomaticus major

Option (C) is correct. The orbicularis oris controls the movement of the lips.

A 35-year-old female is referred for an outpatient swallowing evaluation after having a thyroidectomy. Her complaints include coughing when drinking and dysphonia. Which of the following evaluation options is the most appropriate post-treatment follow-up for the patient? A. Completing a clinical swallow evaluation B. Setting up an appointment for a pharyngeal manometry test C. Using the fiberoptic endoscopic evaluation of swallowing (FEESF E E S) D. Recording the patient during a videofluoroscopic swallow study (VFSSV F S S)

Option (C) is correct. The patient exhibits clinical reasons or indications for choosing a FEESF E E S exam, such as recently having her thyroid removed and experiencing a hoarse voice.

An assessment of a patient with suspected neurodegenerative disease who presents with language problems as the primary symptom reveals the following. Impaired single-word retrieval in speech Naming that includes phonological errors Impaired repetition of sentences and phrases Spared single-word comprehension and object knowledge Spared motor speech abilities Which of the following disorders is the most accurate diagnosis of the patient? A.Broca's aphasia B.Anomic aphasia C.Primary progressive aphasia D.Transcortical motor aphasia

Option (C) is correct. The patient's symptoms represent the diagnostic criteria of primary progressive aphasia (PPAP P A). By definition, they exclude the other variants of PPAP P A and Alzheimer's disease.

An SLPS L P in a private practice receives a letter from the state licensing office informing her that her license expired the previous week. The SLPS L P was unaware that she had been practicing with a lapsed license for seven working days. Which THREE of the following actions are the best course of action for the SLPS L P? A.Continuing to see patients as scheduled B.Discontinuing treatment documentation C.Informing the practice administrator D.Reassigning patients to a licensed SLPS L P E.Alerting patients to the lapse in licensure

Option (C) is correct. The practice administration can begin to move forward with corrective action with patients, families, payers, and the licensing body. Option (D) is correct. Without a license, the SLPS L P should not see patients, so patients should be reassigned for continuing care. Option (E) is correct. Without a license, the SLPS L P should not see patients, so patients should be reassigned for continuing care.

Which of the following groups of phonemes can best be described as the Six-Sound Test by Ling? A. /u/u, as in the word ooze, /e/e, as in the word way, /o/o, as in the word own, /a/a, as in the word path, /æ/latin small letter a e, as in the word hat, /ə/latin small letter schwa, as in the word again B. /f/, /s/, /θ/, /ʃ/, /z/, /h/f, as in the word fast, s, as in the word sit, greek small letter theta, as in the word thumb, latin small letter esh, as in the word she, z, as in the word zebra, h, as in the word hot C. /m/, /a/, /u/, /i/, /s/, /ʃ /m, as in the word mat, a, as in the word path, u, as in the word ooze, i, as in the word he, s, as in the word sit, latin small letter esh, as in the word she D. /d/, /g/, /e/, /o/, /s/, /ʃ/d, as in the word dog, g, as in the word go, e, as in the word way, o, as in the word own, s, as in the word sit, latin small letter esh, as in the word she

Option (C) is correct. The six phonemes that are part of Ling's Six-Sound Test are /m/, /a/, /u/, /i/, /s/, /ʃ /m, as in the word mat, a, as in the word path, u, as in the word ooze, i, as in the word he, s, as in the word sit, latin small letter esh, as in the word she.

Which of the following therapeutic techniques is most appropriate to treat hyperfunctional voice disorders? A.Pushing, pulling, and isometrics B.Lee Silverman Voice Treatment C.Semi-occluded vocal tract exercises D.Coughing and throat clearing

Option (C) is correct. The use of semi-occluded vocal tract exercises, whether use of straws, resonance tubes, lip trills, or fricatives, has demonstrated across multiple studies in the literature to optimize glottal configuration to reduce the impact of glottal closure and reduce potential phonotrauma and to optimize glottal closure to a slightly abducted position, also to reduce the potential for phonotrauma often found in hyperfunctional voice. These exercises have also demonstrated the ability to reduce voice fatigue, a classic complaint of those with hyperfunction, by optimizing glottal impedances in the vocal tract.

When completing a videofluoroscopic swallow study on a geriatric patient, which of the following findings is most appropriately considered typical development? A.Vallecular retention of more than 50 percent of vallecular height B.Nasopharyngeal regurgitation C.Liquid bolus enters pharynx before hyolaryngeal excursion begins D.Oral pocketing

Option (C) is correct. There is known variability in initiation of pharyngeal swallow, notably in the geriatric population. Research indicates that the initiation of the pharyngeal is not necessarily at the ramus of the mandible in the geriatric patient population.

