ASHA CCC Certificate of Clinical Competence Exam — Questions and Answers

Question 1: In order to _____________ file extensions are utilized.

None of the above
Name the file
Identify the file
Identify the file type (Correct answer)
Answer the file name is not last

Correct answer: Identify the file type

File extensions, such as ".doc," ".pdf," or ".jpg," are used by operating systems and applications to identify the type or format of a file. This allows the system to know which program should open the file and how to process its contents. Without extensions, the computer would not easily recognize the file's nature.

Question 2: Which standardized test assesses language comprehension and production in children ages 3–21 and yields an overall Language Score?

CELF-5 (Correct answer)
CASL-2
PPVT-5
EVT-3

Correct answer: CELF-5

The Clinical Evaluation of Language Fundamentals–Fifth Edition (CELF-5) assesses multiple language domains and yields a Core Language Score.

Question 3: Unilateral vocal fold paralysis most commonly results in which vocal symptom?

Breathy, weak voice with reduced projection (Correct answer)
Pitch breaks only
Complete aphonia with no phonation possible
Hyperadduction and pressed voice

Correct answer: Breathy, weak voice with reduced projection

Unilateral paralysis prevents complete glottic closure, resulting in a breathy, weak voice with air escape and reduced loudness.

Question 4: Which approach provides additional instructional support to at-risk children before a formal special education referral is made?

Response to Intervention (RTI) (Correct answer)
IEP development
Functional behavioral assessment
Ecological assessment

Correct answer: Response to Intervention (RTI)

RTI is a tiered prevention model that provides increasingly intensive instruction to at-risk children prior to special education eligibility determination.

Question 5: You can use the internet to

connect to serves all around the world
send electric mail
None of the above
view page
All of the above (Correct answer)

Correct answer: All of the above

The internet is a vast global network that offers a multitude of functionalities. It allows users to connect to servers worldwide, facilitating access to information and services. Sending electronic mail (email) is a primary communication feature, and viewing web pages is how users access content on the World Wide Web. Therefore, all the listed options are valid uses of the internet.

Question 6: Which intervention approach uses naturalistic contexts and child-initiated interactions to facilitate language targets?

Structured language stimulation
Naturalistic developmental behavioral intervention (NDBI) (Correct answer)
Drill-based practice
Discrete trial training

Correct answer: Naturalistic developmental behavioral intervention (NDBI)

NDBIs use natural, play-based interactions following the child's lead to embed language targets within meaningful contexts.

Question 7: Oral sensorimotor treatment for infants with feeding difficulties typically includes techniques such as:

Immediate introduction of solid foods
Non-nutritive sucking, oral stimulation, and pacing (Correct answer)
Modified barium swallow at every session
Nasogastric tube feeding only

Correct answer: Non-nutritive sucking, oral stimulation, and pacing

Oral sensorimotor treatment uses non-nutritive sucking, intraoral stimulation, and pacing strategies to organize and improve feeding mechanics in infants.

Question 8: What exactly is back-up?

Adding more components to your network
Accessing data on tape
Filtering old data from the new data
Protecting data by copying it from the original source to a different destination (Correct answer)

Correct answer: Protecting data by copying it from the original source to a different destination

Back-up is the process of creating duplicate copies of data from its original source and storing them in a separate, secure location. The primary purpose of backing up data is to ensure that information can be recovered in the event of data loss, corruption, or system failure. It's a critical component of data protection and disaster recovery.

Question 9: The _____________ specifies the maximum amount of data that a storage medium can hold.

memory
storage
capacity (Correct answer)
None of the above
access

Correct answer: capacity

Capacity, in the context of computer storage, refers to the maximum amount of data that a storage medium can hold. It quantifies the total storage space available on devices like hard drives, USB drives, or solid-state drives. For example, a 1 terabyte hard drive has a storage capacity of 1 terabyte.

Question 10: Cochlear implants provide auditory stimulation by delivering electrical signals directly to which structure?

Spiral ganglion neurons of the auditory nerve (Correct answer)
Outer hair cells
Auditory brainstem
Tympanic membrane

Correct answer: Spiral ganglion neurons of the auditory nerve

Cochlear implants bypass damaged hair cells and electrically stimulate the spiral ganglion neurons (auditory nerve fibers) to restore sound perception.

Question 11: Vocal hygiene counseling for a patient with voice disorders would include which recommendation?

Avoid humming as it stresses the folds
Increase caffeine intake to energize the voice
Increase hydration and reduce vocal misuse behaviors (Correct answer)
Use a loud voice to strengthen the vocal folds

Correct answer: Increase hydration and reduce vocal misuse behaviors

Vocal hygiene programs emphasize adequate hydration, reduced vocal misuse (shouting, throat clearing), and voice rest to support vocal fold health.

Question 12: Which audiological test assesses the integrity of the auditory brainstem pathway by measuring electrical responses to sound?

Pure tone audiometry
Acoustic reflex threshold testing
Otoacoustic emissions (OAE)
Auditory brainstem response (ABR) (Correct answer)

Correct answer: Auditory brainstem response (ABR)

The ABR records electrical responses from the auditory nerve and brainstem to click or tone-burst stimuli, assessing neural pathway integrity.

Question 13: Which term describes a language disorder with no known etiology and no other co-occurring condition?

Secondary language impairment
Developmental language disorder (DLD) (Correct answer)
Specific reading disorder
Language learning disability

Correct answer: Developmental language disorder (DLD)

Developmental Language Disorder (DLD) is the current preferred term for persistent language difficulties without a known cause.

Question 14: The Penetration-Aspiration Scale (PAS) is an 8-point scale used during instrumental swallowing evaluation to rate:

Depth and response to airway invasion (Correct answer)
Pharyngeal residue severity
Esophageal transit time
Oral preparatory phase integrity

Correct answer: Depth and response to airway invasion

The PAS rates the depth at which material enters the airway and the patient's response (cough, no response) on an 8-point scale.

