🧠 30 HIGH-DIFFICULTY MULTIPLE-CHOICE QUESTIONS — PEDIATRIC SPEECH SOUND DISORDERS

1️⃣ Distinctive Features

What are distinctive features in phonology?
A. Stress patterns that guide rhythm
B. Binary (+/–) properties defining sound contrasts
C. Motor gestures for each phoneme
D. Word-level tone variations

Answer: B. Binary (+/–) properties defining sound contrasts

2️⃣ Generative vs Natural Phonology

What does natural phonology primarily explain?
A. How auditory feedback refines speech perception
B. Innate simplification processes used by children
C. Acoustic properties of vowel height
D. The syntax-phonology interface

Answer: B. Innate simplification processes used by children

3️⃣ Naturalness vs Markedness

A. Natural – frequent/easy; Marked – complex/rare
B. Natural – incorrect; Marked – typical
C. Natural – slow; Marked – fast
D. Natural – voiceless; Marked – voiced

Answer: A. Natural – frequent/easy; Marked – complex/rare

4️⃣ Linear vs Nonlinear Theory

A. Linear – segment-level only; Nonlinear – includes suprasegmentals
B. Linear – slow; Nonlinear – fast
C. Linear – syntax based; Nonlinear – semantic
D. Linear – child; Nonlinear – adult

Answer: A. Linear – segment-level only; Nonlinear – includes suprasegmentals

5️⃣ Therapy Application of Theories

When choose linear vs nonlinear theory in therapy?
A. Linear – segmental issues; Nonlinear – stress/syllable issues
B. Linear – syntax; Nonlinear – semantics
C. Linear – motor; Nonlinear – hearing
D. Linear – adults; Nonlinear – children

Answer: A. Linear – segmental issues; Nonlinear – stress/syllable issues

6️⃣ Optimality Theory

What does Optimality Theory propose?
A. Speech output arises from ranked constraint interaction
B. All speech is random and ungoverned
C. Children memorize phoneme lists
D. Only anatomy determines production

Answer: A. Speech output arises from ranked constraint interaction

7️⃣ Metrical Phonology

What is the focus of metrical phonology?
A. Stress and rhythmic structure within utterances
B. Nasal vs. oral airflow differences
C. Cognitive planning of phrases
D. Visual cues in reading

Answer: A. Stress and rhythmic structure within utterances

8️⃣ Distinguishing Articulation vs Phonological Disorder

A. Articulation – motor errors; Phonological – rule-based error patterns
B. Articulation – language-based; Phonological – motor control
C. Articulation – voice; Phonological – resonance
D. Articulation – syntax; Phonological – semantics

Answer: A. Articulation – motor errors; Phonological – rule-based error patterns

9️⃣ Independent Analysis

What does an independent analysis reveal?
A. Sounds the child can produce, regardless of accuracy
B. Percent consonants correct
C. Degree of stimulability
D. Intelligibility score

Answer: A. Sounds the child can produce, regardless of accuracy

🔟 Relational Analysis

What does a relational analysis measure?
A. Comparison of child productions to adult target forms
B. Suprasegmental rhythm accuracy
C. Number of words per minute
D. Parental intelligibility rating

Answer: A. Comparison of child productions to adult target forms

11⃣ Norm- vs Criterion-Referenced Testing

A. Norm = peer comparison; Criterion = specific skill mastery
B. Norm = standard score; Criterion = IQ score
C. Norm = hearing; Criterion = motor
D. Norm = expressive; Criterion = receptive`

Answer: A. Norm = peer comparison; Criterion = specific skill mastery =

12️⃣ PCC Severity Scale

Which describes PCC severity ranges?
A. 90–100 Mild; 65–89 Mild-Mod; 50–64 Mod-Severe;

Answer: A. 90–100 Mild; 65–89 Mild-Mod; 50–64 Mod-Severe; <50 Severe

13️⃣ Stimulability

What does stimulability testing assess?
A. Child’s ability to imitate a modeled sound
B. Word comprehension
C. Visual recognition
D. Breath support

