🧠 MC - PEDIATRIC SPEECH SOUND DISORDERS (Weeks 1 – 6)

🗂 WEEK 1 — INTRODUCTION & PHONETICS

What does phonology study?
A. Voice quality
B. Sound patterns and rules
C. Grammar and meaning
D. Vocabulary organization

Answer: B. Sound patterns and rules

What does articulation refer to?
A. How air flows through the nasal cavity
B. Physical production of speech sounds
C. The process of swallowing
D. Language comprehension

Answer: B. Physical production of speech sounds

What is the main difference between vowels and consonants?
A. Vowels have an open tract; consonants have constriction
B. Consonants are voiced; vowels are not
C. Consonants are longer in duration
D. Vowels occur only at word endings

Answer: A. Vowels have an open tract; consonants have constriction

What are the three main descriptors for consonants?
A. Tongue height, lip rounding, tension
B. Place, manner, voicing
C. Loudness, pitch, tone
D. Onset, nucleus, coda

Answer: B. Place, manner, voicing

What are the five descriptors for vowels?
A. Front/back, high/low, rounded/unrounded, tense/lax, r-coloring
B. Onset, peak, coda, place, manner
C. Voice, resonance, rhythm, tone, pitch
D. Nasal, oral, plosive, fricative, glide

Answer: A. Front/back, high/low, rounded/unrounded, tense/lax, r-coloring

What are monophthongs?
A. Two articulations in one sound
B. Nasalized vowels
C. One steady articulation
D. Sounds made with lip closure

Answer: C. One steady articulation

What are diphthongs?
A. Two articulations in one vowel sound
B. Stops produced nasally
C. Front vowels only
D. Unrounded vowels

Answer: A. Two articulations in one vowel sound

What is the schwa /ə/?
A. A stressed “uh” sound
B. An unstressed “uh” sound
C. An r-colored vowel
D. A nasalized vowel

Answer: B. An unstressed “uh” sound

What is the “carrot” /ʌ/?
A. A front rounded vowel
B. A stressed “uh” sound
C. An unstressed “uh” sound
D. A diphthong

Answer: B. A stressed “uh” sound

What is the difference between /ɝ/ and /ɚ/?
A. /ɝ/ is stressed; /ɚ/ is unstressed
B. /ɚ/ is stressed; /ɝ/ is unstressed
C. /ɝ/ is fronted; /ɚ/ is backed
D. Both are identical

Answer: A. /ɝ/ is stressed; /ɚ/ is unstressed

What do columns in the IPA chart represent?
A. Place of articulation
B. Manner of articulation
C. Vowel height
D. Voicing distinction

Answer: A. Place of articulation

What do rows in the IPA chart represent?
A. Manner of articulation
B. Place of articulation
C. Voicing
D. Stress

Answer: A. Manner of articulation

What does left vs. right cell mean in IPA?
A. Left – voiced; right – voiceless
B. Left – voiceless; right – voiced
C. Left – nasal; right – oral
D. Left – vowel; right – consonant

Answer: B. Left – voiceless; right – voiced

What do white vs. gray IPA cells mean?
A. White – nasal; gray – oral
B. White – used; gray – unused
C. White – possible but unused; gray – impossible
D. White – voiced; gray – voiceless

Answer: C. White – possible but unused; gray – impossible

When are diacritics used?
A. To indicate stress
B. To modify a sound (e.g., devoicing)
C. To show syllable boundaries
D. To indicate loudness

Answer: B. To modify a sound (e.g., devoicing)

What is coarticulation?
A. When two people speak simultaneously
B. Overlapping of sounds during production
C. A type of articulation disorder
D. Producing a sound twice

Answer: B. Overlapping of sounds during production

What is progressive coarticulation?
A. Later sound affects earlier one
B. Earlier sound affects later one
C. Sounds blend randomly
D. No overlap occurs

Answer: B. Earlier sound affects later one

What is regressive coarticulation?
A. Earlier sound affects later sound
B. Later sound affects earlier one
C. Sounds produced in isolation
D. Airflow is stopped

Answer: B. Later sound affects earlier one

What is a syllable composed of?
A. Nucleus and onset only
B. Onset, nucleus, coda
C. Stress and intonation
D. Consonants only