A patient with the recent onset of idiopathic unilateral vocal fold paralysis with a large glottal gap is evaluated by an otolaryngologist and SLPS L P. The treatment most appropriate for this patient is A.voice therapy B.injection augmentation C.injection augmentation with subsequent voice therapy D.thyroplasty with subsequent voice therapy

Option (C) is correct. Vocal fold injection augmentation can provide immediate improvement for vocal function, even in vocal folds paralyzed in the abducted position far away from midline. Injection augmentation is also a temporary solution, which gives time for spontaneous healing in the acute phase. Subsequent voice therapy provides the patient the opportunity to engage the respiratory and resonatory systems with the new phonatory system post injection and optimize voice outcome.

A 28-year-old classroom teacher complaining of frequent voice loss is seen by an SLPS L P and an otolaryngologist. It is determined the patient's symptoms are linked to significant vocal demands. Which of following recommendations is the most appropriate first step to treat the underlying disorder? A.Advising the patient to undergo complete voice rest until the nodules improve or resolve B.Educating the patient on the importance of hydration and behavioral antireflux strategies C.Recommending voice amplification with resonant voice therapy D.Training strategies to increase vocal loudness

Option (C) is correct. Voice amplification and voice therapy exercises that alter vibratory impact (like vocal function exercises and resonant voice therapy) have been shown to be more effective courses of treatment in heavy voice users as compared to vocal hygiene strategies or respiratory retraining strategies.

Which of the following statements reflects the best strategy for the development of MsMiss. Malone's intervention goals? A.The SLPS L P must decide which goals are appropriate, because the SLP is the communication expert. B.As the patient determines what she needs and wants to say, she must determine the goals. C.Goal setting should be a collaborative process involving the patient and the SLPS L P. D.A number of individuals including, the patient, SLPS L P, and close family members, should collaborate to set goals.

Option (D) is correct. AACA A C intervention works best when regular communication partners are involved along with the patient and SLPS L P.

According to research, which of the following structural factors has the most adverse effect on articulation? A.Short labial frenulum B.Micrognathia C.Unilateral facial palsy D.Class III malocclusion

Option (D) is correct. Class III malocclusion is known to cause obligatory distortions of sibilants and affricates due to placement of the tongue relative to the maxilla.

Which of the following plans is most appropriate when assessing a patient with a history of traumatic brain injury (TBI) to characterize cognitive aspects of communication that affect functional abilities? A.Administering an aphasia battery to form a comprehensive assessment of the patient's linguistic abilities B.Conducting an assessment to evaluate for the presence and severity of dysarthria C.Observing a conversation between the patient and a familiar individual for difficulties in functional communication D.Using standardized tests as needed and supplementing with discourse samples and dynamic assessment

Option (D) is correct. Combining carefully interpreted standardized tests with discourse and dynamic assessment is recommended to achieve the most representative view of a patient's cognitive and linguistic abilities.

When an SLPS L P assesses the communication skills of a bilingual child, it is important for the SLPS L P to evaluate both languages primarily to A.establish a baseline of skills in order to track changes B.determine which language to treat C.establish rapport with the child D.diagnose a communication disorder

Option (D) is correct. Diagnosis is required prior to initiating therapy, and a diagnosis of a communication disorder cannot be established without evaluating skills in both languages.

During a trip to the grocery store, a three-year-old boy with delayed language points to an apple on the floor and says to his mother, "Apple." The boy's mother says, "Yes, that's a big, shiny apple." Based on the mother's response, which of the following language stimulation techniques is she using? A.Imitation B.Parallel talk C.Think aloud D.Expansion

Option (D) is correct. Expansion is a method that entails providing a subject a more complex speech model but does not directly stimulate another response from the subject.

During the course of treatment, as a child manipulates various toys in symbolic play, the clinician vocalizes the child's actions (for example, "You're putting the pan on the stove."). The intervention technique used by the clinician is identified as A.the mand model B.reauditorization C.self-talk D.parallel talk

Option (D) is correct. Parallel talk is a technique a clinician uses when talking aloud about what the child is seeing, hearing, or doing.

An SLPS L P is reviewing research literature for an evidence-based communication intervention for a young child with autism spectrum disorder (ASDA S D). Which of the following research designs provides the strongest proof of efficacy for evidence-based communication intervention? A.Case studies describing a successful treatment for a child with ASDA S D B.Single case designs that rigorously test an intervention for a child with ASDA S D C.A group design with children receiving two different ASDA S D treatments simultaneously D.Randomized controlled trials of a treatment including children with ASDA S D

Option (D) is correct. Randomized controlled trials randomly assign participants into an experimental treatment group and a control group that does not receive the treatment. Randomized controlled trials control bias, and results can be statistically analyzed for effectiveness.

