Group B

Question 1

Which of the following is the most important acoustic cue that distinguishes between an unreleased final /p/ and an unreleased final /b/, as in “cap” versus “cab”?

A.Locus frequency of burst
B.Voice onset time
C.Vocal fundamental frequency
D.Duration of the preceding vowel

Answer 1

Option (D) is correct. Research shows that vowel duration influences a listener’s perception of voicing. Vowels that precede unreleased voiced stop consonants are as much as 1.5 times as long as vowels that precede voiceless stops.

Question 2

When counseling the parents of a child who has an articulation disorder, the SLP can cite developmental norms to show which of the following?

A.The child’s misarticulation will interfere with reading skills.
B.A certain percentage of children of a certain age can correctly articulate the misarticulated sound.
C.The misarticulation is caused by faulty learning.
D.The misarticulation is not physically based.

Answer 2

Option (B) is correct. Developmental norms demonstrate that a certain percentage of children of a given age can correctly articulate certain sounds.

Question 3

Language intervention for a child at the one-word stage should be most strongly influenced by a consideration of the child’s

A.motor skills
B.cognitive skills
C.syntactic skills
D.articulation skills

Answer 3

Option (B) is correct. The cognitive skills of a child at the one-word stage will most strongly influence the child’s speech-language responses, so language intervention for the child should take into account the child’s cognitive skills

Question 4

A single exposure of several hours duration to continuous music with an overall level of 100 dB SPL will most likely produce

A.tinnitus and a temporary threshold shift in high frequencies
B.tinnitus and a distortion of speech perception
C.a temporary threshold shift in the low frequencies
D.a permanent threshold shift

Answer 4

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

Question 5

According to research on the development of Brown’s morphemes in young children, which of the following is a determinant of acquisition order?

A.Phonological ease of production
B.Figurative-language ability
C.Semantic and syntactic complexity
D.Sequencing and segmentation strategie

Answer 5

Option (C) is correct. Brown’s morphemes are acquired by children in an order that is determined by semantic and syntactic complexity, with the simplest forms acquired first. The order of acquisition is typically followed by all children

Question 6

John is a 4 1/2 year old whose consonantal inventory includes word-initial [ w ], [ m ], [ n ], [ p ], [ b ], [ t ], [ d ], and [ f ]. He uses [ t ] for /k/, [ d ] for /ɡ/, [ b ] for /v/, and [ f ] for /θ/. He produces no consonant clusters. His word-final consonantal inventory consists of [m] and [n]. His word shape inventory includes V, CV, CVC, and CVCV. The information given most strongly indicates that the child has

A.childhood apraxia of speech
B.an oral motor impairment
C.delayed phonological development
D.a significant high-frequency hearing loss

Answer 6

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

Question 7

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

A.Left posterior superior temporal gyrus
B.Left inferior frontal gyrus
C.Left superior frontal gyrus
D.Left inferior parietal gyrus

Answer 7

Option (A) is correct. The symptoms that are described in the scenario are consistent with damage to the left posterior superior temporal gyrus.

Question 8

Before an SLP initiates voice intervention, it is most important that the SLP gather information about the

A.cause of the client’s voice problem
B.client’s breathing patterns
C.client’s oral motor skills
D.fundamental frequency of the client’s laryngeal tone

Answer 8

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

Question 9

Excessive nasality is associated with inadequate velopharyngeal closure. An SLP is training a client to self-monitor nasality during speech. Which of the following tactics will best allow the speaker to determine whether there is excessive nasal airflow?

A.Looking in a mirror while speaking
B.Being aware of vowel-sound productions
C.Speaking/phonating while alternately leaving the nostrils open and pinching them closed
D.Monitoring production of consonant blends

Answer 9

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

Question 10

Which of the following best describes the rationale for using standardized, norm-referenced instruments to assess speech-language functioning?

