PASSPOINT PRO
ADULT APHASIA &
COGNITIVE-LINGUISTIC
CLINICAL SIMULATION PRACTICE
20 Complete SLP Cases with Answers & Detailed Rationales
CASES CLINICAL DECISIONS FOCUS
20 80 Adult SLP
aphasia • cognitive-communication • assessment selection • differential diagnosis • treatment
planning • functional communication
PASSPOINT PRO
Practice smarter. Prepare better.
,PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
HOW TO USE THIS CLINICAL SIMULATION SET
Adult aphasia and cognitive-linguistic reasoning
Format Each case begins with a concise referral, history, communication profile, and
assessment snapshot. Four A-D clinical decisions follow each case, with the
answer and a detailed rationale immediately after each question.
Clinical Workflow Work through each case as if you are the treating SLP: identify the communication
profile, choose the next assessment step, select an intervention or strategy, and
connect the plan to functional participation and safety.
Skills Covered Aphasia profiles, motor-speech differential diagnosis, cognitive-communication
disorders, discourse, reading/writing, auditory comprehension, word retrieval,
AAC, bilingual assessment, sensory confounds, executive function, caregiver
training, and functional outcome planning.
CASE COVERAGE
1 Nonfluent Aphasia After Left MCA Stroke
2 Fluent Aphasia With Impaired Auditory Comprehension
3 Conduction-Type Aphasia and Repetition Breakdown
4 Anomic Aphasia and Functional Word Retrieval
5 Severe Global Aphasia in Acute Rehabilitation
6 Right Hemisphere Cognitive-Communication Disorder
7 Dysarthria Versus Aphasia After Subcortical Stroke
8 Executive Dysfunction After Traumatic Brain Injury
9 Mild Vascular Cognitive-Communication Impairment
10 Aphasia With Reading and Writing Impairment
11 Severe Auditory Comprehension Deficit and AAC Support
12 Primary Progressive Aphasia: Semantic Features
13 Logopenic Language Profile With Working-Memory Demands
14 Left Frontal Tumor Resection: Language and Executive Deficits
15 Thalamic Stroke With Word Retrieval and Attention Fluctuation
16 Mild Aphasia and Functional Independence After Stroke
17 Bilingual Aphasia Assessment
18 Hearing Loss as a Confound in Aphasia Assessment
19 Aphasia With Coexisting Apraxia of Speech
20 Multiple Strokes, Severe Cognitive-Linguistic Impairment, and Caregiver Training
Speech-Language Pathology | Adult Neurogenic Communication Disorders 2
,PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
CASE 1
Nonfluent Aphasia After Left MCA Stroke
Case 1 - Nonfluent Aphasia After Left MCA Stroke
Client 68-year-old retired teacher
Referral Communication evaluation 5 days after left middle cerebral artery ischemic
stroke
History Right facial weakness and right upper-extremity weakness. Prior communication
was independent.
Communication Effortful, halting speech; short phrases; frequent omission of grammatical
words; relatively strong yes/no comprehension.
Assessment Snapshot Naming is reduced, repetition of longer utterances is poor, auditory
comprehension is stronger than verbal expression, and oral-motor speech is
slow with occasional groping.
CLINICAL DECISIONS
1. Which communication profile is most consistent with the findings?
A Fluent aphasia with severely impaired comprehension
B Nonfluent aphasia with relatively preserved basic comprehension
C Isolated dysarthria without language impairment
D Right-hemisphere cognitive-communication disorder
Answer: B Explanation: The client shows reduced phrase length, effortful output, and agrammatic
speech with comparatively stronger basic comprehension. That pattern is most
consistent with a nonfluent aphasia profile. Dysarthria may coexist, but it would not
explain the grammatical and word-retrieval deficits.
2. What should the SLP prioritize next to clarify the motor-speech contribution?
A A structured motor-speech examination for apraxia and dysarthria
B A pure-tone hearing test only
C A swallowing trial with thin liquids only
D A personality inventory
Answer: A Explanation: The slow output and groping suggest a possible motor-planning
component in addition to aphasia. A motor-speech examination can separate apraxia of
speech features from weakness-based dysarthria. This distinction changes cueing,
treatment targets, and prognosis.