Which of the following approaches is the most appropriate initial therapy focus for the patient? A.Improving the naturalness of the speech B.Implementing use of the cancellation technique in conjunction with conversational disfluencies C.Improving the ability to pause at appropriate linguistic boundaries when speaking D.Reinforcing the patient's attempts to produce words without the use of fillers, pauses, or word substitutions

Option (D) is correct. Reinforcing open stuttering directly addresses the client's fear of stuttering and provides opportunities for the client to objectively evaluate how other people respond when he stutters openly.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSMD S M-5™) criteria for autism spectrum disorder (ASDASD) and social communication disorder (SCDSCD), which of the following characteristics best helps an SLPS L P provide a differential diagnosis for ASDA S D instead of SCDS C D? A.Deficits in communication appropriate for a social context B.Deficits that result in functional limitations in social participation C.Difficulty following rules for storytelling D.Repetitive and restrictive patterns of behavior

Option (D) is correct. Restricted and repetitive behaviors are indicative of ASDA S D and set ASDA S D apart from SCDS C D.

An SLPS L P is working with a sixth-grade student who is having difficulty comprehending written text. Which of the following strategies would be most effective for the SLPS L P to use to target this difficulty? A.Creating a log in which unfamiliar sight words are written down for later practice B.Developing the student's ability to chunk multisyllabic words into smaller units C.Selecting words from a text that can be used as both spelling and sight words D.Using semantic networks in which ideas are displayed in connected clusters

Option (D) is correct. Semantic networks improve reading comprehension by showing students not only how vocabulary words are related to each other in a conceptual hierarchy, but how ideas in texts are organized in an associative way.

A 24 month old who was screened for autism spectrum disorder (ASDA S D) attends a twice-weekly early intervention program to address developmental delays. Which of the following is the best way to determine the communication goals for the child? A.Aligning with developmental norms for communication behaviors typical of 24 month olds B.Waiting to address communication goals only after behavioral issues have been remediated C.Aligning with goals of other children in the program to heighten intensity of intervention efforts D.Setting goals that address communication challenges within daily activities and routines

Option (D) is correct. Setting goals that address communication challenges within daily activities and routines will best help determine appropriate communication goals for a child with ASDA S D.

Which of the following interventions could be deployed while the patient is swallowing to increase intrabolus pressure? A.Tongue tether maneuver B.Mendelsohn maneuver C.Breath-holding with Valsalva maneuver D.Effortful swallow maneuver

Option (D) is correct. Several studies have shown that when correctly performed, the effortful swallow maneuver increases intrabolus pressure during the swallow.

Which of the following is typical of spondee words? A.They are phonetically balanced two-syllable words. B.They are phonetically balanced monosyllabic words. C.They represent twenty of the most common English words. D.They are two-syllable words produced with equal stress.

Option (D) is correct. Spondee words are characterized as bisyllabic words in which equal stress is placed on both syllables when spoken.

When completing an oral mechanism examination on a patient presenting with stroke-like symptoms, which of the following findings would be most likely to predict aspiration during an instrumental swallow evaluation? A.Inability to swallow on command B.Facial droop C.Absent gag reflex D.Breathy phonation

Option (D) is correct. Studies have demonstrated that breathy phonation would indicate possible vocal fold and/or pharyngeal paralysis.

Jay is 3 years and 8 months old and was diagnosed with stuttering following a speech-language assessment. The diagnosis is based in part on the presence of part-word repetitions on 15% of syllables in conversational speech during the initial evaluation. His mother says that the onset of stuttered speech occurred eight months before the assessment and that the child occasionally is frustrated with his fluency difficulties. Which of the following is the most appropriate recommendation for the SLPS L P to make? A.Monitoring fluency performance until age 5 years and 0 months old, but commencing fluency therapy immediately if Jay's stuttering frequency exceeds 20% of syllables before then. B.Monitoring fluency performance until age 5 years and 0 months old, and commencing fluency therapy immediately if Jay's stuttering has not resolved by then. C.Beginning a treatment program in which Jay learns how to regulate his articulation rate during daily conversational speech. D.Beginning a treatment program in which Jay's parents learn how to respond to his stuttering-related frustration and how to label and comment on his fluent and stuttered utterances.

