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. An SLP can use a direct intervention approach or an indirect intervention approach in providing fluency treatment for a preschool child who stutters. Which of the following statements most accurately characterizes the current evidence regarding the effectiveness of these two approaches to fluency treatment for children younger than five? (A) Evidence clearly indicates more favorable outcomes using direct intervention. (B) Evidence clearly indicates more favorable outcomes using indirect intervention. (C) Evidence clearly supports using a combination of direct and indirect interventions with the same child. (D) There is not sufficient evidence to support the use of a direct intervention approach over an indirect intervention approach
The correct answer is (D). A study completed by the American Speech-Language-Hearing Association in 2010 showed that there is not sufficient evidence to support one form of intervention over the other. (A), (B), and (C) are incorrect. None of these statements are supported by current research.
Which of the following is the primary reason for using standardized norm-referenced instruments to assess communication function? (A) To track progress on a session-bysession basis (B) To provide a comparison against a representative population (C) To develop a database for diagnostic purposes (D) To provide qualitative data for the assessment report
. The correct answer is (B). The primary reason for using a standardized norm-referenced assessment is to compare an individual’s performance to norms generated from a much larger representative sample. Use of a normreferenced assessment enables the client’s behavior to be compared to typical function for individuals in the same age range. (A) is incorrect because standardized assessments are not administered as frequently as every session. (C) is incorrect because inclusion of client information in a diagnostic database is not the primary reason to use a norm-referenced instrument. (D) is incorrect
. According to ASHA, a newborn child should receive an initial hearing screening no later than (A) 1 month of age (B) 3 months of age (C) 1 year of age (D) 2 years of age
The correct answer is (A). According to the Joint Committee on Infant Hearing (2007), all newborn children should receive an initial hearing screening no later than 1 month of age. (B), (C), and (D) are incorrect because the time frames are after 1 month of age.
Which of the following characteristics is most likely characteristic of a client with childhood apraxia of speech? (A) Low muscle tone in the lips, tongue, and jaw (B) Echolalic response patterns (C) Decreased ability to perform diadokokinesis (D) Sensorineural hearing loss
The correct answer is (C). Childhood apraxia of speech is a motor planning disorder. Diadokokinesis is a task in which the rapid, consistent production of “puh-tuh-kuh” is measured. Children with this disorder cannot manipulate the articulators in smooth, controlled volitional ways. (A) is incorrect. Apraxia is not a dysarthria that indicates low muscle tone, which makes (A) incorrect. (B) is incorrect. The apraxic child has trouble imitating responses and so is not echolalic. (D) is incorrect. A specific hearing impairment is not indicative of a motor planning speech disorder
A 68-year-old man sustained a CVA and received a course of speech-language treatment for anomic aphasia. He was discharged after making rapid improvement early in therapy. Three years later his wife reports that he is having more difficulty speaking and understanding, but that his memory skills and orientation abilities remain intact. She has also noticed that his conversation skills are slowly deteriorating. Of the following, which is the most likely explanation for the client’s communicative decline? (A) A transient ischemic attack (B) An astrocytoma, probably in the vicinity of the supramarginal gyrus (C) Primary progressive aphasia (D) Lewy body dementia
The correct answer is (C). Primary progressive aphasia is isolated language deterioration with relative preservation of other cognitive abilities and symptoms that vary, depending upon the site of lesion. Signs and symptoms may include wordfinding problems characterized by pauses during speech, difficulty naming objects, difficulty with comprehension of spoken and written language, and inability to comprehend word meanings. (A), (B), and (D) are incorrect because the symptoms described in the stem do not apply to these diagnoses.
Which of the following correctly indicates the point at which an augmentative and alternative communication (AAC) evaluation should begin? (A) With the trial use of an AAC device (B) After the client has developed the prerequisite cognitive skills (C) With an analysis of the client’s communication needs (D) With a medical consultation
The correct answer is (C). The assessment should analyze the client’s communication needs. (A) is incorrect. The client’s needs must be assessed before a device is provided. (B) is incorrect. While the AAC selection will depend on the client’s cognitive skills, the match of the device to the client should follow an evaluation of the client’s needs. (D) is incorrect. Medical consultation is not needed to conduct an AAC evaluation.