Answer: A. Child’s ability to imitate a modeled sound

14️⃣ Positive Stimulability Implication

A. Poor prognosis
B. Better chance for progress
C. Indicates need for surgery
D. Suggests no disorder

Answer: B. Better chance for progress

15️⃣ Coarticulation Types

Which describes progressive coarticulation?
A. Earlier sound influences later one
B. Later sound influences earlier one
C. No overlap occurs
D. Two simultaneous articulations

Answer: A. Earlier sound influences later one

16️⃣ Regressive Coarticulation

A. Earlier sound affects later one
B. Later sound affects earlier one
C. Unrelated sequencing
D. Prosodic blending only

Answer: B. Later sound affects earlier one

17️⃣ Typical Phonological Processes

Which process normally resolves by age 4?
A. Fronting
B. Final consonant deletion
C. Gliding of /r/
D. Stopping of /fr/

Answer: B. Final consonant deletion

18️⃣ Statistical Learning

A. Detecting frequent sound patterns to infer word boundaries
B. Counting phonemes per utterance
C. Memorizing entire words
D. Producing rhythmic stress

Answer: A. Detecting frequent sound patterns to infer word boundaries

19️⃣ Native Language Neural Commitment

At what age do infants become language-specific listeners?
A. 4 months
B. 8 months
C. 11 months
D. 18 months

Answer: C. 11 months

20️⃣ Motherese

A. Exaggerated prosody used to aid infant learning
B. Fast adult-like speech
C. Whispered articulation pattern
D. Atypical voice disorder

Answer: A. Exaggerated prosody used to aid infant learning

21️⃣ Operant Theory in Speech Learning

A. Caregiver reinforcement encourages repetition
B. Children learn via innate grammar rules only
C. Hearing shapes neural commitment
D. Speech emerges from motor imitation alone

Answer: A. Caregiver reinforcement encourages repetition

22️⃣ Protowords

A. Consistent child-created forms with communicative meaning
B. Random babbles
C. Parental imitation
D. Non-speech vocalizations only

Answer: A. Consistent child-created forms with communicative meaning

23️⃣ Dysarthria vs Apraxia

A. Apraxia – planning deficit; Dysarthria – muscle weakness
B. Apraxia – hearing loss; Dysarthria – language delay
C. Apraxia – structural gap; Dysarthria – hypernasality
D. Apraxia – phonological; Dysarthria – semantic

Answer: A. Apraxia – planning deficit; Dysarthria – muscle weakness

24️⃣ Flaccid Dysarthria Features

A. Weak, breathy voice due to LMN damage
B. Strained-harsh quality
C. Fast rate with reduced range
D. Irregular prosody

Answer: A. Weak, breathy voice due to LMN damage

25️⃣ Spastic Dysarthria Features

A. Strained, slow, effortful speech from UMN lesions
B. Weak breathy voice
C. Rapid slurred speech
D. Excessive movement

Answer: A. Strained, slow, effortful speech from UMN lesions

26️⃣ Hypokinetic Dysarthria

A. Reduced movement & fast rate (Parkinson’s)
B. Weak breathy voice
C. Strained quality
D. Excess prosodic variation

Answer: A. Reduced movement & fast rate (Parkinson’s)

27️⃣ Hyperkinetic Dysarthria

A. Involuntary movements affect speech
B. Weak muscles only
C. Monotone speech
D. Slow rate with flat intonation

Answer: A. Involuntary movements affect speech

28️⃣ Ataxic Dysarthria

A. Irregular timing and uncoordinated prosody (cerebellar)
B. Breathiness and slow rate
C. Hypernasality only
D. Involuntary movements of tongue

Answer: A. Irregular timing and uncoordinated prosody (cerebellar)

29️⃣ Obligatory vs Compensatory Errors (CLP)

A. Obligatory – structural (surgery); Compensatory – learned (therapy)
B. Obligatory – language; Compensatory – voice
C. Obligatory – cognitive; Compensatory – auditory
D. Obligatory – motor; Compensatory – syntax

Answer: A. Obligatory – structural (surgery); Compensatory – learned (therapy)

30️⃣ Hearing Loss Impact on Speech

A. Disrupts contrast development and speech precision
B. Improves resonance
C. Has no effect on phonology
D. Increases vocal loudness accuracy

Answer: A. Disrupts contrast development and speech precision