Praxis® Speech-Language Pathology (5331) Exam — Questions and Answers

Question 1: At what age should most children be able to say simple sentences?

2-3 years (Correct answer)
5 years
4 years
1 year

Correct answer: 2-3 years

By 2-3 years of age, most typically developing children begin to combine two or more words into simple sentences, such as 'Me want juice' or 'Doggie go bye-bye.' This developmental milestone indicates emerging grammatical skills and the ability to express more complex thoughts and needs.

Question 2: A patient with a history of GERD presents with globus sensation, throat clearing, and mild dysphonia. Laryngoscopy reveals posterior commissure erythema and interarytenoid edema. This presentation is most consistent with:

Contact granuloma secondary to intubation
Muscle tension dysphonia
Laryngopharyngeal reflux (Correct answer)
Infectious laryngitis

Correct answer: Laryngopharyngeal reflux

Laryngopharyngeal reflux characteristically causes posterior laryngeal erythema, interarytenoid edema, globus, and chronic throat clearing.

Question 3: The Index of Productive Syntax (IPSyn) is a language sample measure that evaluates:

Pragmatic turn-taking frequency
Narrative episode completeness
The variety of syntactic and morphological structures used (Correct answer)
Vocabulary diversity using type-token ratio

Correct answer: The variety of syntactic and morphological structures used

IPSyn scores the diversity of grammatical structures in a 50-utterance sample, providing a profile of syntactic development.

Question 4: The ethical concept of justice in healthcare delivery most directly requires SLPs to:

Ensure fair and equitable access to services across diverse populations (Correct answer)
Provide the same treatment to every patient regardless of diagnosis
Prioritize treatment for patients with the best prognosis
Charge uniform fees regardless of patient financial status

Correct answer: Ensure fair and equitable access to services across diverse populations

Justice requires fair distribution of services and resources, including addressing disparities in access for underserved populations.

Question 5: What is the primary purpose of a speech-language assessment?

To identify the nature and extent of disorders (Correct answer)
To document academic performance.
To provide therapy without further diagnosis.
To determine eligibility for insurance.

Correct answer: To identify the nature and extent of disorders

The primary goal of a comprehensive speech-language assessment is to systematically gather information to determine if a communication disorder exists, what its specific characteristics are, and how severely it impacts the individual's daily life. This diagnostic process guides the development of an appropriate intervention plan.

Question 6: During an oral-peripheral examination, limited tongue lateralization and reduced velopharyngeal closure are most relevant to assessment of:

Motor speech production and resonance (Correct answer)
Phonological awareness
Auditory discrimination
Narrative cohesion

Correct answer: Motor speech production and resonance

Tongue lateralization affects lingual consonant production, while velopharyngeal closure impacts resonance and nasal airflow during speech.

Question 7: The stimulability testing of an error sound provides information about:

Parent report of home production
The likelihood of improvement with intervention (Correct answer)
The underlying neurological cause of the error
The child's phonological awareness

Correct answer: The likelihood of improvement with intervention

A stimulable error sound suggests the child can produce it with cues, indicating a better prognosis for treatment success.

Question 8: The Transfer phase of stuttering treatment refers to:

Teaching the client to identify stuttering in others before self-monitoring
Moving from individual therapy to group therapy format
Shifting from fluency shaping to stuttering modification approach
Generalizing fluency skills or stuttering modification techniques to real-world speaking situations (Correct answer)

Correct answer: Generalizing fluency skills or stuttering modification techniques to real-world speaking situations

Transfer involves systematically applying the skills learned in the clinic to progressively challenging real-life communication situations.

Question 9: Which factor MOST distinguishes effective telepractice intervention for toddlers compared to older children?

Using shorter sessions and maximizing caregiver coaching as the primary intervention mechanism (Correct answer)
Avoiding all digital games and stimuli
Relying exclusively on child-directed screen time
Conducting all sessions without caregiver presence

Correct answer: Using shorter sessions and maximizing caregiver coaching as the primary intervention mechanism

For toddlers, caregiver-mediated coaching is the most evidence-based telepractice approach because toddlers cannot engage with screens independently and caregivers generalize strategies to daily routines.

Question 10: Which feature of the Preschool Language Scales-5 (PLS-5) makes it particularly useful for infants and toddlers?

It provides separate norms for bilingual children
It includes a nonword repetition subtest
It begins at birth (0 months) and incorporates caregiver interaction items (Correct answer)
It uses dynamic assessment procedures exclusively

Correct answer: It begins at birth (0 months) and incorporates caregiver interaction items

The PLS-5 is normed from birth through 7;11 and includes items assessed through observation of caregiver–child interaction at the earliest age levels.

Question 11: A rural school district asks an SLP to serve students via telepractice. What documentation should the SLP review FIRST before accepting?

The district's building maintenance records
State telepractice regulations, school board policies, and the SLP's licensure status in that state (Correct answer)
The district's lunch menu schedule
The students' class schedules only

Correct answer: State telepractice regulations, school board policies, and the SLP's licensure status in that state

Before accepting any telepractice caseload, the SLP must confirm state regulatory requirements, district policies governing telepractice, and that their license is valid in that state.

Question 12: Which standardized measure is most appropriate for diagnosing social communication disorder by assessing pragmatic language abilities?

Goldman-Fristoe Test of Articulation-3 (GFTA-3)
Bankson Language Test-2 (BLT-2)
Children's Communication Checklist-2 (CCC-2) (Correct answer)
Boston Naming Test (BNT)

Correct answer: Children's Communication Checklist-2 (CCC-2)

The CCC-2 includes scales for pragmatic aspects of communication such as inappropriate initiation, coherence, and social relations.

Question 13: During a Modified Barium Swallow Study (MBSS), penetration to the laryngeal vestibule is observed with thin liquids but the material is immediately expelled. How is this classified using the Penetration-Aspiration Scale?

Score of 1 — material does not enter the airway
Score of 4 — material enters the airway, contacts the vocal folds, and is not ejected
Score of 2 — material enters the airway, remains above the cords, and is ejected (Correct answer)
Score of 6 — material passes below the vocal folds and is ejected into the larynx

Correct answer: Score of 2 — material enters the airway, remains above the cords, and is ejected

A PAS score of 2 indicates material enters the airway above the vocal folds and is successfully expelled, representing penetration without aspiration.

Question 14: When using the Kaufman Speech Praxis Test (KSPT), the SLP is assessing:

Receptive vocabulary breadth
Oral motor and speech movement sequencing for suspected childhood apraxia (Correct answer)
Phonological process use
Narrative discourse organization

Correct answer: Oral motor and speech movement sequencing for suspected childhood apraxia

The KSPT evaluates imitative volitional oral movement and speech sound production to identify childhood apraxia of speech.

Question 15: The Test of Narrative Language (TNL) assesses a child's ability to:

Comprehend and produce oral narratives (Correct answer)
Name pictures rapidly
Repeat sentences of increasing length
Identify rhyming words

Correct answer: Comprehend and produce oral narratives

The TNL evaluates narrative comprehension and production across multiple story formats, making it a functional language measure.

Question 16: Which of the following is a therapeutic intervention for expressive language disorder?

Exclusively phonemic awareness.
Math puzzles.
Silent reading only.
Narrative retelling and sentence expansion (Correct answer)

Correct answer: Narrative retelling and sentence expansion

Expressive language disorder involves difficulties in producing spoken or written language. Narrative retelling helps clients organize thoughts, sequence events, and use more complex sentence structures, while sentence expansion directly targets increasing the length and grammatical complexity of utterances. Both interventions are designed to improve a client's ability to formulate and articulate their ideas effectively.

Question 17: When administering the Autism Diagnostic Observation Schedule (ADOS-2) for communication assessment, the SLP is primarily evaluating:

Social communication and interaction behaviors (Correct answer)
Fluency and stuttering frequency
Receptive vocabulary age equivalents
Phonological accuracy

Correct answer: Social communication and interaction behaviors

The ADOS-2 is a semi-structured observation tool that assesses social communication and interaction to support ASD diagnosis.

