CETP Exam Prep

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

Cranial nerve X (Vagus)

Fela is a third-grade student in a public school. She is a speaker of African American Vernacular English (AAVE) who has difficulty with the Standard American English (SAE) dialect used in her classroom. Her teacher believes that Fela's language skills are affecting her academic performance and has referred her to the school's speech-language pathologist. Which of the following is an appropriate rationale for providing language intervention for Fela?

Select all that apply.

A.It will likely foster better communication with Fela's linguistically and culturally diverse peers.

B.It will likely improve Fela's code-switching ability with her teacher and other adult speakers of SAE.

C.It may expand Fela's later academic and vocational opportunities.

D.It will likely lead Fela to adopt SAE as her primary dialect.

A, B, C

This investigation was motivated by observations that when persons with dysarthria increase loudness, their speech improves. Some studies have indicated that this improvement may be related to an increase of prosodic variation. Studies have reported an increase of fundamental frequency (F0) variation with increased loudness, but there has been no examination of the relation of loudness manipulation to specific prosodic variables that are known to aid a listener in parsing out meaningful information. This study examined the relation of vocal loudness production to selected acoustic variables known to inform listeners of phrase and sentence boundaries: specifically, F0 declination and final-word lengthening. Ten young, healthy women were audio-recorded while they read aloud a paragraph at what each considered normal loudness, twice-normal loudness, and half-normal loudness. Results showed that there was a statistically significant increase of F0 declination, brought about by a higher resetting of F0 at the beginning of a sentence and an increase of final-word lengthening from the half-normal loudness condition to the twice-normal loudness condition. These results suggest that when some persons with dysarthria increase loudness, variables related to prosody may change, which in turn contributes to improvement in communicative effectiveness. However, until this procedure is tested with individuals who have dysarthria, it is uncertain whether a similar effect would be observed.

Which of the following represent(s) the independent variable or variables used in the Watson and Hughes study?

A. Prosody of dysarthric speech

B. F0 declination and final-word lengthening

C. Vocal loudness

D. Speech intelligibility and communicative effectiveness

C. Vocal loudness

A client exhibits weakness, atrophy, and fasciculation's of the right side of the tongue and lower face. The client also has right vocal-fold weakness and nasal regurgitation of fluid when swallowing. These problems are the result of damage to which part of the nervous system?

A. Brain stem

B. Cerebellum

C. Left cerebral cortex

D. Right cerebral cortex

A. Brain stem

- Weakness, atrophy, fasciculation's, and the other described symptoms are all consistent with lower motor neurone locus and suspected cranial nerve abnormalities, which emerge directly from the brainstem.

Hearing loss in infants who are born with a cleft palate is usually related to which of the following?

A. The infant's ability to create positive pressure in the oral cavity

B. Malformation of the middle-ear ossicles associated with malformation of the palate

C. Eustachian tube dysfunction

D. Cochlear dysfunction

C. Eustachian tube dysfunction

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

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

D. Duration of the preceding vowel

- vowel duration influences a listener's perception of voicing

- vowels that precede unreleased voiced stop consonants are as much as 1.5x as long as vowels that precede voiceless stops

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

B. cognitive skills

- the cognitive skills at the one-word stage will most strongly influence the child's speech-language responses

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

A.tinnitus and a temporary threshold shift in high frequencies

B.tinnitus and a distortion of speech perception

C.a temporary threshold shift in the low frequencies

D.a permanent threshold shift

A. tinnitus and a temporary threshold shift in high frequencies

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

A. Left posterior superior temporal gyrus

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.

A, B, D

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 with prepositional phrases

C. Use conjunctions in place of prepositions

D. Use multiple negation improperly

D. Use multiple negation improperly

- Multiple negation is a grammatical feature of Spanish but not English

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

D. contact ulcers

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

B. it is composed largely of aperiodic sounds

- whispered speech is composed largely of aperiodic sounds, as the vocal folds do not vibrate while whispering is taking place

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

A. obtaining the measurements in a professional sound-insulated room

B. including 500Hz in the audiometric screening procedure

C. retesting immediately those who did not pass the first screening

D. waiting 3-5 weeks to retest those who did not pass the first screening

D. waiting 3-5 weeks to retest those who did not pass the first screening

- some children may have a temporary problem due to a cold or ear infection, which may resolve in a few weeks

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

B. recommend that Molly be released from the SLPs active caseload

- 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.

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 modelling

A. establishing successful and useful communication

- naturalistic teaching focuses on the successful production of utterances that are useful in context for communicating

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

A, B, C

- 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

- since it is a longitudinal study, improvement based on language development cannot be ruled out

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

C. palatoglossus

- velopharyngeal closure is largely produced by soft palate elevation, and the only muscle in the list that produces soft palate depression is the palatoglossus.

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

D. an otolaryngologist

An otolaryngologist has referred a 45-year-old man for voice treatment following medialization thyroplasty for a paralyzed vocal fold. Which of the following is the most appropriate therapeutic strategy for the SLP to use?