Answer: B. Onset, nucleus, coda

What is an open syllable?
A. Ends in a vowel
B. Ends in a consonant
C. Has two vowels
D. Has stress on the last sound

Answer: A. Ends in a vowel

What is a closed syllable?
A. Ends in a vowel
B. Ends in a consonant
C. Has three phonemes
D. Lacks a coda

Answer: B. Ends in a consonant

When do you use [ ], / /, and “ ”?
A. [ ] – actual, / / – target, “ ” – report
B. [ ] – report, / / – target, “ ” – actual
C. [ ] – spelling, / / – sound, “ ” – emphasis
D. All mean the same

Answer: A. [ ] – actual, / / – target, “ ” – report

What is orthographic transcription?
A. Actual sound transcription
B. Written spelling of words
C. Sound pattern transcription
D. Stress marking

Answer: B. Written spelling of words

What is phonetic transcription?
A. Written spelling
B. Meaning-based translation
C. Actual sound representation
D. Stress notation

Answer: C. Actual sound representation

What is phonology’s clinical importance?
A. Identifies motor cause of errors
B. Identifies sound pattern rules and simplifications
C. Measures vocal intensity
D. Measures resonance

Answer: B. Identifies sound pattern rules and simplifications

What should you focus on in transcription?
A. What you expect to hear
B. What you actually hear
C. Written spelling only
D. The stress pattern

Answer: B. What you actually hear

🗂 WEEK 2 — THEORIES OF PHONOLOGY

What are distinctive features?
A. Sound contrasts based on meaning
B. Binary (+/–) properties of phonemes
C. Stress and rhythm patterns
D. Tongue-placement diagrams

Answer: B. Binary (+/–) properties of phonemes

Why are distinctive features clinically useful?
A. They measure hearing thresholds
B. They reveal shared traits and error patterns
C. They show vocabulary growth
D. They score intelligibility

Answer: B. They reveal shared traits and error patterns

Which two forms are proposed in generative phonology?
A. Articulatory vs. acoustic
B. Phonological vs. phonetic representation
C. Expressive vs. receptive
D. Pragmatic vs. semantic

Answer: B. Phonological vs. phonetic representation

What does natural phonology explain?
A. Innate simplification processes in children
B. How syntax develops
C. Differences in accent
D. Speech rate variations

Answer: A. Innate simplification processes in children

What is 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

Which theory emphasizes phonological processes?
A. Generative phonology
B. Natural phonology
C. Optimality theory
D. Distinctive features theory

Answer: B. Natural phonology

What is the difference between linear and nonlinear theories?
A. Linear – segment-level only; Nonlinear – includes suprasegmentals
B. Linear – slow; Nonlinear – fast
C. Linear – child-specific; Nonlinear – adult-specific
D. Linear – motor; Nonlinear – language

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

What is metrical phonology concerned with?
A. Stress and rhythmic structure of speech
B. Phoneme contrasts
C. Syntax of utterances
D. Motor sequencing

Answer: A. Stress and rhythmic structure of speech

What does optimality theory state?
A. Speech follows random variation
B. Speech arises from ranked constraints
C. All sounds are equal in complexity
D. Speech depends only on anatomy

Answer: B. Speech arises from ranked constraints

What are pros/cons of optimality theory?
A. + Explains subtle patterns / – Complex and time-intensive
B. + Quick / – Shallow
C. + Easy / – Rarely accurate
D. + Motor / – Cognitive

Answer: A. + Explains subtle patterns / – Complex and time-intensive

Define phoneme.
A. A distinct sound that changes word meaning
B. A sound variant without meaning change
C. A motor plan
D. A stress pattern

Answer: A. A distinct sound that changes word meaning

Define allophone.
A. Variation of a phoneme that doesn’t change meaning
B. Completely different sound category
C. Error pattern
D. Suprasegmental feature

Answer: A. Variation of a phoneme that doesn’t change meaning

What do onset, peak, and coda represent?
A. Parts of a syllable (before, vowel, after)
B. Speech-rate categories
C. Tongue-movement stages
D. Breathing phases

Answer: A. Parts of a syllable (before, vowel, after)

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

🗂 WEEK 3 — TYPICAL DEVELOPMENT

What are the stages of speech development?
A. Babbling → Literacy → Syntax
B. Prelinguistic → First Words → Phonemic Dev. → Stabilization → Mastery
C. Listening → Speaking → Reading
D. Motor → Cognitive → Social

