PASSPOINT PRO
ADULT NEUROGENIC
COMMUNICATION DISORDERS
Aphasia, Cognition & Post-Stroke Clinical Simulation
Practice
12 In-Depth Adult SLP Cases | 144 Clinical Decision Questions
CASES QUESTIONS FORMAT
12 144 Case-Based
Aphasia profiles | motor-speech differential | cognitive-communication | reading & writing | AAC |
participation | partner training | goals | progress monitoring
PASSPOINT PRO
Practice smarter. Prepare better.
,PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
HOW TO USE THIS PRACTICE
Adult neurogenic communication and clinical reasoning
Structure: Each client case contains 12 linked decisions. Work through the case in order because later questions build on the assessment
findings and functional priorities introduced earlier.
Coverage: Broca-type aphasia, Wernicke-type aphasia, conduction aphasia, anomic aphasia, global aphasia, apraxia of speech, dysarthria,
right hemisphere cognitive-communication disorder, traumatic brain injury, alexia/agraphia, subcortical cognitive-linguistic change, AAC, and
community reintegration.
Answer format: The correct answer and a detailed clinical explanation appear immediately after every question so the rationale can be
studied within the evolving case.
CASE MAP
12 clients | 12 decisions per case | 144 total questions
1 Left MCA Stroke with Nonfluent Agrammatic Speech Robert, age 68, 9 days after left middle
cerebral artery stroke
2 Fluent Aphasia with Poor Auditory Comprehension Denise, age 73, 3 weeks after left posterior
temporal stroke
3 Conduction Aphasia with Disproportionate Repetition Difficulty Samuel, age 59, 2 months after left
temporoparietal stroke
4 Mild Anomic Aphasia During Return to Work Alicia, age 47, 7 months after left
hemisphere stroke
5 Severe Global Aphasia in Early Stroke Recovery Mr. Chen, age 81, 12 days after large left
MCA stroke
6 Aphasia with Coexisting Apraxia of Speech Jamal, age 62, 5 weeks after left frontal
stroke
7 Brainstem Stroke with Dysarthria but Intact Language Margaret, age 70, 6 weeks after brainstem
stroke
8 Right Hemisphere Stroke with Cognitive-Communication Disorder Leon, age 65, 4 months after right
hemisphere stroke
9 Traumatic Brain Injury with Executive Communication Deficits Nora, age 34, 10 months after
moderate-severe TBI
10 Posterior Left Stroke with Alexia and Agraphia Harold, age 71, 3 months after posterior left
hemisphere stroke
11 Subcortical Stroke with Slowed Cognitive-Linguistic Processing Yvonne, age 76, 2 months after basal
ganglia and thalamic stroke
12 Chronic Severe Aphasia Using Multimodal AAC George, age 66, 2 years after large left
hemisphere stroke
13 Post-Stroke Communication Recovery for Community Reintegration Patricia, age 58, 14 months after left
hemisphere stroke
12 In-Depth Cases | 144 Questions + Detailed Rationales 2
,PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
CASE 1: LEFT MCA STROKE WITH NONFLUENT AGRAMMATIC SPEECH
Adult neurogenic communication clinical reasoning
CASE 1 Left MCA Stroke with Nonfluent Agrammatic Speech
Client Robert, age 68, 9 days after left middle cerebral artery stroke
Clinical profile Robert produces short, effortful phrases with omitted function words. He follows simple
conversation better than he can express himself and becomes frustrated when speech breaks
down.
Key findings Nonfluent output, agrammatism, reduced phrase length, impaired naming, relatively stronger
simple auditory comprehension, right facial weakness, and no evidence of severe confusion.
Clinical focus Identify a Broca-type aphasia pattern, separate language from motor speech contributions,
and establish early functional communication priorities.
QUESTION 1 Case decision 1/12
Which additional case-history information is most important for clinical planning?
A. Ask about premorbid communication, languages used, education, work demands, handedness, and the family
communication priorities
B. Ask only whether the client can say the alphabet
C. Skip history because the stroke diagnosis already explains everything
D. Ask only which word is hardest to pronounce
Answer: A. Ask about premorbid communication, languages used, education, work demands, handedness,
and the family communication priorities
Explanation: Premorbid language and participation demands are needed to judge change from baseline and to set
meaningful treatment targets.
QUESTION 2 Case decision 2/12
What is the most appropriate immediate assessment or referral step?