Question 15: The Brown's Stages of morphological development are tracked using which measurement?

Percentage of grammatical sentences
Lexical diversity index
Type-token ratio (TTR)
Mean length of utterance (MLU) (Correct answer)

Correct answer: Mean length of utterance (MLU)

MLU (Mean Length of Utterance) in morphemes is used to track syntactic and morphological development according to Brown's Stages.

Question 16: You can _____________with a CD.

None of the above
read and write
write
either read or write
read (Correct answer)

Correct answer: read

While some CDs (like CD-R and CD-RW) allow data to be written, all types of Compact Discs (CDs), including CD-ROMs, CD-Rs, and CD-RWs, are fundamentally designed to be read. Therefore, 'read' is the most universally applicable operation for any CD. The option 'read and write' would only apply to CD-RWs, making 'read' the most accurate general answer.

Question 17: What is 'aided AAC'?

AAC used exclusively in clinical settings with SLP supervision
AAC that requires an external device or tool such as a communication board or speech-generating device (Correct answer)
AAC that only uses body movements and gestures
AAC provided with the assistance of a trained communication partner

Correct answer: AAC that requires an external device or tool such as a communication board or speech-generating device

Aided AAC requires an external tool or device, ranging from low-tech picture boards to high-tech speech-generating devices.

Question 18: Semantic paraphasias involve substituting a target word with a word that is:

A perseverative error
Phonologically similar
Semantically related (Correct answer)
A made-up word (neologism)

Correct answer: Semantically related

Semantic paraphasias are word substitutions based on meaning, such as saying 'chair' for 'table'.

Question 19: The graduate program a CCC candidate attends must be accredited by:

CCNE
CAA (Council on Academic Accreditation) (Correct answer)
LCME
ABET

Correct answer: CAA (Council on Academic Accreditation)

Programs must be accredited by ASHA's Council on Academic Accreditation in Audiology and Speech-Language Pathology.

Question 20: Spaced retrieval training (SRT) is an evidence-based technique used with dementia patients to:

Improve swallowing safety
Reduce agitation with music
Teach and maintain functional information through graduated practice intervals (Correct answer)
Improve phonological awareness

Correct answer: Teach and maintain functional information through graduated practice intervals

SRT uses progressively longer intervals between retrieval attempts to help individuals with dementia learn and retain functional information.

Question 21: Several computers are connected to a server in order to share applications and storage space—

Integrated System
Library
Network (Correct answer)
Grouping

Correct answer: Network

A network is a system of interconnected computers and other devices that can communicate with each other and share resources. When several computers are connected to a server to share applications and storage space, they form a network. This setup allows for centralized data management and efficient resource utilization among users.

Question 22: A child consistently omits the past tense -ed morpheme in obligatory contexts. This is an example of a deficit in which language domain?

Phonology
Morphosyntax (Correct answer)
Pragmatics
Semantics

Correct answer: Morphosyntax

Omission of grammatical morphemes in obligatory contexts is a morphosyntactic deficit affecting grammar production.

Question 23: The Shaker exercise (head-lifting exercise) targets strengthening of which muscle group to improve swallowing?

Pharyngeal constrictors only
Suprahyoid and infrahyoid muscles to improve laryngeal elevation and UES opening (Correct answer)
Cricopharyngeus muscle directly
Tongue intrinsic muscles

Correct answer: Suprahyoid and infrahyoid muscles to improve laryngeal elevation and UES opening

The Shaker exercise strengthens suprahyoid muscles to improve hyolaryngeal excursion, which aids upper esophageal sphincter (UES) opening.

Question 24: Augmentative and Alternative Communication (AAC) should be introduced for adults with aphasia:

As early as appropriate to support communication participation (Correct answer)
Only in end-stage disease
Only when the patient requests it
Only after all restorative treatments have failed

Correct answer: As early as appropriate to support communication participation

AAC should be introduced early to maximize communicative participation and does not interfere with natural speech recovery.

Question 25: Van Riper's stuttering modification therapy targets which emotional aspect of stuttering in addition to the speech behavior itself?

Phonological awareness
Voice onset time
Only speech rate
Fear, avoidance, and negative attitudes toward stuttering (Correct answer)

Correct answer: Fear, avoidance, and negative attitudes toward stuttering

Stuttering modification addresses the fear, avoidance behaviors, and negative attitudes that maintain and exacerbate stuttering.

Question 26: Vocal nodules most commonly develop in which population due to vocal overuse or misuse?

Infants
Elderly men
Professional singers and heavy voice users (Correct answer)
Individuals post-laryngectomy

Correct answer: Professional singers and heavy voice users

Vocal nodules are callous-like lesions on the vocal fold edges commonly caused by chronic vocal overuse and poor vocal hygiene, often in singers and heavy voice users.

Question 27: Word finding difficulties in school-age children are most directly associated with deficits in which language domain?

Semantics and lexical access (Correct answer)
Syntax
Pragmatics
Phonology

Correct answer: Semantics and lexical access

Word finding difficulties reflect problems with semantic organization and lexical retrieval from long-term memory.

Question 28: A compiler converts a high-level language program into _____________

machine language (Correct answer)
None of the above
an algorithm
a debugged program
java

Correct answer: machine language

A compiler is a specialized program that translates source code written in a high-level programming language (like C++ or Python) into machine language. Machine language consists of binary instructions (0s and 1s) that a computer's central processing unit (CPU) can directly understand and execute. This translation is essential for software to run on hardware.

Question 29: A Clinical Fellowship for the CCC-SLP must total at least how many hours of supervised work?

1,260 hours (Correct answer)
640 hours
2,000 hours
1,000 hours

Correct answer: 1,260 hours

The CF requires a minimum of 1,260 hours completed over at least 36 weeks of full-time work.

