EBP Knowledge Checks

Belinda is a first semester Master's level student who is conducting her first diagnostic session. It is important that she provide an assesment that is:

valid and reliable

3 multiple choice options

Adele is a first semester Master's level student who is conducting her first diagnostic session. The child she is testing was born at 32 weeks gestational age. She is now 16 months old. Adele's adjusted age would be:

14 months

3 multiple choice options

Bella is an SLP who is conducting a narrative assessment. She decides to do a dynamic assessment. What does she have to do for an assessment to be dynamic?

She has to test, then teach, then test again to determine if gains are made.

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Jalica is a graduate student training to be an SLP. She decides to give a checklist and a self-assessment to a client who is being evaluated for stuttering. What types of assessments are these?

They are both authentic assessments

3 multiple choice options

The first step in making an evidence-based clinical decision is to:

Ask a clinical question

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ASHA evidence maps, the Informed SLP, and EBP briefs are:

Places where an SLP might find evidence for making a clinical decision about a test

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Evidence-based practice, or EBP, involves three areas that are used together to make clinical decisions these are:

All answers listed

3 multiple choice options

A school-based SLP, Ms. Cashion, receives an email from a parent requesting updates on their child's therapy progress. Ms. Cashion replies with a detailed summary of the child's foals and recent session notes using her personal Gmail account. Which of the following best describes Ms. Chen's action under HIPAA?

It is a violation because she used a non-secure email platform

3 multiple choice options

Case Study: You are evaluating a 4:6 old child, Joy, who is a reticent speaker in unfamiliar settings. Her teacher reports concerns about limited use of complex sentences and difficulty with narrative skills. During a conversational language sample in your clinic, Joy produces very few utterances and is generally non-communicative.

Question: Which of the following is the most appropriate next step to obtain a more representative language sample from Joy?

Elicit a narrative language sample using a familiar wordless picture book or story re-tell task

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Case Study: A new standardized assessment for identifying expressive language delays in toddlers is published. The test developers report that the test scores correlate strongly with later academic performance, particularly in reading and writing.

Question: The strong correlation between the test scores and future academic performance is an example of what type of validity?

Predictive validity

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Case Study: A speech-language pathologist (SLP) administers a standardized articulation test to a 4-year-old child on Monday. The SLP then re-administers the same test to the child two weeks later. The SLP compares the scores from the two administrations to see if they are consistent.

Question: By comparing the scores from the two administrations of the same test, the SLP is assessing the test's:

Test-retest reliability

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Case Study: A new, quick-screening tool for childhood apraxia for speech (CAS) was developed. The tool has a reported sensitivity of 95% and a specificity of 70%

The tool is likely to incorrectly identify many children who do not have CAS (high false-positive rate)

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What is true about the Cookie Theft picture?

Individuals with dementia score more poorly on the Cookie Theft picture compared to those without dementia

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What types of elicitation methods can be found in the Aphasia Bank?

Different picture descriptions

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Justine is an SLP who wants to conduct a language sample with a 14 year old at her school suspected of having a developmental language disorder (DLD). Based on what you've learned in class what tool might you use?

All listed

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An SLP is conducting a language sample for a patient who sustained a severe traumatic brain injury (TBI) six months ago. During a monologue task (retelling a movie plot), the patient provides a significant amount of information, but the content is disorganized, includes irrelevant details, and frequently veers off-topic. To most accurately document this patient's deficit, which metric should the SLP calculate?

Global Coherence Scale

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A patient who recently underwent dental surgery reports "numbness" in the anterior two-thirds of the tongue and difficulty chewing solid foods. During the exam, the clinician observes that the patient's jaw deviates to the affected side when opening the mouth. Which cranial nerve is responsible for these motor and sensory symptoms?

CN V (Trigeminal)

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During the assessment of the oral cavity, a clinician observes that the patient's hard palate has an unusually high, narrow arch. Additionally, the clinician notes the presence of a bifid uvula and a thin, blue line (zona pellucida) along the midline of the soft palate. These finding are most suggestive of:

A submucousal soft palate

3 multiple choice options

During a bedside swallow evaluation, a clinician observes that the patient has difficulty containing a bolus in the oral cavity due to poor labial seal. Additionally, the patient is unable to puff out their cheeks without air escaping. These findings suggest a deficit in which cranial nerve?