Option (D) is correct. The child stutters with moderate severity and has done so for eight months, which results in frustration during communication. This suggests that treatment is necessary now. The actions described are aimed at improving fluency within a behavioral-shaping framework and preventing the development of negative attitudes toward speaking. Labeling and commenting on fluent and stuttered utterances are key components of the Lidcombe Program, a stuttering treatment for young children that has been shown to be effective.

Which of the following nerves provides efferent innervation to the stylopharyngeus muscle and contributes toward the elevation of the pharynx and the larynx? A.The trigeminal B.The hypoglossal C.The vagus D.The glossopharyngeal

Option (D) is correct. The functions described are controlled by cranial nerve IX9, the glossopharyngeal

Which of the following is an etiology for cortical dementia? A.Amyotrophic lateral sclerosis B.Parkinson's disease C.Huntington's disease D.Alzheimer's disease

Option (D) is correct. The most common etiology of dementia is a group of progressive dementing diseases (further categorized as either cortical, subcortical, or mixed). Alzheimer's disease is a cortical dementia.

A 75-year-old patient is referred from a laryngologist with a diagnosis of presbylaryngis/presbyphonia. The patient complains of reduced vocal loudness and increased vocal effort while speaking. Which of the following treatments is most appropriate for the patient? A.Using sigh phonation with soft glottal attacks B.Generating vowel sounds with inhalatory phonation C.Completing voice rest for one week then gradually reintroducing voice use D.Producing vowel sounds and phrases using high vocal intensity phonation

Option (D) is correct. The patient requires voice building; however, many clinicians approach every dysphonic voice as needing rest or protection. Even a new SLPS L P during the Clinical Fellowship Year seeing voice patients should be aware of this common diagnosis and appropriate treatment for it. The evidence-based treatment is one that includes good quality phonation with high vocal intensity.

An SLPS L P engages in interprofessional practice in a large health care center and works with a neurologic rehabilitation team to treat a patient who is status post left-hemisphere stroke. The SLP'sS L P's primary focus on the team is to A.lead the interdisciplinary team to improve patient care B.reduce costs and the number of professionals working at the site C.obtain licenses in multiple areas of practice to engage in a range of services D.improve the patient experience and outcome of care at the site

Option (D) is correct. The primary goal of interprofessional practice is to improve patient care.

A patient presents to a speech-language pathologist with voice changes. After completing a patient assessment, the SLPS L P notes that the patient's vocal quality and function indicate the possibility of a superior laryngeal nerve injury. Which of the following presentations is most consistent with this impression? A.Inspiratory stridor B.Hypernasal resonance C.Complete aphonia D.Reduced pitch range

Option (D) is correct. The superior laryngeal nerve controls the cricoarytenoid muscles, which lengthen the vocal folds for pitch elevation. Injury to this nerve can result in reduced pitch range, particularly in the higher frequency range.

A 5-year-old child's evaluation reveals a developmental speech delay secondary to an intellectual disability. Which of the following statements about etiology is most likely true? A.A genetic etiology can be assumed and treatment can be withheld. B.A genetic etiology can be assumed and compensatory strategies should be taught. C.Prenatal trauma can be assumed and a plan to counsel the parents is necessary. D.The information provided does not allow an assumption to be made on etiology

Option (D) is correct. There are a variety of possible etiologies for developmental delays (as well as for intellectual disabilities). An SLPS L P would need more information to accurately determine etiology.

Based on information from the oral sensorimotor and behavioral observation assessments, which of the following plans for continuing with an oral-feeding trial is most appropriate with the infant? A. An oral-feeding trial should not be attempted until the infant's cleft lip is repaired. B. An oral-feeding trial should not be attempted until a VFSSV F S S or FEESF E E S instrumental examination is completed. C. An oral-feeding trial should be postponed until the infant's airway is examined by a physician. D. An oral-feeding trial by the SLPS L P can proceed during this initial feeding and swallowing assessment.

Option (D) is correct. There is no evidence from the case review and oral sensorimotor/behavioral observations to suggest a neurological abnormality, respiratory disorder, or syndrome associated with feeding and swallowing disorders in infants. In the absence of respiratory and neurological signs, an instrumental evaluation or referral to a physician for a respiratory evaluation would not be indicated prior to an oral-feeding trial at bedside. Many infants with an isolated cleft lip are successful oral feeders prior to surgical repair of the cleft lip. All the evidence presented in the case supports the SLPS L P proceeding with the oral-feeding trial piece of the comprehensive feeding and swallowing assessment.

An SLP works with a toddler on combining words and assessing a variety of semantic relations. Match each toddler utterance with the semantic relation it best reflects. "Doggie eat." "More cookie." "Big cookie." "Eat cookie." Agent +plus Action A. "Doggie eat." Action +plus Object D. "Eat cookie." Attribute +plus Entity C. "Big cookie." Recurrence B. "More cookie.".

