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A 12-year-old phonology patient responds very well to continuous verbal reinforcement.
The SLP wishes to increase the task level for sibilant production to conversational
speech, but is concerned that the accuracy of the patient's productions will diminish
without continuous reinforcement. Which of the following adjustments is most logical for
the patient's treatment plan?
A.Increase task level to conversation and continue with continuous reinforcement for
correct productions
B.Changing the reinforcement schedule to variable-interval
C.Discontinuing reinforcement and providing a performance summary at the end of the
conversation
D.Shifting the feedback to punishment - CORRECT ANSWER: B Option (B) is correct.
Reinforcement is still needed, but a continuous schedule would be awkward and
unnecessary for the described task.
A 24 month old who was screened for autism spectrum disorder (ASDA S D) attends a
twice-weekly early intervention program to address developmental delays. Which of the
following is the best way to determine the communication goals for the child?
A.Aligning with developmental norms for communication behaviors typical of 24 month
olds
B.Waiting to address communication goals only after behavioral issues have been
remediated
C.Aligning with goals of other children in the program to heighten intensity of
intervention efforts
D.Setting goals that address communication challenges within daily activities and
routines - CORRECT ANSWER: D
,A 24-year-old male self-refers for a fluency evaluation. His presenting complaint is
stuttering. During conversation at the initial assessment, he speaks intelligibly at a
typical rate and produces no overt stutter-like disfluencies. He reports that he often
expects to stutter while conversing, but that he usually can prevent or conceal the
occurrence of the expected fluency disruptions either by substituting a word or by
inserting a pause or "um" before the word upon which he expects to be disfluent. He
states that these strategies are useful and that he would like to be able to "talk without
thinking about talking." He reports that he attended speech therapy from elementary
school through high school and that it helped him reduce disfluency significantly during
therapy activities, but his disfluency frequency did not change much during activities
outside of therapy. He fears that coworkers will react negatively to - CORRECT
ANSWER: A Option (A) is correct. Research supports the idea that Cognitive Behavioral
Therapy (CBTC B T) can change the communication-related attitudes of people who
stutter.
A 24-year-old male self-refers for a fluency evaluation. His presenting complaint is
stuttering. During conversation at the initial assessment, he speaks intelligibly at a
typical rate and produces no overt stutter-like disfluencies. He reports that he often
expects to stutter while conversing, but that he usually can prevent or conceal the
occurrence of the expected fluency disruptions either by substituting a word or by
inserting a pause or "um" before the word upon which he expects to be disfluent. He
states that these strategies are useful and that he would like to be able to "talk without
thinking about talking." He reports that he attended speech therapy from elementary
school through high school and that it helped him reduce disfluency significantly during
therapy activities, but his disfluency frequency did not change much during activities
outside of therapy. He fears that coworkers will react negatively to - CORRECT
ANSWER: C, Option (C) is correct. Some people who stutter can prevent anticipated
instances of stutter-like disfluency either by substituting words or by delaying the start of
a word upon which stuttering is anticipated, e.g., by pausing or by interjecting fillers
such as "um." Speech-related fear, concern about listener evaluations, and anticipated
disfluency are all hallmarks of stuttering but are not typical symptoms in SLI or
cluttering. Even though the SLP has not heard stuttering-like disfluency in the patient's
speech, all other symptoms are consistent with a diagnosis of stuttering.
A 24-year-old male self-refers for a fluency evaluation. His presenting complaint is
stuttering. During conversation at the initial assessment, he speaks intelligibly at a
typical rate and produces no overt stutter-like disfluencies. He reports that he often
expects to stutter while conversing, but that he usually can prevent or conceal the
,occurrence of the expected fluency disruptions either by substituting a word or by
inserting a pause or "um" before the word upon which he expects to be disfluent. He
states that these strategies are useful and that he would like to be able to "talk without
thinking about talking." He reports that he attended speech therapy from elementary
school through high school and that it helped him reduce disfluency significantly during
therapy activities, but his disfluency frequency did not change much during activities
outside of therapy. He fears that coworkers will react negatively to - CORRECT
ANSWER: D Option (D) is correct. Reinforcing open stuttering directly addresses the
client's fear of stuttering and provides opportunities for the client to objectively evaluate
how other people respond when he stutters openly.
A 28-year-old classroom teacher complaining of frequent voice loss is seen by an SLPS
L P and an otolaryngologist. It is determined the patient's symptoms are linked to
significant vocal demands. Which of following recommendations is the most appropriate
first step to treat the underlying disorder?
A.Advising the patient to undergo complete voice rest until the nodules improve or
resolve
B.Educating the patient on the importance of hydration and behavioral antireflux
strategies
C.Recommending voice amplification with resonant voice therapy
D.Training strategies to increase vocal loudness - CORRECT ANSWER: C
A 28-year-old female self-refers for a voice evaluation. She exhibits a variable
dysphonia (it is present in some sentences but not in others) which presents as mild-to-
moderate roughness. The SLPS L P desires more objective data about the patient's
voice quality.
Based on the information obtained so far, which of the following assessments best
complements the perceptual assessment to help the SLPS L P determine the underlying
physiological impairment(s)?
A. Performing acoustic assessment
B. Obtaining history of the problem
C. Using the Consensus Auditory-Perceptual Evaluation of Voice (CAPEC A P E-V)
D. Administering the Voice Handicap Index (VHIV H I) - CORRECT ANSWER: A Option
(A) is correct. Acoustic measures can support a perceptual judgement of voice quality
, and have been found in several studies to differentiate normal from pathologic
conditions of the voice.
A 35-year-old female is referred for an outpatient swallowing evaluation after having a
thyroidectomy. Her complaints include coughing when drinking and dysphonia. Which of
the following evaluation options is the most appropriate post-treatment follow-up for the
patient?
A. Completing a clinical swallow evaluation
B. Setting up an appointment for a pharyngeal manometry test
C. Using the fiberoptic endoscopic evaluation of swallowing (FEES)
D. Recording the patient during a videofluoroscopic swallow study (VFSS) - CORRECT
ANSWER: C
A 42-year-old male teacher is referred for a voice evaluation. History and perceptual
voice assessments reveal an eight-month history of progressive dysphonia, which is
currently characterized by a rough and breathy voice. Acoustic and aerodynamic
assessments reveal aperiodic voice signal, reduced frequency range, increased
subglottal air pressure, and increased transglottal airflow. The patient complains of
voice fatigue at the end of the day and pain during phonation. The patient reports
moderate alcohol use but is not currently a smoker. He has no previous history of
chronic voice problems, surgery, or neurological disease.
Based on the patient's history, which of the following assessments will best allow the
SLP to assess vocal fold vibratory dynamics during phonation?
A.Videofluoroscopic assessment
B.Laryngeal videostroboscopy
C.Nasoendoscopy
D.Ultrasound - CORRECT ANSWER: B
A 5-year-old child's evaluation reveals a developmental speech delay secondary to an
intellectual disability. Which of the following statements about etiology is most likely
true?
A.A genetic etiology can be assumed and treatment can be withheld.