Answer: B. Prelinguistic → First Words → Phonemic Dev. → Stabilization → Mastery

What occurs during the prelinguistic stage?
A. Sentence formation
B. Cooing, babbling, jargon
C. Speech errors
D. Reading development

Answer: B. Cooing, babbling, jargon

Describe the first-word stage.
A. Complex sentences
B. 50 words, simple CV/VC shapes
C. Onset of literacy
D. Multi-syllabic words only

Answer: B. 50 words, simple CV/VC shapes

When does stabilization occur?
A. 2 yrs
B. 4–8 yrs
C. 10 yrs
D. Adulthood

Answer: B. 4–8 yrs

What marks mastery?
A. Speech + literacy integration (~8 yrs +)
B. First 50 words
C. Onset of babbling
D. Adult grammar

Answer: A. Speech + literacy integration (~8 yrs +)

Which phonological processes are typical?
A. Fronting, gliding, stopping, cluster reduction, final C deletion
B. Assimilation only
C. Voicing errors only
D. Vowel substitution

Answer: A. Fronting, gliding, stopping, cluster reduction, final C deletion

When are phonological processes concerning?
A. Before age 1
B. When persist beyond typical ages or are atypical
C. When present at birth
D. Never

Answer: B. When persist beyond typical ages or are atypical

What is statistical learning?
A. Counting phonemes
B. Detecting frequent sound patterns to find word boundaries
C. Producing rhythm
D. Analyzing grammar

Answer: B. Detecting frequent sound patterns to find word boundaries

What is native language neural commitment?
A. Preference for musical rhythms
B. By 11 months infants become language-specific listeners
C. Loss of hearing acuity
D. Memory for faces

Answer: B. By 11 months infants become language-specific listeners

What is motherese?
A. Speech disorder
B. Exaggerated prosody used with infants to aid learning
C. Phonological rule
D. Genetic syndrome

Answer: B. Exaggerated prosody used with infants to aid learning

How does variability support learning?
A. It confuses children
B. Helps generalize across speakers and contexts
C. Slows learning
D. Reduces attention

Answer: B. Helps generalize across speakers and contexts

What are protowords?
A. Child-created consistent forms with meaning
B. Adult vocabulary
C. Nonsense syllables only
D. Whispered words

Answer: A. Child-created consistent forms with meaning

What does operant theory explain?
A. Caregiver reinforcement encourages word repetition
B. Genetic inheritance of speech
C. Neurological plasticity
D. Hearing thresholds

Answer: A. Caregiver reinforcement encourages word repetition

What are prosodic features?
A. Stress and intonation patterns (iamb, trochee, spondee)
B. Phoneme contrasts
C. Syntax
D. Articulation placement

Answer: A. Stress and intonation patterns (iamb, trochee, spondee)

How do preschoolers develop phonological awareness?
A. Through rhyming, syllables, blending, reading exposure
B. By imitation alone
C. Through rote spelling
D. By memorizing IPA

Answer: A. Through rhyming, syllables, blending, reading exposure

What are two infant research paradigms?
A. High-amplitude sucking & head-turn/preferential-looking
B. EEG and MRI
C. Speech and language sampling
D. Parent survey and observation

Answer: A. High-amplitude sucking & head-turn/preferential-looking

How does social learning relate to speech?
A. Motor skills like walking and gesturing enhance communication
B. It reduces talking
C. It only affects reading
D. It has no effect

Answer: A. Motor skills like walking and gesturing enhance communication

Why do studies differ on mastery ages?
A. Different definitions of mastery (percent, position, task)
B. Errors in data
C. Language variation only
D. Poor tools

Answer: A. Different definitions of mastery

🗂 WEEK 4 — ASSESSMENT & DIFFERENTIAL DIAGNOSIS

What is the main goal of assessment?
A. Identify motor control only
B. Identify type and severity of disorder to plan therapy
C. Measure parent satisfaction
D. Diagnose hearing loss

Answer: B. Identify type and severity of disorder to plan therapy

What distinguishes an articulation disorder?
A. Pattern of rule-based errors
B. Few consistent motor errors
C. Language comprehension deficit
D. Stuttering behaviors

