Alliance for Accreditation and Certification of Dyslexia Specialists (AACDS) Certification Exam — Questions and Answers

Question 1: What should a practitioner do if a patient experiences an adverse reaction during treatment?

Complete the procedure and document afterward
Stop the procedure immediately and assess the patient (Correct answer)
Have the patient sign a waiver and continue
Continue at a reduced intensity

Correct answer: Stop the procedure immediately and assess the patient

Immediately stopping the procedure and assessing the patient is the correct response to an adverse reaction, prioritizing patient safety above all else.

Question 2: A student's progress monitoring data shows an upward trend exceeding the aim line. According to data decision rules, the CDT should:

Continue the same intervention without modification
Refer the student for special education evaluation
Immediately move the student to a higher tier
Raise the goal and consider fading intervention intensity (Correct answer)

Correct answer: Raise the goal and consider fading intervention intensity

When a student's growth exceeds the aim line, it is appropriate to raise the goal and potentially reduce intervention intensity while maintaining gains.

Question 3: A CDT therapist accidentally emails a student's assessment report to the wrong address. What is the required action under HIPAA?

Delete the sent email and hope the recipient ignores it
Inform only the school administrator, not the family
Notify the affected individual and the relevant authorities as required by breach notification rules (Correct answer)
Document the incident privately and take no further action

Correct answer: Notify the affected individual and the relevant authorities as required by breach notification rules

HIPAA's Breach Notification Rule requires covered entities to notify affected individuals and, depending on scope, the HHS and media after an unsecured PHI breach.

Question 4: A therapist is troubleshooting a noise-canceling headset used during auditory discrimination exercises that is producing a buzzing sound. Which step should be attempted FIRST?

Send the headset for repair without testing further
Replace the headset immediately with a new one
Check and reseat the audio cable connection, then test with a different device to isolate the fault (Correct answer)
Ask the student to tolerate the noise and continue

Correct answer: Check and reseat the audio cable connection, then test with a different device to isolate the fault

Reseating the cable and isolating the fault with a different device quickly determines whether the problem is in the headset, cable, or output device.

Question 5: What is the primary purpose of regulatory compliance in professional practice?

To protect public safety and ensure minimum standards of care (Correct answer)
To create bureaucratic obstacles
To limit the number of practitioners
To increase operating costs

Correct answer: To protect public safety and ensure minimum standards of care

Regulatory compliance exists primarily to protect public safety by ensuring all practitioners meet minimum standards of competence and ethical conduct.

Question 6: What is the correct response to suspected equipment malfunction?

Remove from service immediately, tag as defective, and report to maintenance (Correct answer)
Continue using with adjusted settings
Wait for the next scheduled maintenance check
Let the next shift handle it

Correct answer: Remove from service immediately, tag as defective, and report to maintenance

Immediately removing malfunctioning equipment from service prevents potential harm and ensures only properly functioning equipment is used for professional services.

Question 7: Which document formalizes the goals, services, and accommodations agreed upon by the school team and parents for a student with dyslexia?

504 Plan only
IEP (Individualized Education Program) (Correct answer)
Psychoeducational evaluation
Progress monitoring report

Correct answer: IEP (Individualized Education Program)

The IEP is the legally binding document that outlines specific goals, services, accommodations, and parent consent under IDEA.

Question 8: Which learning disability is most often associated with dyslexia?

Anxiety disorders.
Dyscalculia (difficulty with math). (Correct answer)
Autism spectrum disorder.
Attention deficit hyperactivity disorder (ADHD).

Correct answer: Dyscalculia (difficulty with math).

Dyscalculia, a specific learning disability affecting mathematical abilities, is frequently co-occurring with dyslexia. While dyslexia primarily impacts reading and language, individuals often experience challenges in other academic areas, making dyscalculia a common comorbidity that requires separate but often integrated support.

Question 9: Which of the following best describes the 'dual-deficit hypothesis' relevant to dyslexia assessment?

Dyslexia involves deficits in both phonological processing and processing speed/RAN (Correct answer)
Assessment must evaluate both decoding and comprehension deficits
Students with dyslexia have deficits in both reading and math
Dyslexia is caused by both genetic and environmental factors equally

Correct answer: Dyslexia involves deficits in both phonological processing and processing speed/RAN

The dual-deficit hypothesis posits that many individuals with dyslexia have independent deficits in phonological awareness and naming speed (RAN).

Question 10: A CDT therapist is asked by a divorce attorney to provide therapy records about a student whose parents are in a custody dispute. What should the therapist do first?

Refuse to release any records under any circumstances
Release records to the attorney immediately since they represent the family
Release only records from sessions with the mother present
Obtain a court order or consent from the appropriate legal guardian before releasing (Correct answer)

Correct answer: Obtain a court order or consent from the appropriate legal guardian before releasing

Records should only be released in a custody dispute upon receipt of a court order or valid authorization from the appropriate legal guardian.

Question 11: When is it MOST appropriate for a CDT to refer a family to a private educational advocate?

When parents want to understand their child's IEP rights and the school district is unresponsive (Correct answer)
When the family speaks a language other than English
When the child shows rapid progress and no longer needs services
When the therapist disagrees with the parents' goals

Correct answer: When parents want to understand their child's IEP rights and the school district is unresponsive

An educational advocate helps families navigate IEP processes and advocate for appropriate services when the school district is unresponsive.

Question 12: A CDT employed by a public school district must report suspicions of child abuse. This obligation is governed primarily by which type of law?

IDEA discipline procedures
FERPA confidentiality provisions
State mandatory reporter statutes (Correct answer)
HIPAA privacy regulations

Correct answer: State mandatory reporter statutes

Mandatory reporting of suspected child abuse is governed by state mandatory reporter statutes, which typically classify educators and therapists as mandated reporters.

Question 13: Under HIPAA's Privacy Rule, which of the following is a permitted disclosure without patient authorization?

Disclosing records to public health authorities for disease reporting (Correct answer)
Releasing records to a friend of the family for convenience
Sharing records with a student's employer upon request
Providing records to a research team without an IRB waiver

Correct answer: Disclosing records to public health authorities for disease reporting

HIPAA permits disclosure to public health authorities for legally authorized purposes such as disease reporting without requiring patient authorization.

Question 14: A therapist teaches 'the floss rule' (double l, f, s after a short vowel in a one-syllable word). This rule is part of which instructional strand?

Phonological awareness
Syllable types
Spelling patterns and phonics generalizations (Correct answer)
Morphological analysis

Correct answer: Spelling patterns and phonics generalizations

The floss rule is a spelling generalization that guides students on when to double certain consonants, falling under phonics and spelling patterns.

Question 15: Which term describes the legal requirement that IEP goals must be achievable and based on the individual student's present levels of academic achievement and functional performance?

Appropriate education standard under IDEA (Correct answer)
Benchmark performance criterion
SMART goals framework
Annual goal progression rule

Correct answer: Appropriate education standard under IDEA

IDEA's 'appropriate education' standard, clarified by the Supreme Court in Endrew F. v. Douglas County (2017), requires IEP goals to be reasonably calculated to enable meaningful educational progress based on the child's individual circumstances.

Question 16: When planning intervention intensity for a student with severe dyslexia, research recommends:

Three to five sessions per week of 45–60 minutes each for maximum progress (Correct answer)
Daily 10-minute sessions replacing all classroom reading instruction
Two sessions per week with a focus only on comprehension strategies
One 30-minute session per week to avoid fatigue

Correct answer: Three to five sessions per week of 45–60 minutes each for maximum progress

Research supports high-dosage intervention (3–5 sessions per week, 45–60 minutes) for students with severe dyslexia to produce meaningful gains.

Question 17: A therapist plans to use a document camera to display decodable text for a group session. Which setup step is essential BEFORE students arrive?

Leaving the camera unattended and on overnight to warm up
Setting the camera to record all student interactions automatically
Removing the camera lens cover after students sit down
Confirming focus, brightness, and projection alignment on the display surface (Correct answer)

Correct answer: Confirming focus, brightness, and projection alignment on the display surface

Pre-session setup ensures no instructional time is lost and that the image is legible for all students, especially those with visual sensitivity.

Question 18: A CDT therapist is approached by a pharmaceutical company to endorse a supplement claimed to help dyslexia. What ethical principle is most relevant?

Fidelity
Veracity (Correct answer)
Non-maleficence
Justice

Correct answer: Veracity

Veracity obligates practitioners to be truthful and not endorse or promote treatments that lack scientific evidence, which could mislead families.

Question 19: A screener with high specificity but low sensitivity would be most likely to:

Correctly identify most at-risk students but miss few non-at-risk students
Miss many students who truly need intervention while rarely over-identifying students (Correct answer)
Over-identify students who do not need intervention
Have no impact on identification accuracy

Correct answer: Miss many students who truly need intervention while rarely over-identifying students

Low sensitivity means many true positives (at-risk students) are missed, while high specificity means few false positives (non-at-risk flagged as at-risk).

Question 20: A 10-year-old with dyslexia reads at a 2nd-grade level despite average intelligence and adequate instruction. According to RTI frameworks, this student likely requires which level of intervention?