Option 1, 4, 3 and 2 is the correct order. Agent +plus plus Action is best matched with "Doggie eat" because "doggie" is an agent doing the action of eating. Action +plus plus Object is best matched with "Eat cookie" because eating is an action and "cookie "is the receiver or object of that action. Attribute +plus plus Entity is best matched with "Big cookie" because "big" is an attribute of the object that is a cookie. Recurrence is best matched with "More cookie" because the word "more" signals a desire or observation that a thing or object will occur again. It is correct to use "recurrence" even if the utterance contains several words.

Which TWO of the following statements about the results of a screening test are correct? A.Sensitivity is the proportion of people who fail the screening test who are aspirators B.Specificity is the proportion of people who pass the screening test who are aspirators C.Sensitivity is the proportion of people who pass the screening test who are not aspirators D.Specificity is the proportion of people who pass the screening test who are not aspirators

Options (A) and (D) are correct. The screening test's sensitivity is the proportion of patients who aspirated and failed the screen (top cell in the first column) to the total of all patients who aspirated (total of the first column). The screening test's specificity is the proportion of patients who did not aspirate and passed the screen (bottom cell in the second column) to the total of all patients who did not aspirate on the VFSSV F S S (total of second column).

An 8-year-old male diagnosed with encephalitis was identified with a resultant in a profound bilateral hearing loss. He underwent a bilateral cochlear implantation and needs aural rehabilitation. Which THREE of the following are appropriate recommendations for intervention? A.Evaluating the child's functional communication performance B.Participating in auditory perception training C.Encouraging the child to rely on American Sign Language D.Counseling the child and family E.Limiting the child's exposure to noisy environments

Options (A), (B), and (D) are correct. Best clinical practice includes the assistance with listening ability of perception of speech and other auditory stimuli. Family members and the child should receive orientation to the cochlear implant, routine troubleshooting, and realistic expectations for the child's performance.

Which THREE of the following are additional communication strategies that are valid for MsMiss. Malone? A.Incorporating multimodal communication strategies, such as gestures and writing B.Teaching regular communication partners how to listen and best respond to her C.Limiting social engagements, since language demands are beyond the severely impaired AACA A C user D.Encouraging her to take an active role in initiating communication E.Phasing out device use to increase the rate of spoken-language recovery

Options (A), (B), and (D) are correct. Option (A) is correct because multimodal strategies augment the entirety of communication. Option (B) is correct because AACA A C intervention works best when regular communication partners are involved. Option (D) is correct because taking an active role in initiating communication will help MsMiss. Malone incorporate the AACA A C intervention into her daily life and result in improved confidence and less frustration.

Which of the following are the THREE types of velopharyngeal dysfunction? A.Velopharyngeal insufficiency B.Velopharyngeal mislearning C.Velopharyngeal mismatching D.Velopharyngeal ineffectiveness E.Velopharyngeal incompetence

Options (A), (B), and (E) are correct. Velopharyngeal dysfunction (VDPV D P) is a general term. It is used to describe different disorders of the velopharyngeal valve. These include: velopharyngeal insufficiency (VPIV P I), which is due to abnormal structure, velopharyngeal incompetence (VPIV P I), which is due to abnormal movement, and velopharyngeal mislearning, which is due to abnormal speech sound production.

Which THREE of the following variables are considered risk factors for late language emergence? A.Male gender B.Access to print material C.Low socioeconomic status D.Moderately low birth weight E.Exposure to rich and varied vocabulary

Options (A), (C), and (D) are correct. Being of male gender is a risk factor cited by both ASHAA S H A and researchers for late-talking toddlers. Having a low SESS E S is considered a risk factor by ASHAA S H A and researchers for late talking. Finally low birth weight is a risk factor as well.

An SLPS L P recommends a patient perform a chin-down posture (CDPC D P) when swallowing liquids. Which THREE of the following statements accurately represent published evidence regarding the chin-down posture? A. CDPC D P reduced thin liquid aspiration caused by delayed pharyngeal response in people who had a stroke. B. CDPC D P increased the speed and completeness of oral transit in people with dysphagia after a stroke. C. CDPC D P was shown to narrow the width of the laryngeal inlet and widen the vallecular space during swallowing. D. CDPC D P resulted in an increased upper esophageal sphincter opening diameter in patients with Parkinson's disease. E. CDPC D P does not reduce aspiration after the swallow in patients who had a stroke and aspirate pyriform sinus residue.