Question 18: When differentiating a language difference from a language disorder in a bilingual child, the most valid approach is to:

Rely solely on teacher observation in the classroom
Administer the CELF-5 in English and compare to English norms
Assess in both languages and determine whether difficulties are present across both (Correct answer)
Use only parent report to avoid test bias

Correct answer: Assess in both languages and determine whether difficulties are present across both

A true language disorder persists across all languages the child speaks; errors present in only one language may reflect a difference, not a disorder.

Question 19: An SLP wishes to use a new treatment technique not yet supported by strong evidence. The ethical approach is to:

Wait until the technique has Level I evidence before any use
Use the technique freely as long as the patient consents
Implement it only after informing the patient and documenting the evidence basis (Correct answer)
Avoid the technique entirely regardless of clinical rationale

Correct answer: Implement it only after informing the patient and documenting the evidence basis

SLPs may use emerging techniques when they obtain informed consent and transparently document the current evidence base and clinical rationale.

Question 20: Group therapy for adults who stutter is particularly effective for addressing:

Pharmacological side effect monitoring during drug trials
Formal psychometric assessment of stuttering severity
Acoustic analysis and precise motor programming of fluency targets
Social stigma, avoidance behaviors, and peer support in real-life speaking situations (Correct answer)

Correct answer: Social stigma, avoidance behaviors, and peer support in real-life speaking situations

Group therapy provides a supportive community for practicing fluency and stuttering modification skills, reducing social stigma, and confronting avoidance in real communicative interactions.

Question 21: When using teletherapy apps with gamification for child clients, the SLP's PRIMARY consideration should be:

Selecting the free app with the most downloads
Using the app the child requests regardless of clinical goals
Ensuring the app's tasks align with evidence-based treatment targets (Correct answer)
Choosing the app with the most colorful graphics

Correct answer: Ensuring the app's tasks align with evidence-based treatment targets

Engagement features are secondary to clinical validity; apps must be selected based on whether their tasks target evidence-based speech-language goals.

Question 22: A referential communication task used during language assessment primarily evaluates:

The ability to convey information clearly to a listener who cannot see the stimulus (Correct answer)
Grammatical morpheme use
Narrative macrostructure
Phoneme discrimination

Correct answer: The ability to convey information clearly to a listener who cannot see the stimulus

Referential communication tasks assess how well a speaker can describe objects or events so a naive listener can identify them.

Question 23: The Rossetti Infant-Toddler Language Scale differs from most standardized language assessments because it:

Yields a quotient score based on national norms
Is designed for children age 3–5 only
Measures phonological complexity exclusively
Relies heavily on parent/caregiver report and observation rather than elicited responses (Correct answer)

Correct answer: Relies heavily on parent/caregiver report and observation rather than elicited responses

The Rossetti Scale uses observation and caregiver interview to evaluate communication and interaction in very young children, with no normative scoring.

Question 24: Which augmentative and alternative communication (AAC) strategy is most appropriate for a minimally verbal 5-year-old with autism to expand utterance length?

Sign language exclusively
Core vocabulary combined with aided language stimulation (Correct answer)
High-tech AAC withheld until verbal speech plateaus
Picture exchange for single-word requests only

Correct answer: Core vocabulary combined with aided language stimulation

Core vocabulary on a robust AAC system paired with aided language stimulation models multi-word combinations and promotes expressive language growth.

Question 25: Which acoustic measure is most directly associated with vocal hyperfunction?

Reduced cepstral peak prominence (CPP) (Correct answer)
Elevated fundamental frequency (F0)
Increased subglottal air pressure only
Increased harmonic-to-noise ratio (HNR)

Correct answer: Reduced cepstral peak prominence (CPP)

Reduced CPP reflects greater aperiodicity and noise in the voice signal, characteristic of hyperfunctional voice disorders.

Question 26: Which voice disorder is most strongly associated with a history of repeated intubation trauma?

Posterior glottic stenosis or contact granuloma (Correct answer)
Spasmodic dysphonia
Vocal fold nodules
Reinke's edema

Correct answer: Posterior glottic stenosis or contact granuloma

Repeated or prolonged intubation causes pressure injury at the posterior glottis, predisposing to contact granuloma or subglottic/posterior glottic stenosis.

Question 27: Which situation best exemplifies a violation of patient autonomy in SLP practice?

Offering multiple evidence-based treatment options for the patient to choose from
Involving family members in goal-setting at the patient's request
Providing written information about treatment risks and benefits
Implementing a treatment plan without explaining options or obtaining consent (Correct answer)

Correct answer: Implementing a treatment plan without explaining options or obtaining consent

Implementing treatment without informed consent violates the patient's right to autonomous decision-making.

Question 28: Cervical auscultation as a swallowing assessment tool is best described as:

A standardized measure with established sensitivity and specificity
A gold-standard instrumental measure of aspiration
A replacement for VFSS in high-risk patients
A low-cost clinical adjunct that provides auditory cues about swallowing sounds (Correct answer)

Correct answer: A low-cost clinical adjunct that provides auditory cues about swallowing sounds

Cervical auscultation uses a stethoscope to listen for swallowing sounds and is considered a clinical adjunct, not a standalone diagnostic tool due to limited evidence.

Question 29: Which of the following may be a sign of speech delay?

Speaking in full sentences
Not using single words by 18 months (Correct answer)
Repeating words
Babbling at 6 months

Correct answer: Not using single words by 18 months

A significant developmental milestone is the emergence of first words, typically between 12 and 18 months of age. If a child is not using single words meaningfully by 18 months, it is considered a red flag for a potential speech delay and warrants further evaluation by a Speech-Language Pathologist.

Question 30: What is a characteristic of a fluency disorder?

Speech with frequent interruptions and repetitions (Correct answer)
Misuse of tenses
Inability to form sentences
Limited vocabulary

Correct answer: Speech with frequent interruptions and repetitions

Fluency disorders, such as stuttering, are characterized by disruptions in the smooth, effortless flow of speech. These disruptions often include repetitions of sounds, syllables, or words, prolongations of sounds, and blocks where speech is temporarily halted, leading to frequent interruptions in communication.

Question 31: A patient exhibits falsetto voice (mutational falsetto/puberphonia) after successful puberty. The voice is characterized by:

Diplophonia with asymmetric mucosal wave
Strained voice breaks on vowel-initiated words
Low-pitched, rough voice with visible nodules
Habitual use of a high-pitched falsetto register despite normal laryngeal structure (Correct answer)

Correct answer: Habitual use of a high-pitched falsetto register despite normal laryngeal structure

Mutational falsetto (puberphonia) is a functional disorder where the patient maintains a falsetto register habitually despite having an anatomically normal post-pubertal larynx.

Question 32: A patient with unilateral vocal fold paralysis in the paramedian position most likely presents with which voice quality?

Harsh low-pitched voice
Normal voice with occasional pitch breaks
High-pitched strained voice
Breathy, weak voice with diplophonia (Correct answer)

Correct answer: Breathy, weak voice with diplophonia

Paramedian paralysis results in incomplete glottal closure, causing breathiness, reduced loudness, and diplophonia due to asymmetric vibration.

Question 33: A mean length of utterance (MLU) of 3.5 morphemes in a language sample from a 4-year-old is best interpreted as:

Uninterpretable without a standardized test
Significantly below age expectations (Correct answer)
Within normal developmental range for age
Significantly above age expectations

Correct answer: Significantly below age expectations

By age 4, typical MLU is approximately 4.5–5.0 morphemes; an MLU of 3.5 falls below the expected range.

Question 34: Which outcome measure is MOST appropriate for documenting telepractice treatment efficacy for a school-age child with language disorder?

Number of sessions completed
Parent satisfaction rating alone
Pre- and post-treatment standardized language scores combined with functional communication measures (Correct answer)
Internet speed logs from the session platform

Correct answer: Pre- and post-treatment standardized language scores combined with functional communication measures

Combining standardized test scores with functional communication measures provides the most comprehensive evidence of treatment efficacy for language disorders.