CN VII (Facial)

3 multiple choice options

While evaluating tongue function, a clinician observes that the patient's tongue appears "bunched" and retracted at rest. When asked to protrude the tongue, the movement is limited, and the tongue tip appears notched or heart-shaped. The patient reports difficulty elevating the tongue tip to the alveolar ridge for /l/ and /t/. This structural finding is known as:

Ankyloglossia

3 multiple choice options

You receive a referral for a 4-year-old named Patrick due to concerns about his intelligibility. During the intake with Patrick's mother, she mentions that the family recently moved and that Leo was hesitant to talk to people outside the family. She also states that she is concerned because her younger sister's son had speech therapy for an /r/ sound disorder and feels that Patrick may have a similar issue.

Question: During the intake interview, which of the following is the most appropriate action for the SLP to take to avoid bias and gather the most accurate pre-assessment information?

Ask open-ended questions about Leo's communication in various settings and inquire about his recent transition, while acknowledging her obserations about his cousin

3 multiple choice options

During my parent interview for a 5-year-old child, the father states, "My wife and I have been concerned about how difficult it is for us to understand him. We feel like we're constantly guessing what he's trying to say, especially in the mornings." To reflect the content of the father's statement, which of the following would be the most appropriate SLP response?

"You're concerned because you have trouble understanding your son, particularly in the mornings, and feel like you're guessing what he's saying."

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A parent is tearful during an interview, expressing, "I just feel so defeated. We have tried everything, and it feels like we're getting nowhere with his language development." To reflect the feeling conveyed by the parent, which of the following is the most appropriate response for the SLP?

"It sounds like you're feeling a sense of helplessness and exhaustion".

3 multiple choice options

An SLP is selecting a new test to assess language in bilingual children. The test was high inter-rater reliability (clinicians agree on scoring), but low construct validity (it does not accurately measure language capability in this population). Which of the following is true regarding this test?

The test is consistent but does not measure what it claims to measure

3 multiple choice options

A 5-year-old Cantonese-speaking child, Chun, is referred for a speech-language evaluation by his kindergarten teacher due to concerns about slow language acquisition compared to his peers. The teacher reports that Chun is quiet in class and interacts minimally with others. His parents, who have limited English proficiency, agree to the evaluation with a professional interpreter. During the pre-assessment meeting, you explain to the parents, through the interpreter, that the purpose is to determine Chun's communication skills in both Cantonese and English. The interpreter adds, in Cantonese, "The SLP thinks Chun has a problem because he's not talking like the other children."

Question: The interpreter's addition is a breach of which ethical standard for interpreters?

Maintaining impartiality and avoiding the interjection of personal opinions or explanations

3 multiple choice options

You are evaluating an 8-year-old Somali-speaking child, Aamilina, who was in a recent car accident and has been experiencing cognitive-communication difficulties. During the initial interview with her mother, who does not speak English, you notice the interpreter is having trouble keeping up with the rapid flow of information. The interpreter often interrupts the mother to ask for clarification, which disrupts the conversation and makes it difficult for you to understand the child's pre-morbid language abilities.

Question: What is the most appropriate action for the SLP to take in this situation to adhere to best practices for effective interprofessional communication?

Intervene by speaking in shorter segments and pausing frequently to allow the interpreter to process and convey the information accurately.

3 multiple choice options

You are a pediatric SLP collaborating with a physical therapist (PT) and an occupational therapist (OT) to develop a transdisciplinary intervention plan for a preschooler with cerebral palsy. The child's parents primarily speak Russian, and a professional interpreter is present for the planning meeting. The PT and OT use a lot of discipline-specific jargon, which you notice is confusing for the parents, even after the interpreter translates it.

Question: How should the SLP, demonstrating the IPE core competency of communication, best address this situation?

Interrupt the team and ask everyone to use "plain language" that is accessible to the family and the interpreter

3 multiple choice options

An SLP is working with a patient who recently had a stroke and speaks only American Sign Language (ASL). The certified ASL interpreter is a friend of the patient's family, and the patient seems comfortable with their presence. During a treatment session, the interpreter makes a comment to the SLP about a personal issue the patient is facing, which the patient did not bring up.

Question: The interpreter's action is a violation of which professional and ethical standard?

The duty to maintain confidentiality and professional boundaries

3 multiple choice options

Case Study: SLP D.R. is screening a 3-year-old child using a newly developed, time-efficient screening tool. The tool has a reported sensitivity of 70% and a specificity of 95%

Question: How should D.R. interpret the sensitivity of this screening tool?

The test is only 70% accurate at correctly identifying children who truly have a language delay

3 multiple choice options

Case Study: A school-based SLP, E.R., needs to select a test for a 3-year-old entering a public school early childhood program. The primary concern is the child's readiness for the language demands of the classroom, specifically in areas like basic concepts, following directions, and early literacy skills.