A.Assisting the patient to produce a soft glottal attack

B.Digitally manipulation of the patient's neck to reduce strap-muscle tension

C.Assisting the patient to produce a hard glottal attack

D.Employing techniques aimed at increasing airflow

C. Assisting the patient to produce a hard glottal attack

- medialization thyroplasty moves the paralyzed vocal fold closer to the mid-glottis to allow better compensation by the unaffected fold, only the production of a hard glottal attack addresses the compensatory behavior

For a test of expressive morphology and syntax for speakers of African American Vernacular English (AAVE), the test item that would be considered LEAST biased against such speakers would be one requiring

A.use of the auxiliary verb "be" in the present progressive tense

B.use of the past-tense ending "-ed"

C.use of sentences with multiple negation

D.agreement of personal pronouns with their antecedents in gender and number

D. agreement of personal pronouns with their antecedents in gender and number

- the morphological feature listed is one in which AAVE does not differ from SAE

Research regarding the use of intensive phonemic-awareness treatment for children who have difficulty learning to read has demonstrated that the treatment

A. is effective only for children from 4-8 years old

B. is effective mainly with children who have remediated all phonological process errors

C. is effective only when combined with a supplemental literacy program

D. might have no direct relationship to improvement in reading abilities

D. might have no direct relationship to improvement in reading abilities

- intensive phonemic-awareness treatment programs are thought to improve reading by training children to better differentiate and process speech sounds, however, research has not successfully separated the effects of intensive intervention, so no direct relationship has yet to be proved

An SLP is planning treatment for a 5-year-old child with multiple speech-production errors. The most effective strategy the clinician can use to treat the child is to

A.arrange error sounds by developmental pattern and correct them sound by sound

B.start with sounds the child can make and use them as bridges to error sounds

C.teach sounds in isolation, then use nonsense syllables, and then build to words

D.delineate phonological processes in operation and address them through minimal-contrast pairs

D. delineate phonological processes in operation and address them through minimal-contrast pairs

- the most efficient procedure for the child would be for the SLP to define the phonological processes in operation and address them through minimal-contrast pairs

A teacher asks the speech-language pathologist for advice regarding a child who talks excessively during class, rarely listens to instructions, and does work only intermittently. Attempts at alternative seating for the child have not been successful. Of the following, which is the most appropriate recommendation that the speech-language pathologist can provide to the teacher?

A.Have the school counselor consider working with the child and the parents on self-control and discipline

B.Put the child on a management system for classroom behavior

C.Refer the child for evaluation by members of the child-study team

D.Suggest remedial speech-language services for the child to improve the child's interactive communication

C. refer the child for evaluation by members of the child-study team

- the child has a behavioural problem that should be evaluated for the purposes of identification and management planning

A speech-and-hearing clinic has recently opened, but referrals are slow in coming. Which of the following would be most appropriate and effective for the clinic's director to do first?

A. ask local hospitals to provide names of recent clients likely to need speech-language services

B. identify and define the major consumer groups and referral sources, and develop a plan to reach them

C. identify the weaknesses in the competition, and inform consumer groups and referral sources of the weaknesses

D. wait for demand to increase on its own, because marketing speech-language services is against the ASHA Code of Ethics

B. identify and define the major consumer groups and referral sources, and develop a plan to reach them

Native speakers of a language possess several capacities or abilities that provide insight into their language competence. Sentences such as "Visiting friends can be a nuisance" are especially useful to test a person's ability to

A.recognize syntactic ambiguity

B.interpret metaphoric language

C.distinguish homophones by means of syntactic cues

D.recognize a semantically anomalous sentence

A. recognize syntactic ambiguity

- there are two ways to parse or interpret the structure of this sentence, one interpretation is that it is bothersome to visit friends, the other is that friends who have come for a visit are bothersome; therefore, this sentence would be appropriate as a part of a test of a person's ability to recognize syntactic ambiguity

A two-year-old child produces the following utterances during a play-based conversation with her mother.

Utterance Gloss/Child's Intended Meaning

No kitty: It's not a kitty.

My doggie: This toy dog is mine.

No goat: It's not a goat.

Kitty house: The cat is in the house.

Big kitty: It's a big cat.

Doggie ball: The dog pushed the ball.

Which of the following semantic-syntactic constructions does the child show evidence of using?

Select all that apply.

A.Disappearance

B.Denial

C.Possessor + possession

D.Attribute + entity

E.Agent + action

B, C, D, E

- denial: "no kitty"

- possessor + possession:

my doggie"

- attribute + entity: "big kitty"

- agent + action: "doggie ball"

Which of the following errors is likely to persist the longest in the speech of children who are learning SAE as a first language and are following normal developmental course for speech and language acquisition?

A. assimilation

B. consonant cluster reduction

C. final-consonant deletion

D. velar fronting

B. consonant cluster reduction

- this is the most persistent of the normal developmental processes listed

For which of the following conditions is most appropriate for the SLP to recommend that the patient's primary-care physician refer the patient to a prosthodontist for construction of a palatal-lift appliance?

A. sub mucous cleft palate

B. unrepaired cleft of the secondary palate

C. flaccid paralysis of the soft palate

D. congenitally short palate

C. flaccid paralysis of the soft palate

- a palatal lift appliance would be appropriate for a patient with flaccid paralysis characterized by an intact palate that does not function

Which of the following is a typical symptom of cerebellar involvement?

A. overshooting or undershooting an intended target

B. rigidity during voluntary motions

C. spasticity during involuntary action

D. word-finding difficulty

A. overshooting or undershooting a target

Which of the following communication disorders is most frequently associated with significant dysphagia?

A. aphasia

B. ataxic dysarthria

C. flaccid dysarthria

D. organic voice tremor

C. flaccid dysarthria

- flaccid dysarthria and dysphagia are both disorders likely to be characterized by the flaccidity or weakness of the promoter and laryngeal mechanisms that results from cranial nerve damage, the two disorders frequently coexist

Which of the following is the ratio of reinforcement that will most quickly cause a newly acquired behavior to be habituated?

A. a random ratio of tokens to correct responses

B. a ratio of 1:1

C. a ratio of 1:4

D. a ratio of 1:10

A. a random ratio of tokens to correct responses

- when the goal is to reinforce a behavior that has already been acquired, a random ratio of tokens to correct responses creates an intermittent reinforcement schedule and is the most effective, this reinforcement schedule decreases the child's dependence on the token reward

Mr. Charles, age 78, has had Alzheimer's disease for the past nine years. A recent speech and language evaluation at his nursing home indicated severe deficits in verbal reasoning, memory, word finding, discourse, pragmatics, phonology, semantics, and syntax. Which of the following should the speech-language pathologist do next?