What type of reinforcement results in the most rapid learning of new behavior? (A) Fixed-ratio (B) Fixed-interval (C) Continuous (D) Variable-interval
The correct answer is (C). The primary reason is because in continuous reinforcement the desired behavior is reinforced every time it occurs. This schedule is generally best during the initial stages of learning to create a strong association between the behavior and the response. (A), (B), and (D) are incorrect because they represent partial reinforcement schemes in which the correct response is reinforced only part of the time. Learned behaviors are acquired more slowly with partial reinforcement.
An SLP determines the mean length of utterance (MLU) of a language sample from a three-year-old child. Two weeks later, the SLP reevaluates the same sample and again determines the MLU. The extent to which the two scores are similar is most directly a function of the (A) validity of the scores (B) reliability of the scores (C) skewness of the score distribution (D) speededness of the measure
The correct answer is (B). Reliability is the consistency with which a test measures or the degree to which repeated measurement with the same instrument of the same individual would tend to produce the same result. Larger values indicate greater reliability; a reliability of 0.90 or greater is desirable for a test to be used in making decisions about individuals. (A) is incorrect because validity refers to how well a test measures what it is purported to measure. (C) is incorrect because skewness refers to the symmetry of the data. (D) is incorrect because speededness refers to the time it takes to complete the test.
Which of the following types of cerebral palsy is characterized by low muscle tone, impaired balance, and tremor? (A) Ataxic (B) Spastic (C) Athetoid (D) Hemiplegic
The correct answer is (A). Ataxic cerebral palsy is characterized by low muscle tone, impaired balance, and tremors. The other types do not have these characteristics. (B) is incorrect. Spastic cerebral palsy involves jerky, uncontrolled movements and high muscle tone. (C) is incorrect. Athetoid cerebral palsy is characterized by slow, arrhythmic, writhing, involuntary movements of the extremities. (D) is incorrect because “Hemiplegic” specifies the body part affected, not to the type of movement pattern.
Which of the following types of fibers facilitates communication between the right and left hemispheres by connecting cortical areas in the two hemispheres? (A) Association (B) Commissural (C) Efferent (D) Afferent
The correct answer is (B). Commissural fibers are the only ones that bridge between the two cortical hemispheres; hence, (A), (C), and (D) are incorrect.
An SLP has targeted the phonological process of “stopping of initial fricatives” for remediation and is using the word “shoes” to establish the new behavior. The SLP now wishes to investigate whether the speaker can generalize the newly learned pattern to untrained words. If it is assumed that generalization will occur on words whose phonetic characteristics are most like the trained word “shoes,” which of the following words should be selected? (A) Shouting (B) Fished (C) Ocean (D) Shook
The correct answer is (D). Generalization probes are a principle feature of phonological therapy. The answer choices require the clinician to pay attention to the position of the fricative sound in a word and also the word’s syllable structure. (A), (B), and (C) are incorrect because both the fricative sound and syllable structure are incorrect.
An SLP is behaving ethically if he or she does which of the following? (A) Offers to provide speech or language services solely by correspondence for an individual whose disability prevents easy access to the professional’s office (B) Diagnoses a speech disorder solely through correspondence as long as the correspondence is thorough and careful (C) Offers general information of an educational nature by correspondence (D) Indicates the specific duration of the therapeutic program
The correct answer is (C). According to the 2010 Code of Ethics of the American Speech-LanguageHearing Association (ASHA), general information of an educational nature by correspondence is allowed. (A), (B), and (D) are incorrect. These choices are not approved and are discussed in Principle of Ethics I, Rule K.
Under the requirement for a child to receive a free and appropriate public education in the least restrictive environment, a public school must provide sign language interpreter services to a child under which of the following conditions? (A) The school district can recover the cost of interpreter services from a third-party payer. (B) The child’s physician indicates that the services of an interpreter are medically necessary. (C) The interpreter has been requested by the parent in the IEP meeting. (D) The IEP team determines that interpreter services are necessary for the child.
The correct answer is (D). Free and appropriate public education in the least restrictive environment is a central tenet of IDEA, which governs special education services in the public schools. IDEA makes clear that the services to be provided to a student must be endorsed as educationally necessary by the entire IEP team, which includes the student’s parents, a regular education teacher, a special education teacher, a representative of the local education agency, and others as appropriate. (A), (B), and (C) are incorrect because they do not meet the specifications set forth by IDEA.
Which of the following is the major physical or organic factor underlying impairment in the speech of persons with cleft palate?