Speech-Language Pathology | Adult Neurogenic Communication Disorders 3
, PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
3. Which early treatment activity best matches this profile?
A Practice highly functional phrases with supported verbal and multimodal cueing
B Require paragraph-length spontaneous speech without cues
C Focus only on visual scanning tasks
D Avoid all gestures so spoken language is forced
Answer: A Explanation: Early therapy should support successful communication while stimulating
language production. Functional phrases, written keywords, gestures, and graded
verbal cueing reduce communication breakdowns. Forcing long unsupported speech is
likely to increase frustration and reduce accuracy.
4. Which family strategy is most appropriate?
A Ask several questions at once to increase stimulation
B Use short questions, allow extra response time, and confirm the intended message
C Correct every grammatical error immediately
D Speak for the client before he attempts to respond
Answer: B Explanation: Short questions and extra processing time reduce linguistic load while
preserving the client’s participation. Confirming the message helps repair
misunderstandings without taking over the conversation. Immediate correction of every
error can disrupt communication and confidence.
CASE 2
Fluent Aphasia With Impaired Auditory Comprehension
Case 2 - Fluent Aphasia With Impaired Auditory Comprehension
Client 74-year-old woman
Referral Evaluation 1 week after left posterior temporal stroke
History No prior speech-language diagnosis. Family reports she now talks a great deal
but is difficult to understand.
Communication Fluent speech with normal rate and melody, frequent semantic and phonemic
substitutions, vague content, and limited awareness of errors.
Assessment Snapshot Single-word auditory comprehension is inconsistent, sentence comprehension is
poor, repetition is impaired, and naming contains paraphasias.
CLINICAL DECISIONS
Speech-Language Pathology | Adult Neurogenic Communication Disorders 4
ADULT APHASIA &
COGNITIVE-LINGUISTIC
CLINICAL SIMULATION PRACTICE
20 Complete SLP Cases with Answers & Detailed Rationales
CASES CLINICAL DECISIONS FOCUS
20 80 Adult SLP
aphasia • cognitive-communication • assessment selection • differential diagnosis • treatment
planning • functional communication
PASSPOINT PRO
Practice smarter. Prepare better.
,PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
HOW TO USE THIS CLINICAL SIMULATION SET
Adult aphasia and cognitive-linguistic reasoning
Format Each case begins with a concise referral, history, communication profile, and
assessment snapshot. Four A-D clinical decisions follow each case, with the
answer and a detailed rationale immediately after each question.
Clinical Workflow Work through each case as if you are the treating SLP: identify the communication
profile, choose the next assessment step, select an intervention or strategy, and
connect the plan to functional participation and safety.
Skills Covered Aphasia profiles, motor-speech differential diagnosis, cognitive-communication
disorders, discourse, reading/writing, auditory comprehension, word retrieval,
AAC, bilingual assessment, sensory confounds, executive function, caregiver
training, and functional outcome planning.
CASE COVERAGE
1 Nonfluent Aphasia After Left MCA Stroke
2 Fluent Aphasia With Impaired Auditory Comprehension
3 Conduction-Type Aphasia and Repetition Breakdown
4 Anomic Aphasia and Functional Word Retrieval
5 Severe Global Aphasia in Acute Rehabilitation
6 Right Hemisphere Cognitive-Communication Disorder
7 Dysarthria Versus Aphasia After Subcortical Stroke
8 Executive Dysfunction After Traumatic Brain Injury
9 Mild Vascular Cognitive-Communication Impairment
10 Aphasia With Reading and Writing Impairment
11 Severe Auditory Comprehension Deficit and AAC Support
12 Primary Progressive Aphasia: Semantic Features
13 Logopenic Language Profile With Working-Memory Demands
14 Left Frontal Tumor Resection: Language and Executive Deficits
15 Thalamic Stroke With Word Retrieval and Attention Fluctuation
16 Mild Aphasia and Functional Independence After Stroke
17 Bilingual Aphasia Assessment
18 Hearing Loss as a Confound in Aphasia Assessment
19 Aphasia With Coexisting Apraxia of Speech
20 Multiple Strokes, Severe Cognitive-Linguistic Impairment, and Caregiver Training
Speech-Language Pathology | Adult Neurogenic Communication Disorders 2
,PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
CASE 1
Nonfluent Aphasia After Left MCA Stroke
Case 1 - Nonfluent Aphasia After Left MCA Stroke
Client 68-year-old retired teacher
Referral Communication evaluation 5 days after left middle cerebral artery ischemic
stroke
History Right facial weakness and right upper-extremity weakness. Prior communication
was independent.