A.They enable the clinician to generate weekly statements about a client’s treatment progress.
B.They provide the clinician with the information that is necessary to generate a specific and comprehensive treatment plan.
C.They enable the clinician to understand and make informed statements about how a client’s performance compares with the performance of other people.
D.They provide the clinician with reliable information about how well a client is likely to respond to treatment.

Answer 10

Option (C) is correct. The use of standardized normative instruments enables a clinician to compare a client’s language and speech function with the average normal function for a person in the client’s age range.

Question 11

An SLP who is treating an adolescent who stutters designs a treatment plan that includes three fluency management strategies: prolonged speech, cancellation, and pullout.

Which of the following is true about the use of these treatment strategies?

Select all that apply.

A.Use of prolonged speech is likely to reduce the frequency of part-word repetitions and sound prolongations significantly.
B.Each of the three strategies entails deliberate regulation of speech motor movements.
C.The client will seek to apply cancellation whenever he feels anxious about the possibility of stuttering overtly.
D.The client will seek to apply pullout during the course of part-word repetition or sound prolongation.

Answer 11

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

Question 12

A client with anomic aphasia is a native speaker of Spanish with fair proficiency in English. Production of the word “shoes” as [tʃuz] on a repetition task is most likely due to which of the following factors?

A.Phonological interference from the speaker’s native language
B.Semantic interference from the speaker’s native language
C.Semantic paraphasia due to the aphasia
D.Phonemic paraphasia due to the aphasia

Answer 12

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

Question 13

An SLP has a consultation with a self-referred adult who has a fluency disorder. The client had been enrolled in treatment programs with the clinician three times before and had reached from 75 to 90 percent fluency before dropping out of treatment for various reasons. Thirty percent of the client’s syllables are spoken disfluently. The client also exhibits signs of depression and anxiety. Which of the following is the most appropriate action for the SLP to take?

A.Encouraging the client to re-enroll for remedial services
B.Encouraging the client to take responsibility for maintaining fluency by using techniques learned in the previous treatment sessions
C.Recommending that the client schedule a neurological evaluation
D.Referring the client for psychological counseling

Answer 13

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

Question 14

Immediately following removal of a benign tumor from the base of the brain, a 76-year-old client exhibits severe nasalization and a weak, breathy voice. A four-month postsurgical assessment reveals no improvement. At this time, the remediation strategy for this client should focus on

A.evaluation for prosthetic or surgical intervention
B.strengthening exercises for the oral articulators
C.a trial period using the yawn-sign technique
D.complete vocal rest

Answer 14

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

Question 15

A 12-year-old native speaker of Spanish who has been studying English as a second language for three years is most likely to do which of the following when speaking English in casual conversation with teachers at school?

A.Use the auxiliary “have” in place of “be” in progressive tenses
B.Use incorrect word order within prepositional phrases
C.Use conjunctions in place of prepositions
D.Use multiple negation improperly

Answer 15

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

Question 16

A 4-month-old-infant who has a low birth weight but passed a neonatal hearing screening was evaluated for development of communication skills. The speech-language pathologist found that the infant followed moving objects visually, showed interest in mouthing and banging objects, and began sucking in anticipation of eating, but failed to localize to environmental sounds. On the report to the infant’s primary care physician, the most appropriate recommendation by the speech-language pathologist is

A.consideration of auditory amplification
B.hearing-loss counseling for the parents
C.careful parent monitoring of the child’s speech-language development
D.evaluation of auditory function by an audiologist

Answer 16

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

Question 17

A 60-year-old man says that he has “trouble thinking of names and words” and that it is interfering with his job performance. The problem began three months ago after he had a minor cerebrovascular accident. He does not report any other problems. His conversation is characterized by some hesitancies, latencies, repetitions, interjections, and self-corrections. On the basis of an interview and the results of an aphasia battery, it is concluded that he has a mild aphasia. The most appropriate course of action is to

A.advise the client to wait for three more months in order to allow spontaneous recovery to take place
B.begin a treatment program designed to decrease dysfluencies in his speech
C.offer a treatment program designed to improve word-retrieval skills
D.encourage the client to increase his reading of information related to his profession in order to facilitate recall of professional terminology

Answer 17

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

Question 18

Which of the following procedures would be effective in remediating a falsetto voice for an adult male with a severe bilateral hearing loss?