A.Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is least deficient

B.Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is most deficient

C.Initiate group treatment with other adults with language impairments to improve spontaneous conversational speech and pragmatic skills

D.Examine his living conditions and, if necessary, educate the nursing staff concerning ways to help him communicate more effectively

D. examine his living conditions and if necessary educate the nursing staff concerning ways to help him communicate more effectively

- SLP treatment is very unlikely to be effective and thus is not appropriate

A physician told the spouse of a client that melodic intonation therapy (MIT) would improve the client's speech considerably. The most appropriate next action by the SLP would be to

A. provide MIT, as recommended

B. tell the physician that it is inappropriate to make recommendations for a speech treatment

C. consider the potential value of incorporating MIT into the clients treatment

D. explain MIT to the clients spouse to assist in the decision making process about the type of therapy to use

C. consider the potential value of incorporating MIT into the clients treatment

- the SLP has a responsibility for determining the value of this procedure in relation to the objectives of the speech-language treatment program

Which of the following muscles is primarily responsible for vocal fold abduction?

A. posterior cricoarytenoid

B. cricothyroid

C. interarytenoid

D. lateral cricoarytenoid

A. posterior cricoarytenoid

- the PCA muscle has its origin on the posterior wall of the cricoid lamina, and inserts onto the lateral arytenoid cartilage

- given the anatomy of the cricoarytenoid joint, PCA contraction can only produce rotation of the arytenoid cartilages such that the vocal processes are displaced laterally, abducting the vocal folds

Which of the following contributes to UES opening? Select all that apply.

A. partial relaxation of the cricopharyngeal portion of the inferior constrictor muscle

B. superior and anterior hyolaryngeal excursion

C. velopharyngeal closure

D. posterior and inferior hyolaryngeal excursion

A, B.

- partial relaxation of the cricopharyngeal portion of the inferior constrictor muscle is part of the neurological sequence

- superior and anterior hyolaryngeal excursion provides a mechanical opening

A client has been determined to have poor UES opening secondary to decreased hyolaryngeal excursion, following a lateral medullary stroke. Cognitive functions are WNL. Which of the following interventions would be the most appropriate recommendation for this client as an initial course of treatment for the underlying disorder?

A. thermotactile stimulation

B. mendelsohn maneuver

C. thickened liquids

D. chin tuck posture (head/neck flexion)

B. mendelsohn maneuver

- it is the only of the listed interventions designed and shown in research to prolong the duration and diameter of UES opening

An individual attempting to sustain /f/ is showing in the midsaggital view above. The most important reason why this speaker will not produce an acceptable /f/ is that

A. the upper central incisors are tipped too far labially

B. the lower central incisors are tipped too far labially

C. intraoral air pressure will be insufficient

D. lip placement is inadequate

C. intraoral air pressure will be insufficient

- the speakers velopharyngeal port is open, allowing a flow of air into the nasal cavity

If a child's language exhibits the phonological process of gliding, the child might say [wɛd] for "red." When asked, "Do you mean wed?" the child may respond, "No! [wɛd]!" Such a response demonstrates which of the following?

A.Phonological development lags behind semantic development.

B.Semantic development lags behind phonological development.

C.Linguistic competence lags behind linguistic performance.

D.Linguistic performance lags behind linguistic competence.

D. linguistic performance typically lags behind linguistic competence

Establishment of which of the following is most important in ensuring that the results of any diagnostic test of speech or language are replicable?

A.Content validity

B.Interjudge reliability

C.Split-half reliability

D.Face validity

B. inter judge reliability

- a test that has inter judge reliability is one whose results are replicable, even if different people administer the test

Linguistic approaches to the treatment of sound-production errors in children are based on the notion that the errors are systematic and rule-based and that the goal of treatment is to modify a child's rule system to approximate the rule system used by adults. Which of the following is a treatment objective that reflects a linguistic approach to treatment?

A. the child will contrast alveolar stops with velar stops in meaningful word pairs

B. the child will produce voiceless alveolar sibilants correctly in unstructured conversation

C. the child will coarticulate stop plus liquid clusters as easily as other children of the same age

D. the child will recognize and identify phonetic distortions of his or her error sound

A. the child will contrast alveolar stops with velar stops in meaningful word pairs

- the objective refers to speech sounds in terms of general distinctive-feature classes, rather than in terms of isolated phonemes or overly specific classifications

Which of the following is the most reasonable standard to apply when judging whether a client has achieved generalization of a targeted skill?

A. the client uses the targeted skill under stimulus conditions that were not present during the training process and without reinforcement

B. the client maintains the correct production of the targeted skill when the reinforcement schedule is changed

C. the client correctly produces the targeted skill effortlessly and without hesitation

D. the client is able to monitor the errors and correct them with only a minimal number of cues from the clinician

A. the client uses the targeted skill under stimulus conditions that were not present during the training process and without reinforcement

- it shows that the client is exhibiting the skill independently in situations not covered during training

A child who is 4 years and 4 months old is referred for assessment of speech sound development, with the following results.

Phonological error pattern Sounds in error Error frequency (# of errors/# of opportunities to produce error)

Stopping ​Observed only on ð 85%

Fronting /k/ → [t]

/g/ → [d]

/ng/ → [n] 90%

100%

20%

Gliding /r/ → [w] 100%

Final consonant deletion Obstruents à null 80% (The only phonemes the child used correctly in the word-final position were /n, m/.)