(A) Congenital hearing loss from otitis media (B) Broad irregular maxillary arch (C) Palatopharyngeal insufficiency (D) Irregular vocal fold abduction
The correct answer is (C). Palatopharyngeal insufficiency or, more specifically, velopharyngeal insufficiency is the major cause of the hypernasal speech associated with cleft palate. (A), (B), and (D) are incorrect because otitis media is not congenital; in cleft palate, the maxillary arch is often collapsed and thus is narrow; and irregular vocal fold abduction is not associated with cleft palate.
Intervention from a speech-language pathologist for a nursing home resident who experiences advanced dementia would most effectively focus on (A) conversational turn-taking (B) expressive vocabulary (C) interpretation of facial expression (D) simplification of the communication environment
The correct answer is (D). The primary reason is because appropriate intervention for an individual with advanced dementia is geared toward simplifying the individual’s communication environment. (A), (B), and (C) are incorrect because an individual with advanced dementia is not likely to benefit significantly from intervention targeting improved communication skills.
An adult female has received 20 sessions of voice therapy for hoarseness related to vocal nodules. Data for pre- and post-evaluation measures for this individual are: Pretherapy Current Fundamental 175 200 frequency (Hz) Phonation duration 10 15 (sec.) Jitter (percent) 1.2 .68 Mean phonatory 100 150 airflow (ml/sec.) Which of the following is most strongly indicated by the data? (A) The patient’s voice is improving. (B) The patient’s voice is deteriorating. (C) Perturbation is worse, but the other measures are better. (D) The patient’s voice is still abnormal
The correct answer is (A). All measures discussed demonstrate improvement. There is no certainty that the voice is still abnormal. Perturbation, having gone down, shows some improvement. Based only on the data shown, one could say that there is some improvement. (B), (C), and (D) are incorrect because the patient has shown improvement and perturbation has shown some improvement.
Which of the following statements best characterizes the ethics of formulating prognoses for clients with speech and language disorders? (A) No assessment is complete until a precise statement can be formulated regarding the prognosis. (B) The extreme complexity of speech and language processes and behaviors makes it impossible to formulate prognoses. (C) After an assessment has been completed, it is usually appropriate to make a reasonable statement about prognosis. (D) A clinician’s ability to make prognostic statements depends on the availability of standardized tests to quantify the severity of a speech and language disorder.
The correct answer is (C). According to the 2010 ASHA Code of Ethics, Principle of Ethics I, Rule J, a speech-language pathologist can make a reasonable statement about a client’s prognosis. (A), (B), and (D) are contrary to the spirit of this ethical position.
The Spanish-speaking parents of a nine-yearold bilingual child report that their child communicates in Spanish with complete utterances and has a good vocabulary in comparison to other children in the neighborhood. Their concern is that the child interrupts their conversations and has not learned social rules that are important within the family and community. Testing confirms similar problems in English-speaking settings. The SLP would most likely recommend that therapy focus on which of the following language areas? (A) Syntax (B) Morphology (C) Semantics (D) Pragmatics
The correct answer is (D). The parents have described adequate syntactic and semantic knowledge by the child. Testing in English confirms similar strengths. The area that has been identified as a weakness is pragmatics and social rules for interaction.
Melodic intonation therapy (MIT) is generally considered most appropriate for a client with which of the following? (A) Broca’s aphasia (B) Conduction aphasia (C) Transcortical sensory aphasia (D) Global aphasia
The correct answer is (A). MIT is a process in which SLPs sing or hum phrases to individuals with the goal of having individuals tap, sing, or hum the phrase back to the SLP. Research has shown MIT to be successful with people diagnosed with Broca’s aphasia, because their comprehension is better than their expression and they retain the ability to repeat. (B) is incorrect. Individuals with conduction aphasia have extreme difficulty repeating , so MIT would not be beneficial. (C) and (D) are incorrect. Individuals with transcortical sensory aphasia and global aphasia have auditory comprehension skills which are extremely impaired so they are not likely to benefit from MIT as the approach requires ability to comprehend what the speaker is saying and to appreciate their own productions in order to repeat.