Question 35: What type of goal should be written for therapy sessions?

Goals based on peer therapist input.
General and vague goals.
Flexible and unwritten goals.
SMART goals that are measurable and time-bound (Correct answer)

Correct answer: SMART goals that are measurable and time-bound

Therapy goals should be written as SMART goals: Specific, Measurable, Achievable, Relevant, and Time-bound. This framework ensures that goals are clear, trackable, realistic, aligned with client needs, and have a defined timeframe for accomplishment, facilitating effective progress monitoring and accountability.

Question 36: Which symbol system is most widely used in AAC systems in the United States?

Widgit Symbols
Picture Communication Symbols (PCS) (Correct answer)
Blissymbols
Rebus symbols

Correct answer: Picture Communication Symbols (PCS)

Picture Communication Symbols (PCS), developed by Mayer-Johnson, are the most widely used symbol set in AAC in the United States, featured in many low- and high-tech AAC systems.

Question 37: During FEES, 'white-out' occurs when the epiglottis inverts and the larynx elevates, causing temporary loss of endoscopic view. This phase corresponds to:

The oral transport phase
The esophageal phase
The pharyngeal swallow (Correct answer)
The oral preparatory phase

Correct answer: The pharyngeal swallow

White-out during FEES coincides with the pharyngeal swallow when laryngeal elevation and epiglottic inversion block the camera view.

Question 38: A child with bilateral vocal fold nodules and a hyperfunctional voice pattern would MOST benefit from which initial treatment approach?

Phonosurgery to remove nodules
Botulinum toxin to cricothyroid muscle
Indirect voice therapy addressing vocal hygiene and vocal load (Correct answer)
Tracheotomy to rest the larynx

Correct answer: Indirect voice therapy addressing vocal hygiene and vocal load

Pediatric vocal fold nodules typically resolve with indirect therapy focused on reducing vocal misuse, improving hydration, and decreasing vocal load.

Question 39: A school-age child presents with phonological disorder characterized by cluster reduction. Which intervention approach is MOST efficient for targeting multiple error patterns simultaneously?

Social stories intervention
Melodic intonation therapy
Cycles approach (Hodson) (Correct answer)
Traditional Van Riper articulation therapy

Correct answer: Cycles approach (Hodson)

The Cycles approach systematically targets multiple phonological patterns in rotating cycles, promoting overall phonological system reorganization.

Question 40: What role does continuous improvement play in fluency disorders & stuttering for SLP certified professionals?

It focuses exclusively on cost reduction
It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation (Correct answer)
It applies only to new professionals in their first year
It is optional and only necessary during certification renewal

Correct answer: It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation

Continuous improvement is fundamental to professional practice in fluency disorders & stuttering, involving regular evaluation, feedback integration, and process enhancement to maintain high standards.

Question 41: Neuroimaging studies in adults who stutter most consistently reveal:

Bilateral hypoactivation of the supplementary motor area
Overactivation of right hemisphere motor areas and underactivation of left auditory cortex (Correct answer)
Hypoactivation of Wernicke's area with normal Broca's area function
Underactivation of right hemisphere motor areas and overactivation of left auditory cortex

Correct answer: Overactivation of right hemisphere motor areas and underactivation of left auditory cortex

Adults who stutter show overactivation of right hemisphere motor regions compensating for underactivation of the left auditory cortex and speech motor network.

Question 42: An adult with ALS is losing the ability to speak. Which AAC planning principle should guide early intervention before speech is fully lost?

Wait until speech is completely unintelligible before introducing AAC
Begin voice banking and message banking while intelligible speech remains (Correct answer)
Introduce AAC only after the client's family requests it
Focus exclusively on non-electronic low-tech options to avoid device dependency

Correct answer: Begin voice banking and message banking while intelligible speech remains

Voice banking captures the person's natural voice early for use in speech-generating devices before dysarthria severely degrades speech quality.

Question 43: Which of the following best describes 'fringe vocabulary' in an AAC system?

High-frequency words used by most people in most contexts
Vocabulary placed around the edges of a communication display
Specific, individualized words unique to a person's interests, activities, and experiences (Correct answer)
Words that cannot be represented by graphic symbols

Correct answer: Specific, individualized words unique to a person's interests, activities, and experiences

Fringe vocabulary refers to less frequent, highly individualized words related to a person's specific topics, people, places, and interests — it complements core vocabulary to enable personalized communication.

Question 44: In a connected speech fluency analysis, which measure best captures the proportion of stuttering-like disfluencies (SLDs) in a sample?

Overall disfluency rate
Phonation threshold pressure
Number of words per minute
Percent syllables stuttered (%SS) (Correct answer)

Correct answer: Percent syllables stuttered (%SS)

Percent syllables stuttered (%SS) specifically quantifies stuttering-like disfluencies (part-word repetitions, prolongations, blocks) per syllable spoken.

Question 45: A 4-year-old with language impairment shows a mean length of utterance (MLU) of 2.1 morphemes. Which immediate intervention target is most developmentally appropriate?

Metalinguistic awareness tasks
Complex embedded clauses
Agent + action + object combinations (Correct answer)
Passive sentence forms

Correct answer: Agent + action + object combinations

Agent-action-object combinations are characteristic of MLU Stage II-III and represent the next achievable step beyond simple two-word combinations.

Question 46: Which instrumental assessment provides the MOST direct visualization of vocal fold mucosal wave dynamics during phonation?

Aerodynamic phonation threshold pressure measurement
Electroglottography (EGG)
Acoustic analysis with Praat
Videostroboscopy (Correct answer)

Correct answer: Videostroboscopy

Videostroboscopy uses a strobe light synchronized to vocal frequency to create apparent slow-motion images of mucosal wave motion.

Question 47: Which instrumental swallowing assessment provides real-time visualization of bolus transit through the pharynx and esophagus?

Cervical auscultation
Flexible Endoscopic Evaluation of Swallowing (FEES)
Bedside clinical swallow evaluation
Videofluoroscopic Swallow Study (VFSS) (Correct answer)

Correct answer: Videofluoroscopic Swallow Study (VFSS)

VFSS (modified barium swallow study) uses fluoroscopy to view the entire swallow in real time, including the esophageal phase.

Question 48: What is a typical intervention for articulation disorders?

Articulation drills in speech therapy (Correct answer)
Surgery
Vision correction
Hearing aids

Correct answer: Articulation drills in speech therapy

Articulation disorders involve difficulties in producing specific speech sounds correctly. The primary intervention involves direct speech therapy, where an SLP uses articulation drills and techniques to teach the client how to correctly produce the target sounds, often starting in isolation, then syllables, words, phrases, and sentences.

Question 49: Which of the following is a standardized assessment tool for articulation?

Goldman-Fristoe Test of Articulation (Correct answer)
Peabody Picture Vocabulary Test
CELF-5
Rossetti Infant-Toddler Language Scale

Correct answer: Goldman-Fristoe Test of Articulation

The Goldman-Fristoe Test of Articulation (GFTA) is a widely used, standardized, norm-referenced assessment tool specifically designed to evaluate an individual's articulation skills. It systematically assesses the production of consonants and consonant blends in various word positions, providing a comprehensive picture of speech sound errors.

Question 50: When a SLP professional encounters an unfamiliar challenge in fluency disorders & stuttering, what is the recommended first course of action?

Postpone addressing the issue indefinitely
Proceed based on personal intuition alone
Research applicable standards, consult with subject matter experts, and document the approach (Correct answer)
Apply the solution used for the most recent similar problem without adaptation

Correct answer: Research applicable standards, consult with subject matter experts, and document the approach

Professional practice requires a methodical approach to unfamiliar challenges: research the applicable standards, consult experts when needed, and document the reasoning for the chosen approach.

Question 51: An SLP is treating an adult with right hemisphere damage who demonstrates tangential discourse. Which intervention technique specifically targets discourse coherence?