Epenthesis Insertion of ə into stop /s/ clusters 10%

Which of the following phonological error patterns is most appropriate to address in a treatment program?

Select all that apply.

A.Stopping

B.Fronting

C.Gliding

D.Final consonant deletion

E.Epenthesis

B, D

- fronting and final consonant deletion should be suppressed earlier, as they make the biggest difference in intelligibility

When treating a client who is using an electronic AAC device, the SLP's primary goal should be to

A. ensure that the client develops skill in using every technical aspect of the aid

B. ensure that the client's caregivers learn how to modify the aid's hardware and any applicable software to meet the client's communication needs

C. train the client to use the aid as independently and interactively as possible in a variety of settings

D. help the client develop the skills necessary for moving on to a more sophisticated device

C. train the client to use the aid as independently and interactively as possible in a variety of settings

- generalization with respect to the environments in which the AAC device is used effectively would help accomplish the goal of the best functional outcome for the client

Which of the following formants typically characterizes a high vowel?

A. High-frequency second formant (F2)

B. High-frequency first formant (F1)

C. Low-frequency first formant (F1)

D. Low-frequency second formant (F2)

C. Low-frequency first formant (F1)

- F1 is inversely associated with tongue height, such that high vowels tend to have low F1 frequencies

A 65-year-old patient is transferred from another facility with a diagnosis of aphasia. The patient's symptoms, however, appear more consistent with apraxia. Which of the following tasks for the patient is most appropriate when assessing verbal apraxia of speech?

A. Repeating words of increasing length

B. Recalling three common items

C. Performing voluntary oral movements

D. Following two-step commands

A. Repeating words of increasing length

- inability to repeat two-syllable words is a clear indicator of apraxia of speech

The head lift exercise was designed to produce which of the following changes in swallow biomechanics?

A. Increase in laryngeal closure duration

B. Strengthening of the base of the tongue

C. Increase in diameter and duration of the UES opening

D. Prolonged relaxation of the cricopharyngeal portion of he inferior constrictor muscle

C. Increase in diameter and duration of the UES opening

Which of the following sounds are typically mastered by the time a child turns 3?

A. /k/ and /g/

B. /p/ and /b/

C. /l/ and /s/

D. /ch/ and /sh/

B. /p/ and /b/

When assessing the ability of a student with cerebral palsy to access an AAC device, which of the following physical factors must be evaluated first?

A. upper extremity range of motion

B. lower extremity strength

C. trunk stability and control

D. fine motor dexterity

C. Trunk stability and control

- trunk stability will guide the clinician in making an appropriate recommendation for the type of device client can access as it influences more distal movements

Place the phonemes in order of typical acquisition

A. /p/

B. "th"

C. /k/

D. "zh"

A, C, B, D

- /p/ is developed between ages 1 and 3

- /k/ is developed by age 3.5

- "th" is developed between ages 3 and 8

- "zh" is developed between ages 6 and 8

Inhalation during respiration is primarily carried out through the movement of which of the following muscles or muscle groups?

A.Diaphragm

B.Internal intercostals

C.External intercostals

D.Scalenes

A. Diaphragm

- the diaphragm is the muscle that creates the most volume in the lungs

An SLP provides home practice for a patient with aphasia as part of discharge plans. The patient is approximately six-months post left-hemisphere stroke that resulted in aphasia. Verbal output has improved significantly since the stroke; however, the patient is still very concerned that written expression is moderately impaired at the single-word level. The homework assignment is to implement copy-and-recall treatment to improve written expression, which involves practicing writing target words (from photographs) and then copying those words multiple times. However, during a follow-up phone call, the SLP determines that the patient is struggling to write the assigned target words because the patient "can't think of the correct letters." Although a model is provided on the back of each target photograph, the patient wants to find a way to practice without looking at the answer. The SLP's best course of action is to suggest that the patient

A.try anagramming the words using letter tiles to form the target word

B.practice writing the alphabet in order multiple times before beginning the homework again

C.use a cell phone voice-to-text application as a compensatory strategy

D.use drawing to convey messages instead of using written expression

A. try anagramming the words using letter tiles from the target word

- this approach would give the client the best access to completing the homework as the letter tiles would provide a support for the client to complete the homework and are a regular part of this treatment approach

An SLP uses evidence-based practice by integrating the perspectives and values of the client, patient, or caregivers into the treatment plan. Which of the following best reflects simultaneous incorporation of the host culture's perspectives and values and maintenance of the native culture's perspectives and values?

A.Acculturation

B.Assimilation

C.Enculturation

D.Ethnocentrism

A. Acculturation

- acculturation is the incorporation of the host culture's perspective and the native culture's perspective and values

The commonly used chin-down posture was initially developed to eliminate thin-liquid aspiration in people with delayed pharyngeal stage onset after having a stroke, and when its efficacy was investigated, it was found to be 50% effective. For whom is the chin-down posture ineffective at eliminating thin-liquid aspiration?

A. People who have cricopharyngeal dysfunction

B. People who aspirate residue from the pyriform sinuses

C. People who have impaired lingual function

D. People who aspirate residue from the valleculae

B. People who aspirate residue from the pyriform sinuses

- people with a pyriform sinus residue with a height that was less than 50 percent of the pyriform sinus heigh aspirated significantly more than those with less or no pyriform sinus residue

Which of the following neuroimaging studies specifies which artery or arteries is/are occluded in a patient with a stroke?

A. electroencephalography

B. magnetoencephalography

C. evoked-response potentials

D. CT or MR angiography

D. CT or MR angiography

Which of the following statements best indicates a screening tool with high sensitivity?