Question 30: Pediatric feeding disorders differ from dysphagia in that feeding disorders more often involve which component?

Behavioral and sensory aversions in addition to motor deficits (Correct answer)
Aspiration without behavioral factors
Pharyngeal phase deficits only
Esophageal dysmotility exclusively

Correct answer: Behavioral and sensory aversions in addition to motor deficits

Pediatric feeding disorders frequently involve behavioral refusal, sensory sensitivities, and anxiety around food in addition to any motor or structural swallowing issues.

Question 31: On an audiogram, the air-bone gap indicates which finding?

Normal hearing
Sensorineural hearing loss
Central auditory processing disorder
Conductive component to the hearing loss (Correct answer)

Correct answer: Conductive component to the hearing loss

An air-bone gap, where bone conduction thresholds are better than air conduction thresholds, indicates a conductive component to the hearing loss.

Question 32: What is 'feature matching' in the AAC assessment process?

Selecting AAC symbols that visually resemble real objects as closely as possible
Matching AAC device costs to an individual's insurance coverage specifications
Pairing communication partners with AAC users based on shared personality traits
Matching AAC device features to an individual's communication needs, motor abilities, and environments (Correct answer)

Correct answer: Matching AAC device features to an individual's communication needs, motor abilities, and environments

Feature matching involves identifying an individual's needs, skills, and environments, then selecting an AAC system whose features best align with that profile.

Question 33: Narrative macrostructure refers to which aspect of storytelling ability?

Vocabulary diversity within stories
Sentence length in narratives
Grammatical accuracy of sentences
Overall story organization including story grammar elements (Correct answer)

Correct answer: Overall story organization including story grammar elements

Narrative macrostructure refers to the overall organization and completeness of story grammar elements such as setting, problem, and resolution.

Question 34: Which assessment tool is widely used to classify aphasia type based on fluency, comprehension, and repetition?

Western Aphasia Battery (WAB) (Correct answer)
MMSE
Boston Naming Test (BNT)
Token Test

Correct answer: Western Aphasia Battery (WAB)

The Western Aphasia Battery assesses fluency, comprehension, repetition, and naming to classify aphasia type and severity.

Question 35: The Cycles Approach was developed primarily to treat which type of disorder?

Highly unintelligible phonological disorders (Correct answer)
Stuttering
Apraxia of speech
Voice disorders

Correct answer: Highly unintelligible phonological disorders

The Cycles Approach, developed by Hodson and Paden, targets children with highly unintelligible speech due to multiple phonological process errors.

Question 36: The CF mentor must conduct a minimum number of monitoring activities each segment, including:

Daily co-treatment sessions
Weekly written exams
On-site observations and other monitoring contacts (Correct answer)
Annual reviews only

Correct answer: On-site observations and other monitoring contacts

Mentors complete required on-site observations plus additional monitoring activities each CF segment.

Question 37: Which assessment approach samples a child's phoneme production across a variety of contexts using real words?

Nonsense syllable probe
Single-word articulation test (Correct answer)
Stimulability testing
Connected speech sample

Correct answer: Single-word articulation test

A single-word articulation test elicits target phonemes in a standardized set of real words across various positions.

Question 38: A child who consistently omits final consonants (e.g., 'ca' for 'cat') is demonstrating which phonological process?

Cluster reduction
Epenthesis
Weak syllable deletion
Final consonant deletion (Correct answer)

Correct answer: Final consonant deletion

Final consonant deletion is the omission of the final consonant in a syllable or word.

Question 39: Traumatic brain injury (TBI) most commonly results in which type of communication disorder?

Selective mutism
Motor speech disorder only
Classical aphasia syndromes
Cognitive-communication disorder (Correct answer)

Correct answer: Cognitive-communication disorder

TBI often causes diffuse damage resulting in cognitive-communication disorders affecting attention, memory, organization, and social communication.

Question 40: What is the purpose of language sample analysis (LSA) in evaluating a child's language?

To obtain a standardized norm-referenced score
To assess phonological awareness only
To measure hearing thresholds
To describe naturalistic language in terms of complexity and accuracy (Correct answer)

Correct answer: To describe naturalistic language in terms of complexity and accuracy

Language sample analysis provides a descriptive, naturalistic measure of a child's spontaneous language use across multiple domains.

Question 41: Which term describes a speech error that is inconsistent across repeated productions of the same word?

Variable error (Correct answer)
Assimilation error
Consistent error
Phonological delay

Correct answer: Variable error

Variable (inconsistent) errors occur when a child produces the same word differently across multiple trials, which may indicate childhood apraxia of speech.

Question 42: Frontotemporal dementia (FTD) primarily affects which cognitive-behavioral domains first?

Behavior, personality, and language (Correct answer)
Sensory processing and motor function
Attention and working memory
Visuospatial processing and memory

Correct answer: Behavior, personality, and language

FTD predominantly affects the frontal and temporal lobes, causing early changes in behavior, personality, and language.

Question 43: Central auditory processing disorder (CAPD) is characterized by difficulty processing auditory information despite:

Normal cognitive ability
Normal peripheral hearing sensitivity (Correct answer)
Normal reading ability
Normal language skills

Correct answer: Normal peripheral hearing sensitivity

CAPD involves deficits in processing, interpreting, or using auditory information even when peripheral hearing thresholds are within normal limits.

Question 44: Which type of dementia is the most common and is associated with amyloid plaques and neurofibrillary tangles?

Lewy body dementia
Vascular dementia
Frontotemporal dementia
Alzheimer's disease (Correct answer)

Correct answer: Alzheimer's disease

Alzheimer's disease is the most common dementia, characterized pathologically by amyloid-beta plaques and tau neurofibrillary tangles.

Question 45: Which resonance disorder is characterized by insufficient nasal resonance on nasal phonemes /m/, /n/, and /ŋ/?