Tier 3 — intensive individualized intervention (Correct answer)
Tier 2 — small-group supplemental intervention
Tier 1 — differentiated core instruction only
No intervention until a formal psychoeducational evaluation is completed

Correct answer: Tier 3 — intensive individualized intervention

A student reading three or more years below grade level despite prior instruction meets criteria for Tier 3 intensive, individualized intervention within an RTI/MTSS framework.

Question 21: Under the Every Student Succeeds Act (ESSA), states are encouraged to use which framework to identify and support struggling readers, including those with dyslexia?

Discrepancy model (IQ-achievement gap)
Response to Intervention (RTI) / Multi-Tiered System of Supports (MTSS) (Correct answer)
Medical diagnosis-first model
Grade retention policy

Correct answer: Response to Intervention (RTI) / Multi-Tiered System of Supports (MTSS)

ESSA promotes MTSS/RTI frameworks, which use universal screening and progress monitoring to identify and support students with reading difficulties including dyslexia.

Question 22: According to the International Dyslexia Association (IDA), which professional is primarily responsible for screening students for dyslexia risk in the school setting?

Any trained educator, including classroom teachers, reading specialists, and CDTs (Correct answer)
School nurses during annual health screenings
Only special education teachers
Only licensed psychologists

Correct answer: Any trained educator, including classroom teachers, reading specialists, and CDTs

IDA supports universal screening conducted by trained educators at multiple levels, not restricted to psychologists or special education staff.

Question 23: The Term 'curriculum-based measurement' (CBM) in the context of reading progress monitoring refers to:

Annual state achievement tests aligned to grade-level standards
Teacher-created rubrics for evaluating writing quality
Brief, standardized, repeated probes drawn from the curriculum used to gauge rate of improvement (Correct answer)
Assessments embedded in a specific commercial reading program's chapter tests

Correct answer: Brief, standardized, repeated probes drawn from the curriculum used to gauge rate of improvement

CBMs are brief, standardized, repeatable probes designed to measure student growth in the curriculum over time, widely used in RTI/MTSS frameworks.

Question 24: A CDT who is experiencing symptoms of a respiratory infection should:

Notify parents and let them decide whether to proceed with the session
Follow workplace illness policy, which may include staying home or consulting a supervisor (Correct answer)
Wear a mask and continue all sessions as scheduled
Reduce session length by half to minimize exposure

Correct answer: Follow workplace illness policy, which may include staying home or consulting a supervisor

Therapists should follow their institution's illness policy, which typically requires staying home when symptomatic to protect vulnerable students.

Question 25: Orthographic mapping refers to the process by which readers:

Memorize whole-word shapes through repeated visual exposure
Copy words from the board to build muscle memory
Form permanent memory representations of words by connecting phonemes, graphemes, and meaning (Correct answer)
Use context clues to predict the next word in a sentence

Correct answer: Form permanent memory representations of words by connecting phonemes, graphemes, and meaning

Orthographic mapping, described by Kilpatrick, is the mental process of permanently connecting a word's pronunciation, spelling, and meaning into long-term memory.

Question 26: A student accidentally spills a small amount of blood on a shared work surface. The correct cleanup procedure includes:

Having a custodian handle it while continuing the session elsewhere
Wiping with a dry cloth and proceeding with the session
Spraying disinfectant directly and wiping immediately
Donning gloves, cleaning with detergent, then applying an EPA-registered disinfectant (Correct answer)

Correct answer: Donning gloves, cleaning with detergent, then applying an EPA-registered disinfectant

Blood spills require gloves, initial cleaning to remove organic material, followed by disinfection with an EPA-registered product allowed to dwell per instructions.

Question 27: A student with dyslexia struggles most with reading pseudowords (nonsense words) compared to real words. This pattern primarily reflects a deficit in:

Orthographic lexical memory for sight words
Semantic access to word meanings
Visual scanning of text
Phonological decoding using grapheme-phoneme rules (Correct answer)

Correct answer: Phonological decoding using grapheme-phoneme rules

Pseudoword reading requires applying phonological decoding rules without any lexical support; poor pseudoword reading is a hallmark indicator of the phonological decoding deficit in dyslexia.

Question 28: The concept of 'reading with the right brain' as a compensatory strategy in dyslexia refers to:

A therapeutic exercise involving left-handed writing
Reading text presented in the left visual field only
Bilateral brain activation replacing left-hemisphere reading circuits
Using visual memory and context strategies to compensate for inefficient phonological processing (Correct answer)

Correct answer: Using visual memory and context strategies to compensate for inefficient phonological processing

Dyslexic readers often over-rely on right-hemisphere strategies such as context guessing and visual pattern matching to compensate for inefficient left-hemisphere phonological decoding.

Question 29: A school district uses an RTI/MTSS model. Under this framework and IDEA, a child may be identified as having a specific learning disability if they:

Are two or more years below grade level in reading
Have a family history of dyslexia confirmed by a physician
Demonstrate a severe discrepancy between IQ and achievement scores
Fail to respond adequately to scientifically based intervention and show low achievement (Correct answer)

Correct answer: Fail to respond adequately to scientifically based intervention and show low achievement

Under IDEA's RTI alternative to the IQ-discrepancy model, a child may be identified as having a specific learning disability based on inadequate response to scientifically based instruction combined with low achievement.

Question 30: Which aspect of reading does Rapid Automatized Naming (RAN) most directly assess in a dyslexia screening context?

Reading comprehension and vocabulary knowledge
Phoneme blending accuracy
Processing speed and automaticity of symbol-sound retrieval (Correct answer)
Visual-spatial tracking of text

Correct answer: Processing speed and automaticity of symbol-sound retrieval

RAN measures how quickly a student can name a series of familiar items, reflecting processing speed and automatic retrieval—both implicated in dyslexia.

Question 31: A therapist discovers that a set of decodable readers stored in the therapy room have developed musty odors and visible mold on their covers. What is the correct response?

Spray the books with air freshener and continue using them
Wipe the covers with a wet cloth and return them to the shelf to dry
Use the books only with students who have no allergies
Remove all affected materials, discard or quarantine them per facility policy, and inspect storage conditions to prevent recurrence (Correct answer)

Correct answer: Remove all affected materials, discard or quarantine them per facility policy, and inspect storage conditions to prevent recurrence

Moldy materials must be removed and the environment corrected; continued exposure poses health risks and masks an underlying humidity or storage problem.

Question 32: Which of the following is a common strategy for teaching children with dyslexia?

Using multisensory learning techniques. (Correct answer)
Using group activities exclusively.
Only focusing on auditory processing.
Teaching through visual aids only.

Correct answer: Using multisensory learning techniques.

Multisensory learning techniques are highly effective for children with dyslexia because they engage multiple senses (visual, auditory, kinesthetic, tactile) simultaneously. This approach helps reinforce connections between sounds, symbols, and motor actions, which strengthens memory and understanding for individuals who struggle with traditional phonics instruction. Examples include tracing letters while saying their sounds or using manipulatives.

Question 33: How does a language-based learning disability affect a child's ability to decode words?

It helps the child decode words faster.
It only affects mathematical word problems.
It causes difficulty in recognizing and decoding words. (Correct answer)
It makes decoding words easier.

Correct answer: It causes difficulty in recognizing and decoding words.

A language-based learning disability, such as dyslexia, directly impacts the brain's ability to process language sounds and symbols. This makes it challenging for a child to connect letters to sounds (phonics) and blend those sounds to form words, leading to significant difficulty in recognizing and decoding words accurately and fluently.

Question 34: A student with strong listening comprehension but severely impaired reading comprehension and poor decoding most likely has which primary profile?

Dyslexia — phonological processing deficit affecting decoding and reading comprehension (Correct answer)
Hyperlexia with intact phonological processing
Poor comprehender profile (language comprehension deficit)
Attention-deficit disorder masquerading as a reading disability

Correct answer: Dyslexia — phonological processing deficit affecting decoding and reading comprehension

Strong listening comprehension with poor decoding and secondary poor reading comprehension is the classic dyslexia profile: the language system is intact but phonological decoding is impaired.

Question 35: Which research finding best supports structured literacy instruction over whole-language approaches for students with dyslexia?

Context clues are more effective than decoding for unknown word identification in dyslexia
Balanced literacy produces equivalent outcomes to structured literacy for at-risk students
Whole-language improves reading motivation more than phonics-based approaches
The National Reading Panel (2000) found strong evidence for explicit, systematic phonics instruction (Correct answer)

Correct answer: The National Reading Panel (2000) found strong evidence for explicit, systematic phonics instruction

The National Reading Panel's 2000 report found strong scientific evidence that systematic, explicit phonics instruction is essential for all readers and especially critical for students with dyslexia.

Question 36: Which theoretical model proposes that skilled reading requires both a phonological pathway and a direct orthographic pathway to access word meaning?

The Dual-Route Cascaded (DRC) model (Correct answer)
The Connectionist Triangle model
The Orton-Gillingham model
The Simple View of Reading

Correct answer: The Dual-Route Cascaded (DRC) model

The Dual-Route Cascaded model posits a lexical (direct orthographic) route and a sublexical (phonological) route for reading, explaining different error patterns in dyslexia.

Question 37: Which federal law explicitly requires schools to use 'objective criteria' including 'a pattern of strengths and weaknesses' when identifying students with specific learning disabilities?