A. the majority of the children who passed the screening were found to have a communication disorder

B. many of the children who passed the screening did not have a communication disorder

C. all of the children who failed the screening were found to have a communication disorder

D. most of the children who failed the screening did not have a communication disorder

C. All of the children who failed the screening were found to have a communication disorder

- sensitivity is the success rate in identifying all of the children who truly have a disorder

A 72-year-old right-handed female is evaluated following a left-hemisphere stroke. Findings reveal a moderate Broca's aphasia. Which of the following is the primary goal of intervention for the client?

A. to improve the client's pragmatic skills and abilities

B. to increase the client's ability to express functional comprehension abilities

C. to improve the client's ability to express production of syntactically appropriate sentences

D. to enable the client's ability to use a digital AAC system

C. To improve the client's ability to express production of syntactically appropriate sentences

- improvement of expression, particularly syntax, is the most appropriate focus of treatment for Broca's aphasia

Management of which one of the following examination observations alone will produce the best improvement in the pneumonia risk of an adult patient with chronic dysphagia?

A.Poor oral bolus control and containment

B.Poor oral hygiene and dependence for oral care

C.Delayed onset of the pharyngeal stage of swallowing

D.Impaired distension of the upper esophageal sphincter

B. Poor oral hygiene and dependence for oral care

- these are significant independent predictors of pneumonia in people with chronic dysphagia

Early intentional communication typically emerges in the months leading up to a child's first birthday. Which of the following communicative functions typically emerges first in this period?

A.Requesting

B.Commenting

C.Protesting

D.Greeting

C. Protesting

Which of the following is an example of each task?

A. Alternating attention

B. Sustained attention

C. Selective attention

D. Working memory

A. sorting playing cards by color, then sorting by number, and then by color again

- alternating attention involves switching between two tasks or parts of a task

B. focusing on hearing a person speaking while the television is on

- sustained attention involves maintaining attention over a period of time

C. listening to a list of spoken words for a target word

- selective attention involves a simple short-term task such as listening for specific words in a list

D. solving a complex math problem in your head

- working memory involves holding information in your head and manipulating that information

A 72-year-old male presents to a skilled nursing facility following a complicated hospital stay. The patient is morbidly obese and has a history of COPD, depression, hypertension, diabetes, Belly's palsy, encephalopathy, and congestive heart failure. During his stay, he was not intubated but became very weak as a result of an extended time in bed. In the hospital, he was put on nectar-thick liquids due to aspiration of thin liquids and poor oral control of regular solids. The patient worked until he was 50 years old, but his health conditions led to his early retirement. Before his hospitalization, the patient did not leave his house very often, and his wife helped him with all ADLs.

While evaluating the patient, the SLP noticed that the patient was disoriented and confused, appeared to be hallucinating, grunted loudly when attempting to stand, and presented with aphonia. There was no indication of this condition in the patients chart, and his wife stated that he had no trouble using his voice while in the hospital. An ENT consult stated there was no structural reason for the aphonia. Suspecting that the aphonia was of a psychogenic ethology, the SLP made a referral to the resident psychiatrist and began treatment for both the aphonia and for dysphagia.

After a few sessions of speech therapy, the patient has made limited progress with his aphonia. The psychiatrist has continued to work with the patient and recommends CBT sessions and continued speech therapy.

A primary factor causing the patients psychogenic aphonia is the presence of:

A. depression

B. Bell's palsy

C. COPD

D. hallucinations

A. depression

- depression can lead to psychogenic disorders and given what this patient has been through, it is very likely that his depression has deepened during his hospital stay

A 72-year-old male presents to a skilled nursing facility following a complicated hospital stay. The patient is morbidly obese and has a history of COPD, depression, hypertension, diabetes, Belly's palsy, encephalopathy, and congestive heart failure. During his stay, he was not intubated but became very weak as a result of an extended time in bed. In the hospital, he was put on nectar-thick liquids due to aspiration of thin liquids and poor oral control of regular solids. The patient worked until he was 50 years old, but his health conditions led to his early retirement. Before his hospitalization, the patient did not leave his house very often, and his wife helped him with all ADLs.

While evaluating the patient, the SLP noticed that the patient was disoriented and confused, appeared to be hallucinating, grunted loudly when attempting to stand, and presented with aphonia. There was no indication of this condition in the patients chart, and his wife stated that he had no trouble using his voice while in the hospital. An ENT consult stated there was no structural reason for the aphonia. Suspecting that the aphonia was of a psychogenic ethology, the SLP made a referral to the resident psychiatrist and began treatment for both the aphonia and for dysphagia.

After a few sessions of speech therapy, the patient has made limited progress with his aphonia. The psychiatrist has continued to work with the patient and recommends CBT sessions and continued speech therapy.

Which of the following strategies can the SLP use to most effectively engage the patient in monitoring his progress?

A. recording their sessions for the patient to listen to later

B. reinforcing that the aphonia is not the patient's fault

C. helping the patient recognize his control over his vocal quality

D. asking the patient to keep a journal of why he feels like he cannot use his voice

C. helping the patient recognize his control over his vocal quality

- once the patient understands that he is in control and can use his voice, he will be more likely to use his voice consistently

Which of the following is generally considered the most effective and appropriate for viewing the vocal folds during phonation?

A. stroboscopy

B. endoscopy

C. fluoroscopy

D. laryngeal mirror examination

A. stroboscopy

FERPA guarantees parents access to their child's educational records. However, this mandate does not apply to the daily records kept by an SLP working in a school setting if these records:

A. are not used for treatment-related reimbursement from state or local government

B. remain in the school district in which the SLP works

C. are kept in the sole possession of the SLP

D. are not distributed to anyone outside of the child's school

C. are kept in the sole possession of the SLP

- FERPA states that daily notes can be kept in the sole possession of the SLP as long as the purpose is to serve as a "memory jogger" for the creator of the record

A study examined the effect of a new treatment on the memory of a patient with Wernicke-Korsakoff syndrome. Shown on a graph is the percentage of errors made on an item-recall probe administered several times before treatment (baseline), during treatment, after treatment was discontinued (withdrawal), and after treatment was reinstated.