Cul-de-sac resonance
Hyponasality (Correct answer)
Mixed resonance
Hypernasality

Correct answer: Hyponasality

Hyponasality results from obstruction of the nasal passage, reducing nasal resonance on nasal consonants.

Question 46: The IDDSI (International Dysphagia Diet Standardisation Initiative) framework provides standardized terminology for:

Texture-modified food and thickened liquid levels (Correct answer)
Oral motor treatment approaches
Instrumental assessment procedures
Swallowing exercise protocols

Correct answer: Texture-modified food and thickened liquid levels

IDDSI defines eight standardized levels (0–7) of texture-modified foods and thickened liquids to improve communication and safety in dysphagia management.

Question 47: Otoacoustic emissions (OAEs) measure the function of which structure?

Middle ear ossicles
Outer hair cells of the cochlea (Correct answer)
Auditory cortex
Auditory nerve (CN VIII)

Correct answer: Outer hair cells of the cochlea

OAEs are sounds generated by the outer hair cells of the cochlea and are measured to assess cochlear (outer hair cell) integrity.

Question 48: Silent aspiration is defined as aspiration that occurs without which response?

Esophageal peristalsis
Laryngeal elevation
Cough or throat clear (Correct answer)
Tongue retraction

Correct answer: Cough or throat clear

Silent aspiration occurs when material enters the airway below the vocal folds without triggering a cough or throat-clearing response.

Question 49: Although computer programs are created in a high-level programming language, the human-readable version is referred to as _____________

Cache
Instruction set
Source code (Correct answer)
Word size
None of the above

Correct answer: Source code

Source code is the original, human-readable set of instructions written by a programmer in a high-level programming language. Before a computer can execute these instructions, the source code must be translated into machine language by a compiler or interpreter. It represents the fundamental blueprint of a software program.

Question 50: Melodic Intonation Therapy (MIT) is primarily indicated for which aphasia profile?

Global aphasia with severe comprehension deficit
Non-fluent aphasia with relatively preserved comprehension (Correct answer)
Conduction aphasia
Fluent aphasia with comprehension deficits

Correct answer: Non-fluent aphasia with relatively preserved comprehension

MIT uses melodic, rhythmic speech to leverage right hemisphere processing in individuals with non-fluent aphasia and preserved comprehension.

Question 51: Which phase of swallowing involves the bolus being moved from the anterior to the posterior oral cavity by the tongue?

Esophageal phase
Oral preparatory phase
Pharyngeal phase
Oral transport phase (Correct answer)

Correct answer: Oral transport phase

The oral transport (propulsion) phase involves the tongue propelling the bolus posteriorly toward the pharynx.

Question 52: Which structure is primarily responsible for velopharyngeal closure during speech?

Velum (soft palate) (Correct answer)
Tongue dorsum
Epiglottis
True vocal folds

Correct answer: Velum (soft palate)

The velum elevates and retracts to contact the posterior pharyngeal wall, closing the velopharyngeal port during oral speech production.

Question 53: Which approach uses personally relevant materials and life history to support communication and quality of life in individuals with dementia?

Response elaboration training
Errorless learning
PECS
Reminiscence therapy (Correct answer)

Correct answer: Reminiscence therapy

Reminiscence therapy uses personally meaningful memories, photographs, and life history materials to engage individuals with dementia and support communication.

Question 54: Which treatment for stuttering teaches clients to initiate phonation gently and manage airflow to produce fluent speech?

Stuttering modification therapy
Acceptance and commitment therapy
Fluency shaping therapy (Correct answer)
Easy onset only

Correct answer: Fluency shaping therapy

Fluency shaping therapy uses targets like easy onset, light articulatory contacts, and slow rate to establish fluency from scratch.

Question 55: Posterior tongue tie (posterior ankyloglossia) in infants is associated with difficulty in which feeding aspect?

Esophageal motility
Liquid thickening tolerance
Creating adequate suction and cupping during breastfeeding (Correct answer)
Pharyngeal swallow triggering

Correct answer: Creating adequate suction and cupping during breastfeeding

Posterior tongue tie restricts tongue elevation and cupping, impairing the suction and compression mechanics needed for efficient breastfeeding.

Question 56: A child who uses fewer than 50 words and no word combinations by age 24 months is classified as a:

Child with DLD
Child with autism
Late talker (Correct answer)
Late bloomer

Correct answer: Late talker

A 'late talker' is a toddler between 18–24 months with limited expressive vocabulary without other developmental concerns.

Question 57: Universal newborn hearing screening (UNHS) in the US uses which two primary technologies?

Pure tone audiometry and ABR
Behavioral audiometry and OAE
OAE and ABR (Correct answer)
Tympanometry and OAE

Correct answer: OAE and ABR

UNHS programs use OAE and/or ABR testing because both are objective, require no behavioral response, and can be performed on sleeping newborns.

Question 58: A child with cleft palate who undergoes palatoplasty may still require speech therapy primarily because of residual issues with which aspect of speech?

Velopharyngeal function and compensatory articulation errors (Correct answer)
Fluency
Hearing
Phonation

Correct answer: Velopharyngeal function and compensatory articulation errors

Even after surgical repair, children may retain compensatory articulation errors and residual velopharyngeal insufficiency requiring speech therapy.

Question 59: — is a type of storage that keeps or preserves data after the power has been turned off.

None of these
Direct storage
Volatile storage
Sequential storage
Non-volatile storage (Correct answer)

Correct answer: Non-volatile storage

Non-volatile storage is a type of computer memory that retains stored information even when the power supply is turned off. This characteristic is crucial for persistent data storage, such as operating systems, applications, and user files. Examples include hard disk drives (HDDs), solid-state drives (SSDs), and ROM.

