COMD 674 Simucase Kelly Intervention
Transcript Exam Actual Exam 2026/2027 –
Complete Exam-Style Questions | 100% Verified
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Assessment & Differential Diagnosis
(Phonetic Transcription, Error Pattern Analysis, Stimulability, Language Evaluation)
Q1: During the initial assessment, Kelly produces the word "sun" as [θʌn]. Which phonological process is
Kelly demonstrating?
A. Fronting
B. Stopping
C. Interdentalization of /s/ [CORRECT]
D. Cluster reduction
Correct Answer: C
Rationale: The best answer is C. Kelly is substituting the voiceless interdental fricative /θ/ for the
alveolar fricative /s/, which represents an interdentalization pattern. This choice is correct because the
transcription clearly shows /s/ → /θ/, a common error pattern in children with speech sound disorders.
In clinical practice, we carefully analyze the exact place, manner, and voicing of substituted sounds to
identify error patterns accurately rather than broadly categorizing.
Q2: Kelly's language sample reveals MLU of 3.2 morphemes at age 4;6. Which interpretation is most
accurate?
A. Kelly's language development is significantly delayed
B. Kelly's MLU falls within the low average range and warrants continued monitoring [CORRECT]
C. Kelly's language is age-appropriate and no further evaluation is needed
,D. Kelly's expressive language is superior to same-age peers
Correct Answer: B
Rationale: The best answer is B. At 4;6, expected MLU ranges from approximately 3.5 to 5.0
morphemes, so 3.2 falls slightly below age expectations but not severely delayed. This choice is correct
because it reflects the nuanced interpretation of standardized data—low average suggests mild concern
rather than significant impairment. This aligns with evidence-based practice which indicates that
borderline scores warrant monitoring and targeted intervention rather than dismissal or over-
pathologizing.
Q3: Kelly produces "play" as [peɪ]. Which phonological process is demonstrated?
A. Final consonant deletion
B. Cluster reduction [CORRECT]
C. Stopping
D. Gliding
Correct Answer: B
Rationale: The best answer is B. Kelly is reducing the consonant cluster /pl/ to the single consonant /p/,
which is the definition of cluster reduction. This choice is correct because the liquid /l/ is omitted while
the stop /p/ is retained, following the typical pattern of cluster reduction where the less sonorant sound
is preserved. In clinical practice, we track cluster reduction carefully because it significantly impacts
intelligibility and often persists longer than other phonological processes.
Q4: During stimulability testing, Kelly is able to correctly produce /s/ in isolation when given maximal
cues but reverts to [θ] in spontaneous speech. Which clinical implication is most appropriate?
A. Kelly is not a good candidate for speech therapy
B. Kelly has apraxia of speech and needs motor-based intervention
C. Kelly demonstrates stimulability, suggesting good prognosis for intervention targeting /s/ [CORRECT]
D. Kelly's stimulability indicates the sound is developmentally appropriate and will resolve without
intervention
Correct Answer: C
, Rationale: The best answer is C. Stimulability—the ability to produce a sound correctly with support—is
a strong positive prognostic indicator for speech intervention. This choice is correct because children
who can be stimulated for a sound typically make faster progress in therapy than those who cannot. This
reflects the standard of care that directs us to use stimulability as a key factor in target selection and
prognosis, while recognizing that stimulability alone doesn't mean the sound will generalize without
structured intervention.
Q5: Kelly's assessment shows consistent use of the following error patterns: stopping of fricatives,
cluster reduction, and final consonant deletion. Which differential diagnosis is most likely?
A. Childhood apraxia of speech
B. Phonological disorder [CORRECT]
C. Articulation disorder only
D. Dysarthria
Correct Answer: B
Rationale: The best answer is B. The presence of multiple, consistent phonological processes (stopping,
cluster reduction, FCD) points toward a phonological disorder rather than a motor-based articulation
problem. This choice is correct because phonological disorders are characterized by rule-governed error
patterns affecting multiple sound classes, whereas articulation disorders typically involve isolated sound
distortions or substitutions. This aligns with evidence-based practice which indicates that children with
multiple phonological processes benefit from phonological intervention approaches rather than
traditional articulation therapy.
Q6: Kelly produces "cat" as [kæt] correctly but says "dog" as [dɑg] correctly. However, "fish" is produced
as [fɪs] and "shoe" as [su]. Which pattern is most evident?
A. Kelly has no speech sound errors
B. Kelly demonstrates stopping of affricates and deaffrication [CORRECT]
C. Kelly has a lisp on all sibilants
D. Kelly's errors are random and inconsistent
Correct Answer: B
Rationale: The best answer is B. Looking at the pattern, Kelly produces /ʃ/ as /s/ (deaffrication or
fricative simplification) and shows difficulty with the affricate /tʃ/ (implied by context of the Kelly case
Transcript Exam Actual Exam 2026/2027 –
Complete Exam-Style Questions | 100% Verified
– Pass Guaranteed – A+ Graded
Assessment & Differential Diagnosis
(Phonetic Transcription, Error Pattern Analysis, Stimulability, Language Evaluation)
Q1: During the initial assessment, Kelly produces the word "sun" as [θʌn]. Which phonological process is
Kelly demonstrating?