Which of the following represents the dependent variable in the study?

A. Wernicke-Korsakoff syndrome

B. treatment

C. the percentage of errors on a memory test

D. withdrawal of treatment

C. the percentage of errors on a memory test

- the percentage of errors on a memory test depends on other factors, hence it is the dependent variable

Which of the following strategies is the most appropriate for an SLP to try in an effort to minimize the perception of mild nasal emission in a patient?

A. increasing fundamental frequency

B. using light articulatory contacts

C. reducing mouth opening

D. increasing rate of speech

B. using light articulatory contacts

To compensate for the effects of normal aging on cognitive functions, older adults will naturally demonstrate

A. greater amounts of bilateral activation of prefrontal brain regions

B. significant reduction in the activation of the hippocampus

C. increased activation in areas of the cortex responsible for visual-spatial processing

D. an increase in semantic abilities that do not rely on long-term memory abilities

A. greater amounts of bilateral activation of the prefrontal brain regions

- alterations in the prefrontal areas in particular are some of the changes seen in normal aging, in part to compensate for reduced frontal activation

For a patient with potential pharyngeal phase dyspaghia and pooling of secretions following open-heart surgery with suspected recurrent laryngeal nerve damage, which of the following instrumental examinations for swallowing provides the most direct view for evaluating the patient based on history and suspected difficulties?

A. upper GI series

B. FEES

C. VFSS

D. videostroboscopic examination of vocal folds

B. FEES

- recurrent laryngeal nerve damage during open-heart surgery would only involve the left vocal fold. this exam allows for both assessment for pharyngeal phase dysphagia, by presenting foods and liquids during the assessment procedure, and a direct view of the functioning of both vocal folds, as well as determining the pooling of secretions

A 7-month-old infant presents to an SLP for a swallow evaluation prompted by parental concerns related to the child coughing and choking frequently when swallowing thin liquids. The parents have attempted to feed the child small amounts of pureed foods, but the child spits them out. Which of the following developmental milestones is a typically developing 7 month old most likely to demonstrate during a swallow evaluation?

A. showing the ability to manipulate food

B. creating vertical jaw movements

C. using the rooting reflex when food is seen

D. engaging tongue elevation patterns

B. creating vertical jaw movements

- using jaw movements to initiate chewing begins to emerge around 5 to 7 months

It is most appropriate for a SLP to treat hyperadduction of the vocal folds by having the client

A. increase muscular effort through pushing or lifting while vocalizing

B. using light and gentle vocal fold contacts

C. attempt quick onset of phonation

D. use drills with exaggerated contrastive stress on words

B. use light and gentle vocal fold contacts

- having the client use light and gentle vocal fold contacts will help to reduce tension and thus would be effective in treating hyperadduction of the vocal folds

Which of the following muscles is responsible for changing vocal pitch?

A. posterior cricoarytenoid

B. thyroarytenoid

C. lateral cricoarytenoid

D. cricothyroid

D. cricothyroid

- the cricothyroid is responsible in vocal fold pitch as it tenses the vocal folds

Children with semantic-pragmatic language disorders often have difficulty learning deictic words because such terms

A. require an understanding of indirect directives

B. take the perspective of the communication partner

C. refer to object permanence

D. have many alternate forms

B. take the perspective of the communication partner

- deictic terms are words whose meaning shifts depending on the point of view of the speaker; difficulties with such terms is a core feature of semantic-pragmatic language disorders

A patient is diagnosed with a CVA of the temporal lobe. The patient exhibits deficits in repetition, written expression, and auditory comprehension. In addition, literal paraphasia are noted. These findings are consistent with what type of aphasia?

A. Broca's

B. Conduction

C. Anomic

D. Global

B. Conduction

- a temporal lobe stroke and the symptoms described are typical of a patient with conduction aphasia

Mr. Lewis, a fourth-grade teacher, has referred a 9-year-old student to the school speech-language pathologist (SLP) because he is concerned that the student's speech is interfering with spelling performance. The SLP observes that the student substitutes the voiceless labiodental fricative for the voiceless interdental fricative in the word-final position and that the student reverses /s/ and /k/forward slash s forward slash and forward slash k forward slash in words such as "ask." Which of the following areas needs to be considered first?

A.Auditory discrimination

B.Dialectal differences

C.Disordered phonological system

D.Dyslexia

B. Dialectal differences

- an f/th substitution as well as the reversal of "sk" in ask are common characteristics of a dialectal difference

Of the following, which is generally the most appropriate treatment goal for clients who have had a laryngectomy

A. acceptance of the alaryngeal status

B. production of an esophageal voice

C. use of a voice prosthesis

D. restoration of oral communication

D. restoration of oral communication

- the ultimate treatment goal for clients who have had a laryngectomy is the restoration of oral communication, no matter how it is addressed

Which of the following sets of minimal pair words best targets the phonological patterns of stopping of fricatives?