Question 60: Dynamic assessment in language evaluation differs from standardized testing because it:

Only assesses expressive language
Requires no clinician involvement
Uses only norm-referenced scores
Measures the child's response to mediated instruction (Correct answer)

Correct answer: Measures the child's response to mediated instruction

Dynamic assessment follows a test-teach-retest model to measure the child's learning potential and responsiveness to scaffolding.

Question 61: Which of the following is not a hardware component?

None of the above
A mouse
An MP3 file (Correct answer)
A keyboard
A monitor

Correct answer: An MP3 file

Hardware refers to the physical, tangible components of a computer system that you can touch. A keyboard, mouse, and monitor are all physical devices. An MP3 file, however, is a digital audio file, which is a form of software or data, not a physical component of the computer itself.

Question 62: Which term describes the ability of a child to correctly produce a sound when given a model or cue?

Coarticulation
Stimulability (Correct answer)
Automaticity
Generalization

Correct answer: Stimulability

Stimulability refers to the child's ability to produce a sound correctly when provided with auditory and/or visual cues.

Question 63: Which disfluency types are considered 'stuttering-like disfluencies' (SLDs)?

Revisions and abandoned utterances only
Interjections, revisions, and phrase repetitions
Filled pauses and multisyllabic word repetitions
Part-word repetitions, prolongations, and blocks (Correct answer)

Correct answer: Part-word repetitions, prolongations, and blocks

SLDs include part-word repetitions, prolongations, and blocks, which are more closely associated with developmental stuttering.

Question 64: Which instrumental assessment is used to visualize velopharyngeal function during speech by inserting a scope through the nose?

Nasopharyngoscopy (Correct answer)
Modified barium swallow
Electropalatography
Videostroboscopy

Correct answer: Nasopharyngoscopy

Nasopharyngoscopy uses a flexible endoscope passed transnasally to provide a direct view of the velopharyngeal mechanism during speech.

Question 65: Which aphasia syndrome is characterized by relatively preserved repetition with non-fluent output and poor comprehension?

Mixed transcortical aphasia (Correct answer)
Transcortical sensory aphasia
Transcortical motor aphasia
Global aphasia

Correct answer: Mixed transcortical aphasia

Mixed transcortical aphasia features poor fluency, poor comprehension, but preserved repetition, often due to watershed lesions.

Question 66: FEES (Fiberoptic Endoscopic Evaluation of Swallowing) is advantageous over MBSS in which clinical situation?

When radiation exposure must be minimized and bedside evaluation is needed (Correct answer)
When fluoroscopy is available and preferred
When the oral preparatory phase is the primary concern
When esophageal phase must be visualized

Correct answer: When radiation exposure must be minimized and bedside evaluation is needed

FEES is portable, radiation-free, and can be performed at bedside, making it preferable when fluoroscopy is unavailable or radiation is contraindicated.

Question 67: Which evidence-based approach uses minimal pairs to contrast error and target sounds to facilitate phonological change?

Minimal opposition contrast therapy (Correct answer)
Cycles approach
DTTC
Nuffield dyspraxia programme

Correct answer: Minimal opposition contrast therapy

Minimal opposition contrast therapy pairs words that differ by only one phoneme to highlight the communicative impact of the error.

Question 68: Which federal law mandates free appropriate public education (FAPE) and related services, including speech-language pathology, for children with disabilities?

Section 504
ADA
IDEA (Correct answer)
NCLB

Correct answer: IDEA

The Individuals with Disabilities Education Act (IDEA) ensures FAPE and related services, including SLP services, for eligible children.

Question 69: Which language component involves understanding and applying rules for combining words into sentences?

Syntax (Correct answer)
Morphology
Pragmatics
Phonology

Correct answer: Syntax

Syntax refers to the rules governing sentence structure, including word order and grammatical relationships.

Question 70: Which communication characteristic is most prominent in the early stages of Alzheimer's disease?

Fluent jargon aphasia
Complete mutism
Word finding difficulty and topic maintenance problems (Correct answer)
Severe phonological errors

Correct answer: Word finding difficulty and topic maintenance problems

Early Alzheimer's disease typically presents with anomia and difficulty maintaining conversational topics due to memory and semantic deficits.

Question 71: Which of the following is a device for generating output?

Printer
A and B both (Correct answer)
Mouse
Monitor
None of the above

Correct answer: A and B both

Output devices are components that display or present information processed by a computer to the user. A monitor provides visual output, while a printer produces physical hard copies of documents or images. Both devices serve the function of generating output from the computer system.

Question 72: Which distinctive feature differentiates /p/ from /b/?

Voicing (Correct answer)
Place of articulation
Manner of articulation
Nasality

Correct answer: Voicing

/p/ is voiceless and /b/ is voiced; they share the same bilabial place and stop manner.

Question 73: What does the abbreviation 'SGD' stand for in AAC?

Supported Gestural Dialogue
Sequential Grid Design
Symbol Guided Display
Speech Generating Device (Correct answer)

Correct answer: Speech Generating Device

SGD stands for Speech Generating Device, a category of high-tech AAC systems that produce electronic voice output.

Question 74: Which evidence-based aphasia treatment focuses on restoring word retrieval through repeated naming practice with feedback?

Treatment of Underlying Forms (TUF)
Melodic Intonation Therapy (MIT)
Supported Conversation for Adults with Aphasia (SCA)
Semantic Feature Analysis (SFA) (Correct answer)

Correct answer: Semantic Feature Analysis (SFA)

Semantic Feature Analysis targets word retrieval by activating semantic networks through systematic feature generation.

Question 75: Percentage of consonants correct (PCC) is a metric used to quantify which aspect of speech?

Articulation accuracy (Correct answer)
Voice quality
Intelligibility
Prosody

Correct answer: Articulation accuracy

PCC measures the proportion of consonants produced correctly in a speech sample, reflecting articulation accuracy.

Question 76: Glottal stop substitutions in children with cleft palate are considered which type of errors?