A. Fronting
B. Stopping
C. Interdentalization of /s/ [CORRECT]
D. Cluster reduction
Correct Answer: C
Rationale: The best answer is C. Kelly is substituting the voiceless interdental fricative /θ/ for the
alveolar fricative /s/, which represents an interdentalization pattern. This choice is correct because the
transcription clearly shows /s/ → /θ/, a common error pattern in children with speech sound disorders.
In clinical practice, we carefully analyze the exact place, manner, and voicing of substituted sounds to
identify error patterns accurately rather than broadly categorizing.
Q2: Kelly's language sample reveals MLU of 3.2 morphemes at age 4;6. Which interpretation is most
accurate?
A. Kelly's language development is significantly delayed
B. Kelly's MLU falls within the low average range and warrants continued monitoring [CORRECT]
C. Kelly's language is age-appropriate and no further evaluation is needed
,D. Kelly's expressive language is superior to same-age peers
Correct Answer: B
Rationale: The best answer is B. At 4;6, expected MLU ranges from approximately 3.5 to 5.0
morphemes, so 3.2 falls slightly below age expectations but not severely delayed. This choice is correct
because it reflects the nuanced interpretation of standardized data—low average suggests mild concern
rather than significant impairment. This aligns with evidence-based practice which indicates that
borderline scores warrant monitoring and targeted intervention rather than dismissal or over-
pathologizing.
Q3: Kelly produces "play" as [peɪ]. Which phonological process is demonstrated?
A. Final consonant deletion
B. Cluster reduction [CORRECT]
C. Stopping
D. Gliding
Correct Answer: B
Rationale: The best answer is B. Kelly is reducing the consonant cluster /pl/ to the single consonant /p/,
which is the definition of cluster reduction. This choice is correct because the liquid /l/ is omitted while
the stop /p/ is retained, following the typical pattern of cluster reduction where the less sonorant sound
is preserved. In clinical practice, we track cluster reduction carefully because it significantly impacts
intelligibility and often persists longer than other phonological processes.
Q4: During stimulability testing, Kelly is able to correctly produce /s/ in isolation when given maximal
cues but reverts to [θ] in spontaneous speech. Which clinical implication is most appropriate?
A. Kelly is not a good candidate for speech therapy
B. Kelly has apraxia of speech and needs motor-based intervention
C. Kelly demonstrates stimulability, suggesting good prognosis for intervention targeting /s/ [CORRECT]
D. Kelly's stimulability indicates the sound is developmentally appropriate and will resolve without
intervention
Correct Answer: C
, Rationale: The best answer is C. Stimulability—the ability to produce a sound correctly with support—is
a strong positive prognostic indicator for speech intervention. This choice is correct because children
who can be stimulated for a sound typically make faster progress in therapy than those who cannot. This
reflects the standard of care that directs us to use stimulability as a key factor in target selection and
prognosis, while recognizing that stimulability alone doesn't mean the sound will generalize without
structured intervention.
Q5: Kelly's assessment shows consistent use of the following error patterns: stopping of fricatives,
cluster reduction, and final consonant deletion. Which differential diagnosis is most likely?
A. Childhood apraxia of speech
B. Phonological disorder [CORRECT]
C. Articulation disorder only
D. Dysarthria
Correct Answer: B
Rationale: The best answer is B. The presence of multiple, consistent phonological processes (stopping,
cluster reduction, FCD) points toward a phonological disorder rather than a motor-based articulation
problem. This choice is correct because phonological disorders are characterized by rule-governed error
patterns affecting multiple sound classes, whereas articulation disorders typically involve isolated sound
distortions or substitutions. This aligns with evidence-based practice which indicates that children with
multiple phonological processes benefit from phonological intervention approaches rather than
traditional articulation therapy.
Q6: Kelly produces "cat" as [kæt] correctly but says "dog" as [dɑg] correctly. However, "fish" is produced
as [fɪs] and "shoe" as [su]. Which pattern is most evident?
A. Kelly has no speech sound errors
B. Kelly demonstrates stopping of affricates and deaffrication [CORRECT]
C. Kelly has a lisp on all sibilants
D. Kelly's errors are random and inconsistent
Correct Answer: B
Rationale: The best answer is B. Looking at the pattern, Kelly produces /ʃ/ as /s/ (deaffrication or
fricative simplification) and shows difficulty with the affricate /tʃ/ (implied by context of the Kelly case