Options (A), (C), and (E) are correct. A study conducted by Shanahan et aland others. in 1993 showed that using the CDPC D P reduced thin liquid aspiration caused by delayed pharyngeal response in people who suffered had a stroke. Studies have shown that using CDPC D P during swallowing narrows the width of the laryngeal inlet and widens the vallecular space during swallowing when the CDPC D P is used. The 1993 study performed by Shanahan et aland others. showed that the CDPC D P does not reduce aspiration after swallowing in patients who had a stroke and aspirate pyriform sinus residue.

Which THREE of the following statements are true regarding the treatment of swallowing disorders? A.Thickened liquids cause dehydration because they require more water to be metabolized. B.The chin-down posture eliminates thin-liquid aspiration from the pyriform sinuses. C.Supraglottic swallow may cause cardiac arrhythmia in patients with coronary artery disease or stroke history. D.Mass practice and task specificity are important principles of exercise therapy. E.Periodontal disease due to poor oral hygiene increases aspiration risk in people with dysphagia. F.Shaker and jaw-opening exercises are designed to increase the upper esophageal sphincter opening.

Options (C), (D) and (F) are correct. Studies have found that patients with strokes or coronary artery disease who perform the supraglottic swallow maneuver can develop cardiac arrhythmia, the definition of motor learning theory states mass practice and task specificity are important principles of exercise therapy, and Shaker and jaw-opening exercises are designed to increase upper esophageal sphincter opening.

A study is conducted to determine how well a dysphagia screening test predicts aspiration that is later confirmed with a videofluoroscopic swallow study (VFSSV F S S). The study results are presented in the table below. VFSSV F S S Results Aspiration No Aspiration Dysphagia screen results Failed screen 45 20 Passed screen 5 30 Which THREE of the following statements about this dysphagia screening test are true? A.The screening test's sensitivity is 90% B.The screening test's sensitivity is 69% C.The screening test's specificity is 90% D.The screening test's specificity is 60% E.The number of false negatives was 5 F.The number of false negatives was 20

Options (A), (D), and (E) are correct. The screening test's sensitivity is the proportion of patients who aspirated and failed the screen (top cell in the first column) to the total of all patients who aspirated on the VFSS (total of the first column); therefore, 45/50 = 0.9045 divided by 50, equals 0.90. The screening test's specificity is the proportion of patients who did not aspirate and passed the screen (bottom cell in the second column) to the total of all patients who did not aspirate on the VFSSV F S S (total of second column); therefore, 30/50 = 0.6030 divided by 50, equals 0.60. False negatives are patients who passed the screen who actually aspirated on the VFSSV F S S (bottom cell of first column).

A 55-year-old female presents for a speech evaluation because of concerns with recent changes in the clarity of her speech. She has also noticed occasional coughing when drinking, and her friends have commented that her voice sounds different. A recent visit to her primary care doctor could not determine the cause of her speech changes or coughing. Select the THREE most important factors for the SLPS L P to explore during the patient interview. A.Difficulties with hearing, vision, and fine or gross motor skills B.History of a psychological or psychiatric disorder C.Employment history and current stressors in her life D.Onset and duration of her speech changes E.Consistency of the symptoms

Options (A), (D), and (E) are correct. This patient scenario is strongly suggestive of a late-onset or acquired neurological disorder based on the combination of speech changes across multiple subsystems and swallowing problems. In this case, the most important information for the SLPS L P to obtain includes whether changes in other motor skills and vision and hearing accompany the changes in the duration, onset, course, and consistency of the changes in swallowing, voice, and resonance. This would help the SLPS L P determine the most important procedures to include in the evaluation and referrals regarding the etiology of the symptoms.

The following components of a case history were collected from a medical record review and interview with a patient and the patient's caregiver. The patient has a prior history of all of the following conditions, but only three of them are significant predictors of an elevated likelihood of clinically significant dysphagia. Which THREE of the following historical items at the time of the referral to the SLPS L P are suggestive of an elevated likelihood of clinically significant dysphagia in a 70-year-old adult? A.The patient had pneumonia as a child and then again 10 years ago. B.The patient has a history of stroke or other neurological disease. C.The patient has been losing weight since recovering from anterior cervical spine fusion. D.The patient was cured of pharyngeal cancer with radiation therapy 30 years ago. E.The patient was intubated for surgery and routinely extubated postoperatively 24 hours before the SLPS L P consult. F.The patient has a history of spasmodic dysphonia and underwent botulinum toxin injection 10 years ago.

Options (B), (C), and (D) are correct. There are numerous studies indicating the increased dysphagia/aspiration likelihood in people with a remote history of head-neck radiation, any neurological disease or stroke, or an otherwise-unexplained weight loss.