Answer: B. Few consistent motor errors

What distinguishes a phonological disorder?
A. Single sound error only
B. Pattern of rule-based errors reducing intelligibility
C. Voice disorder symptoms
D. Resonance issues

Answer: B. Pattern of rule-based errors reducing intelligibility

When is a screening appropriate?
A. To determine if a full evaluation is needed
B. To begin therapy
C. To confirm diagnosis
D. To determine eligibility for surgery

Answer: A. To determine if a full evaluation is needed

What does a comprehensive evaluation include?
A. Vocabulary checklist
B. Case history, hearing screen, oral mech, language sample, tests, stimulability
C. Parent questionnaire only
D. Writing assessment

Answer: B. Case history, hearing screen, oral mech, language sample, tests, stimulability

What is an independent analysis used for?
A. Compare to adult targets
B. Determine what sounds the child can produce
C. Measure reading ability
D. Assess cognitive level

Answer: B. Determine what sounds the child can produce

What is a relational analysis used for?
A. Compare productions to adult target forms
B. Measure intensity
C. Assess hearing
D. Observe syntax

Answer: A. Compare productions to adult target forms

What is a norm-referenced test?
A. Comparison to norms or peers
B. Observation checklist
C. Informal conversation
D. Parental report

Answer: A. Comparison to norms or peers

What is a criterion-referenced test?
A. Compares to set skill or standard, not peers
B. Measures hearing
C. Compares to norms
D. Checks reading comprehension

Answer: A. Compares to set skill or standard, not peers

Which test measures articulation?
A. KLPA
B. GFTA
C. CELF
D. CASL

Answer: B. GFTA

Which test measures phonological patterns?
A. GFTA
B. KLPA
C. CELF
D. Goldman-Ellis

Answer: B. KLPA

What does PCC (Percent Consonants Correct) indicate?
A. Speech fluency rate
B. Intelligibility severity
C. Vocabulary size
D. Voice pitch

Answer: B. Intelligibility severity

What is the PCC severity scale?
A. 90–100 Mild; 65–89 Mild-Mod; 50–64 Mod-Severe; <50 Severe
B. 100–75 Severe; 74–50 Mod; 49–25 Mild
C. 1–10 ratio
D. 50–100 range

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

What does stimulability testing assess?
A. Ability to imitate a sound when modeled
B. Memory for words
C. Hearing perception
D. Writing accuracy

Answer: A. Ability to imitate a sound when modeled

What does a positive stimulability result indicate?
A. Poor prognosis
B. Better chance for progress
C. No effect
D. Therapy not needed

Answer: B. Better chance for progress

What are advantages of GFTA testing?
A. Quick, systematic, tests all positions
B. Broad vocabulary test
C. Slow but detailed
D. Focuses on syntax

Answer: A. Quick, systematic, tests all positions

What are limitations of GFTA testing?
A. Doesn’t show patterns or rules
B. Too long to administer
C. Requires reading
D. Not standardized

Answer: A. Doesn’t show patterns or rules

🗂 WEEK 5–6 — SPEECH DISORDERS BY ETIOLOGY

What is a cleft lip and palate (CLP)?
A. Neurological impairment
B. Congenital split in lip/palate affecting speech and resonance
C. Motor planning deficit
D. Hearing condition

Answer: B. Congenital split in lip/palate affecting speech and resonance

What are obligatory errors in CLP?
A. Structural cause, require surgery
B. Learned placement, require therapy
C. Caused by hearing loss
D. Due to motor weakness

Answer: A. Structural cause, require surgery

What are compensatory errors in CLP?
A. Structural cause
B. Learned misplacements requiring speech therapy
C. Random mistakes
D. Intonation issues

Answer: B. Learned misplacements requiring speech therapy

What are common issues associated with CLP?
A. Feeding, resonance, hearing loss, psychosocial effects
B. Memory loss only
C. Reading problems
D. Limited vocabulary

Answer: A. Feeding, resonance, hearing loss, psychosocial effects

What professionals are on the CLP treatment team?
A. Surgeon, SLP, audiologist, psychologist
B. Dentist only
C. Teacher only
D. Parent only

Answer: A. Surgeon, SLP, audiologist, psychologist

What does pharyngeal flap surgery improve?
A. Velopharyngeal closure to reduce hypernasality
B. Tongue mobility
C. Vocal fold vibration
D. Breathing rate