Vocal hygiene education for voice quality
Repetition drills at the sentence level
Phonological cueing hierarchy for word retrieval
Story grammar mapping and main idea identification tasks (Correct answer)

Correct answer: Story grammar mapping and main idea identification tasks

Story grammar mapping helps clients with RHD recognize relevant information and organize discourse around main ideas and themes.

Question 52: A 65-year-old patient with ALS has intact cognition but progressive bulbar weakness. Diet modification alone is being considered. What is the PRIMARY long-term consideration that should be discussed proactively with this patient?

Increasing IDDSI texture level to accommodate chewing deficits
Candidacy for and timing of PEG tube placement (Correct answer)
Return to normal diet after voice therapy
Surgical repair of the cricopharyngeus

Correct answer: Candidacy for and timing of PEG tube placement

In ALS, bulbar dysfunction is progressive and irreversible; proactive discussion of PEG tube placement before nutritional or respiratory compromise is critical for patient safety and quality of life.

Question 53: Which condition is characterized by abnormal loudness growth and difficulty tolerating ordinary environmental sounds?

Auditory neuropathy
Recruitment (Correct answer)
Diplacusis
Tinnitus

Correct answer: Recruitment

Recruitment is the abnormally rapid growth of loudness perception, causing even moderate sounds to seem uncomfortably loud, common with cochlear hair cell damage.

Question 54: Which method evaluates a child's ability to learn with guidance?

Static assessment
Norm-referenced assessment
Dynamic assessment (Correct answer)
Screening evaluation

Correct answer: Dynamic assessment

Dynamic assessment is an interactive approach that evaluates a child's learning potential by observing how they respond to guided instruction and scaffolding during the assessment process. Unlike static assessments, it focuses on the child's modifiability and ability to learn new skills, providing insights into their learning style and intervention needs.

Question 55: Phonation threshold pressure (PTP) is defined as:

The minimum subglottal air pressure needed to initiate and sustain oscillation (Correct answer)
The maximum subglottal pressure achievable during loud phonation
The intraoral pressure during bilabial stop consonant production
The pressure differential across the glottis at modal register

Correct answer: The minimum subglottal air pressure needed to initiate and sustain oscillation

PTP is the minimum lung pressure required to set vocal fold tissue into oscillation and is sensitive to changes in vocal fold hydration and stiffness.

Question 56: Contact granulomas of the vocal process are best managed with which COMBINATION approach?

Voice therapy, anti-reflux treatment, and possibly botulinum toxin to the thyroarytenoid (Correct answer)
Laser ablation followed by systemic steroids
Radiation therapy and voice rest
Surgery alone with microflap excision

Correct answer: Voice therapy, anti-reflux treatment, and possibly botulinum toxin to the thyroarytenoid

Contact granulomas respond best to a multimodal approach: behavioral voice therapy to reduce hard glottal contacts, anti-reflux management, and sometimes botox to reduce forceful adduction.

Question 57: When implementing peer-mediated intervention for a child with autism, the SLP's primary role is to:

Train and support typically developing peers as communication partners (Correct answer)
Deliver all language prompts directly
Reduce natural reinforcers
Eliminate adult scaffolding immediately

Correct answer: Train and support typically developing peers as communication partners

In peer-mediated intervention, the SLP coaches neurotypical peers to initiate and respond to the target child, increasing natural social communication opportunities.

Question 58: Jitter is best described as:

Cycle-to-cycle variation in vocal fold amplitude
The ratio of harmonic to noise energy in the voice
Cycle-to-cycle variation in fundamental frequency (period perturbation) (Correct answer)
Average vocal intensity across an utterance

Correct answer: Cycle-to-cycle variation in fundamental frequency (period perturbation)

Jitter measures the degree of cycle-to-cycle variability in the period (duration) of vocal fold vibration and reflects aperiodicity in the voice source.

Question 59: Which intervention framework uses 'follow the child's lead,' natural consequences, and incidental teaching as core techniques?

Enhanced milieu teaching (EMT) (Correct answer)
Lindamood phoneme sequencing
PROMPT motor approach
Structured behavioral intervention

Correct answer: Enhanced milieu teaching (EMT)

Enhanced milieu teaching combines child-following strategies with naturalistic behavioral techniques like time delay and incidental teaching to promote functional communication.

Question 60: A toddler shows no response to name-calling and does not startle to loud sounds. What is the MOST urgent referral?

Audiological evaluation with ABR (Correct answer)
Developmental pediatrician for autism screening
Speech-language pathology evaluation
Occupational therapy for sensory processing

Correct answer: Audiological evaluation with ABR

Absent startle and no response to name in a toddler require immediate audiological evaluation including ABR to rule out hearing loss.

Question 61: A patient with Reinke's edema most commonly presents with which demographic profile and voice characteristic?

Middle-aged female smoker with a low-pitched, rough voice (Correct answer)
Elderly male with breathy diplophonia
Child with bilateral swelling and chronic hoarseness
Young female non-smoker with high-pitched voice breaks

Correct answer: Middle-aged female smoker with a low-pitched, rough voice

Reinke's edema is strongly associated with chronic cigarette smoking and predominantly affects middle-aged women, causing diffuse polypoid swelling that lowers the fundamental frequency markedly.

Question 62: On the Oral and Written Language Scales (OWLS-II), a significantly lower Listening Comprehension score compared to Oral Expression suggests:

A fluency disorder
A pragmatic language disorder only
Primarily a receptive language disorder (Correct answer)
Primarily an expressive language disorder

Correct answer: Primarily a receptive language disorder

A low Listening Comprehension score relative to Oral Expression points to receptive language as the primary area of deficit.

Question 63: A patient scores well on single-word naming tasks but shows marked difficulty on the Cookie Theft picture description. This dissociation is most characteristic of:

Apraxia of speech
Wernicke's aphasia with jargon output
Broca's aphasia with preserved confrontation naming
Connected speech or discourse-level deficits despite intact naming (Correct answer)

Correct answer: Connected speech or discourse-level deficits despite intact naming

Some individuals perform adequately on isolated naming but struggle to organize and produce extended connected discourse, revealing discourse-level deficits.

Question 64: What does a language sample analysis involve?

Testing vocabulary using flashcards.
Evaluating spontaneous language in context (Correct answer)
Analyzing scripted reading tasks.
Counting the number of words a child knows.

Correct answer: Evaluating spontaneous language in context

Language sample analysis (LSA) is a valuable assessment method where an SLP collects and analyzes a child's spontaneous conversational speech in a naturalistic setting. This allows for the evaluation of various linguistic features, such as mean length of utterance (MLU), vocabulary diversity, and grammatical complexity, in a real-world context.

Question 65: Which statement about the natural recovery rate for stuttering in preschool-age children is most accurate?

Natural recovery is equally likely across all ages of onset
Approximately 30-40% of children who begin stuttering recover without intervention
Nearly all children who begin stuttering before age 3 recover spontaneously
Approximately 75-80% of children who begin stuttering recover naturally without intervention (Correct answer)

Correct answer: Approximately 75-80% of children who begin stuttering recover naturally without intervention

Research indicates that approximately 75-80% of preschool children who begin stuttering will recover naturally, often without formal treatment.

Question 66: When obtaining informed consent for telepractice, which element is MOST important to include beyond standard consent?

Potential technology limitations and how they may affect service delivery (Correct answer)
The client's preferred session time
Client's insurance information
The SLP's years of experience

Correct answer: Potential technology limitations and how they may affect service delivery

Informed consent for telepractice must specifically address technology limitations, privacy risks, and how technical issues could impact service quality.

Question 67: Which finding on videostroboscopy is most indicative of a submucosal lesion rather than a surface lesion?

Increased mucosal wave amplitude
Anterior glottic chink during phonation
Absence or severe reduction of mucosal wave over the lesion (Correct answer)
Irregular phase closure pattern

Correct answer: Absence or severe reduction of mucosal wave over the lesion

Submucosal lesions (e.g., cysts) stiffen the cover, markedly reducing or eliminating the mucosal wave over that area, unlike surface lesions that may preserve some wave.