A school district does not use a standard therapy log for SLPS L P services. An SLPS L P who works for the district develops a form to document therapy services provided. Which THREE of the following are key to include on the form to document the provision of speech and language IEPI E P services? A.The date a student's IEPI E P was established B.Student performance during the therapy session C.Names of other students in the group D.Types of services provided within a therapy session E.Signature from the SLPS L P verifying delivery of services

Options (B), (D), and (E) are correct. Information on student performance is important data and helps to track progress, listing the types of services indicates what was provided, and the SLP'sS L P's signature documents who provided the service.

Which THREE of the following treatment strategies is most appropriate for the patient if the SLPS L P finds the infant is safe for continued oral breastfeeding and follows up with the infant and mother with therapy and education prior to discharge home from the hospital? A.Introducing external pacing with the infant's intake rate to support airway protection B.Providing the mother with contact information for the local cleft lip and palate team for ongoing care and support C.Incorporating adaptive seating for the infant during oral feedings D.Positioning the infant in the optimal feeding position at the mother's breast E.Completing education with the infant's mother about feeding interactions, strategies, and oral care

Options (B), (D), and (E) are correct. Providing the mother with contact information for the local cleft lip and palate team for ongoing care and support would be an appropriate strategy. Positioning an infant with either the cleft lip at the top of the mother's breast or with the cleft lip against the mother's breast can aid in achieving lip closure around the nipple and/or help prevent leakage of milk from the infant's oral cavity. Completing education with this new mother will be very important, especially considering that this mother expressed concern and anxiety surrounding feeding her infant with a cleft lip.

A 60-year-old male is referred to the SLPS L P in an acute rehabilitation center for a videofluoroscopic swallowing study (VFSSV F S S) following a first-time stroke: a lateral medullary stroke damaging the right nucleus ambiguus and other centers. The clinical examination revealed ptosis of the left eye, soft palate elevation to the right of midline, symmetrical lingual protrusion, and a breathy dysphonia with precise articulation of all consonants. The patient is unable to swallow his saliva and coughs when he attempts to do so. Based on the stroke type and clinical examination observations, which THREE of the following swallow impairments would the SLPS L P likely observe on the VFSSV F S S? A.Incomplete clearance of material from the oral cavity B.Impaired or absent opening of the upper esophageal sphincter C.Anterior loss of bolus contents during the oral preparatory stage D.Nasopharyngeal regurgitation during the pharyngeal stage E.Adequate excursion of the hyolaryngeal complex F.Unilateral pharyngeal paralysis

Options (B), (D), and (F) are correct. Impaired or absent opening of the upper esophageal sphincter, nasopharyngeal regurgitation during the pharyngeal stage, and unilateral pharyngeal paralysis are all to be expected based on this type of stroke and the clinical observations.

Two laws applicable to public schools are the Individuals with Disabilities Education Act (IDEAI D E A) and Section 504 of the Rehabilitation Act. While these laws are similar in that they both address the communication needs of students with disabilities, there are clear differences between them. For each column, select all statements that apply. Statement IDEAI D E A Section 504 A child is eligible under this law if he or she has any physical or mental condition that substantially limits a major life activity. 1. 2. This law provides an eligible student with an IEPI E P. 3. 4. A child must have one of 13 specified disabilities to receive services under this law. 5. 6. This law prevents discrimination against persons with disabilities. 7. 8. The Office of Special Education and Rehabilitative Services administers this law. 9. 10. The Office for Civil Rights administers this law. 11. 12.

The correct answers are, in order, Section 504; IDEAI D E A; IDEAI D E A; IDEAI D E A and Section 504; IDEAI D E A; Section 504. Section 504 is correct because mental conditions include those conditions that interfere with academics, such as expressive and receptive language; and when a child may not qualify for an IEPI E P due to the mental condition, the child can receive a 504 plan. IDEAI D E A is correct because providing students with IEPsI E Ps falls under the province of IDEAI D E A. IDEAI D E A is correct because IDEA designates 13 different categories of eligibility for special education services. Both IDEAI D E A and Section 504 are correct because antidiscrimination laws protect students with disabilities and their right to public education. IDEAI D E A is correct because the Office of Special Education and Rehabilitative Services is responsible for administering IDEAI D E A regulations. Section 504 is correct because Section 504 of the ADAA D A and 504 Plans fall under the jurisdiction of civil rights law.