Question: Which assessment is generally considered to be better aligned with classroom-based language demands for this age group?

CELF-P3, because its subtests focus on semantics, morphology, and syntax skills that are foundational to academic tasks.

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Case Study: SLP V.C. is reviewing a test manual for a new language assessment for toddlers (ages 18-36 months). The manual reports a sensitivity of 0.88 and a specificity of 0.82 at the recommended cut score.

Question: How should V.C. evaluate these psychometric properties?

Both sensitivity and specificity are in the "adequate" range (0.80-0.89), suggesting acceptable diagnostic accuracy.

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Case Study: SLP H.F. is working in an infant-toddler program and needs a comprehensive tool to assess various developmental domains (cognitive, language, motor, social-emotional).

Question: Which assessment tool provides the most comprehensive evaluation across multiple developmental areas for this population?

Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4)

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A 22-month-old toddler presents with a significant history of prematurity and late-onset babbling. The clinician wants to assess a broad range of developmental areas including cognition, motor, and language using a single standardized tool. Which assessment is most appropriate?

Mullen Scales of Early Learning (MSEL)

3 multiple choice options

A 30-month-old child is being evaluated for a suspected language delay. The clinician needs a tool that allows for information to be gathered through direct observation, elicitation, and caregiver report to establish a developmental age for interaction-attachment, pragmatics, and play. Which tool should be selected?

Rossetti Infant-Toddler Language Scale

3 multiple choice options

A 4-year-old child demonstrates strong basic vocabulary but struggles significantly with using correct morphological markers (e.g., plurals, past tense -ed, possessives) in spontaneous speech. The clinician wants a rigorous, standardized measure specifically targeting the child's internal grammar/morphology. Which is the best choice?

Rossetti Scales

3 multiple choice options

A 4-year-old bilingual (Spanish/English) child is referred for a language evaluation. The clinician wants to use the SPELT-3 to assess English grammar. What is the most critical professional consideration the SLP must make before interpreting the results?

The child's errors may be due to language transfer rather than a disorder.

3 multiple choice options

An SLP is evaluating a 4-year-old with significant phonological delays and suspected oral language deficits. To better understand the child's ability to create a cohesive story from visual cues, the SLP chooses an assessment that provides a standardized measure of narrative language. Which tool is most appropriate?

TNL-2

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A child (4 years, 11 months) is struggling with letter-sound correspondence and cannot identify words that start with the same sound. The SLP wants to determine if the child is at risk for later reading disabilities using the TILLS. Which subtest is the most appropriate for this age to assess the phonological foundations of reading?

Phonemic awareness

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The SLP is using the TNL-2 with a 5-year-old. The child is shown a sequence of pictures and asked to create an original story. This task is measuring which specific modality of narrative language?

Oral narrative production

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A preschooler is being screened for reading readiness. The SLP asks the child to clap out the "parts" of the word "elephant" (el-e-phant). This task assesses which level of phonological awareness?

Syllable segmentation

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A 72-year-old patient who underwent prolonged intubation following cardiac surgery is referred for an instrumental swallowing evaluation. The patient presents with a breathy voice and occasional coughing on thin liquids. The SLP wants to directly visualize the vocal folds and check for any laryngeal pathology before proceeding with oral trials.

Which instrumental assessment is most appropriate?

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

3 multiple choice options

A newborn is having significant difficulty with breastfeeding. The SLP observes that the infant has a very weak latch and the tongue does not seem to cup around the nipple or move in a rhythmic, undulating fashion.

Which cranial nerve is primarily responsible for the motor innervation of the tongue during sucking?

Cranial Nerve XII (Hypoglossal)

3 multiple choice options

During a clinical bedside swallow evaluation, a patient exhibits significant residue in the lateral sulci (pocketing) and reduced labial seal, leading to anterior spillage of the bolus.

These symptoms are most characteristic of a deficit in which phase?

Oral phase

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A patient reports that they cannot feel food or liquid in the back of their throat, often leading to "choking" because they don't realize the bolus has moved past the oral cavity.

Which cranial nerve is primarily responsible for sensory information from the base of the tongue and the upper pharynx

Cranial Nerve IX (Glossopharyngeal)

3 multiple choice options

A 4-year-old child presents with inconsistent errors on both consonants and vowels across repeated productions of the same words, lengthened and disrupted coarticulatory transitions, and inappropriate prosody. During a dynamic assessment, the child demonstrates groping behaviors and a slow rate of speech. These clinical markers are most characteristic of:

Childhood Apraxia of Speech (CAS)

3 multiple choice options

An SLP is evaluating a 3-year-old's receptive vocabulary using the Peabody Picture Vocabulary Test, Fifth Edition (PPVT-5). The child’s score falls significantly below the mean. To get a more comprehensive view of the child's language abilities including receptive morphology and syntax, which of the following assessments would be the most appropriate next step?