A.Development of phonation from coughing
B.Pushing exercises
C.Manual depression of the larynx
D.Manual elevation of the larynx

Answer 18

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

Question 19

Cognitive therapy for stuttering focuses on which of the following?

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

Answer 19

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

Question 20

A prospective client is described as a man in his forties who is under chronic stress. He uses his voice extensively in daily life has a hard-driving personality, and exhibits glottal fry. The client has the classic profile of a person at high risk for

A.spastic dysphonia
B.acute laryngitis
C.vocal nodules
D.contact ulcers

Answer 20

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

Question 21

Which of the following most accurately represents the etiology of cleft palate?

A.Genetic factors alone
B.Environmental influences alone
C.Genetic factors interacting with environmental influences
D.Medications taken by the mother during pregnancy

Answer 21

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

Question 22

For which individual would a recommendation for an augmentative and alternative communication (AAC) intervention be least appropriate?

A.A preschool child with a language-learning disorder and highly unintelligible speech
B.A teenager with a repaired cleft palate who continues to experience hypernasality
C.A young adult with severe cerebral palsy precluding functional oral communication
D.A 55-year-old man who has had a laryngectomy

Answer 22

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

Question 23

Which of the following is an accurate statement about whispered speech?

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

Answer 23

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

Question 24

Which of the following actions will most effectively control the problem of overreferral in school screening programs that use impedance/immittance measurements?

A.Obtaining the measurements in a professional sound-insulated room
B.Including 500 Hz in the audiometric screening procedure
C.Retesting immediately those who did not pass the first screening
D.Waiting three to five weeks to retest those who did not pass the first screening

Answer 24

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

Question 25

Six months ago, an SLP evaluated 4-year-old Molly’s speech fluency during conversation. At that time, she displayed physically relaxed repetitions of words and phrases (occurring at a frequency of 2 per 100 words), and interjections such as “um” (occurring at a frequency of 1 per 100 words). She did not display any sound prolongations or facial grimaces; she did not produce any pitch rises or phonatory breaks; and she did not appear to avoid any sounds or words. Results from several formal tests suggested that her articulation and language development were within normal limits. Molly reportedly began producing repetitions and interjections at age 24 months, and the frequency of these disfluency types reportedly has remained stable since then. The SLP did not recommend speech-language intervention following the previous evaluation; however, she did provide the parents with information about fluency development, symptoms of stuttering, and general suggestions for how to facilitate children’s fluency. A reevaluation is scheduled for next week. Which of the following is most appropriate for the SLP to do if Molly’s speech fluency has remained the same since the previous evaluation?

A.Recommend that Molly immediately begin fluency therapy, in which the focus is on reducing the frequency of repetitions and interjections in her conversational speech
B.Recommend that Molly be released from the SLP’s active caseload
C.Recommend that Molly be referred for psychological counseling, with a focus on on helping Molly improve speech fluency by learning how to manage anxiety more effectively
D.Recommend monthly evaluations of Molly’s speech fluency until she is five years old

Answer 25

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

Question 26

“Book read me.”
“Me TV see.”

The utterances above, spoken by a 3-year-old monolingual English-speaking child, indicate that the child most likely has a problem with which of the following?

A.Semantic redundancy
B.Syntactic relationships
C.Morphological relationships
D.Pragmatics

Answer 26

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

Question 27

Which of the following is a type of perturbation that can be measured to determine the amount of noise in the voice?

A.Changes in the frequency range between F1 and F2 over time
B.Changes in the frequency range between F2 and F3 over time
C.F3 cycle-to-cycle variations in sound energy over time
D.F0 cycle-to-cycle variations in sound energy over time

Answer 27

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

Question 28

Which of the following describes an important diagnostic distinction between apraxia of speech and dysarthria?