Match each treatment strategy with the type of dysarthria for which the strategy is most effective. Using rhythmic or metered cueing Practicing relaxation exercises Implementing sensory tricks Performing pushing-pulling exercises Spastic B. Practicing relaxation exercises Ataxic A. Using rhythmic or metered cueing Flaccid D. Performing pushing-pulling exercises Hyperkinetic C. Implementing sensory tricks

The correct matches are Spastic - Practicing relaxation exercises, Ataxic - Using rhythmic or metered cueing, Flaccid - Performing pushing-pulling exercises, and Hyperkinetic - Implementing sensory tricks. People with spastic dysarthria need to practice relaxation exercises to reduce muscle tone and increase flexibility. Those with ataxic dysarthria benefit from rhythmic or metered cueing due to inability to adequately pace their speech production. Flaccid dysarthria is effectively treated with pushing and pulling exercises to help strengthen muscles and increase tone. People with hyperkinetic dysarthria benefit from sensory tricks to reduce involuntary movements. Any other order is incorrect because the treatment strategies cannot interchangeably treat other types of dysarthria and would be ineffective if applied to the wrong dysarthria type.

An SLPS L P conducts a videofluoroscopic swallowing study (VFSSV F S S) for a patient referred for suspected dysphagia secondary to stroke. The SLPS L P finds that the patient has dysphagia characterized by delayed onset of the pharyngeal response, limited lingual retraction, limited oropharyngeal propulsion, and the need to swallow two or more times to clear boluses. Some aspiration of hypopharyngeal residue occurs after the swallow from the pyriform sinuses. During the VFSSV F S S, several compensatory maneuvers (chin-down posture) were attempted to test their efficacy. The SLPS L P is developing a treatment plan to eliminate aspiration and to improve lingual strength, retraction, and oropharyngeal propulsion through a combined strategy using compensatory and restorative maneuvers, including a progressive resistive exercise program of isometric tongue-press exercises using an instrument that measures the pressure of tongue contact with the hard palate (IOPII O P I or SwallowStrong). The SLPS L P measures the patient's baseline maximum tongue-press pressure generation with the instrument and begins treatment. Question: Place the following steps of the progressive resistive exercise component of treatment in the correct order. Obtain measure of maximum tongue-press pressure generation Calculate an exercise target that is below the patient's maximum pressure generation, and begin progressive resistance exercises Perform VFSSV F S S to evaluate efficacy of tongue-press progressive resistive exercise program on swallow impairments Increase exercise target and continue three sets of 10 repetitions per day, three days per week, of exercises at the treatment target B. Calculate an exercise target that is below the patient's maximum pressure generation, and begin progressive resistance exercises A. Obtain measure of maximum tongue-press pressure generation D. Increase exercise target and continue three sets of 10 repetitions per day, three days per week, of exercises at the treatment target C. Perform VFSSV F S S to evaluate efficacy of tongue-press progressive resistive exercise program on swallow impairments

The correct order is (2), (4), (1), (3) (BDAC). The above scenario is not specific to tonguepress exercises. It uses tongue-press exercises as a method of treatment to illustrate a well-designed, evidence-based intervention program of rehabilitation.

Place the swallowing function with the cranial nerve that is primarily responsible for making the function possible. Closing the vocal folds for airway protection Closing the jaw for chewing Closing the lips to contain bolus Controlling tongue movement during bolus transport in the mouth Cranial nerve V 5, trigeminal B. Closing the jaw for chewing Cranial nerve VII7, facial C. Closing the lips to contain bolus Cranial nerve X10, vagus A. Closing the vocal folds for airway protection Cranial nerve XII12, hypoglossal D. Controlling tongue movement during bolus transport in the mouth

The correct responses are, in order, cranial nerve V5, trigeminal: closes the jaw for chewing; cranial nerve VII7, facial: closes the lips to contain bolus; cranial nerve X10, vagus: closes the vocal folds for airway protection; cranial nerve XII12, hypoglossal: controls tongue movements during bolus transport in the mouth. Any other responses would be anatomically inaccurate representations of what each cranial nerve controls regarding swallowing functions.

An SLPS L P evaluates the speech of a child with suspected velopharyngeal dysfunction. Loading sentences with which of the following types of stimuli would be most helpful to include in the speech evaluation? A. Nasal phonemes B. High-pressure oral stops and fricatives C. Sustained /α/greek small letter alpha, as in the word hot sounds D. Liquids and glides

ption (B) is correct. High-pressure consonants are most sensitive to the effects of velopharyngeal dysfunction (VPDV D P), which involves a potential for weak pressure and nasal emission, both being obligatory features of VPDV D P. In addition, sentence-level stimuli are needed to include a variety of vowels that allow the listener the opportunity to perceive hypernasal resonance, which is also associated with velopharyngeal dysfunction.