Answer: A. Velopharyngeal closure to reduce hypernasality

Which genetic disorders are associated with SSDs?
A. Down Syndrome, Fragile X, VCFS (22q11 deletion)
B. Parkinson’s, ALS, CP
C. Stuttering, TBI, Dyslexia
D. ADHD, Autism, Apraxia

Answer: A. Down Syndrome, Fragile X, VCFS (22q11 deletion)

What are Down Syndrome speech features?
A. Delayed phonology, macroglossia, low tone, frequent OME
B. Excessive pitch
C. Rapid speech rate
D. Limited vocabulary only

Answer: A. Delayed phonology, macroglossia, low tone, frequent OME

What are Fragile X speech characteristics?
A. Cognitive delay, delayed phonology, prosody issues
B. Rapid fluency
C. Pure motor weakness
D. No speech effect

Answer: A. Cognitive delay, delayed phonology, prosody issues

What are VCFS features?
A. Cleft palate, resonance problems, facial differences
B. Normal speech development
C. Articulation only
D. Pure language delay

Answer: A. Cleft palate, resonance problems, facial differences

Define dysarthria.
A. Motor speech disorder due to muscle weakness
B. Planning disorder
C. Structural abnormality
D. Language delay

Answer: A. Motor speech disorder due to muscle weakness

Define apraxia.
A. Motor planning disorder with inconsistent errors
B. Weak muscles
C. Nasal resonance problem
D. Language delay

Answer: A. Motor planning disorder with inconsistent errors

Difference between apraxia and dysarthria?
A. Apraxia = planning deficit; Dysarthria = muscle weakness
B. Apraxia = structural; Dysarthria = learned
C. Both identical
D. Apraxia = hearing; Dysarthria = cognition`

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

What are flaccid dysarthria characteristics?
A. Weak, breathy speech
B. Strained, harsh tone
C. Rapid rate
D. Hypernasality only

Answer: A. Weak, breathy speech

What are spastic dysarthria characteristics?
A. Strained, slow, effortful speech
B. Weak, breathy
C. Rapid, slurred
D. Uncoordinated timing

Answer: A. Strained, slow, effortful speech

What are hypokinetic dysarthria features?
A. Reduced movement, fast rate (e.g., Parkinson’s)
B. Excessive movement
C. Weak, breathy tone
D. Irregular prosody

Answer: A. Reduced movement, fast rate (e.g., Parkinson’s)

What are hyperkinetic dysarthria features?
A. Involuntary movements affecting speech
B. Weak muscles
C. Slow rate only
D. Harsh voice

Answer: A. Involuntary movements affecting speech

What are ataxic dysarthria features?
A. Irregular timing and uncoordinated prosody
B. Rapid speech
C. Weakness only
D. Slow rate

Answer: A. Irregular timing and uncoordinated prosody

How does hearing loss affect speech?
A. Disrupts accurate speech contrast development
B. Improves vocal loudness
C. Eliminates resonance
D. Increases articulation precision

Answer: A. Disrupts accurate speech contrast development

What is OME (Otitis Media with Effusion)?
A. Fluctuating mild–moderate hearing loss
B. Severe permanent loss
C. Visual disorder
D. Nasal obstruction

Answer: A. Fluctuating mild–moderate hearing loss

Why are cochlear implants beneficial?
A. Provide early detailed auditory input for better speech outcomes
B. Cause hypernasality
C. Replace tongue movement
D. Reduce speech rate

Answer: A. Provide early detailed auditory input for better speech outcomes

What are two main therapy components for children with hearing loss?
A. Amplify residual hearing and train speech perception/production
B. Teach sign language only
C. Focus on reading skills
D. Practice listening tests

Answer: A. Amplify residual hearing and train speech perception/production

How can clinicians enhance therapy outcomes in hearing loss?
A. Use visual/tactile cues and reduce background noise
B. Ignore auditory feedback
C. Increase complexity immediately
D. Avoid amplification

Answer: A. Use visual/tactile cues and reduce background noise

How are signed and spoken languages similar?
A. Both show babbling, dialects, and “slips” in production
B. One is visual, one is auditory—no overlap
C. Sign has no grammar
D. Spoken has no dialects

Answer: A. Both show babbling, dialects, and “slips” in production