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

Answer 28

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

Question 29

Naturalistic teaching chiefly involves which of the following?

A.Establishing successful and useful communication
B.Using multiple trials and training techniques
C.Using more adult-initiated interactions than child-initiated interactions
D.Using differential reinforcement, fading, and modeling

Answer 29

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

Question 30

Ms. Helene, a 60-year-old woman with a suspected neurological disorder, is referred for speech-language evaluation. She achieves a score of 35/50 on a measure of confrontation object-naming ability. This score is below norms established for individuals of her age and educational level. Based on these results alone, which of the following statements can most reliably be made about Ms. Helene’s disorder?

A.She has anomic aphasia, which might or might not be associated with other language deficits.
B.She has aphasia, but the type of aphasia cannot be specified on the basis of this test score alone.
C.She does not have aphasia but probably does have a memory disturbance.
D.She has difficulty with naming, but the precise nature of the deficit cannot be determined on the basis of this test score alone.

Answer 30

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

Question 31

A 67-year-old male patient with no history of swallowing problems has undergone a cardiothoracic surgical procedure. Postoperatively, he is found to be aspirating while swallowing and is diagnosed with a left vocal-fold paralysis and left pharyngeal paresis. Which of the following is the most likely etiology?

A.An intraoperative CVA in the right pons
B.Damage to the right recurrent laryngeal nerve
C.Damage to the left recurrent laryngeal nerve
D.A left hemispheric stroke

Answer 31

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

Question 32

A team of SLPs is evaluating whether a new language intervention is suitable for use with children who are on their caseload. The clinicians read an article documenting research on the effect of a novel treatment on the language performance of 30 children with specific language impairment. The researchers administered a standardized language test to the children before and after the treatment program. The children’s posttreatment scores on the test were significantly higher than their pretreatment scores. This led the researchers to conclude that the treatment was highly effective.

Based on the preceding description, which of the following appears to be a significant limitation of the design of the study?

Select all that apply.

A.The use of a single-group pretest-posttest design
B.The absence of a control group
C.The inability to rule out the possibility that the children’s language scores improved for reasons other than the treatment
D.The use of random assignment to place the children into the treatment group
E.The number of participants in the study

Answer 32

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

Question 33

Which of the following muscles produces the opposing action to those that produce velopharyngeal closure?

A.Musculus uvulae
B.Levator veli palatini
C.Palatoglossus
D.Stylopharyngeus

Answer 33

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

Question 34

Questions 64-67 refer to the following.

Michael is a 32-month-old boy who has been receiving early intervention services over the past ten months for delayed speech and expressive-language development. Although his birth was reportedly unremarkable, Michael does have a history of recurrent otitis media with effusion. His parents described him as having been a “well-behaved and quiet baby.” When Michael began receiving services, he communicated mainly through gestures and crude vocalizations. An open resting mouth position with slight tongue protrusion was sometimes noted. However, his receptive-language skills were found to be age appropriate and he showed no oral motor deficits during feeding. Michael’s expressive-language skills have shown some progress since he began working with the speech-language pathologist, but he remains poorly intelligible. Michael’s imitation of tongue, lip, and jaw movements is characterized by inconsistent groping and errors of sequencing not observed in his spontaneous oral movements. Michael has an age-appropriate vocabulary and produces utterances of up to five words. Articulation errors, especially metathesis of phones and syllables, increase as his utterance length increases. Michael’s intelligibility is greatest at the single-word level. Automatic speech and highly familiar utterances are much more intelligible than his imitated productions.

As part of ongoing assessment, the SLP’s most appropriate action is to have Michael’s parents consult with his primary-care provider for referral to

A.a special educator
B.a neurologist
C.a psychologist
D.an otolaryngologist

Answer 34

Option (D) is correct. Michael’s history of recurrent middle ear infections, an otolarygologist would be able to clinically manage otitis media and make provisions to obtain an audiological assessment.