Correct answer:

Clinical Evaluation of Language Fundamentals—Preschool-3 (CELF-P3)

3 multiple choice options

An SLP is evaluating a 5-year-old’s phonological processing using the CTOPP-2. The child scores poorly on the "Nonword Repetition" subtest. This specific task is a sensitive measure of:

Phonological memory

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A 4-year-old is asked to produce the /s/ sound. The child produces a clear /s/ in "ice" but a /t/ in "soap." This demonstrates that the child is:

Stimulable for /s/ in the final position of words.

3 multiple choice options

A 45-year-old teacher presents with chronic hoarseness and vocal fatigue. During the initial interview, the client sounds hoarse and notes that their voice is consistently worse by the end of the school day. The SLP needs a reliable, self-perceived measure of the impact of the voice disorder on their daily life. Which assessment tool is the most appropriate for this purpose?

Vocal Handicap Index (VHI)

3 multiple choice options

An SLP is evaluating the voice of an elderly client with suspected Parkinson's disease. The primary perceptual complaint is that the client is consistently speaking too softly, making it difficult to be understood in noisy environments. Which aspect of voice assessment should the SLP prioritize using instrumental or objective measures to document the severity?

Loudness (Intensity)

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A client is asked to sustain the phoneme /z/ for as long as possible. The client sustains the /z/ for 8 seconds. When asked to sustain the voiceless fricative /s/ for as long as possible, the client sustains it for 20 seconds. What can the SLP infer from this specific finding?

This result is highly indicative of a laryngeal pathology impacting phonation.

3 multiple choice options

During a clinical resonance assessment, an SLP asks a child to produce non-nasal sounds and sentences with pressure consonants (e.g., "Buy Bobby a puppy"). The SLP also uses a mirror under the child's nose during these productions. The mirror fogs up consistently. This observation indicates which resonance issue?

Hypernasality (Nasal Emission)

3 multiple choice options

A 7-year-old child with cerebral palsy and spastic quadriplegia has unintelligible speech and limited fine motor skills. He is mainstreamed into a general education classroom with support and demonstrates strong cognitive skills and literacy potential. He currently uses a communication board with 40 symbols accessed via a head pointer, but his communication partners struggle to keep up with his pace and locate vocabulary efficiently. The SLP is beginning a comprehensive AAC assessment. Which aspect of the WHO-ICF framework is the SLP primarily addressing when considering this student's inability to efficiently participate in rapid classroom discussions?

Participation Restrictions

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A 3-year-old child with ASD has no functional speech and exhibits significant behavioral challenges, including limited attention to tasks and frequent meltdowns when frustrated. The parents report he can independently use an iPad for leisure activities (watching videos) but does not use it to request items or interact. The family expresses concern that using AAC will prevent their child from developing natural speech. The SLP should address this Environmental Factor (specifically, Attitudes of family members) by stating that research strongly indicates:

AAC use facilitates or does not hinder natural speech development.

3 multiple choice options

A 65-year-old client suffered a severe stroke resulting in global aphasia and apraxia of speech. He is oriented but highly frustrated by his severe expressive communication difficulties. He can point reliably with his right hand. The goal is immediate functional communication within the hospital setting. Which low-tech AAC system is best suited for immediate implementation at the bedside to facilitate basic needs requests (e.g., "pain," "nurse," "bathroom")?

A laminated visual analog scale for pain and a simple picture/word communication board.

3 multiple choice options

A 10-year-old child currently uses a 12-button static-display device. The SLP wants to trial a dynamic display device with multiple pages to increase vocabulary rapidly. The child successfully learns to navigate a few pages during the trial. This successful trial is an example of what type of assessment approach?

Dynamic assessment

3 multiple choice options

An SLP is evaluating a young child suspected of having CAS. During the assessment, the SLP observes the child exhibiting "groping" behaviors with their mouth and tongue while trying to produce specific sounds, as well as lengthened and disrupted co-articulatory transitions between sounds and syllables. What specific aspect of CAS is the SLP observing?

Motor planning and programming difficulties.

3 multiple choice options

An SLP is assessing an elderly person with suspected dementia. The patient exhibits significant memory impairment, difficulty with complex tasks, and some visuospatial problems. To obtain a comprehensive understanding of the patient's function, the SLP uses a person-centered approach which includes interviewing the caregiver. What is an advantage of this person-centered assessment method?