Communication Effortful, halting speech; short phrases; frequent omission of grammatical
words; relatively strong yes/no comprehension.
Assessment Snapshot Naming is reduced, repetition of longer utterances is poor, auditory
comprehension is stronger than verbal expression, and oral-motor speech is
slow with occasional groping.
CLINICAL DECISIONS
1. Which communication profile is most consistent with the findings?
A Fluent aphasia with severely impaired comprehension
B Nonfluent aphasia with relatively preserved basic comprehension
C Isolated dysarthria without language impairment
D Right-hemisphere cognitive-communication disorder
Answer: B Explanation: The client shows reduced phrase length, effortful output, and agrammatic
speech with comparatively stronger basic comprehension. That pattern is most
consistent with a nonfluent aphasia profile. Dysarthria may coexist, but it would not
explain the grammatical and word-retrieval deficits.
2. What should the SLP prioritize next to clarify the motor-speech contribution?
A A structured motor-speech examination for apraxia and dysarthria
B A pure-tone hearing test only
C A swallowing trial with thin liquids only
D A personality inventory
Answer: A Explanation: The slow output and groping suggest a possible motor-planning
component in addition to aphasia. A motor-speech examination can separate apraxia of
speech features from weakness-based dysarthria. This distinction changes cueing,
treatment targets, and prognosis.
Speech-Language Pathology | Adult Neurogenic Communication Disorders 3
, PASSPOINT PRO | ADULT SLP CLINICAL SIMULATION APHASIA & COGNITIVE-LINGUISTIC PRACTICE
3. Which early treatment activity best matches this profile?
A Practice highly functional phrases with supported verbal and multimodal cueing
B Require paragraph-length spontaneous speech without cues
C Focus only on visual scanning tasks
D Avoid all gestures so spoken language is forced
Answer: A Explanation: Early therapy should support successful communication while stimulating
language production. Functional phrases, written keywords, gestures, and graded
verbal cueing reduce communication breakdowns. Forcing long unsupported speech is
likely to increase frustration and reduce accuracy.
4. Which family strategy is most appropriate?
A Ask several questions at once to increase stimulation
B Use short questions, allow extra response time, and confirm the intended message
C Correct every grammatical error immediately
D Speak for the client before he attempts to respond
Answer: B Explanation: Short questions and extra processing time reduce linguistic load while
preserving the client’s participation. Confirming the message helps repair
misunderstandings without taking over the conversation. Immediate correction of every
error can disrupt communication and confidence.
CASE 2
Fluent Aphasia With Impaired Auditory Comprehension
Case 2 - Fluent Aphasia With Impaired Auditory Comprehension
Client 74-year-old woman
Referral Evaluation 1 week after left posterior temporal stroke
History No prior speech-language diagnosis. Family reports she now talks a great deal
but is difficult to understand.
Communication Fluent speech with normal rate and melody, frequent semantic and phonemic
substitutions, vague content, and limited awareness of errors.
Assessment Snapshot Single-word auditory comprehension is inconsistent, sentence comprehension is
poor, repetition is impaired, and naming contains paraphasias.
CLINICAL DECISIONS
Speech-Language Pathology | Adult Neurogenic Communication Disorders 4
