Group D

Question 1

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

Answer 1

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

Question 2

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

Answer 2

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.

Question 3

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.

Answer 3

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

Question 4

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 CTE varies from person to person.
C. There is doubt that Brennan has CTE, given that he played professional football for only a short period.
D. The progression of CTEis reversible if Brennan undergoes therapy during its initial phase.

Answer 4

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

Question 5

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

Answer 5

Option (B) is correct. Because CTE 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.

Question 6

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

Answer 6

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.

Question 7

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

Answer 7

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.

Question 8

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

Answer 8

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.

Question 9

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

Answer 9

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.

Question 10

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.

Answer 10

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.

Question 11

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

Answer 11

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.

Question 12

An SLP 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

Answer 12

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.

Question 13

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

Answer 13

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 ASD.

Question 14

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)

Answer 14

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.

Question 15

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

Answer 15

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.

Question 16

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

Answer 16

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

Question 17

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 (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 VFSS 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 VFSS to evaluate efficacy of tongue-press progressive resistive exercise program on swallow impairments

Answer 17

he 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.

Question 18

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 VFSS, which of the following observations was the SLP 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.

Answer 18

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.

Question 19

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

Answer 19

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

Question 20

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

Answer 20

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.

Question 21

n SLPS L P in a public school will be seeing a student who is returning to school after experiencing a traumatic brain injury (TBI). The student has dysphagia, and the SLP will provide dysphagia therapy as part of the student’s IEPI. 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 TBI
C.Incorporating the parents’ request that the student eat in the cafeteria with peers
D.Reviewing

Answer 21

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 PICO question.

Question 22

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 SLP 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 SLP consult.
F.The patient has a history of spasmodic dysphonia and underwent botulinum toxin injection 10 years ago.

Answer 22

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.

Question 23

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 SLP 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.

Answer 23

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.

Question 24

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 SLP. Which of the following is the most appropriate next step for the evaluating SLP?

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

Answer 24

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.

Question 25

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

Answer 25

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.

Question 26

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

Answer 26

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.

Question 27

An SLP evaluates a 5-year-old child who produces several sounds in error. The SLP wants to determine the consistency of the child’s errors by conducting stimulability testing. The most appropriate next step for the SLP 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 SLP 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

Answer 27

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.

Question 28

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

Answer 28

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.

Question 29

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

Answer 29

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.

Question 30

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

Answer 30

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.

Question 31

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”

Answer 31

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.

Question 32

Which of the following muscles opposes lip retraction (spreading) ?

A.Risorius
B.Levator labii superioris
C.Orbicularis oris
D.Zygomaticus major

Answer 32

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

Question 33

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

Answer 33

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.