Question 68: A singer reports pitch breaks and voice fatigue after extended performance. Stroboscopy shows a left-sided vocal fold polyp with irregular mucosal wave. The MOST appropriate initial management is:

Voice rest followed by behavioral voice therapy (Correct answer)
Immediate microlaryngoscopy
Proton pump inhibitor therapy alone
Botulinum toxin injection

Correct answer: Voice rest followed by behavioral voice therapy

Initial conservative management with voice rest and behavioral therapy is recommended before surgical intervention for vocal fold polyps, particularly in professional voice users.

Question 69: Which assessment approach is most appropriate when standardized tests cannot be administered via telepractice due to copyright or technical limitations?

Conduct dynamic assessment or criterion-referenced procedures (Correct answer)
Administer the test verbally without visual stimuli
Omit formal assessment entirely
Use only parent-report measures

Correct answer: Conduct dynamic assessment or criterion-referenced procedures

Dynamic and criterion-referenced assessments are valid alternatives when standardized tools cannot be adapted for telepractice, and they provide ecologically relevant data.

Question 70: Which pharyngeal phase landmark indicates the onset of the pharyngeal swallow response during videofluoroscopic study?

Hyoid bone anterior and superior excursion
Velopharyngeal closure (Correct answer)
Lip closure around the bolus
Tongue tip elevation to the alveolar ridge

Correct answer: Velopharyngeal closure

Velopharyngeal closure marks the onset of the pharyngeal swallow response, as it prevents nasal regurgitation and signals the beginning of pharyngeal stage events.

Question 71: A language sample analyzed using Systematic Analysis of Language Transcripts (SALT) reveals a high rate of maze behaviors. Mazes are clinically significant because they may indicate:

Fluent but inaccurate grammar
Word-finding difficulties or increased cognitive-linguistic demand (Correct answer)
Advanced syntactic complexity
Phonological instability

Correct answer: Word-finding difficulties or increased cognitive-linguistic demand

Maze behaviors (false starts, revisions, fillers) are associated with word retrieval difficulties and increased processing load.

Question 72: When interpreting results of a standardized test for a bilingual child, the SLP should report:

Results as equivalent to monolingual peers given similar raw scores
Standard scores with clear notation that norms may not apply and results should be interpreted cautiously (Correct answer)
Only percentile ranks without mentioning testing limitations
Standard scores as definitive measures of language ability

Correct answer: Standard scores with clear notation that norms may not apply and results should be interpreted cautiously

Ethical reporting requires transparency about the limitations of applying monolingual norms to bilingual children so that results are not misinterpreted.

Question 73: In Acceptance and Commitment Therapy (ACT) applied to stuttering, the primary goal is to:

Increase psychological flexibility and reduce avoidance rather than eliminate disfluencies (Correct answer)
Establish a hierarchy of feared words and desensitize through flooding
Eliminate cognitive distortions through structured rational emotive exercises
Train the client to use slow speech with rhythmic pacing

Correct answer: Increase psychological flexibility and reduce avoidance rather than eliminate disfluencies

ACT for stuttering targets psychological flexibility, acceptance of stuttering as part of one's experience, and commitment to meaningful life pursuits regardless of disfluency.

Question 74: When performing a voice evaluation, the clinician notes that the patient's voice improves significantly when speaking in a higher pitch. This finding is MOST suggestive of:

Muscle tension dysphonia with a depressed laryngeal posture (Correct answer)
Abductor spasmodic dysphonia
Paradoxical vocal fold motion
Spasmodic dysphonia (adductor type)

Correct answer: Muscle tension dysphonia with a depressed laryngeal posture

Patients with hypertensive MTD and a lowered laryngeal position often experience voice improvement at higher pitches because the larynx is lifted and muscle tension patterns shift.

Question 75: According to ASHA's evidence-based practice framework, which combination should guide pediatric language intervention decisions?

Peer consensus and tradition
Clinical expertise alone
Research evidence alone
Research evidence, clinical expertise, and client/family values (Correct answer)

Correct answer: Research evidence, clinical expertise, and client/family values

ASHA's EBP framework requires integrating the best available external research evidence with clinical expertise and the client's and family's values and preferences.

Question 76: The principle of nonmaleficence in SLP practice means:

Distributing services equitably across populations
Avoiding actions that cause unnecessary harm to patients (Correct answer)
Respecting patient autonomy in all treatment decisions
Maximizing clinical benefits for every patient

Correct answer: Avoiding actions that cause unnecessary harm to patients

Nonmaleficence is the ethical duty to avoid causing unnecessary harm, a core principle guiding clinical decision-making.

Question 77: A patient presents with a breathy voice quality and bowing of both vocal folds visible on laryngoscopy. This pattern is most consistent with:

Spasmodic dysphonia
Reinke's edema
Muscle tension dysphonia
Presbylaryngis (Correct answer)

Correct answer: Presbylaryngis

Presbylaryngis (aging larynx) is characterized by vocal fold bowing, atrophy, and resultant breathy voice due to incomplete glottal closure.

Question 78: In the context of accent modification services, ASHA's position is that:

Accents are not a disorder but SLPs may offer elective accent modification (Correct answer)
Only phoneticians should provide accent modification
Accent modification is a required intervention for English learners
SLPs should not provide accent modification services

Correct answer: Accents are not a disorder but SLPs may offer elective accent modification

ASHA affirms that accents and dialects are not disorders; however, SLPs may offer accent modification as an elective service when requested by the individual.

Question 79: When computing percent consonants correct (PCC) in a speech sample, which error type is counted as incorrect?

Substitutions, omissions, and distortions (Correct answer)
Distortions only
Omissions only
Substitutions and omissions only

Correct answer: Substitutions, omissions, and distortions

PCC counts substitutions, omissions, and distortions all as errors; only correctly produced consonants are counted as correct.

Question 80: What is an example of an informal assessment tool?

IQ test
Standardized language test
Speech audiogram
Observation checklist (Correct answer)

Correct answer: Observation checklist

Informal assessment tools, such as observation checklists, interviews, and language samples, are non-standardized methods used to gather information about a client's communication skills in naturalistic settings. They provide valuable qualitative data that complements standardized test results and offers insights into functional communication.

Question 81: A patient with bilateral vocal fold paralysis (BVFP) presents with dysphagia. What is the MOST likely mechanism contributing to aspiration in this population?

Reduced UES opening due to reduced hyolaryngeal excursion
Impaired epiglottic inversion due to laryngeal fixation
Failure of vocal fold adduction to protect the subglottis during swallowing (Correct answer)
Reduced lingual pressure generation impairing oral transit

Correct answer: Failure of vocal fold adduction to protect the subglottis during swallowing

In BVFP, the inability of the paralyzed vocal folds to adduct compromises the last line of laryngeal airway defense, increasing aspiration risk during swallowing.

Question 82: The SETT framework, used in AAC and assistive technology decision-making, stands for:

Selection, Evaluation, Targeting, Therapy
Speech, Education, Technology, Training
Symbols, Expression, Transmission, Training
Student, Environment, Tasks, Tools (Correct answer)

Correct answer: Student, Environment, Tasks, Tools

The SETT framework (Zabala, 1995) guides AAC and AT decision-making by considering the Student's needs and abilities, the Environments of use, the Tasks the student needs to perform, and the Tools that can support performance.

Question 83: What is the most effective way to measure success in voice disorders & treatment within SLP professional practice?

Compare only with industry averages without considering context
Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives (Correct answer)
Count only the number of activities completed
Rely solely on supervisor opinion

Correct answer: Use a combination of quantitative metrics, qualitative assessments, and stakeholder feedback aligned with defined objectives

Effective measurement combines multiple data sources — quantitative metrics, qualitative assessments, and stakeholder feedback — all aligned with clearly defined objectives for a comprehensive evaluation.