Section 504 of the Rehabilitation Act
Every Student Succeeds Act (ESSA)
Individuals with Disabilities Education Act (IDEA) 2004 (Correct answer)
Americans with Disabilities Act (ADA)

Correct answer: Individuals with Disabilities Education Act (IDEA) 2004

IDEA 2004 allows states to use either RTI data or a pattern of strengths and weaknesses approach (alongside other criteria) to identify students with specific learning disabilities including dyslexia.

Question 38: A CDT therapist realizes mid-treatment that a student's needs exceed their competence level. What is the ethical obligation?

Consult online resources and continue without disclosing the limitation
Refer the student to a more qualified professional and transition care appropriately (Correct answer)
Discharge the student without providing a referral
Continue treating while independently studying the relevant area

Correct answer: Refer the student to a more qualified professional and transition care appropriately

Practicing within one's competence is a core ethical obligation; when a case exceeds a therapist's skills, referral and proper transition of care are required.

Question 39: A structured literacy lesson introduces the digraph 'sh' only after students have mastered single consonants and short vowels. This exemplifies which instructional principle?

Fluency building
Explicit instruction
Cumulative sequence (Correct answer)
Diagnostic teaching

Correct answer: Cumulative sequence

Cumulative sequence means each new concept builds on previously mastered skills, ensuring no gaps in foundational knowledge.

Question 40: Which type of home activity MOST directly reinforces structured literacy instruction?

Playing word games that do not involve phoneme manipulation
Watching educational TV programs about letters
Reading independently without any support
Practicing phoneme-grapheme correspondence using letter tiles or sound boxes (Correct answer)

Correct answer: Practicing phoneme-grapheme correspondence using letter tiles or sound boxes

Letter tiles and sound boxes replicate the multisensory, phoneme-grapheme activities used in structured literacy sessions.

Question 41: An evaluator is comparing a student's listening comprehension to their reading comprehension. A significant gap where listening comprehension is much higher indicates:

A comprehension-based learning disability
A decoding deficit that limits access to text meaning (Correct answer)
Below-average intelligence affecting both modalities
A language processing disorder unrelated to dyslexia

Correct answer: A decoding deficit that limits access to text meaning

When listening comprehension far exceeds reading comprehension, it suggests the student understands language but cannot access text due to decoding difficulties.

Question 42: How can teachers and parents collaborate during the screening and monitoring process?

By allowing the child to choose their own interventions.
By communicating regularly and adjusting strategies together. (Correct answer)
By only focusing on academic achievements.
By keeping separate records of the child's progress.

Correct answer: By communicating regularly and adjusting strategies together.

Effective collaboration between teachers and parents is vital during the screening and monitoring process for dyslexia. Regular communication ensures that both parties are aware of the child's progress, challenges, and successes, allowing them to align strategies, reinforce learning at home, and collectively advocate for the child's educational needs.

Question 43: A student consistently reads 'horse' as 'house' and 'farm' as 'form.' These errors most likely indicate a deficit in which area?

Rapid automatized naming speed
Vowel pattern and medial phoneme discrimination (Correct answer)
Sight word memory for high-frequency words
Phoneme segmentation at the onset level

Correct answer: Vowel pattern and medial phoneme discrimination

Confusing medial vowels and similar-sounding medial consonants indicates difficulty discriminating vowel patterns and medial phonemes within words.

Question 44: A therapist is using curriculum-based measurement (CBM) as part of a dyslexia evaluation. CBM data is best used to:

Assess phonological awareness in isolation
Replace standardized norm-referenced tests
Monitor response to intervention over time (Correct answer)
Determine eligibility for a formal dyslexia diagnosis

Correct answer: Monitor response to intervention over time

CBM is a formative assessment tool designed to track student progress and response to instruction over repeated administrations.

Question 45: A student with dyslexia writes 'wuz' for 'was' and 'sed' for 'said.' These phonetically plausible misspellings indicate which type of spelling knowledge?

Morphological spelling knowledge
Phonological spelling strategy with limited orthographic knowledge (Correct answer)
Visual memory-based whole-word spelling
No functional phonological awareness

Correct answer: Phonological spelling strategy with limited orthographic knowledge

Phonetically plausible errors show the student is applying phoneme-grapheme correspondences but lacks the orthographic pattern knowledge needed for conventional spelling.

Question 46: Why is screening important for identifying dyslexia?

To determine if a student is ready for school.
To assess a student's IQ.
To identify at-risk students early and provide early intervention. (Correct answer)
To evaluate math skills.

Correct answer: To identify at-risk students early and provide early intervention.

Screening is vital for identifying dyslexia because it allows for the early detection of students who are at risk. Early identification means that intervention can begin sooner, which is proven to be significantly more effective in mitigating reading difficulties and improving long-term academic outcomes for children with dyslexia.

Question 47: A CDT therapist discovers that a colleague is using an unvalidated assessment tool and misrepresenting results to families. What is the most appropriate ethical course of action?

Advise the families directly without consulting the colleague
Confront the colleague publicly at a staff meeting
Report the concern through appropriate professional or institutional channels (Correct answer)
Ignore it to maintain collegial relationships

Correct answer: Report the concern through appropriate professional or institutional channels

Reporting through proper channels, such as a supervisor or ethics board, addresses the concern while following due process and protecting all parties.

Question 48: Which of the following best describes a dual relationship that a CDT therapist must avoid?

Providing therapy to a student who is also a family friend (Correct answer)
Treating two students with similar diagnoses
Using the same assessment tool for multiple students
Consulting with a colleague about a difficult case

Correct answer: Providing therapy to a student who is also a family friend

A dual relationship occurs when a therapist has a personal or professional role outside the therapeutic one, which can compromise objectivity and create conflicts of interest.

Question 49: Which of the following background history factors is most relevant to include in a dyslexia assessment intake?

Extracurricular activity participation
The student's preferred learning style
Dietary habits and sleep patterns
Family history of reading difficulties (Correct answer)

Correct answer: Family history of reading difficulties

Dyslexia has a strong genetic component, and a family history of reading difficulties is a significant risk factor to document.

Question 50: Which federal law requires schools to provide parents with information about their child's special education eligibility and services?

ADA Title III
IDEA (Individuals with Disabilities Education Act) (Correct answer)
FERPA
HIPAA

Correct answer: IDEA (Individuals with Disabilities Education Act)

IDEA mandates that parents be informed and involved in all eligibility, evaluation, and IEP decisions.

Question 51: When graphing progress monitoring data, the 'aim line' is drawn from:

The student's lowest score to their highest score
The class average at the start of the year to the class average at the end of the year
The national norm for the grade level across all time points
The student's first data point to the final benchmark goal by the end of the intervention period (Correct answer)

Correct answer: The student's first data point to the final benchmark goal by the end of the intervention period

The aim line connects the student's baseline score to the target goal, providing a visual benchmark for adequate rate of improvement.

Question 52: Which of the following BEST describes the role of decodable texts in a structured literacy program?

They are used exclusively for students with severe dyslexia
They emphasize high-frequency sight words at the expense of phonics patterns
They provide controlled practice applying only the phonics patterns explicitly taught so far (Correct answer)
They replace leveled readers to improve reading motivation

Correct answer: They provide controlled practice applying only the phonics patterns explicitly taught so far

Decodable texts are carefully controlled so that the vast majority of words use phonics patterns the student has already been explicitly taught, allowing successful application of decoding strategies.

Question 53: Which of the following best distinguishes dyslexia from an intellectual disability when reading difficulties are present?

Students with dyslexia perform at grade level in all non-reading academic areas
Students with dyslexia always have higher verbal IQ scores than performance IQ scores
Dyslexia is characterized by unexpected reading difficulty relative to overall cognitive ability and adequate instruction (Correct answer)
Intellectual disability never co-occurs with dyslexia

Correct answer: Dyslexia is characterized by unexpected reading difficulty relative to overall cognitive ability and adequate instruction

The defining feature of dyslexia is unexpected reading difficulty—the reading deficit is disproportionate to the student's overall cognitive ability and cannot be explained by intellectual disability alone.

Question 54: Research by Stanovich (1986) introduced the 'Matthew Effect' in reading, which means:

Students with dyslexia always catch up to peers with intensive intervention
Reading fluency is the best predictor of long-term academic success
Early reading difficulties compound over time as poor readers read less and fall further behind (Correct answer)
Strong decoders eventually develop comprehension problems without vocabulary instruction

Correct answer: Early reading difficulties compound over time as poor readers read less and fall further behind

The Matthew Effect describes how early reading failure leads to less reading practice, slower vocabulary growth, and widening achievement gaps compared to strong readers.

Question 55: The 'Simple View of Reading' model defines reading comprehension as the product of which two components?

Decoding and language comprehension (Correct answer)
Decoding and vocabulary
Fluency and background knowledge
Phonemic awareness and syntax

Correct answer: Decoding and language comprehension

Gough and Tunmer's Simple View states that Reading Comprehension = Decoding × Language Comprehension, highlighting that both must be adequate for proficient reading.

Question 56: Which of the following scenarios represents appropriate use of screening data under ethical guidelines for CDTs?

Sharing screening data with the IEP team to inform instructional planning and intervention decisions (Correct answer)
Sharing a student's screening results publicly to motivate the student to improve
Using screening scores alone to formally diagnose a student with dyslexia
Withholding screening results from parents until a formal evaluation is completed

Correct answer: Sharing screening data with the IEP team to inform instructional planning and intervention decisions

Screening data should inform instructional planning and be shared with relevant team members; it cannot diagnose dyslexia and must not be withheld from parents.

Question 57: An e-reader used in dyslexia therapy allows font customization. Which combination of settings is MOST supported by research for students with dyslexia?

Larger font size, dyslexia-friendly sans-serif typeface, increased line and letter spacing (Correct answer)
Small font, serif typeface, narrow line spacing
Justified alignment with small margins and default spacing
Italic font style with standard spacing to add visual variety

Correct answer: Larger font size, dyslexia-friendly sans-serif typeface, increased line and letter spacing

Research supports larger, open sans-serif fonts with expanded spacing to reduce visual crowding and improve letter discrimination for readers with dyslexia.

Question 58: During a clinical interview with a parent, they report the child had delayed speech milestones. This information is clinically significant because:

Speech delay rules out a dyslexia diagnosis
Late talkers always have reading disabilities
The assessment should be delayed until speech is fully resolved
Early language delays may co-occur with phonological processing weaknesses (Correct answer)

Correct answer: Early language delays may co-occur with phonological processing weaknesses

Early language delays often indicate underlying phonological processing weaknesses that can contribute to later reading difficulties.

Question 59: During phoneme segmentation practice, a student segments 'ship' as /sh/-/i/-/p/. This response indicates:

Confusion between phonemes and syllables
A need to revisit blending before segmenting
Correct phoneme segmentation recognizing 'sh' as one phoneme (digraph) (Correct answer)
An error—'sh' should be separated into /s/ and /h/

Correct answer: Correct phoneme segmentation recognizing 'sh' as one phoneme (digraph)

'Sh' is a digraph representing a single phoneme /ʃ/, so segmenting 'ship' as three phonemes—/sh/-/i/-/p/—is phonemically correct.

Question 60: Which principle of biomedical ethics obligates a CDT therapist to act in the best interest of the student, even when that may conflict with institutional policies?

Justice
Non-maleficence
Autonomy
Beneficence (Correct answer)

Correct answer: Beneficence

Beneficence requires the practitioner to act in the patient's or student's best interest, prioritizing their welfare above institutional convenience.

Question 61: Which of the following best describes the prevalence of dyslexia in the general population according to current research?

Approximately 25–30% of all students
Approximately 2–3% of the population
Approximately 5–10% (some estimates up to 15–20% with milder profiles) (Correct answer)
Exactly 1 in 100 individuals

Correct answer: Approximately 5–10% (some estimates up to 15–20% with milder profiles)

Research estimates suggest 5–10% of the population has dyslexia severe enough to impact daily functioning, with some estimates reaching 15–20% when milder reading difficulties on the continuum are included.

Question 62: The 'phonological core deficit' model of dyslexia was most prominently developed and supported by which researcher?

Maryanne Wolf
Frank Vellutino (Correct answer)
Sally Shaywitz
Keith Stanovich

Correct answer: Frank Vellutino

Frank Vellutino's research in the 1970s–1990s was foundational in establishing that phonological (not visual) processing deficits are the core cause of dyslexia.

Question 63: Morphological awareness — understanding prefixes, roots, and suffixes — becomes increasingly important for reading development beginning at approximately which grade level?

Kindergarten through 1st grade
Only in high school and college
2nd through 3rd grade
4th grade and beyond (Correct answer)

Correct answer: 4th grade and beyond

From approximately 4th grade onward, academic vocabulary becomes heavily morphologically complex, making morphological awareness critical for reading comprehension and spelling of multisyllabic words.

Question 64: A CDT therapist works in a private practice and charges a sliding scale fee. One client cannot afford any fee. What is the ethical principle most directly relevant to this situation?

Beneficence
Justice (Correct answer)
Fidelity
Non-maleficence

Correct answer: Justice

Justice requires fair and equitable distribution of services and resources, prompting consideration of access for all clients regardless of financial status.

Question 65: A parent signs a release of information form allowing a CDT therapist to share records with a psychiatrist. Two years later, the psychiatrist's office requests updated records. Is the original release still valid?

No, releases typically expire and a new authorization is required (Correct answer)
Yes, if the same diagnosis is involved
No, only the student can authorize re-release as an adult
Yes, releases of information never expire

Correct answer: No, releases typically expire and a new authorization is required

Releases of information generally have an expiration date, and a new signed authorization is required before disclosing additional records.

Question 66: Which ergonomic equipment consideration is MOST important when positioning a keyboard for a student with dyslexia who also has fine motor difficulties?

Positioning the keyboard to the student's non-dominant side to encourage crossing midline
Using the largest available keyboard regardless of the student's hand size
Raising the keyboard so the student looks down at it for visual guidance
Placing the keyboard at a height that keeps the student's wrists neutral and elbows at approximately 90 degrees (Correct answer)

Correct answer: Placing the keyboard at a height that keeps the student's wrists neutral and elbows at approximately 90 degrees

Neutral wrist position and 90-degree elbow angle reduce fatigue and strain, supporting longer and more productive sessions for students with motor challenges.

Question 67: When using a digital audio recorder to document a student's oral reading during a CDT session, which file management practice is most important?

Storing all recordings in a single unnamed folder
Keeping recordings on the device indefinitely without backup
Sharing recordings via unencrypted public cloud storage
Labeling recordings with the student's initials, date, and session number in a secure folder (Correct answer)

Correct answer: Labeling recordings with the student's initials, date, and session number in a secure folder

Proper labeling and secure storage ensures compliance with FERPA and makes session data retrievable for progress monitoring.

Question 68: What is an important factor in ensuring successful progress monitoring for dyslexia?

Giving consistent and timely feedback on progress. (Correct answer)
Providing feedback only at the end of the year.
Evaluating progress based solely on test scores.
Focusing only on behavioral improvements.

Correct answer: Giving consistent and timely feedback on progress.

Consistent and timely feedback on progress is an important factor in ensuring successful progress monitoring for dyslexia. Regular feedback helps students understand their strengths and areas for improvement, motivates them, and allows educators to make immediate instructional adjustments, ensuring the intervention remains targeted and effective.

Question 69: Which ethical standard requires CDT therapists to honor commitments made to students and families, such as following through on referrals?

Autonomy
Fidelity (Correct answer)
Beneficence
Justice

Correct answer: Fidelity

Fidelity is the ethical obligation to keep promises and honor commitments, including following through on referrals and treatment plans discussed with families.

Question 70: What is the role of regular assessments in screening for dyslexia?

To diagnose other medical conditions.
To evaluate social behavior.
To track the child's progress and adjust interventions. (Correct answer)
To measure intelligence.

Correct answer: To track the child's progress and adjust interventions.

Regular assessments in screening for dyslexia are crucial for tracking a child's development and the impact of interventions. They provide objective data on specific literacy skills, allowing educators and parents to monitor progress, identify areas of continued struggle, and make informed decisions about adjusting intervention strategies to meet the child's evolving needs.

Question 71: A CDT notices a parent is consistently late to sessions and disengaged. The BEST initial response is to:

Reduce session frequency without discussion
Schedule a non-threatening conversation to explore barriers to participation (Correct answer)
Discharge the student for non-compliance
Contact the school principal immediately

Correct answer: Schedule a non-threatening conversation to explore barriers to participation

Exploring barriers non-judgmentally often reveals logistical, cultural, or emotional obstacles that can be addressed collaboratively.

Question 72: A CDT reviewing a prior evaluation report notes the student's Working Memory Index (WMI) is significantly lower than their Verbal Comprehension Index (VCI). This discrepancy is clinically relevant because:

VCI scores are not meaningful in a dyslexia profile
Working memory weakness can interfere with holding phonemes in mind during decoding (Correct answer)
Low WMI confirms a dyslexia diagnosis on its own
This pattern indicates a primary attention deficit disorder

Correct answer: Working memory weakness can interfere with holding phonemes in mind during decoding

Working memory is critical for phonological loop functioning; weaknesses here can impede the ability to hold and manipulate sounds during decoding tasks.

Question 73: Which brain imaging finding is most consistently associated with dyslexia in neurological research?

Overactivation of the visual cortex
Enlarged corpus callosum
Increased gray matter in the right frontal lobe
Reduced activation in left temporoparietal regions during reading (Correct answer)

Correct answer: Reduced activation in left temporoparietal regions during reading

fMRI studies consistently show reduced activation in left temporoparietal areas (including the angular gyrus and Wernicke's area) in individuals with dyslexia during reading tasks.

Question 74: Why is continuing education important for maintaining ethical practice?

It is only needed to maintain certification status
It replaces the need for experience
It ensures practitioners stay current with evolving standards and best practices (Correct answer)
It is optional for experienced practitioners

Correct answer: It ensures practitioners stay current with evolving standards and best practices

Continuing education ensures practitioners stay current with evolving standards, new research, and best practices, directly supporting ethical and competent practice.

Question 75: Dyscalculia that co-occurs with dyslexia is best described as which type of comorbidity?

Comorbid condition sharing some neurological risk factors (Correct answer)
Secondary consequence caused exclusively by dyslexia
Coincidental overlap with no shared etiology
Mutually exclusive condition

Correct answer: Comorbid condition sharing some neurological risk factors

Dyscalculia and dyslexia frequently co-occur and share some genetic and neurological risk factors, though they also have distinct etiological pathways.

Question 76: In Orton-Gillingham-based instruction, what is the correct sequence for introducing a new phonogram?

Blending→Segmenting→Reading→Spelling
Visual→Auditory→Kinesthetic→Blending
Spelling→Reading→Auditory→Visual
Auditory discrimination→Visual recognition→Kinesthetic writing→Blending into words (Correct answer)

Correct answer: Auditory discrimination→Visual recognition→Kinesthetic writing→Blending into words

OG introduces new phonograms by first developing auditory discrimination, then visual recognition, then kinesthetic writing, and finally blending into words.

Question 77: Which early literacy skill assessed in kindergarten screening is the STRONGEST predictor of later reading difficulties?

Phoneme segmentation fluency (Correct answer)
Listening vocabulary
Print concept awareness
Letter-name knowledge alone

Correct answer: Phoneme segmentation fluency

Phoneme segmentation fluency is one of the most robust early predictors of reading difficulties and future decoding ability.

Question 78: The term 'specific language impairment' (SLI), now often called 'developmental language disorder' (DLD), differs from dyslexia primarily in that DLD involves:

Oral language deficits that precede and accompany literacy difficulties (Correct answer)
Only reading deficits with intact oral language
Exclusively phonological awareness deficits without grammar issues
A purely genetic etiology with no environmental contributors

Correct answer: Oral language deficits that precede and accompany literacy difficulties

DLD/SLI involves pervasive oral language deficits (grammar, vocabulary, narrative) that exist before formal literacy instruction, whereas dyslexia primarily manifests in written language with relatively stronger oral language.

Question 79: A dyslexia therapist wants to share a student's progress data with a university research team. What is required before disclosing this information?

Verbal permission from the student only
Written informed consent from the student or guardian (Correct answer)
A signed agreement between the therapist and the university
Approval from the therapist's supervisor

Correct answer: Written informed consent from the student or guardian

Written informed consent from the student or their legal guardian is required before sharing identifiable information with any third party, including researchers.

Question 80: Which of the following behaviors by a CDT violates professional safety boundaries with a student?

Using a visual timer visible to the student
Keeping session notes in a locked file
Meeting with a student alone in an unobservable, secluded location without parental consent (Correct answer)
Sitting across a table from the student during reading tasks

Correct answer: Meeting with a student alone in an unobservable, secluded location without parental consent

Meeting alone with a student in a secluded, unobservable area without consent violates professional safety guidelines designed to protect both the student and the therapist.

Question 81: Which accommodation is MOST commonly recommended for a student with dyslexia taking standardized tests?

Removal of all reading components
Smaller font size to focus attention
A separate room with no proctor
Oral administration or extended time (Correct answer)

Correct answer: Oral administration or extended time

Extended time and oral administration reduce the processing-speed and decoding demands that disadvantage students with dyslexia on standardized tests.

Question 82: A dyslexia therapist shares a therapy room with other clinicians. Which of the following is the BEST practice for surface disinfection between student sessions?

Use an EPA-registered disinfectant and allow the required contact (dwell) time (Correct answer)
Spray surfaces and wipe immediately for efficiency
Wipe surfaces with a dry paper towel to remove visible debris
Disinfect only surfaces the student visibly touched

Correct answer: Use an EPA-registered disinfectant and allow the required contact (dwell) time

EPA-registered disinfectants must remain wet on the surface for the manufacturer-specified contact time to be effective.

Question 83: Which of the following is a diagnostic tool commonly used to identify dyslexia?

Electrocardiogram.
X-rays of the brain.
Blood tests.
Reading and spelling assessments. (Correct answer)

Correct answer: Reading and spelling assessments.

Dyslexia is a language-based learning disability, and its primary symptoms manifest in difficulties with reading and spelling. Therefore, diagnostic tools focus on assessing these specific skills, often through standardized tests that evaluate phonological awareness, decoding, reading fluency, and spelling accuracy to identify patterns consistent with dyslexia.

Question 84: Which of the following would be MOST appropriate to include in a progress monitoring report shared with parents of a student receiving dyslexia intervention?

A graph showing the student's growth over time compared to the aim line, with plain-language explanation (Correct answer)
Raw score data only, without context or explanation
Detailed psychometric reliability coefficients of the assessment tool
Percentile ranks from the initial eligibility evaluation only

Correct answer: A graph showing the student's growth over time compared to the aim line, with plain-language explanation

Graphs with plain-language explanations make progress data accessible to parents and support collaborative decision-making.

Question 85: A parent requests to add a statement of disagreement to their child's evaluation report. Under FERPA, the school must:

Destroy the original report and start fresh
Permit the parent to insert a written statement of disagreement into the record (Correct answer)
Reject the request and seal the original report
Rewrite the report to match the parent's perspective

Correct answer: Permit the parent to insert a written statement of disagreement into the record

FERPA allows parents to insert a statement of disagreement that becomes part of the official record when they believe the record is inaccurate.

Question 86: When selecting a progress monitoring tool for a student with dyslexia who is working on decoding, the CDT should prioritize an instrument that is:

Sensitive to small increments of growth in targeted skills (Correct answer)
Administered no more than twice per year
Lengthy and comprehensive to capture all skill areas
Based solely on teacher observation rather than direct measurement

Correct answer: Sensitive to small increments of growth in targeted skills

Effective progress monitoring tools must be sensitive enough to detect incremental gains, allowing timely instructional decisions.

Question 87: What is the primary purpose of conducting a comprehensive patient assessment in Certified Dental Technicians practice?

To establish baseline measurements and identify treatment needs (Correct answer)
To fulfill insurance documentation requirements
To reduce the length of treatment sessions
To minimize staff workload

Correct answer: To establish baseline measurements and identify treatment needs

Comprehensive patient assessment establishes baseline measurements and identifies specific treatment needs, forming the foundation for effective care planning.

Question 88: A shared set of magnetic letter tiles is used across multiple students. What is the best infection control practice for these manipulatives?

Avoid using shared manipulatives entirely
Only clean the tiles at the end of the school day
Assign each student a permanent personal set
Wipe tiles with a disinfecting wipe between student uses and allow them to air dry (Correct answer)

Correct answer: Wipe tiles with a disinfecting wipe between student uses and allow them to air dry

Disinfecting shared manipulatives between each student use and allowing adequate drying time reduces the risk of pathogen transmission.

Question 89: Under IDEA 2004, which evaluation component is specifically required before a child can be identified as having a specific learning disability?

The school must obtain informed written consent from parents prior to evaluation (Correct answer)
A standardized IQ test must be administered
A private neuropsychological assessment must be completed
The child must fail at least two grade levels

Correct answer: The school must obtain informed written consent from parents prior to evaluation

IDEA 2004 mandates that schools obtain informed written parental consent before conducting any initial evaluation for special education eligibility.

Question 90: Which aspect of phonological processing involves the ability to hold and manipulate speech sounds in short-term memory?

Rapid automatized naming
Phonological awareness
Phoneme-grapheme correspondence
Phonological memory (verbal working memory) (Correct answer)

Correct answer: Phonological memory (verbal working memory)

Phonological memory refers to the ability to store phonological information in short-term/working memory and is one of three core components of phonological processing (along with PA and RAN).

Question 91: During a parent meeting, a caregiver expresses guilt that their child's dyslexia is their fault. The CDT should FIRST:

Acknowledge the emotion and then provide accurate information about the hereditary nature of dyslexia (Correct answer)
Dismiss the comment and redirect to the intervention plan
Confirm that genetics does play a role to validate the concern
Refer the parent immediately to a psychologist

Correct answer: Acknowledge the emotion and then provide accurate information about the hereditary nature of dyslexia

Acknowledging the parent's emotion first builds trust, after which accurate psychoeducation can reduce guilt and increase engagement.

Question 92: A CDT wants to assess whether a student has made meaningful progress in phonemic awareness after 12 weeks of intervention. Which approach best demonstrates reliable growth?

Show multiple progress monitoring data points collected across the intervention period with an upward trend (Correct answer)
Compare the student's score on a single post-test to a national norm
Use only the student's end-of-year report card grade
Ask the classroom teacher for an informal rating of the student's reading

Correct answer: Show multiple progress monitoring data points collected across the intervention period with an upward trend

Multiple data points over time are far more reliable evidence of genuine growth than a single post-test comparison.

Question 93: A CDT therapist is treating a student whose insurance company requests detailed session notes. What is the ethical concern with providing full session notes?

Full session notes may contain sensitive details beyond what is necessary for billing purposes (Correct answer)
Session notes are only relevant to the school, not insurers
Providing notes would violate HIPAA in all circumstances
Insurance companies cannot legally receive any records

Correct answer: Full session notes may contain sensitive details beyond what is necessary for billing purposes

The minimum necessary standard under HIPAA limits disclosure to only the information needed for the specific purpose, protecting student privacy.

Question 94: Which practice BEST maintains the accuracy of a handheld digital timer used during timed reading fluency assessments?

Resetting it only at the start of each school year
Calibrating it using the student's subjective sense of elapsed time
Checking it against a reference clock before each assessment and replacing batteries on a scheduled cycle (Correct answer)
Running it continuously to prevent battery drain from repeated start/stop cycles

Correct answer: Checking it against a reference clock before each assessment and replacing batteries on a scheduled cycle

Regular comparison to a reference clock and scheduled battery replacement ensures timing accuracy for valid fluency data.

Question 95: A student who is 16 years old requests that their dyslexia therapy records not be shared with their parents. How should the CDT therapist respond?

Honor the request fully, as the student has full autonomy at 16
Immediately share all records with parents without discussion
Explain that FERPA rights are held by parents until the student turns 18 in most cases (Correct answer)
Transfer records to a third party to avoid the conflict

Correct answer: Explain that FERPA rights are held by parents until the student turns 18 in most cases

Under FERPA, parents retain rights to educational records until the student turns 18, though the therapist should still discuss privacy concerns sensitively with the student.

Question 96: When a CDT transitions from one employer to another, which ethical obligation regarding client records must be met?

The CDT may retain personal copies of all records for professional reference
All client records must be transferred to the new employer automatically
The CDT must ensure clients have access to their records and continuity of care (Correct answer)
The CDT must destroy all records to protect confidentiality

Correct answer: The CDT must ensure clients have access to their records and continuity of care

Professional ethics require that clients have access to their records and that the CDT facilitates continuity of care during any transition in practice.

Question 97: What is the most effective method for preventing cross-contamination?

Proper hand hygiene and use of personal protective equipment (Correct answer)
Cleaning equipment once daily
Using antibiotics prophylactically
Limiting patient interactions

Correct answer: Proper hand hygiene and use of personal protective equipment

Hand hygiene combined with appropriate PPE use is the cornerstone of infection prevention, creating multiple barriers against pathogen transmission.

Question 98: What is the best practice for documenting assessment findings?

Use subjective descriptions without measurements
Wait until the end of the day to document from memory
Only document abnormal findings
Record findings objectively using measurable criteria immediately after assessment (Correct answer)

Correct answer: Record findings objectively using measurable criteria immediately after assessment

Documenting findings objectively with measurable criteria immediately after assessment ensures accuracy, provides legal protection, and creates reliable baseline data for tracking progress.

Question 99: A CDT is working with a student who has a known latex allergy. Which material should the therapist avoid using during sessions?

Foam stress balls
Dry-erase markers
Plastic letter tiles
Latex gloves when handling shared manipulatives (Correct answer)

Correct answer: Latex gloves when handling shared manipulatives

Latex gloves or latex-containing materials must be avoided for students with latex allergies to prevent allergic reactions.

Question 100: What is the appropriate retention period for professional records?

One year after the last service
Until storage space runs out
As specified by state/federal law and professional licensing requirements (Correct answer)
Only as long as the client remains active

Correct answer: As specified by state/federal law and professional licensing requirements

Record retention must follow state/federal laws and professional licensing requirements, which typically specify minimum retention periods for different record types.

Question 101: When storing multisensory sandpaper letter tiles, which condition is most likely to cause them to degrade prematurely?

Storing them in a cool, dry environment
Stacking them loosely in an open bin
Keeping them in labeled zip-lock bags
Exposing them to high humidity and direct sunlight (Correct answer)

Correct answer: Exposing them to high humidity and direct sunlight

Humidity causes sandpaper to lose grit adhesion and warps cardboard backing, while sunlight fades tactile contrast cues.

Question 102: What is the primary characteristic of dyslexia?

Difficulty with word recognition and spelling. (Correct answer)
Difficulty with arithmetic.
Difficulty with motor skills.
Difficulty with comprehension.

Correct answer: Difficulty with word recognition and spelling.

Dyslexia is a specific learning disability characterized by difficulties with accurate and/or fluent word recognition, and by poor spelling and decoding abilities. These difficulties typically stem from a deficit in the phonological component of language, which is often unexpected in relation to other cognitive abilities. It is not primarily a visual problem or a general learning disability.

Question 103: Which patient right is protected under Section 504 of the Rehabilitation Act as it applies to students with dyslexia?

The right to reasonable accommodations in educational programs (Correct answer)
The right to transfer to any school of their choice
The right to a full-time personal aide
The right to free private tutoring

Correct answer: The right to reasonable accommodations in educational programs

Section 504 protects students with disabilities, including dyslexia, from discrimination and entitles them to reasonable accommodations in school programs.

Question 104: A CDT therapist learns that a student shared suicidal ideation during a session. What is the appropriate action?

Notify parents or guardians and appropriate crisis resources immediately (Correct answer)
Maintain confidentiality and document in records only
Wait to see if the student mentions it again before acting
Refer the student to a psychiatrist at the next scheduled appointment

Correct answer: Notify parents or guardians and appropriate crisis resources immediately

Disclosure of suicidal ideation triggers an exception to confidentiality; the therapist must notify guardians and connect the student with crisis resources immediately.

Question 105: Which of the following is an example of explicit instruction in structured literacy?

Letting students guess the meanings of words.
Allowing students to figure out word meanings on their own.
Teaching spelling rules step-by-step and providing plenty of practice. (Correct answer)
Relying on reading comprehension alone.

Correct answer: Teaching spelling rules step-by-step and providing plenty of practice.

Explicit instruction means directly teaching skills and concepts in a clear, unambiguous way. Teaching spelling rules step-by-step and providing ample opportunities for guided practice is a perfect example, as it ensures students understand the rules and can apply them systematically, rather than relying on rote memorization or guessing.

Question 106: A CDT administers the Comprehensive Test of Phonological Processing (CTOPP-2) and finds a student scores 1.5 standard deviations below the mean on Phonological Memory. This indicates:

Average performance with minor variability
No concern unless decoding scores are also low
A strength that should be leveraged in intervention
A significant weakness in holding phonological information in working memory (Correct answer)

Correct answer: A significant weakness in holding phonological information in working memory

A score 1.5 SD below the mean falls at approximately the 7th percentile, indicating a clinically meaningful phonological memory deficit.

Question 107: Which of the following is an example of a Tier 1 universal screening tool commonly used to identify students at risk for dyslexia in US schools?

Woodcock-Johnson Tests of Achievement (WJ-IV)
Gray Oral Reading Tests (GORT-5)
DIBELS Next (Dynamic Indicators of Basic Early Literacy Skills) (Correct answer)
Wechsler Individual Achievement Test (WIAT-III)

Correct answer: DIBELS Next (Dynamic Indicators of Basic Early Literacy Skills)

DIBELS Next is a widely used universal screener that provides brief, repeatable measures of early literacy skills for school-wide administration.

Question 108: How often should a practitioner review applicable regulations and standards?

Only when notified of a violation
Every five years at renewal time
Regularly, as regulations are updated frequently and compliance is ongoing (Correct answer)
Only during initial licensure

Correct answer: Regularly, as regulations are updated frequently and compliance is ongoing

Regular review of regulations is necessary because standards evolve frequently, and maintaining current knowledge is essential for ongoing compliance.

Question 109: Which of the following is the safest way to dispose of a broken pencil with a sharp tip in a therapy room?

Leave it on the desk for custodial staff
Place it directly in the open wastebasket
Wrap the sharp end in tape or paper and place it in a puncture-resistant container (Correct answer)
Snap the tip off with fingers before disposing

Correct answer: Wrap the sharp end in tape or paper and place it in a puncture-resistant container

Sharp objects should be wrapped or placed in puncture-resistant containers to prevent injury to the therapist, students, or custodial staff.

Question 110: Which assessment tool is most commonly used to evaluate a patient's functional status?

Standardized functional capacity scales (Correct answer)
Insurance claim forms
Visual inspection only
Patient self-report without verification

Correct answer: Standardized functional capacity scales

Standardized functional capacity scales provide objective, reproducible measurements of patient functional status that can be compared over time.

Question 111: The 'Simple View of Reading' (Gough & Tunmer, 1986) defines reading comprehension as the product of which two components?

Decoding and linguistic comprehension (Correct answer)
Phonological awareness and vocabulary
Word recognition and working memory
Fluency and background knowledge

Correct answer: Decoding and linguistic comprehension

The Simple View of Reading formula is RC = D × LC, meaning Reading Comprehension equals Decoding multiplied by Linguistic Comprehension.

Question 112: A CDT is monitoring a student's spelling progress as an indirect indicator of phonics and orthographic knowledge. Which measure would provide the most direct reflection of phonics application?

Measuring reading comprehension on a passage-level assessment
Analyzing phoneme-grapheme correspondences in student spelling errors on a standardized spelling inventory (Correct answer)
Administering a sight-word vocabulary test
Counting total words spelled correctly in a writing sample

Correct answer: Analyzing phoneme-grapheme correspondences in student spelling errors on a standardized spelling inventory

Error analysis on a spelling inventory reveals which phoneme-grapheme patterns a student has or has not mastered, directly informing phonics instruction.

Question 113: Which standardized assessment is most appropriate for measuring a student's oral reading fluency with normative data?

Woodcock Reading Mastery Tests (WRMT-III)
Gray Oral Reading Tests (GORT-5) (Correct answer)
Dynamic Indicators of Basic Early Literacy Skills (DIBELS)
Test of Word Reading Efficiency (TOWRE-2)

Correct answer: Gray Oral Reading Tests (GORT-5)

The GORT-5 measures oral reading rate, accuracy, fluency, and comprehension with standardized normative scores.

Question 114: A student with dyslexia is also known to have epilepsy. During a session, the student begins to seize. What is the therapist's FIRST action?

Restrain the student to prevent injury
Place something between the student's teeth
Immediately begin CPR
Clear the area of hazards and protect the student's head (Correct answer)

Correct answer: Clear the area of hazards and protect the student's head

The first priority during a seizure is to remove nearby hazards and cushion the head; restraining the person or placing objects in the mouth is dangerous.

Question 115: Which condition is characterized by significant difficulty with written expression, including handwriting, spelling, and written composition, often co-occurring with dyslexia?

Dysgraphia (Correct answer)
Dyscalculia
Dyspraxia
Developmental coordination disorder

Correct answer: Dysgraphia

Dysgraphia specifically affects written expression and often co-occurs with dyslexia since both involve language-based processing, though dysgraphia also has a motor component.

Question 116: The 'Wolf Naming Speed Deficit' refers to deficits in which cognitive process that is separate from phonological awareness?

Phoneme segmentation
Verbal working memory
Orthographic processing speed
Rapid automatized naming (RAN) (Correct answer)

Correct answer: Rapid automatized naming (RAN)

Maryanne Wolf's research identified rapid automatized naming (RAN) as a second core deficit in dyslexia, distinct from phonological awareness, leading to the double-deficit hypothesis.

Question 117: Which of the following is an example of an informal assessment tool used in a dyslexia evaluation?

Woodcock-Johnson IV Letter-Word Identification
Informal Reading Inventory (IRI) (Correct answer)
CTOPP-2 Phoneme Elision subtest
GORT-5 Passage fluency score

Correct answer: Informal Reading Inventory (IRI)

Informal Reading Inventories are criterion-referenced, non-standardized tools used to determine independent, instructional, and frustration reading levels.

Question 118: Which technique is MOST appropriate for teaching a student to identify syllable types in multisyllabic words?

Asking the student to guess based on context clues
Teaching the student the word as a whole-word sight word
Using colored markers or tiles to segment and label each syllable type (Correct answer)
Having the student read the word aloud multiple times until it feels familiar

Correct answer: Using colored markers or tiles to segment and label each syllable type

Using colored markers or tiles to visually and kinesthetically segment and label syllable types is a structured, multisensory approach aligned with OG methodology.

Question 119: When a student's progress monitoring data shows high variability (zigzag pattern) around the aim line, the CDT should FIRST:

Assume the student is not responding to intervention and refer for evaluation
Average the data points and make a decision based on the average alone
Immediately change the intervention program
Examine whether the probes are being administered and scored consistently, and look for sources of variability (Correct answer)

Correct answer: Examine whether the probes are being administered and scored consistently, and look for sources of variability

High variability often reflects inconsistent administration conditions or other external factors, which must be ruled out before changing the intervention.

Question 120: A therapist uses magnetic letters to have a student build and manipulate words. This activity primarily targets:

Listening comprehension strategies
Reading fluency and prosody
Phoneme-grapheme correspondence through kinesthetic encoding (Correct answer)
Sight word recognition via visual memory

Correct answer: Phoneme-grapheme correspondence through kinesthetic encoding

Manipulating magnetic letters engages kinesthetic and visual channels to reinforce the link between sounds and their written symbols.

Question 121: Which feature of an error analysis is most informative when assessing a student's phonological decoding strategy?

Whether the errors are visually similar to the target word
Whether nonsense word errors are phonetically plausible (Correct answer)
Whether errors occur more in fiction versus nonfiction texts
Whether the student self-corrects after prompting

Correct answer: Whether nonsense word errors are phonetically plausible

Phonetically plausible nonsense word errors (e.g., reading 'bim' as 'beem') show the student is attempting to apply letter-sound rules rather than guessing.

Question 122: A parent asks why their child must read aloud slowly and repeat words during therapy. The BEST response by the CDT is:

Avoid explaining the rationale to keep sessions simple
Suggest the parent limit reading at home to avoid frustration
Explain that repetition builds automaticity and strengthens neural pathways for decoding (Correct answer)
Tell the parent that the child has a severe deficit requiring intensive remediation

Correct answer: Explain that repetition builds automaticity and strengthens neural pathways for decoding

Explaining the neuroscience of automaticity helps parents understand and value the repeated-reading practice.

Question 123: Which skill represents the most advanced level of phonological awareness?

Word segmentation in sentences
Phoneme manipulation (Correct answer)
Rhyme recognition
Syllable blending

Correct answer: Phoneme manipulation

Phoneme manipulation — adding, deleting, or substituting individual phonemes — is the most advanced phonological awareness skill because it requires precise attention to the smallest sound units.

Question 124: The IDA's Dyslexia Handbook recommends that dyslexia screening occur at which point in a student's schooling?

Only upon a formal referral from a physician
After third grade, when reading demands increase significantly
Beginning in kindergarten or early first grade (Correct answer)
Only after a student fails two consecutive grades

Correct answer: Beginning in kindergarten or early first grade

IDA recommends early screening beginning in kindergarten or early first grade so that at-risk students receive intervention before reading failure becomes entrenched.

Question 125: When educating parents about dyslexia, which explanation best describes its neurological basis?

A vision problem that causes letters to reverse
A temporary delay that resolves without intervention
A personal choice or lack of effort
A difference in how the brain processes phonological information (Correct answer)

Correct answer: A difference in how the brain processes phonological information

Dyslexia is a neurologically-based difference in phonological processing, not a vision problem or lack of effort.

Question 126: How can parents support children with dyslexia at home?

By only focusing on math skills.
By providing extra reading practice and a positive environment. (Correct answer)
By discouraging reading practice.
By forcing the child to read at a fast pace.

Correct answer: By providing extra reading practice and a positive environment.

Parents play a vital role in supporting children with dyslexia by creating a positive and encouraging home environment. Providing consistent, extra reading practice, making reading enjoyable, and celebrating small successes helps build confidence and reinforces the skills learned in intervention, fostering a love for reading despite challenges.

Question 127: What constitutes a boundary violation in professional practice?

Maintaining strict professional communication
Engaging in dual relationships that could impair professional judgment (Correct answer)
Attending continuing education events
Following organizational policies

Correct answer: Engaging in dual relationships that could impair professional judgment

Dual relationships that could impair professional judgment represent boundary violations, potentially compromising the quality and objectivity of professional services.

Question 128: In the context of language-based learning disabilities, which term refers to a significant discrepancy between oral language comprehension and reading comprehension with intact decoding?

Specific language impairment
Developmental language disorder with dyslexia
Hyperlexia
Language comprehension deficit (poor comprehender profile) (Correct answer)

Correct answer: Language comprehension deficit (poor comprehender profile)

Poor comprehenders decode accurately but fail to understand text because of underlying language comprehension deficits, representing a distinct profile from dyslexia.

Question 129: The Elkonin boxes technique is PRIMARILY used to develop:

Vocabulary through semantic mapping
Sight word automaticity through repetition
Reading fluency and expression
Phoneme segmentation by mapping sounds to boxes (Correct answer)

Correct answer: Phoneme segmentation by mapping sounds to boxes

Elkonin (sound) boxes provide a concrete visual scaffold where students push a token into a box for each phoneme they hear, supporting segmentation.

Question 130: A student with dyslexia also shows significant difficulty with mental arithmetic and number fact retrieval. The evaluator should consider assessing for:

ADHD as the primary diagnosis
Dyscalculia as a co-occurring condition (Correct answer)
A global intellectual disability
Visual processing disorder only

Correct answer: Dyscalculia as a co-occurring condition

Dyscalculia frequently co-occurs with dyslexia and should be assessed when a student shows significant number processing or arithmetic fact difficulties alongside reading deficits.

Question 131: How should a professional handle a situation where they lack competence?

Attempt the work and learn from mistakes
Refer the client to a qualified professional or seek additional training (Correct answer)
Delegate to an unlicensed assistant
Accept the work to avoid losing the client

Correct answer: Refer the client to a qualified professional or seek additional training

Referring to qualified professionals or obtaining additional training when facing competence limitations protects clients and upholds professional standards.

Question 132: When should a dyslexia therapist introduce cursive handwriting to a student who confuses print letters?

Only at the request of the classroom teacher
Early in treatment, as cursive eliminates many common letter reversals and supports kinesthetic learning (Correct answer)
Only after the student has mastered all 26 print letters
Never—cursive is not recommended in structured literacy programs

Correct answer: Early in treatment, as cursive eliminates many common letter reversals and supports kinesthetic learning

Cursive handwriting is often introduced early because its connected letterforms eliminate many reversal confusions (b/d, p/q) and reinforce kinesthetic letter memory.

Question 133: According to the IDA definition, which of the following is NOT a primary characteristic of dyslexia?

Difficulties with accurate word recognition
Difficulties with reading comprehension caused by poor listening comprehension (Correct answer)
Difficulties with spelling
Difficulties with decoding

Correct answer: Difficulties with reading comprehension caused by poor listening comprehension

The IDA definition specifies that reading comprehension difficulties in dyslexia result from deficits in phonological processing, not from poor listening/language comprehension (which would indicate a different profile).

Question 134: In the Orton-Gillingham lesson plan, the 'new learning' phase should:

Always follow the student's interest rather than the scope and sequence
Introduce only one new concept or phonogram to avoid cognitive overload (Correct answer)
Be skipped on days the student shows fatigue or resistance
Introduce 3-5 new phonograms to maximize each session

Correct answer: Introduce only one new concept or phonogram to avoid cognitive overload

OG methodology prescribes introducing only one new concept per lesson to maintain the incremental, mastery-based progression that defines structured literacy.

Question 135: Which of the following describes 'orthographic mapping,' as defined by David Kilpatrick?

The relationship between spelling patterns and reading rate
Mapping punctuation and formatting cues to reading fluency
The visual memorization of whole words through repeated exposure
The process by which phonemic awareness and letter-sound knowledge bond pronunciations to spellings in long-term memory (Correct answer)

Correct answer: The process by which phonemic awareness and letter-sound knowledge bond pronunciations to spellings in long-term memory

Orthographic mapping (Kilpatrick) is the mental process of using phonemic awareness and grapheme-phoneme knowledge to permanently store words' pronunciations, spellings, and meanings simultaneously in long-term memory.

Question 136: A CDT is asked to determine whether a previously diagnosed student still qualifies for dyslexia-based accommodations after intervention. The most appropriate approach is to:

Administer updated standardized reading assessments to document current performance levels (Correct answer)
Repeat only the phonological awareness subtests from the original evaluation
Remove accommodations since the student received intervention
Rely solely on teacher observation reports

Correct answer: Administer updated standardized reading assessments to document current performance levels

Updated standardized assessments provide current, objective data needed to document ongoing areas of need and justify continued accommodations.

Question 137: A parent requests that a CDT therapist withhold the student's dyslexia diagnosis from the student themselves. Ethically, how should the therapist respond?

Share the diagnosis with the student in an age-appropriate manner after discussing with the parent (Correct answer)
Comply fully with the parent's request
Refer the case to another therapist to avoid conflict
Immediately disclose the diagnosis without consulting the parent

Correct answer: Share the diagnosis with the student in an age-appropriate manner after discussing with the parent

The therapist should discuss the importance of age-appropriate disclosure with the parent, as withholding a diagnosis can harm the student's self-understanding and autonomy.

Question 138: A CDT is asked to evaluate whether a school's dyslexia screener is effective. Which psychometric property ensures the tool correctly identifies students who truly have dyslexia risk?

Sensitivity (Correct answer)
Reliability
Standard error of measurement
Specificity

Correct answer: Sensitivity

Sensitivity refers to a tool's ability to correctly identify true positives—students who actually have a reading risk or disability.

Question 139: A morpheme is best described as:

A syllable that always contains at least one vowel phoneme
A single speech sound produced in spoken language
The smallest meaningful unit of language (Correct answer)
A letter combination that represents one sound

Correct answer: The smallest meaningful unit of language

A morpheme is the smallest unit of language that carries meaning, such as the prefix 'un-,' the suffix '-ed,' or a free morpheme like the base word 'play.'

Question 140: The phonological loop, a component of working memory important for reading, consists of:

A phonological store and an articulatory rehearsal process (Correct answer)
Visuospatial sketchpad and central executive
Central executive and episodic buffer only
Long-term phonological memory and semantic store

Correct answer: A phonological store and an articulatory rehearsal process

Baddeley's phonological loop comprises a phonological store (holds sound-based information briefly) and a subvocal articulatory rehearsal process that refreshes decaying traces.

Question 141: Which observation during an oral reading sample would most strongly suggest a student is using a logographic (whole-word guessing) strategy?

Skipping unfamiliar words entirely
Reading 'house' as 'horse' based on first and last letters (Correct answer)
Self-correcting after rereading the sentence
Sounding out each phoneme slowly but accurately

Correct answer: Reading 'house' as 'horse' based on first and last letters

Substituting a visually similar word (same initial/final letters) indicates the student is pattern-matching on word shape rather than applying phonics.

Question 142: The term 'diagnostic teaching' in structured literacy refers to:

Referring students to psychologists for formal evaluation
Using running records to measure oral reading fluency
Administering standardized tests at the start of the school year
Continuously assessing student responses within lessons to adjust instruction (Correct answer)

Correct answer: Continuously assessing student responses within lessons to adjust instruction

Diagnostic teaching means the teacher constantly observes and analyzes student errors during instruction and adjusts pacing, review, and approach in real time.

Question 143: Phonemic awareness specifically focuses on:

Understanding syllable stress patterns in multisyllabic words
Recognizing word families and spelling patterns
The ability to hear, identify, and manipulate individual phonemes in spoken words (Correct answer)
Letter-sound correspondences in printed text

Correct answer: The ability to hear, identify, and manipulate individual phonemes in spoken words

Phonemic awareness is a subset of phonological awareness that specifically involves working with phonemes — the smallest individual units of sound in spoken words.

Question 144: Which of the following is a hallmark characteristic of the written language of older students with dyslexia who have partially compensated for reading difficulties?

Inability to write any legible words without assistive technology
Use of simple vocabulary to avoid misspelling more complex words they know orally (Correct answer)
Complete absence of spelling errors in all written work
Consistently poor reading comprehension despite accurate decoding

Correct answer: Use of simple vocabulary to avoid misspelling more complex words they know orally

Compensated students often use simpler, safer vocabulary in writing to avoid misspelling multisyllabic words they know and use orally, masking their true language knowledge.

Question 145: A CDT therapist is reviewing a student's IEP and notices services that were promised but never delivered. What is the therapist's ethical responsibility?

Ignore it, as IEP compliance is the school's responsibility alone
Notify only the parents without involving the school team
Remove the undelivered services from the IEP to align it with reality
Document the gap and advocate for the student to receive the agreed-upon services (Correct answer)

Correct answer: Document the gap and advocate for the student to receive the agreed-upon services

Therapists have an ethical duty to advocate for students when promised services are not delivered, as this directly affects the student's right to a Free Appropriate Public Education (FAPE).

Question 146: Which measure is MOST useful for monitoring the fluency component of reading progress in a student receiving dyslexia intervention?

Curriculum-embedded vocabulary quiz
Phoneme isolation task
Oral reading fluency probe (words correct per minute) (Correct answer)
Silent reading comprehension passage

Correct answer: Oral reading fluency probe (words correct per minute)

Oral reading fluency probes provide a reliable, sensitive index of reading automaticity and are widely used for progress monitoring.

Question 147: A student with dyslexia benefits most from which type of feedback during oral reading errors?

Ignoring errors to preserve reading flow and confidence
Prompting the student to apply a specific decoding strategy before supplying the word (Correct answer)
Asking the student to re-read the entire paragraph to find the error
Immediate correction by the therapist reading the word aloud for the student

Correct answer: Prompting the student to apply a specific decoding strategy before supplying the word

Prompting strategy use before supplying the word teaches self-correction and builds independent decoding skills.

Question 148: How often should equipment be sterilized or disinfected?

Between each patient use according to manufacturer guidelines (Correct answer)
Weekly during routine maintenance
Only when visibly soiled
Once per shift

Correct answer: Between each patient use according to manufacturer guidelines

Equipment must be sterilized or disinfected between each patient use following manufacturer guidelines to prevent cross-contamination and ensure patient safety.

Question 149: Phoneme substitution involves:

Deleting a phoneme from a word to form a shorter word
Adding a new phoneme to the beginning or end of an existing word
Counting the total number of phonemes contained in a word
Replacing one phoneme in a word with a different phoneme to create a new word (Correct answer)

Correct answer: Replacing one phoneme in a word with a different phoneme to create a new word

Phoneme substitution means replacing one phoneme in a word with another phoneme, such as changing /k/ to /b/ in 'cat' to produce 'bat.'

Question 150: When interpreting a student's score on the KTEA-3 Word Recognition subtest for screening purposes, which score type is MOST useful for comparing the student to same-age peers?

Age equivalent
Grade equivalent
Raw score
Standard score (Correct answer)

Correct answer: Standard score

Standard scores (mean 100, SD 15) allow direct comparison to a normative same-age peer group and are the most interpretable for screening decision-making.

Question 151: How should equipment cleaning products be selected?

The same product for all equipment types
Based on manufacturer recommendations and material compatibility (Correct answer)
Whichever product is least expensive
Based on personal preference

Correct answer: Based on manufacturer recommendations and material compatibility

Manufacturer recommendations ensure cleaning products are compatible with equipment materials, preventing damage while achieving effective decontamination.

Alliance for Accreditation and Certification of Dyslexia Specialists (AACDS) Certification Exam

This exam certifies individuals as competent Dyslexia Therapists, demonstrating expertise in multisensory structured language education for individuals with dyslexia.

150

Questions

180 min

Time Limit

70%

To Pass

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