A. Use one brief naming screener and stop
B. Complete a comprehensive aphasia evaluation with bedside functional communication sampling and motor-speech
screening
C. Begin treatment before identifying the communication profile
D. Delay all assessment until spontaneous recovery is complete
Answer: B. Complete a comprehensive aphasia evaluation with bedside functional communication sampling
and motor-speech screening
Explanation: The profile clearly suggests aphasia, but early assessment should also determine whether apraxia or
dysarthria contributes to the effortful output.
12 In-Depth Cases | 144 Questions + Detailed Rationales 3
, PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
QUESTION 3 Case decision 3/12
Which assessment component should be emphasized to characterize this communication profile?
A. Rely only on a single total test score
B. Assess only articulation regardless of the referral
C. Emphasize naming, sentence production, auditory comprehension, repetition, reading, writing, and connected speech
D. Use only orientation questions to characterize communication
Answer: C. Emphasize naming, sentence production, auditory comprehension, repetition, reading, writing,
and connected speech
Explanation: Aphasia assessment must sample multiple language modalities because strengths and weaknesses may
differ across tasks.
QUESTION 4 Case decision 4/12
How should the speech-output findings be interpreted?
A. Assume every speech error reflects the same disorder
B. Classify the problem only from speech rate
C. Ignore error pattern, prosody, and language context
D. Interpret the short, effortful, agrammatic utterances as a nonfluent language pattern while screening for coexisting
apraxia of speech
Answer: D. Interpret the short, effortful, agrammatic utterances as a nonfluent language pattern while
screening for coexisting apraxia of speech
Explanation: Agrammatism and reduced phrase length point to aphasia, but articulatory planning deficits can coexist after a
left hemispheric stroke.
QUESTION 5 Case decision 5/12
What is the best interpretation of the cognitive-communication findings?
A. Treat preserved awareness and relatively stronger simple comprehension as important strengths for supported
communication
B. Assume intact social greeting means cognition is normal
C. Use naming accuracy as the only measure of cognition
D. Ignore attention and executive demands during communication
Answer: A. Treat preserved awareness and relatively stronger simple comprehension as important strengths
for supported communication
Explanation: These abilities can be used to establish reliable yes-no responses, choices, and treatment participation even
when verbal output is limited.
12 In-Depth Cases | 144 Questions + Detailed Rationales 4
ADULT NEUROGENIC
COMMUNICATION DISORDERS
Aphasia, Cognition & Post-Stroke Clinical Simulation
Practice
12 In-Depth Adult SLP Cases | 144 Clinical Decision Questions
CASES QUESTIONS FORMAT
12 144 Case-Based
Aphasia profiles | motor-speech differential | cognitive-communication | reading & writing | AAC |
participation | partner training | goals | progress monitoring
PASSPOINT PRO
Practice smarter. Prepare better.
,PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
HOW TO USE THIS PRACTICE
Adult neurogenic communication and clinical reasoning
Structure: Each client case contains 12 linked decisions. Work through the case in order because later questions build on the assessment
findings and functional priorities introduced earlier.
Coverage: Broca-type aphasia, Wernicke-type aphasia, conduction aphasia, anomic aphasia, global aphasia, apraxia of speech, dysarthria,
right hemisphere cognitive-communication disorder, traumatic brain injury, alexia/agraphia, subcortical cognitive-linguistic change, AAC, and
community reintegration.
Answer format: The correct answer and a detailed clinical explanation appear immediately after every question so the rationale can be
studied within the evolving case.