Developmental phonological errors
Compensatory articulation errors (Correct answer)
Motor programming errors
Resonance errors

Correct answer: Compensatory articulation errors

Glottal stop substitutions are compensatory articulation errors developed to manage air pressure given inadequate velopharyngeal closure.

Question 77: Hypernasality is most directly associated with inadequate function of which structure?

Larynx
Velopharyngeal mechanism (Correct answer)
Tongue
Lips

Correct answer: Velopharyngeal mechanism

Inadequate velopharyngeal closure allows excessive nasal resonance, causing hypernasality.

Question 78: Which aphasia type features fluent speech, impaired comprehension, and impaired repetition with paraphasias?

Conduction aphasia
Broca's aphasia
Transcortical motor aphasia
Wernicke's aphasia (Correct answer)

Correct answer: Wernicke's aphasia

Wernicke's aphasia is characterized by fluent, paraphasic speech with poor comprehension and poor repetition.

Question 79: Cricopharyngeal dysfunction (CP dysfunction) refers to impairment of which structure's ability to open during swallowing?

Upper esophageal sphincter (Correct answer)
Glottis
Velopharyngeal port
Epiglottis

Correct answer: Upper esophageal sphincter

Cricopharyngeal dysfunction involves failure of the cricopharyngeus muscle (main component of the UES) to relax and open during swallowing, causing bolus retention in the pharynx.

Question 80: Which surgical procedure involves injecting material into a paralyzed vocal fold to improve glottic closure?

Thyroplasty Type I only
Vocal fold augmentation injection (Correct answer)
Arytenoidectomy
Laser cordectomy

Correct answer: Vocal fold augmentation injection

Vocal fold augmentation involves injecting materials (e.g., collagen, fat, Radiesse) to medialize a paralyzed or atrophic vocal fold for improved closure.

Question 81: Which phonological process involves moving a back consonant to a more anterior position, such as saying 'tat' for 'cat'?

Stopping
Backing
Fronting (Correct answer)
Vocalization

Correct answer: Fronting

Fronting occurs when velar or palatal sounds are replaced by alveolar or dental sounds.

Question 82: When you're formatting text in Word, which grouping do you use?

Paragraphs, indexes and sections
Indexes, characters and tables
Characters, sections and paragraphs (Correct answer)
Tables, paragraphs and indexes

Correct answer: Characters, sections and paragraphs

When formatting text in Word, the primary groupings for applying styles and attributes are characters, sections, and paragraphs. Character formatting applies to individual letters or words, paragraph formatting affects entire paragraphs, and section formatting controls page layout and headers/footers for distinct parts of a document. These three levels provide comprehensive control over document appearance.

Question 83: Real-ear measurement (REM) in hearing aid fitting verifies that the aid provides the prescribed gain by measuring sound at which location?

At the level of the tympanic membrane in the ear canal (Correct answer)
Outside the ear canal at the aid microphone
At the hearing aid speaker output only
In a 2cc coupler

Correct answer: At the level of the tympanic membrane in the ear canal

REM uses a probe microphone placed near the tympanic membrane to measure the actual sound pressure level delivered by the hearing aid in the individual's ear.

Question 84: Which SLP role in dementia care involves training care partners to use strategies that enhance communication?

Care partner coaching and education (Correct answer)
Diagnostic workup only
Feeding tube placement
Pharmacological management

Correct answer: Care partner coaching and education

SLPs train care partners in communication strategies such as simplified language, visual cues, and validation to optimize interactions with individuals with dementia.

Question 85: The Lee Silverman Voice Treatment (LSVT LOUD) is an evidence-based voice treatment specifically designed for patients with:

Parkinson's disease (Correct answer)
Unilateral vocal fold paralysis
Spasmodic dysphonia
Vocal nodules

Correct answer: Parkinson's disease

LSVT LOUD targets the hypokinetic dysarthria of Parkinson's disease by training patients to use increased vocal effort and loudness.

Question 86: At what age is the phoneme /r/ typically acquired by most children?

Age 7 (Correct answer)
Age 4
Age 5
Age 3

Correct answer: Age 7

The phoneme /r/ is one of the latest to be acquired, typically mastered by age 7.

Question 87: Presbycusis is defined as age-related hearing loss and typically presents as which audiometric pattern?

Low-frequency sensorineural hearing loss
High-frequency sensorineural hearing loss (Correct answer)
Flat conductive hearing loss
Unilateral conductive loss

Correct answer: High-frequency sensorineural hearing loss

Presbycusis typically causes a bilateral, symmetric, high-frequency sensorineural hearing loss due to cochlear hair cell degeneration with age.

Question 88: Which evidence-based technique involves repeating a child's utterance with a corrected or expanded grammatical form?

Modeling
Prompting
Recasting (Correct answer)
Scaffolding

Correct answer: Recasting

Recasting repeats the child's utterance with a grammatical or semantic correction without explicitly marking the error.

Question 89: Which process describes a child replacing a fricative with a stop, such as saying 'tun' for 'sun'?

Gliding
Stopping (Correct answer)
Assimilation
Fronting

Correct answer: Stopping

Stopping is a phonological process where fricatives or affricates are replaced by stop consonants.

Question 90: The term "collection" refers to a group of related files called _____________

Character
Field
None of the above
Data base (Correct answer)
Record

Correct answer: Data base

A database is an organized collection of related data, typically stored and accessed electronically. It is designed to efficiently store, manage, and retrieve large amounts of information. This collection often consists of multiple related files or tables, making 'database' the correct term for a group of related files.

Question 91: Tympanometry assesses the function and compliance of which structure?

Tympanic membrane and middle ear system (Correct answer)
Cochlea
Eustachian tube only
Auditory nerve

Correct answer: Tympanic membrane and middle ear system

Tympanometry measures tympanic membrane compliance and middle ear pressure to assess middle ear function and pathology.

