Disordered Chewing:
Name 4 different types of chew-patterns
Rotary, Suckle, Munch, Unilateral, Vertical, Diagonal, Mixed
Explain the difference in terms of both definition & the causes of Aphasia vs. a CCD
Aphasia: A language-specific disorder affecting production and comprehension (speaking, writing, reading) due to brain damage. Caused by damage to left-hemisphere brain language centers; stroke (most common),traumatic brain injury (TBI), brain tumors, and progressive neurological disorders (e.g., Alzheimer's, primary progressive aphasia)
CCD: Involves communication difficulties caused by underlying cognitive impairments like memory, attention, or executive function. Caused by damage to the right-hemisphere; stroke, TBI, dementia, brain tumor, and other neurodegenerative diseases (e.g., Parkinson's).
Explain the difference between apraxia and dysarthria
apraxia = motor planning, dysarthria = muscle weakness
Explain the difference of indirect/direct fluency treatment and how you would target both
Indirect Fluency Therapy (Often used for ages <6) Goal: Create a low-pressure environment to improve fluency without discussing stuttering. Methods: Educating parents, modeling slow speech, decreasing conversational pressure, reducing "rapid-fire" questions, and reducing interruptions. Focus: Changes the environment, not the child's speaking mechanics
Direct Fluency Therapy (Used for higher awareness/older kids/adults) Goal: Explicitly target stuttering behaviors to increase fluency or improve speech comfort. Methods: Fluency shaping (e.g., easy onset, slow rate) and stuttering modification (making stuttering easier). Types: Behavioral approaches like the Lidcombe Program (giving verbal contingencies for fluent vs. stuttered speec
Explain GLP and scripting and why it is not “non-functional” as if you were speaking to a caregiver.
correct response.
Name 5 different compensatory strategies that can also be indicative of a visual thrust and explain what they are
Mentalis grimace, lip pursing, chin tuck, facial contractions, tension in upper extremeties
Name 2 different therapeutic techniques for both Aphasia and CCD and explain
Aphasia: SFA, MIT, RET, CILT, Script training, VAT, VNeST, Total communication
CCD: Naming, task sequencing, RET, Visual attention training, compensatory strategies, enviornmental modifications, functional communication training, memory exercises
Explain how the 5 different subsystems of speech can be affected by dysarthria
Respiration =
phonation =
resonance =
articulation =
prosody =
Explain the difference between a true fluency disorder and an APD
fluency disorder - TRUE stuttering behaviors (blocks, prolongations, repititons... etc.)
APD - may report 'dysfluent' speech although difficulties lie in thought organization and processing leading to perception of dysfluent speech
What are 3 different language goals for a GLP? Explain how we would measure progress
Any correct response.
Explain the difference between a unilateral chew-pattern and a munch-chew pattern
Unilateral: The consistent, habitual use of one side of the jaw for mastication
Munch: Simple vertical jaw movements and a flattened tongue raising food to the hard palate
Compare and contrast 2 different aphasia and 2 different cognitive communication assessments
CCD: MoCA, CLQT+
Aphasia: BDAE, WAB, QAB, ALA
Name and explain at least 3 different types of therapeutic techniques for dysarthria and how to implement them
breath support, oral motor exercises, phonatory strengthening exercises, articulation training, AAC, Rate control
Specific theraputic approaches: LSVT, Speak OUT! (what do these aim to improve?)
Explain the difference between stuttering and cluttering and how these may be targeted differently.
Stuttering = disruption in fluency (pauses, repetitions, blocks)
Cluttering = breakdown in rate + organization of speech
Explain what to do vs. what not to do when working with GLPs.
do NOT: Over-cueing or drilling single words too early, Forcing imitation, Ignoring scripts (they are meaningful!), Excessive questioning
DO: prioritize communication that is: Useful Meaningful & Spontaneous - by following the childs lead, provide visual/contextual supports, repeat with variation, model functional gestalts, provide mitigation support, acknowledge and interpret scripts and use declarative language as opposed to questions
Explain the difference between a diagonal chew-pattern and a rotary-chew pattern
Diagonal: The consistent, habitual use of one side of the jaw for mastication
Rotary: The circular grinding motion of the jaw used to break down fibrous or tough foods. It requires tongue lateralization
How would you do differential diagnosis of Aphasia and CCD? Must include description of assessments and billing codes
Correct response required
Name and explain at least 3 different types of therapeutic techniques for apraxia and how to implement them
PROMPT, motor learning, DTTC, AAC, High intensity repitition, MIT
Explain and demonstrate an easy onset, light contact, and continuous phonation as if you were speaking to a patient.
correct response
Name and explain 3 different therapeutic strategies when working with GLPs/Scripted language
modeling gestaults
acknowledge and interpret scripts
mitigation support
use declarative language
follow the childs lead
use of visual/contextual supports
repeition with variation
Why is the development of a rotary-chew important? Name and explain at least 3 potential results of an underdeveloped chew-pattern.
Rotary chewing, bolus lateralization, and bolus formation are important oral motor skills that support safe, efficient, and comfortable eating in adults. Difficulties with these skills can impact nutrition, hydration, meal enjoyment, and overall safety during eating.
When an immature or underdeveloped mastication pattern is present, there is evidence that it can:
Excessive muscle compensation
Lead to a greater risk of choking due to difficulty managing tougher textures and food across the midline of the mouth
Overuse of jaw muscles
Unequal masseter development
Contribute to TMJ strain and dysfunction
Explain when you would use the Aphasia/CCD/Phonological Disorder/Dysarthria diagnosis code.
correct response.
Explain at least 4 differences between CAS and a Phonological disorder
Error Consistency: CAS features high inconsistency (saying the same word differently across trials), while phonological disorders show consistent, predictable patterns (e.g., always replacing /k/ with /t/).
Motor Movement: CAS involves observable "groping" (trial-and-error mouth movements) and difficulty with speech motor planning/coordination (transitional movements).
Prosody: CAS often presents with unusual prosody (e.g., equal stress, segmented speech, robotic rhythm).
Vowels: Vowel distortions are a strong marker for CAS.
Utterance Length: In CAS, errors increase significantly with longer or more complex syllables (e.g., "banana" is harder than "cat").
Automatic Speech: Children with CAS may have easier, more fluent production during automatic speech (e.g., saying "hi") compared to volitional, purposeful speech.
Demonstrate pausing/phrasing, cancellations & pull-outs, and preparatory sets and why each works for fluency patients as if you were speaking to a patient.
correct response
Provide a brief overview of the 6 GLP stages
1 = unanalanyzed gestualts = scripts
2 = mitigation
3= single words
4 = origional sentences
5= complex grammar
6= advanced language & pragmatics