Question 84: In acoustic voice analysis, a high jitter percentage primarily indicates:

Excessive loudness variation
Increased mean airflow rate during phonation
Cycle-to-cycle frequency perturbation of vocal fold vibration (Correct answer)
Reduced vocal tract resonance

Correct answer: Cycle-to-cycle frequency perturbation of vocal fold vibration

Jitter measures the variability of the fundamental frequency period between consecutive vocal fold cycles, with elevated values indicating irregular vibration.

Question 85: Which assessment tool uses caregiver report and is commonly used to screen language development in children from birth to 3 years?

Clinical Evaluation of Language Fundamentals (CELF)
Peabody Picture Vocabulary Test (PPVT)
MacArthur-Bates Communicative Development Inventories (MB-CDI) (Correct answer)
Test of Language Development (TOLD)

Correct answer: MacArthur-Bates Communicative Development Inventories (MB-CDI)

The MB-CDI is a validated caregiver-report tool that captures vocabulary and early grammatical development in infants and toddlers from birth to 30 months.

Question 86: A client using Delayed Auditory Feedback (DAF) device reports improved fluency only while wearing it. This suggests:

The device is providing a fluency aid but is not replacing the need for behavioral treatment (Correct answer)
The client has psychogenic rather than neurogenic stuttering
DAF has produced permanent changes in the speech motor network
The client should increase DAF delay to 500ms for maintenance

Correct answer: The device is providing a fluency aid but is not replacing the need for behavioral treatment

Fluency aids like DAF alter auditory feedback to temporarily disrupt the feedback loop; they do not produce lasting neurological change and must be paired with behavioral strategies.

Question 87: When treating a child with childhood apraxia of speech (CAS), which practice schedule principle is MOST supported by motor learning research?

Massed practice of a single target for the entire session
High frequency of practice with random ordering of targets (Correct answer)
Minimal practice with maximum wait time between trials
Low frequency of practice with blocked ordering to reduce errors

Correct answer: High frequency of practice with random ordering of targets

High-intensity practice with random target ordering promotes the motor learning and generalization needed to treat CAS effectively.

Question 88: A Spanish-English bilingual child scores below the 10th percentile on an English standardized language test. The SLP should:

Recommend immediate intensive English language intervention
Also assess Spanish language skills before drawing diagnostic conclusions (Correct answer)
Conclude the child has limited cognitive ability
Diagnose a language disorder based on this score alone

Correct answer: Also assess Spanish language skills before drawing diagnostic conclusions

A low score on an English-only measure does not distinguish language disorder from language difference; Spanish skills must be assessed to make an accurate diagnosis.

Question 89: When selecting treatment goals for an adult with TBI who has cognitive-communication deficits, which factor should be prioritized in treatment planning?

Normalization of all standardized test scores
Targeting deficits in order of severity from most to least impaired
Focusing exclusively on memory remediation before addressing communication
The client's functional communication needs and participation goals (Correct answer)

Correct answer: The client's functional communication needs and participation goals

Functional communication needs and participation goals guide TBI treatment planning to maximize real-world outcomes and quality of life.

Question 90: Cluttering is differentiated from stuttering primarily by the presence of:

Consistent word-final repetitions
Avoidance of specific phonemes under communicative pressure
Rapid or irregular speech rate with reduced self-awareness (Correct answer)
Tense sound prolongations with high anxiety

Correct answer: Rapid or irregular speech rate with reduced self-awareness

Cluttering is characterized by rapid or irregular speech rate, excessive disfluencies, and typically reduced awareness of the problem, distinguishing it from stuttering.

Question 91: Which principle of motor learning supports practicing a single speech sound in many different word contexts rather than drilling one word repeatedly?

Blocked practice
Massed practice
Variable practice (Correct answer)
Random practice

Correct answer: Variable practice

Variable practice involves varying the task across multiple contexts, which promotes generalization of motor speech skills.

Question 92: How should SLP professionals handle confidential information related to multicultural & bilingual considerations?

Share freely with all colleagues for transparency
Delete all records after project completion
Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations (Correct answer)
Store information without any security measures

Correct answer: Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations

Confidential information must be handled according to established protocols, regulatory requirements, and professional ethics standards, including proper access control and disclosure procedures.

Question 93: Which population is most commonly associated with the use of high-tech AAC systems in clinical practice?

Children with mild articulation disorders
Adults with temporary voice disorders following laryngeal surgery
Individuals with complex communication needs such as ALS, cerebral palsy, or autism spectrum disorder (Correct answer)
Individuals with mild fluency disorders

Correct answer: Individuals with complex communication needs such as ALS, cerebral palsy, or autism spectrum disorder

High-tech AAC is primarily indicated for individuals with complex communication needs (CCN) — those who cannot rely on natural speech alone due to conditions such as ALS, cerebral palsy, autism, or other significant communication impairments.

Question 94: An SLP who serves on an expert witness panel must ensure their testimony is:

Withheld if it conflicts with the employer's interests
Limited to opinions that will not be challenged by opposing counsel
Favorable to the party that retained them
Objective, accurate, and within their scope of expertise (Correct answer)

Correct answer: Objective, accurate, and within their scope of expertise

Expert witnesses must provide objective, truthful testimony based on their professional expertise, regardless of who retained them.

Question 95: Which standardized assessment is specifically designed to evaluate phonological awareness skills in children ages 5–9?

PPVT-5
CTOPP-2 (Correct answer)
EVT-3
GFTA-3

Correct answer: CTOPP-2

The CTOPP-2 (Comprehensive Test of Phonological Processing) measures phonological awareness, phonological memory, and rapid naming.

Question 96: Which measure is most appropriate for tracking expressive vocabulary growth in a toddler with language delay over time?

Standardized receptive vocabulary score
Mean length of utterance in morphemes
Percentage of consonants correct
Number of different words in a language sample (Correct answer)

Correct answer: Number of different words in a language sample

Number of different words (NDW) in a language sample is a sensitive, naturalistic measure of expressive lexical diversity in toddlers.

Question 97: Which theoretic framework underlies the use of script therapy for children with autism spectrum disorder?

Generativist nativist theory
Schema theory and script knowledge (Correct answer)
Social cognitive theory
Operant conditioning exclusively

Correct answer: Schema theory and script knowledge

Script therapy is grounded in schema/script theory, leveraging children's knowledge of predictable event sequences to scaffold functional communication.

Question 98: Which principle of motor learning is MOST important when designing practice for a child with developmental language disorder learning a new grammatical structure?

Variable practice with high-frequency distributed sessions (Correct answer)
No feedback to encourage self-monitoring
Blocked practice only
Mass practice in a single extended session

Correct answer: Variable practice with high-frequency distributed sessions

Variable practice across contexts with frequent, distributed sessions enhances generalization and retention of new language structures in children with DLD.

Question 99: An SLP working with a child with APD uses metalinguistic strategies. Which of the following is an example?

Providing amplification via FM system
Listening to filtered speech in therapy
Reducing reverberation in the treatment room
Teaching the child to request repetition and use context clues when missing information (Correct answer)

Correct answer: Teaching the child to request repetition and use context clues when missing information

Metalinguistic/metacognitive strategies empower the child to self-monitor, request clarification, and use linguistic context to compensate for processing deficits.

Question 100: Which approach is MOST appropriate when treating a child with autism spectrum disorder who is nonverbal and has limited joint attention?

Discrete trial training focusing on imitation and joint attention (Correct answer)
Phonological awareness training with rhyming tasks
Traditional articulation therapy using minimal pairs
Oral motor exercises to strengthen articulators

Correct answer: Discrete trial training focusing on imitation and joint attention

Discrete trial training targeting imitation and joint attention builds foundational communication skills for nonverbal children with ASD.

Question 101: A key limitation of using parents as interpreters during assessment is:

It violates HIPAA regulations in all cases
Parental interpretation can introduce bias and compromise assessment validity (Correct answer)
Parents do not have legal permission to participate in assessments
Parents are unlikely to understand clinical terminology

Correct answer: Parental interpretation can introduce bias and compromise assessment validity

Parents may unintentionally simplify, elaborate, or omit content, reducing the validity and reliability of assessment findings.

Question 102: Which laryngoscopic finding is most consistent with unilateral vocal fold paralysis?