Question 92: The following are the most often used input devices:

Keyboard, mouse (Correct answer)
Microphone, printer
Digital camera, speaker
Scanner, monitor

Correct answer: Keyboard, mouse

Input devices are essential for users to interact with a computer and provide it with data and commands. The keyboard is primarily used for typing text and entering commands, while the mouse is used for pointing, clicking, and navigating the graphical user interface. These two are the most fundamental and widely used input devices for general computer operation.

Question 93: Cognitive-communication disorders following right hemisphere brain damage commonly include deficits in:

Phonological processing
Pragmatics, discourse, and prosody (Correct answer)
Syntactic comprehension
Reading decoding

Correct answer: Pragmatics, discourse, and prosody

Right hemisphere damage frequently causes deficits in pragmatic communication, discourse organization, prosodic interpretation, and inferencing.

Question 94: Which amplification fitting approach is most commonly used as the prescriptive target for adult hearing aid fittings?

NAL-NL2 (Correct answer)
CROS fitting
BICROS fitting
Mirror gain prescription

Correct answer: NAL-NL2

NAL-NL2 (National Acoustic Laboratories Non-Linear fitting procedure) is a widely adopted prescriptive target for optimizing speech intelligibility in hearing aid fittings.

Question 95: A document's paragraph and character styles, as well as everything things you customized like toolbars and menus, are stored in a file called a.

Base Document
Guide
Pattern
Template (Correct answer)

Correct answer: Template

A template is a pre-designed document that serves as a blueprint for creating new files with a consistent look and structure. It typically includes predefined paragraph and character styles, page layouts, and often customized toolbars or menus. Using templates saves time and ensures uniformity across multiple documents.

Question 96: Which service delivery model places the SLP directly in the classroom to support language learning within the curriculum?

Pull-out model
Consultative model
Collaborative classroom model (Correct answer)
Telehealth model

Correct answer: Collaborative classroom model

The collaborative classroom (integrated) model embeds speech-language services within the general education setting.

Question 97: Which type of hearing protection device (HPD) provides the highest noise reduction rating (NRR) in ideal conditions?

Semi-insert ear canal caps
Custom molded earplugs
Foam earplugs (Correct answer)
Earmuffs

Correct answer: Foam earplugs

Foam earplugs have the highest published NRR values (up to 33 dB) when properly inserted, exceeding earmuffs in ideal conditions.

Question 98: Coursework for the CCC must cover the basic science areas of:

Biological, physical, statistical/mathematical, and behavioral/social sciences (Correct answer)
Only anatomy and physiology
Pharmacology and surgery
Business administration

Correct answer: Biological, physical, statistical/mathematical, and behavioral/social sciences

ASHA standards require coursework across biological, physical, statistical, and social/behavioral sciences.

Question 99: Noise-induced hearing loss (NIHL) preferentially affects which frequency region on the audiogram?

Only high frequencies above 8000 Hz
4000 Hz (4 kHz notch) (Correct answer)
All frequencies equally
250–500 Hz low frequencies

Correct answer: 4000 Hz (4 kHz notch)

NIHL characteristically produces a 'noise notch' at 4000 Hz (4 kHz) due to the resonance properties of the ear canal and mechanical vulnerability of that cochlear region.

Question 100: Documents that have been converted to _____________ can be posted on the internet.

HTML (Correct answer)
Machine Language
Doc File
Http
None of the above

Correct answer: HTML

HTML (HyperText Markup Language) is the standard markup language for documents designed to be displayed in a web browser. To post documents on the internet, they are typically converted into HTML format, which browsers can interpret and render as web pages. While other formats can be linked, HTML is essential for creating the structure and content of web pages themselves.

Question 101: Anomia refers to difficulty with which language task?

Repetition
Sentence comprehension
Word retrieval or naming (Correct answer)
Reading aloud

Correct answer: Word retrieval or naming

Anomia is the inability or reduced ability to retrieve words, commonly manifested as difficulty naming objects or pictures.

Question 102: The Stuttering Severity Instrument (SSI-4) rates severity based on which three components?

Rate, intelligibility, and tension
Frequency, duration, and physical concomitants (Correct answer)
Frequency, avoidance, and attitude
Avoidance, anticipation, and struggle

Correct answer: Frequency, duration, and physical concomitants

The SSI-4 measures stuttering frequency, average duration of the three longest stuttering events, and physical concomitants.

Question 103: Which morpheme is typically among the first 14 acquired according to Brown's sequence?

Third-person regular -s
Contractible copula
Articles 'a' and 'the'
Present progressive -ing (Correct answer)

Correct answer: Present progressive -ing

The present progressive morpheme -ing is among the earliest morphemes acquired, appearing in Brown's Stage I–II.

Question 104: Phonological awareness intervention is particularly important for children at risk for which academic difficulty?

Reading disabilities (Correct answer)
Math disabilities
Social-emotional problems
Writing mechanics difficulties

Correct answer: Reading disabilities

Phonological awareness is a critical predictor of reading acquisition, and deficits are strongly linked to reading disabilities like dyslexia.

Question 105: A speech-language pathologist selects intervention targets using a complexity approach. Which sounds are prioritized?

Early-developing sounds the child inconsistently produces
Sounds with the highest stimulability
Late-developing sounds the child does not produce (Correct answer)
Sounds the child produces correctly in isolation

Correct answer: Late-developing sounds the child does not produce

The complexity approach targets late-developing, non-stimulable sounds to promote system-wide generalization.

Question 106: Which treatment is considered the most effective medical management for adductor spasmodic dysphonia?

Vocal fold augmentation
Voice therapy alone
Resonance therapy
Botulinum toxin (Botox) injections into the thyroarytenoid muscle (Correct answer)

Correct answer: Botulinum toxin (Botox) injections into the thyroarytenoid muscle

Botulinum toxin injections into the thyroarytenoid (or cricothyroid) muscles temporarily paralyze the overactive muscles, reducing spasms in spasmodic dysphonia.