CASE MAP
12 clients | 12 decisions per case | 144 total questions
1 Left MCA Stroke with Nonfluent Agrammatic Speech Robert, age 68, 9 days after left middle
cerebral artery stroke
2 Fluent Aphasia with Poor Auditory Comprehension Denise, age 73, 3 weeks after left posterior
temporal stroke
3 Conduction Aphasia with Disproportionate Repetition Difficulty Samuel, age 59, 2 months after left
temporoparietal stroke
4 Mild Anomic Aphasia During Return to Work Alicia, age 47, 7 months after left
hemisphere stroke
5 Severe Global Aphasia in Early Stroke Recovery Mr. Chen, age 81, 12 days after large left
MCA stroke
6 Aphasia with Coexisting Apraxia of Speech Jamal, age 62, 5 weeks after left frontal
stroke
7 Brainstem Stroke with Dysarthria but Intact Language Margaret, age 70, 6 weeks after brainstem
stroke
8 Right Hemisphere Stroke with Cognitive-Communication Disorder Leon, age 65, 4 months after right
hemisphere stroke
9 Traumatic Brain Injury with Executive Communication Deficits Nora, age 34, 10 months after
moderate-severe TBI
10 Posterior Left Stroke with Alexia and Agraphia Harold, age 71, 3 months after posterior left
hemisphere stroke
11 Subcortical Stroke with Slowed Cognitive-Linguistic Processing Yvonne, age 76, 2 months after basal
ganglia and thalamic stroke
12 Chronic Severe Aphasia Using Multimodal AAC George, age 66, 2 years after large left
hemisphere stroke
13 Post-Stroke Communication Recovery for Community Reintegration Patricia, age 58, 14 months after left
hemisphere stroke
12 In-Depth Cases | 144 Questions + Detailed Rationales 2
,PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
CASE 1: LEFT MCA STROKE WITH NONFLUENT AGRAMMATIC SPEECH
Adult neurogenic communication clinical reasoning
CASE 1 Left MCA Stroke with Nonfluent Agrammatic Speech
Client Robert, age 68, 9 days after left middle cerebral artery stroke
Clinical profile Robert produces short, effortful phrases with omitted function words. He follows simple
conversation better than he can express himself and becomes frustrated when speech breaks
down.
Key findings Nonfluent output, agrammatism, reduced phrase length, impaired naming, relatively stronger
simple auditory comprehension, right facial weakness, and no evidence of severe confusion.
Clinical focus Identify a Broca-type aphasia pattern, separate language from motor speech contributions,
and establish early functional communication priorities.
QUESTION 1 Case decision 1/12
Which additional case-history information is most important for clinical planning?
A. Ask about premorbid communication, languages used, education, work demands, handedness, and the family
communication priorities
B. Ask only whether the client can say the alphabet
C. Skip history because the stroke diagnosis already explains everything
D. Ask only which word is hardest to pronounce
Answer: A. Ask about premorbid communication, languages used, education, work demands, handedness,
and the family communication priorities
Explanation: Premorbid language and participation demands are needed to judge change from baseline and to set
meaningful treatment targets.
QUESTION 2 Case decision 2/12
What is the most appropriate immediate assessment or referral step?
A. Use one brief naming screener and stop
B. Complete a comprehensive aphasia evaluation with bedside functional communication sampling and motor-speech
screening
C. Begin treatment before identifying the communication profile
D. Delay all assessment until spontaneous recovery is complete
Answer: B. Complete a comprehensive aphasia evaluation with bedside functional communication sampling
and motor-speech screening
Explanation: The profile clearly suggests aphasia, but early assessment should also determine whether apraxia or
dysarthria contributes to the effortful output.
12 In-Depth Cases | 144 Questions + Detailed Rationales 3
, PASSPOINT PRO | ADULT NEUROGENIC SLP APHASIA | COGNITION | POST-STROKE
QUESTION 3 Case decision 3/12
Which assessment component should be emphasized to characterize this communication profile?
A. Rely only on a single total test score
B. Assess only articulation regardless of the referral
C. Emphasize naming, sentence production, auditory comprehension, repetition, reading, writing, and connected speech
D. Use only orientation questions to characterize communication
Answer: C. Emphasize naming, sentence production, auditory comprehension, repetition, reading, writing,
and connected speech
Explanation: Aphasia assessment must sample multiple language modalities because strengths and weaknesses may
differ across tasks.
QUESTION 4 Case decision 4/12
How should the speech-output findings be interpreted?
A. Assume every speech error reflects the same disorder
B. Classify the problem only from speech rate
C. Ignore error pattern, prosody, and language context
D. Interpret the short, effortful, agrammatic utterances as a nonfluent language pattern while screening for coexisting
apraxia of speech
Answer: D. Interpret the short, effortful, agrammatic utterances as a nonfluent language pattern while
screening for coexisting apraxia of speech
Explanation: Agrammatism and reduced phrase length point to aphasia, but articulatory planning deficits can coexist after a
left hemispheric stroke.
QUESTION 5 Case decision 5/12
What is the best interpretation of the cognitive-communication findings?
A. Treat preserved awareness and relatively stronger simple comprehension as important strengths for supported
communication
B. Assume intact social greeting means cognition is normal
C. Use naming accuracy as the only measure of cognition
D. Ignore attention and executive demands during communication
Answer: A. Treat preserved awareness and relatively stronger simple comprehension as important strengths
for supported communication
Explanation: These abilities can be used to establish reliable yes-no responses, choices, and treatment participation even
when verbal output is limited.
12 In-Depth Cases | 144 Questions + Detailed Rationales 4