A 60-year-old man has Parkinson’s disease and is in the early stage of dementia. It would be appropriate to address which of the following goals first in therapy? (A) To educate the family or caregivers (B) To decrease jargon (C) To decrease circumlocution (D) To improve motor skills
The correct answer is (A). When dementia is associated with Parkinson’s disease, it is usually irreversible. Therefore, the family or caregivers must understand the nature of the linguistic and intellectual problems, and learn how to maximize the abilities of the client. The sooner the family or caregivers are made aware of the condition of thethe better the intervention is likely to be. (B), (C), and (D) are incorrect because although all are appropriate goals, they would not be the first goal in therapy.
An intervention to improve receptive vocabulary involves a computer program that presents three pictures on the screen and requests that the child point to the picture that the computer indicates via digitized speech. The child’s intervention goal is 80 percent correct responding. A response rate of 30 percent correct most likely indicates that the (A) software has been moderately effective in helping the child reach his goal (B) child’s visual discrimination surpasses his auditory discrimination (C) child’s responses are essentially random (D) child is ready to progress to an on-screen array of four pictures
The correct answer is (C). Because there are three pictures, a response rate close to 33 percent (one-third) is at the level of chance. (A) is incorrect because the child’s performance is only at chance levels, indicating no trend toward successful performance. (B) is incorrect because no conclusion about the superiority of one modality over another can be determined from the limited information provided. (D) is incorrect because the difficulty level of the task should only be increased when performance at the easier level is satisfactory.
Which of the following is an accurate statement about what IDEA requires for any IEP? (A) The IEP must include a multiyear outline of instructional objectives. (B) The IEP must include a section on assistive devices, regardless of the nature or degree of the student’s disability. (C) The IEP must be in effect before special education services or related services are provided. (D) The IEP must not be made available to any school personnel except special education teachers.
The correct answer is (C). According to IDEA, an IEP must be in effect before special education and related services are provided to an eligible student. None of the other choices are required. (A) is incorrect. The objectives in an IEP are ordinarily for a single year. (B) is incorrect. IDEA requires that an IEP include a statement of the services and aids to be provided to the child. For some students with disabilities, this will include assistive devices, but many students with disabilities do not require such devices. (D) is incorrect. Although special education teachers certainly have access to their students’ IEPs, IDEA requires that regular education teachers and other service providers who are responsible for implementing a student’s IEP have access to it as well.
Which of the following is true about supporting a young child’s acquisition of English as a second language? (A) A focus in the family on the English speaking culture as well as the language will support the child’s acquisition of English. (B) To support language development, family members should speak to the child in the language they are most comfortable using. (C) If a child has a language disorder, a delay in learning English will best help the child achieve the highest ultimate level of fluency. (D) Even without support, the child can be expected to be fully fluent in English in less than two years.
The correct answer is (B). Family members speaking to the child in the language they are most comfortable using will not have a negative effect on the child and will allow them to more easily support the child through the acquisition. (A) is incorrect. The child’s native culture should continue to be valued. (C) is incorrect. Even a child with a language disorder can learn a second language. (D) is incorrect. Full acquisition of a new language takes many years to accomplish.
Ms. March, age 70, receives speech-language treatment at her assisted living facility for aphasia secondary to a stroke (CVA). Medicare is reimbursing a home health agency that visits the facility for Ms. March’s treatment following submission of an evaluation and treatment plan from the SLP employed by the home health agency. To ensure that reimbursement for treatment continues, the SLP must (A) administer a standardized aphasia battery weekly to assess progress (B) include recommendations for family participation in the treatment plan (C) secure the physician’s endorsement of treatment continuation on a schedule dictated by Medicare (D) initiate treatment within six months of Ms. March’s hospitalization for the stroke
The correct answer is (C). Medicare will only authorize continued treatment with physician approval. (A), (B), and (D) are incorrect because they are not used as a basis for treatment eligibility
An SLP is providing services to adults with neurogenic disorders of communication. Of the following clients, which will likely have the most favorable management prognosis? (A) John, who has a brain injury resulting in a slight concussion (B) Jim, who has a traumatic brain injury resulting in paralysis (C) Juan, who has amyotrophic lateral sclerosis (D) Helen, who has Huntington’s chorea
The correct answer is (A). The disorder is most limited in scope among those mentioned and, therefore, most likely to be amenable to therapy or treatment. (B) is incorrect because the problem described is diffused or dispersed throughout the head with major impairments to the nerves. (C) and (D) are incorrect because the disorders mentioned are progressive in nature.