Question 107: Which cognitive domain is most critical for assessing a patient's ability to profit from aphasia therapy?

Executive inhibition only
Working memory and attention (Correct answer)
Visual-spatial processing
Long-term semantic memory

Correct answer: Working memory and attention

Working memory and attention are essential for learning and retaining new information, directly affecting rehabilitation potential.

Question 108: Which condition is associated with the language profile of hyperlexia, relatively strong decoding, but poor reading comprehension?

Dyslexia
Autism spectrum disorder (ASD) (Correct answer)
DLD
ADHD

Correct answer: Autism spectrum disorder (ASD)

Hyperlexia, characterized by early word decoding with poor comprehension, is frequently observed in children with ASD.

Question 109: Which instrumental assessment uses fluoroscopy to evaluate all phases of swallowing in real time?

Fiberoptic endoscopic evaluation of swallowing (FEES)
Ultrasound imaging
Modified barium swallow study (MBSS) (Correct answer)
High-resolution manometry

Correct answer: Modified barium swallow study (MBSS)

The Modified Barium Swallow Study uses dynamic fluoroscopy with barium-coated boluses to visualize swallowing physiology across all phases.

Question 110: During the Clinical Fellowship, what percentage of time must be spent in direct clinical contact?

At least 10%
At least 80% (Correct answer)
At least 25%
At least 50%

Correct answer: At least 80%

At least 80% of the CF must involve direct clinical activities such as assessment and intervention.

Question 111: When it comes to computer input and output, input refers to_____________

data or information that has been entered into the computer
Both (A) and (C) (Correct answer)
retrieval of data or information that has been input into the computer
any data processing that occurs from new data input into the computer
the transmission of data that has been input to the computer

Correct answer: Both (A) and (C)

Input in computing refers to both the data or information that is entered into the computer system and the process of transmitting that data into the system. This means that anything fed into the computer, whether it's text from a keyboard or a file from a drive, along with its transmission, constitutes input. Both aspects are crucial for the computer to receive and process information.

Question 112: Natural recovery from stuttering without treatment occurs in approximately what percentage of children?

10–15%
25–35%
50–80% (Correct answer)
90–95%

Correct answer: 50–80%

Research indicates that 50–80% of children who stutter will naturally recover, often before puberty.

Question 113: The acoustic stapedial reflex is elicited by loud sounds and involves contraction of which muscle?

Tensor veli palatini
Stapedius muscle (Correct answer)
Tensor tympani
Levator veli palatini

Correct answer: Stapedius muscle

The acoustic reflex involves reflexive contraction of the stapedius muscle in response to loud sounds, stiffening the ossicular chain.

Question 114: What is the primary purpose of augmentative and alternative communication (AAC)?

To improve articulation skills in individuals with speech sound disorders
To replace hearing aids for individuals with hearing loss
To treat the underlying neurological cause of communication disorders
To supplement or replace natural speech and writing for individuals with severe communication disorders (Correct answer)

Correct answer: To supplement or replace natural speech and writing for individuals with severe communication disorders

AAC aims to supplement or replace natural speech and writing, enhancing communication participation for those with severe communication impairments.

Question 115: Broca's aphasia is characterized by which pattern of language deficits?

Fluent paraphasic speech with poor repetition
Non-fluent speech with severely impaired comprehension
Fluent speech with comprehension deficits
Non-fluent speech with relatively preserved comprehension (Correct answer)

Correct answer: Non-fluent speech with relatively preserved comprehension

Broca's aphasia is marked by effortful, non-fluent speech with relatively preserved auditory comprehension.

Question 116: Videostroboscopy evaluates vocal fold function primarily by observing:

Respiratory support for speech
Subglottal pressure
Vocal fold mucosal wave and closure patterns (Correct answer)
Resonance characteristics

Correct answer: Vocal fold mucosal wave and closure patterns

Videostroboscopy uses a strobe light synchronized to vocal fold vibration to visualize the mucosal wave and vibratory characteristics.

Question 117: Which compensatory swallowing strategy involves turning the head toward the weaker side to redirect the bolus?

Effortful swallow
Supraglottic swallow
Head turn (Correct answer)
Chin tuck

Correct answer: Head turn

Head rotation toward the damaged side closes off that pyriform sinus, directing the bolus to the stronger side for safer passage.

Question 118: Which compensatory technique involves the patient holding their breath before and during the swallow to protect the airway?

Shaker exercise
Effortful swallow
Mendelsohn maneuver
Supraglottic swallow (Correct answer)

Correct answer: Supraglottic swallow

The supraglottic swallow involves volitional breath hold before swallowing to close the airway, followed by a cough after the swallow.

Question 119: An example of a _____________ is = SUM (B1 : B8)

Function
Call address
Value
Formula (Correct answer)

Correct answer: Formula

In spreadsheet applications like Microsoft Excel, a formula is an expression that performs calculations or other operations on values in a worksheet. Formulas always begin with an equals sign (=) and can include cell references, operators, and functions. The example '=SUM(B1:B8)' is a classic formula using the SUM function to add values in a range of cells.

Question 120: Which term describes the perception of sound (ringing, buzzing, hissing) in the absence of an external sound source?

Diplacusis
Hyperacusis
Tinnitus (Correct answer)
Auditory hallucinations

Correct answer: Tinnitus

Tinnitus is the subjective perception of sound without an external acoustic stimulus, often associated with cochlear damage.

ASHA CCC Certificate of Clinical Competence Exam

The ASHA Certificate of Clinical Competence (CCC) Exam assesses speech-language pathology knowledge across speech sound disorders, language disorders in children and adults, fluency and voice disorders, swallowing and feeding disorders, and audiology and hearing sciences.

120

Questions

150 min

Time Limit

70%

To Pass

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