A. sun and ton

B. sip and ship

C. star and tar

D. shoe and shoot

A. sun and ton

- these are minimal pair words and substituting /t/ for /s/ is an example of the phonological process of stopping of fricatives

The acoustic reflex is triggered in a person with typical hearing when the listener is exposed to a sound above approximately

A. 85 dBHL

B. 130 dBHL

C. 1000Hz

D. 6500 Hz

A. 85 dbHL

- the acoustic middle ear reflex in a person with typical hearing usually occurs at about 85 dbHL

An SLP is working with a 30-month-old child who is at the one-word production level. The goal of treatment is to facilitate growth in play as a precursor to the acquisition of two-word semantic relationships. To achieve the goal, the SLP can best begin by facilitating

A.the use of pretend play, such as brushing a doll's hair or feeding a doll with a bottle

B.the purposeful exploration of toys

C.exploration, by mouthing of toys

D.mean-end behaviors, such as pulling a string to get a toy

A. the use of pretend play, such as brushing a doll's hair or feeding a doll with a bottle

- the child needs to be encouraged to proceed to the two-word production stage, and the use of pretend play will encourage action/object two-word phrases such as "feed baby" and "brush hair"

Compensatory swallowing maneuvers and interventions are designed to mitigate a biomechanical impairment during the swallow; however, some of them have unintended consequences that have been documented in scientific literature. Which of the following swallow maneuvers has been found to produce cardiac arrhythmia (irregular heartbeat) in patients with stroke or cardiovascular diseases?

A.Mendelsohn maneuver

B.Chin-down posture

C.Supraglottic swallow maneuver

D.Head rotation toward the weak side

C. supraglottic swallow maneuver

- 85% of people with a history of stroke and/or cardiovascular disease developed cardiac arrhythmia while performed the supraglottic or super-supraglottic swallow

Which of the following signs of dysphagia is the most common oral-stage observation when assessing a patient with Parkinson's Disease?

A. repeated non propulsive lingual movements

B. eating quickly and impulsively

C. spilling liquids out of mouth because of poor labial seal

D. holding food in mouth because of poor sensation

A. repeated non propulsive lingual movements

- lingual destination is very characteristic of patients with PD and does not manifest in many other disorders

Patient is a 77-year-old female with a left hemisphere stroke. Sensorimotor clinical examination revealed right lower facial droop, impaired oral sensation, absence of dentition, need for frequent prompts to engage the patient in evaluation procedures, and aphasia. Bedside swallow evaluation with pureed food and nectar-thick liquids revealed food remnants in right lateral sulcus, drooling from the right oral cavity, and intermittent cough that was not present before the swallow evaluation. Prior medical history includes COPDC O P D, diabetes, and congestive heart failure. Patient does not want an instrumental examination.

Based on the data above, which of the following is most likely to lead to a clinically significant dysphagia-related adverse event?

A.Impaired oral sensorimotor function

B.Prior medical history

C.Impaired level of alertness

D.Aphasia

C. impaired level of alertness

- it is extremely important that the patient is alert and as upright as possible when addressing swallowing and trying out different foods

List the order of which phonological awareness skills develops first

A. listing words that start with the same sound

B. recognizing words that rhyme

C. counting syllables in single words

D. creating words by blending onset and rime

B, C, D, A

- recognizing words hat rhyme occurs between 30 and 36 months

- counting syllables in single words occurs by 4 years of age

- blending words into rime occurs near 5 years of age

- listing words that start with the same sound occurs between 6 and 7 years of age

According to empirical research with people who stutter, which TWO of the following are true regarding the age of symptom onset for most cases?

A.It is usually earlier for girls than for boys.

B.It is similar for girls and boys.

C.It most often occurs in the range of 2 to 5 years old.

D.It most often occurs in the range of 6 to 9 years old

A, C

- research findings indicate that the age of onset for stuttering symptoms is somewhat earlier for girls than boys, and in most cases, symptom onset occurs in the preschool years

Which of the following assessment descriptions represents an s/z ratio that is indicative of a vocal pathology?

A. 1.0

B. 1.1

C. 1.3

D. 1.5

D. 1.5

- an s/z ratio greater than 1.4 is indicative of possible laryngeal pathology; the client was able to produce a longer sound when the vocal folds were not involved, and the sound prolongation was less when the vocal folds were involved

An SLP must assess receptive language and expressive language in a developing language learner. Which of the following standardized assessments is best for each task?

PPVT: 1. Receptive language 2. Expressive language

CELF-P: 3. Receptive language 4. Expressive language

PLS-5: 5. receptive language 6. expressive language

1, 3, 4, 5, 6

- the PPVT is used to assess only receptive language skills

Which of the following best represents an inter professional treatment model?

A. the SLP designs an intervention plan to be implemented by an SLPA

B. the SLP and general education teacher plan weekly language activities that they deliver jointly to the classroom

C. the SLP conducts the evaluation and the team designs the treatment program

D. Two district SLPs design language screening tools for the RTI team

B. the SLP and general education teacher plan weekly language activities that they deliver jointly to the classroom

- this is the only option that involves two different professions working together on the same area or issue

An 82-year-old female patient is admitted to an SNF following an acute hospital stay. Her diagnoses include UTI, frequent falls with subsequent hip fracture, and COPD. No surgery was required for the hip fracture. Before admission to the hospital, she was living independently and able to complete all ADLs on her own. She is referred to the SLP for cognitive screening because she has difficulty carrying over new information, confusion regarding weight-bearing status, and difficulty processing directions. The SLP administers the MoCA and the patient scores 17/30. The patient's main deficits are in the areas of short-term memory, executive functioning, and planning.

After the patient is appropriately treated both medically and therapeutically, cognitive deficits remain and the interdisciplinary team does not recommend that the patient return home independently. The patient's family is frustrated with this recommendation and seeks input from other sources.

Which of the following treatment procedures is appropriate for the patient?