It helps identify meaningful activities and communication strategies specific to the individual's life and context.

3 multiple choice options

An SLP is evaluating a patient whose speech is characterized by a strained-strangled vocal quality, slow rate, hypernasality, and a monotonous pitch/loudness. The underlying neuromuscular condition involves bilateral upper motor neuron damage. These speech characteristics are most indicative of which type of dysarthria?

Spastic dysarthria.

3 multiple choice options

A 72-year-old patient who recently experienced a left-hemisphere stroke is undergoing an aphasia assessment. The patient's speech is slow, effortful, and produced in short, 1-3 word utterances, primarily containing content words (telegraphic speech). The patient understands most of what is said to them but struggles to repeat simple phrases. They are visibly frustrated by their difficulty speaking. Which type of aphasia does this presentation most likely indicate?

Broca's aphasia

3 multiple choice options

A 5-year-old bilingual child, who speaks Spanish and English, was referred for a speech-language evaluation. The assessment revealed a receptive language delay primarily in English, with some cross-linguistic influence from Spanish. You are preparing to share your findings with the family and the multidisciplinary team, which includes an educator and an occupational therapist (OT). The family expresses concern that using two languages is confusing their child and requests that you only focus on English.

Which of the following represents the most ethical and effective course of action?

Explain to the team and family that bilingualism is not the cause of the language disorder and that they should continue to use both languages, providing resources to support this.

3 multiple choice options

You are a graduate student completing a hospital placement. Your patient, a 65-year-old male with a history of stroke, was recently assessed for dysphagia. You recommend thickened liquids, but the patient is resistant. He informs the dietitian that he finds the taste and texture unappealing and refuses to drink them. The dietitian approaches you to discuss the patient's refusal and concerns about dehydration.

What is the most appropriate action to take in this IPE scenario?

Collaborate with the dietitian and patient to find a balance between safety and quality of life, which may include offering alternative modifications or exploring different strategies for hydration.

3 multiple choice options

You are on an IPP team developing a long-term plan for a 10-year-old with complex communication needs, including severe intellectual disability and limited verbal skills. The team includes the student's teacher, occupational therapist, and the student's parent. You have completed an AAC evaluation and believe a high-tech communication device is warranted. During the planning meeting, the parent expresses concerns that the device will prevent her child from talking.

How should you address the parent's concern while maintaining an IPP approach?

Explain that research shows AAC use can facilitate, not hinder, verbal speech and demonstrate how the device can be used in different settings to meet communication needs.

3 multiple choice options

A 6-year-old with a significant speech sound disorder is referred to you. The evaluation reveals a pattern of phonological processes, including final consonant deletion and fronting, that are impacting intelligibility. You share these findings with the teacher during a conference, but you notice she appears confused and unsure how to incorporate this information into the classroom.

What is the most effective way to share this information with the teacher as part of your IPE responsibilities?

Translate the assessment findings into practical, classroom-based strategies, such as providing picture cues or focusing on specific sounds during storytime, while avoiding technical jargon.

3 multiple choice options

An SLP receives a referral for a 72-year-old patient post-stroke with suspected dysphagia. During the clinical bedside swallow evaluation, the patient exhibits a wet, gurgly voice quality immediately after swallowing a thin liquid trial. This finding is most likely indicative of:

Pharyngeal residue with potential for aspiration after the swallow.

3 multiple choice options

When assessing an adult who stutters, the clinician observes core behaviors of stuttering as well as associated physical movements (e.g., subtle eye rolling, slight head jerking). These associated behaviors are best described as:

Secondary behaviors developed as tension responses or escape/avoidance mechanisms.

3 multiple choice options

A 22-year-old college student who has stuttered since childhood expresses significant fear of public speaking and avoids social situations where they might have to talk. The client exhibits frequent blocks and secondary physical behaviors. Beyond a speech sample and disfluency count, which of the following is a critical component of a comprehensive assessment for this individual?

The use of a self-report measure to assess the impact of stuttering on quality of life and communication attitudes.

3 multiple choice options

An adolescent client presents with a rapid speaking rate and reports that people frequently ask them to repeat themselves. The clinician notes a high frequency of interjections and revisions, along with occasional word final disfluencies. Which characteristic is a key indicator the clinician should look for during assessment to confirm the presence of cluttering rather than just a fast rate of speech?

A breakdown in intelligibility due to excessive coarticulation and abnormal pausing.

3 multiple choice options