One vocal fold fixed in a paramedian or lateral position with glottal gap (Correct answer)
Bilateral vocal fold edema
Supraglottic compression during phonation only
Bilateral vocal fold bowing symmetrically

Correct answer: One vocal fold fixed in a paramedian or lateral position with glottal gap

Unilateral vocal fold paralysis presents with one immobile fold, often in a paramedian or lateral position, creating an asymmetric glottal gap.

Question 103: Which feature distinguishes the Clinical Evaluation of Language Fundamentals (CELF-5) Screener from the full CELF-5 battery?

The screener uses dynamic assessment procedures
The screener evaluates phonology, not language
The screener provides a pass/fail decision rather than standard scores (Correct answer)
The screener is normed only on children under 6

Correct answer: The screener provides a pass/fail decision rather than standard scores

The CELF-5 Screener yields a pass/fail outcome to quickly identify who needs further evaluation, not diagnostic standard scores.

Question 104: During a dynamic assessment, an SLP provides mediated learning experiences and then re-tests to determine:

The severity of the disorder on a standardized scale
The child's learning potential and modifiability (Correct answer)
The child's static language age
Whether an interpreter is needed

Correct answer: The child's learning potential and modifiability

Dynamic assessment evaluates a child's responsiveness to instruction, revealing learning potential beyond a static test score.

Question 105: Which body has authority to investigate alleged violations of ASHA's Code of Ethics by its members?

Centers for Medicare & Medicaid Services
The Joint Commission
ASHA's Board of Ethics (Correct answer)
State licensing boards only

Correct answer: ASHA's Board of Ethics

ASHA's Board of Ethics is the body responsible for investigating and adjudicating ethical complaints against ASHA members.

Question 106: The s/z ratio is used clinically to identify:

Tongue strength for articulation
Glottal insufficiency affecting phonation relative to airflow (Correct answer)
Respiratory volume adequacy
Nasality in resonance disorders

Correct answer: Glottal insufficiency affecting phonation relative to airflow

An s/z ratio greater than 1.4 suggests the patient can sustain /s/ (airflow only) significantly longer than /z/ (voicing required), indicating glottal inefficiency.

Question 107: In evaluating APD, the Dichotic Digits Test assesses which auditory processing skill?

Binaural separation and integration (Correct answer)
Auditory closure
Auditory figure-ground
Temporal resolution

Correct answer: Binaural separation and integration

The Dichotic Digits Test presents different digit sequences simultaneously to each ear, assessing binaural separation and integration.

Question 108: According to Light (1989), 'communication competence' in AAC encompasses which four domains?

Cognitive, motor, sensory, and linguistic competence
Linguistic, operational, social, and strategic competence (Correct answer)
Phonological, syntactic, semantic, and pragmatic competence
Receptive, expressive, written, and pragmatic competence

Correct answer: Linguistic, operational, social, and strategic competence

Light's model of communicative competence for AAC users includes linguistic competence (language knowledge), operational competence (device use), social competence (interaction skills), and strategic competence (compensatory strategies).

Question 109: On the Western Aphasia Battery–Revised (WAB-R), which subtest directly measures auditory verbal comprehension?

Spontaneous Speech
Repetition
Yes/No Questions and Sequential Commands (Correct answer)
Naming and Word Finding

Correct answer: Yes/No Questions and Sequential Commands

The Auditory Verbal Comprehension section of the WAB-R includes yes/no questions, auditory word recognition, and sequential commands.

Question 110: An SLP working with a bilingual child who stutters should be aware that:

Bilingualism itself causes stuttering and one language should be discontinued
Stuttering in bilingual children always resolves by school age regardless of other risk factors
Stuttering may vary in frequency and severity across languages and should be assessed in both languages (Correct answer)
Stuttering only occurs in the dominant language and the second language need not be assessed

Correct answer: Stuttering may vary in frequency and severity across languages and should be assessed in both languages

Stuttering in bilingual speakers can differ across languages in severity and type, making assessment in both languages essential for an accurate clinical picture.

Question 111: Which factor is essential in choosing an assessment tool?

Cost of the test
Cultural and linguistic appropriateness (Correct answer)
Ease of scoring
Length of the tool

Correct answer: Cultural and linguistic appropriateness

It is crucial to select assessment tools that are culturally and linguistically appropriate for the individual being evaluated to ensure fair and accurate results. Using tools that are biased or do not account for a client's background can lead to misdiagnosis or inaccurate identification of communication strengths and weaknesses.

Question 112: What is a criterion-referenced test used for?

To diagnose physical conditions.
To rank within a class.
To evaluate individual performance against set criteria (Correct answer)
To compare with other peers.

Correct answer: To evaluate individual performance against set criteria

Criterion-referenced tests measure an individual's performance against a predetermined set of standards or criteria, rather than comparing them to a peer group. This type of test determines if a person has mastered specific skills or knowledge, making it useful for tracking progress toward specific therapy goals.

Question 113: Which of the following best describes the 'super-supraglottic swallow' technique and its PRIMARY purpose?

Sustained hyolaryngeal elevation after swallow to prolong UES opening
Breath hold before swallow only, to close the vocal folds and protect the airway
Effortful swallow while tilting the head forward to redirect the bolus away from the airway
Breath hold with bearing-down effort before and during swallow to tilt the arytenoids anteriorly and close the laryngeal vestibule before the swallow (Correct answer)

Correct answer: Breath hold with bearing-down effort before and during swallow to tilt the arytenoids anteriorly and close the laryngeal vestibule before the swallow

The super-supraglottic swallow adds a bearing-down (Valsalva) effort to the supraglottic technique, which tilts the arytenoids anteriorly to close the laryngeal inlet before the swallow begins, providing maximal airway protection.

Question 114: Social anxiety disorder and stuttering co-occur at elevated rates. When both are present, the recommended treatment approach is to:

Focus exclusively on stuttering treatment since anxiety is secondary
Treat social anxiety first because it is the primary cause of stuttering
Refer exclusively to psychiatry before initiating any speech therapy
Address both conditions, as treating anxiety alone does not resolve stuttering and vice versa (Correct answer)

Correct answer: Address both conditions, as treating anxiety alone does not resolve stuttering and vice versa

Co-occurring social anxiety and stuttering require integrated treatment since each condition independently maintains the other and neither resolves with unilateral treatment.

Question 115: A school SLP is writing annual IEP goals for a 7-year-old with language disorder. Which goal format best meets IDEA requirements?

Student will work on grammar during pull-out sessions twice per week
SLP will provide language therapy targeting morphosyntax
By annual review, student will produce grammatically correct sentences with irregular past tense verbs in 4 out of 5 opportunities across 3 sessions (Correct answer)
Student will improve language skills

Correct answer: By annual review, student will produce grammatically correct sentences with irregular past tense verbs in 4 out of 5 opportunities across 3 sessions

IDEA-compliant IEP goals must be measurable and include the skill, condition, criterion, and timeframe.

Question 116: A patient with myasthenia gravis is most likely to demonstrate which characteristic dysphagia pattern?

Dysphagia exclusively for solids due to impaired mastication
Consistent dysphagia that is worst in the morning and improves with fatigue
Progressive deterioration of swallowing function across a meal due to fatigable neuromuscular transmission (Correct answer)
Sudden onset complete dysphagia without fluctuation

Correct answer: Progressive deterioration of swallowing function across a meal due to fatigable neuromuscular transmission

Myasthenia gravis causes fatigable weakness at the neuromuscular junction, so swallowing typically deteriorates across a meal as the muscles fatigue with repeated use.

Question 117: Why is a case history important in speech-language evaluation?

It replaces formal assessments.
It determines the therapy plan only.
It is only required for insurance.
It offers essential background information (Correct answer)

Correct answer: It offers essential background information

A thorough case history provides crucial background information about a client's developmental milestones, medical history, family communication patterns, and educational experiences. This context helps the SLP understand potential contributing factors to the communication disorder and informs the selection and interpretation of assessment tools.