A. engaging in spaced retrieval

B. naming divergent items

C. following specific directions

D. completing word searches

A. engaging in spaced retrieval

- the patients goal is to return to prior level of function, so spaced retrieval techniques will help her return to her previous level of memory ability or at least teach her compensatory strategies to assist with her memory loss

An 82-year-old female patient is admitted to an SNF following an acute hospital stay. Her diagnoses include UTI, frequent falls with subsequent hip fracture, and COPD. No surgery was required for the hip fracture. Before admission to the hospital, she was living independently and able to complete all ADLs on her own. She is referred to the SLP for cognitive screening because she has difficulty carrying over new information, confusion regarding weight-bearing status, and difficulty processing directions. The SLP administers the MoCA and the patient scores 17/30. The patient's main deficits are in the areas of short-term memory, executive functioning, and planning.

After the patient is appropriately treated both medically and therapeutically, cognitive deficits remain and the interdisciplinary team does not recommend that the patient return home independently. The patient's family is frustrated with this recommendation and seeks input from other sources.

Which of the following diagnoses is most appropriate for this patient?

A. cognitive communication deficit

B. other symbolic dysfunction

C. age-related cognitive decline

D. mild cognitive impairment

B. other symbolic dysfunction

- when treating a patient for cognitive impairment not caused by a stroke, SLPs should use a diagnosis of other symbolic dysfunction

Which of the following activities is a principal component of the Lidcombe Program for Childhood Stuttering?

A. teaching caregivers to provide feedback to their child about the child's fluent and stuttered speech

B. teaching caregivers to support their child's communication attempts but to avoid acknowledging to child's fluency performance

C. teaching children to describe their emotional state to the caregiver when stuttering is anticipated on an upcoming word

D. teaching children to present nonverbal cues to their caregivers when stuttering is anticipated on an upcoming word

A. teaching caregivers to provide feedback to their child about the child's fluent and stuttered speech

- the Lidcombe Program is considered a direct therapy approach in which primary caregivers explicitly provide feedback on the child's level of fluency; all other options are indirect therapy approaches

According to ASHA and the Joint Committee on Infant Hearing (JCIHJ C I H) recommendations of 2007, for babies who fail the newborn hearing screening, the follow-up diagnostic audiologic evaluation should be completed no later than

A.3 months of age

B.6 months of age

C.9 months of age

D.12 months of age

A. 3 months of age

During an OME of an adult who has had a right hemisphere stroke in the territory of the middle cerebral artery, testing for lingual motor function reveals protrusion of the tongue to the left of the midline. Which of the following is true?

A. the patient has a lesion affecting the hypoglossal nerve

B. the patient exhibits unilateral left lingual weakness

C. left vocal fold paralysis should be expected because of the site of the lesion

D. the right hypoglossal nerve is damaged

B. the patient exhibits unilateral left lingual weakness

- the right side of the tongue is stronger and forces the tongue to the left, the imbalance in strength causes the tongue to deviate from midline to the left upon protrusion

Which of the following are characteristics of cluttering vs. stuttering?

1. excessive frequency of part- and whole-word repetitions

2. excessive frequency of revisions

3. active attempts to avoid or conceal communication difficulties

4. reduced intelligibility in conjunction with rapid rate

5. misarticulating of multisyllabic words

6. limited concern and awareness of communication deficits

7. use of word avoidance and circumlocution in response to anticipated disfluency

Stuttering: 1, 3, 7

Cluttering: 2, 4, 5, 6

Which of the following is the most common phonological problem evidenced by young children aged 29 months?

A. cluster reduction

B. velar fronting

C. nasal assimilation

D. dimunitization

A. cluster reduction

An SLP 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 SLP 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 2 actions

B. requesting wants in any modality

- requests are very important for early development of language and for day-to-day verbal interactions with others; requests are usually the first type of communication acquired by an infant

A 75-year-old patient with a history of COPD 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 patients condition, which of the following assessment procedures is most appropriate for an SLP 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 pre-existing dysphagia with the patient and the patient's family; if there is no history of dysphagia, recommending to advance the patient's diet

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

- 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

- a 24 hours "deferral time" benchmark is not particularly useful

A study is conducted to determine how well dysphagia screening test predicts aspiration that is later confirmed with a VFSS. The study results are presented below

Failed screen

Aspiration: 45

No aspiration: 20

Passed screen

Aspiration: 5

No aspiration: 30

Which three of the following statements about this dysphagia screening test are true?

A. the test's sensitivity is 90%

B. the test's sensitivity is 69%

C. the test's specificity is 90%

D. the test's specificity is 60%

E. the number of false negatives was 5

F. the number of false negatives was 20

A, D, E

- the sensitivity is the proportion of patients who aspirated and failed the screen compared to the total of all patients who aspirated on the VFSS, therefore, 45/50= 0.90

- the specificity is the proportion of patients who did not aspirate and passed the screen compared to the total of all patients who did not aspirate on the VFSS, therefore, 30/50= 0.60

- false negatives are patients who passed the screen who actually aspirated on the VFSS

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 SLPs best response to the parents concern?

A. at Sharon's age, jargon is normal and may even continue for another 3-4 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

A. at Sharon's age, jargon is normal and may even continue for another 3-4 months

- jargon typically continues until around 18 months of age

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

D. the glossopharyngeal

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 2-3 times to clear liquid and solid boluses. She underwent a VFSS that showed a limited duration of UES opening. The SLP 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 FEES evaluation to determine if the patient is performing the maneuver properly

B. performing cervical auscultation (CA) to quantify improved swallowing with the maneuver

C. using submittal surface electromyography (sEMG) 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

C. using sEMG as biofeedback during attempts to perform the maneuver

- sEMG has been shown to improve acquisition of the Mendelsohn maneuver in some people though the maneuver itself is very difficult to learn

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 judgement

B. laryngeal visualization