Question 118: A patient with head and neck cancer is experiencing post-radiation dysphagia. Which prophylactic exercise program aims to prevent radiation-induced fibrosis before treatment completion?

Dietary texture modification initiated only after swallowing deteriorates
Botox injection into the cricopharyngeus before radiation
Prophylactic swallowing exercises (e.g., jaw stretching, tongue range-of-motion, effortful swallow) begun during radiation (Correct answer)
Waiting 6 months post-radiation to reassess swallow function

Correct answer: Prophylactic swallowing exercises (e.g., jaw stretching, tongue range-of-motion, effortful swallow) begun during radiation

Prophylactic swallowing exercises maintain muscle flexibility and movement during radiation to reduce post-treatment fibrotic complications.

Question 119: Which of the following is the BEST indicator of a true language disorder versus a language difference in a culturally and linguistically diverse child?

The child's difficulties are present across both languages and in comparison to same-language peers (Correct answer)
The child is not making progress in English after 6 months of school
The child scores below the 10th percentile on an English-only standardized test
Parents report more concerns than teachers

Correct answer: The child's difficulties are present across both languages and in comparison to same-language peers

Comparing the child's performance to same-language peers and evaluating across all languages is the most valid method to distinguish disorder from difference.

Question 120: Which ASHA ethical principle addresses the obligation to accurately represent one's credentials and competencies?

Principle III — Public statements (Correct answer)
Principle II — Competence
Principle IV — Relationships with colleagues
Principle I — Welfare of those served

Correct answer: Principle III — Public statements

Principle III of ASHA's Code of Ethics governs public statements, including the accurate representation of credentials and competencies.

Question 121: What role does the 'e-helper' or telepractice facilitator play in school-based telepractice?

Replaces the SLP for IEP meetings
Independently conducts therapy sessions when the SLP is unavailable
Acts as an on-site support person who assists with technology, materials, and student management (Correct answer)
Designs the student's IEP goals

Correct answer: Acts as an on-site support person who assists with technology, materials, and student management

The e-helper or facilitator is a trained on-site support person who manages materials, assists the student, and handles technical issues under the SLP's remote supervision.

Question 122: How should SLP professionals handle confidential information related to pediatric language intervention?

Share freely with all colleagues for transparency
Delete all records after project completion
Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations (Correct answer)
Store information without any security measures

Correct answer: Follow established protocols for data protection, access control, and disclosure in accordance with applicable regulations

Confidential information must be handled according to established protocols, regulatory requirements, and professional ethics standards, including proper access control and disclosure procedures.

Question 123: A 70-year-old patient with dementia is refusing thickened liquids and pureed foods. The family insists on a regular diet. According to ethical principles guiding SLP practice, which approach is MOST appropriate?

Immediately place a nasogastric tube to ensure nutrition without oral feeding risk
Override the patient and family wishes and enforce diet restrictions to prevent aspiration pneumonia
Conduct a risk-benefit discussion with the team and family, document informed decision-making, and honor the patient's autonomy if cognitively capable of expressing preferences (Correct answer)
Discharge the patient from dysphagia services as non-compliant

Correct answer: Conduct a risk-benefit discussion with the team and family, document informed decision-making, and honor the patient's autonomy if cognitively capable of expressing preferences

Patient autonomy and informed consent are core ethical principles; the SLP should provide clear risk information, document the discussion, and respect the patient's right to make informed dietary decisions.

Question 124: A preschooler is receiving language intervention using focused stimulation. What is the SLP's primary technique in this approach?

Using error correction and imitation drills in structured trials
Administering frequent probes to measure percent correct responses
Providing many models of a target form in meaningful contexts without requiring production (Correct answer)
Requiring the child to repeat target structures immediately after each model

Correct answer: Providing many models of a target form in meaningful contexts without requiring production

Focused stimulation provides multiple models of a target form in naturalistic contexts, allowing the child to acquire the form without required responses.

Question 125: The term 'specific language impairment (SLI)' has largely been replaced in current literature and clinical practice by:

Language learning disability (LLD)
Primary language impairment (PLI)
Autism spectrum disorder
Developmental language disorder (DLD) (Correct answer)

Correct answer: Developmental language disorder (DLD)

The term developmental language disorder (DLD) was recommended by the CATALISE consortium to replace SLI for greater clinical utility and reduced stigma.

Question 126: A child with Down syndrome typically demonstrates relative strengths in which area that can be leveraged during intervention?

Visual learning and visual-spatial skills (Correct answer)
Expressive morphosyntax
Phonological processing
Auditory working memory

Correct answer: Visual learning and visual-spatial skills

Individuals with Down syndrome often show relative strengths in visual processing and visual memory, making visual supports and AAC effective intervention tools.

Question 127: The SCAN-3 is a standardized test battery designed to screen for:

Phonological disorders
Receptive language delays
Auditory processing disorders in children and adults (Correct answer)
Reading disabilities

Correct answer: Auditory processing disorders in children and adults

The SCAN-3 (for Children and Adolescents) is a standardized battery used to screen for auditory processing disorders using subtests such as filtered words and competing sentences.

Question 128: A 3-year-old with DLD consistently omits grammatical morphemes. Which strategy best targets morpheme acquisition during play?

Parallel talk without feedback
Imitation drilling
Corrective recasting (Correct answer)
Semantic mapping

Correct answer: Corrective recasting

Corrective recasting provides the target morpheme in a meaningful, corrected response immediately following the child's utterance, supporting implicit learning.

Question 129: What role does continuous improvement play in voice disorders & treatment for SLP certified professionals?

It applies only to new professionals in their first year
It is optional and only necessary during certification renewal
It focuses exclusively on cost reduction
It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation (Correct answer)

Correct answer: It drives ongoing enhancement of practices, processes, and outcomes through systematic evaluation

Continuous improvement is fundamental to professional practice in voice disorders & treatment, involving regular evaluation, feedback integration, and process enhancement to maintain high standards.

Question 130: During a social skills group for school-age children with pragmatic language difficulties, which skill should be targeted before topic maintenance?

Figurative language interpretation
Perspective-taking in complex narratives
Conversational repair
Joint attention and topic initiation (Correct answer)

Correct answer: Joint attention and topic initiation

Joint attention and topic initiation are foundational pragmatic skills that must be established before the child can sustain and maintain conversational topics.

Question 131: How can a therapist measure therapy effectiveness?

By comparing notes with another therapist.
Using consistent data collection and outcome measures (Correct answer)
Relying on client’s memory.
Through client appreciation.

Correct answer: Using consistent data collection and outcome measures

Measuring therapy effectiveness requires systematic and consistent data collection throughout the intervention process. This involves tracking client performance on specific goals, using objective outcome measures, and analyzing progress over time to determine if the chosen strategies are yielding desired results and to inform future treatment decisions.

Question 132: Which professional typically conducts hearing screenings during speech evaluations?

Speech-language pathologist
School psychologist
Audiologist (Correct answer)
Occupational therapist

Correct answer: Audiologist

While Speech-Language Pathologists often conduct basic hearing screenings, an Audiologist is the specialized professional trained to conduct comprehensive hearing evaluations and diagnose hearing loss. Given that hearing can significantly impact speech and language development, an audiologist's expertise is crucial for accurate diagnosis and management of hearing-related communication difficulties.

Question 133: When an SLP uses the Peabody Picture Vocabulary Test (PPVT-5) with an English language learner, the primary concern is:

The PPVT-5 does not include a standard score
The test is too long for ELL students
The test cannot be administered without an interpreter
Norms may not reflect the child's dual-language experience, risking misidentification (Correct answer)

Correct answer: Norms may not reflect the child's dual-language experience, risking misidentification

Standardized norms for the PPVT-5 are based on monolingual English speakers; applying them to ELL students may lead to over-identification of disorders.

Praxis® Speech-Language Pathology (5331) Exam

This exam certifies individuals seeking to become Speech-Language Pathologists, assessing their knowledge and skills required for entry-level practice.

132

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150 min

Time Limit

60%

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No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds