Praxis SLP Speech-Language Pathology Exam — Questions and Answers

Question 1: A school-age child with language impairment has difficulty understanding indirect requests such as 'Can you open the window?' Which aspect of language is primarily impaired?

Expressive morphology
Pragmatic/inferential language (Correct answer)
Phonological processing
Syntax comprehension

Correct answer: Pragmatic/inferential language

Understanding indirect speech acts requires pragmatic inference — recognizing that a yes/no question functions as a polite request.

Question 2: In the early stages of Alzheimer's disease, which pattern of cognitive-communication deficits is most commonly observed?

Intact memory with significant deficits in visuospatial skills and facial recognition.
Anomia, difficulty maintaining conversational topics, and impaired episodic memory. (Correct answer)
Severe motor speech impairment and non-fluent speech.
Profound auditory comprehension deficits and frequent use of neologisms.

Correct answer: Anomia, difficulty maintaining conversational topics, and impaired episodic memory.

Early-stage Alzheimer's disease typically presents with memory impairment (especially for recent events, i.e., episodic memory) and language deficits, most notably anomia (word-finding difficulty). This combination leads to pragmatic difficulties, such as repeating stories or losing the thread of a conversation. More severe deficits like major comprehension loss or motor speech problems occur in later stages.

Question 3: An SLP is assessing a 5-year-old who frequently provides tangentially related or irrelevant answers to questions. To differentiate between a primary receptive language deficit (not understanding the question) and an expressive language deficit (unable to formulate a response), which of the following actions is most informative?

Requesting that the child tell a story based on a wordless picture book.
Asking the child to follow a series of multi-step commands without requiring a verbal response. (Correct answer)
Administering a standardized articulation test to assess speech sound production.
Calculating the child's Mean Length of Utterance (MLU) from a spontaneous language sample.

Correct answer: Asking the child to follow a series of multi-step commands without requiring a verbal response.

Asking the child to follow commands isolates the receptive language component. If the child can successfully follow complex directions, it suggests they understand the language being presented. This helps rule out a receptive deficit as the primary cause of the irrelevant verbal responses. The other options heavily rely on assessing expressive language skills.

Question 4: Which neuroimaging finding is most consistently associated with adults who stutter?

Hyperactivation of the cerebellum at rest
Reduced white matter integrity in the arcuate fasciculus (Correct answer)
Reduced activation in Broca's area during fluent speech
Overactivation of right hemisphere motor areas during speech

Correct answer: Reduced white matter integrity in the arcuate fasciculus

DTI studies consistently show reduced white matter integrity in the left arcuate fasciculus in people who stutter, disrupting sensorimotor integration for speech.

Question 5: A client uses prolonged speech with a slow rate and achieves high fluency in clinic but reports minimal carry-over to daily communication. The BEST next step is:

Increase in-clinic practice time using more reading passages
Discontinue treatment and retest after 6 months
Transfer and maintenance activities across varied real-world speaking situations (Correct answer)
Add pharmacotherapy to augment the behavioral gains

Correct answer: Transfer and maintenance activities across varied real-world speaking situations

Transfer activities targeting real-life situations (phone calls, meetings, social conversations) are essential when clinic fluency does not generalize to daily communication.

Question 6: Flaccid dysarthria is most commonly associated with damage to which neurological component?

Cerebellum
Supplementary motor area
Lower motor neurons (cranial or spinal nerves) (Correct answer)
Basal ganglia

Correct answer: Lower motor neurons (cranial or spinal nerves)

Flaccid dysarthria results from damage to the lower motor neurons, including cranial nerves serving the speech mechanism, causing hypotonia and weakness.

Question 7: Which of the following is a core feature of pragmatic language impairment (PLI) that distinguishes it from specific language impairment (SLI)?

Reduced mean length of utterance
Impaired use of language in social contexts despite adequate syntax (Correct answer)
Difficulty with structural grammar rules
Low scores on standardized vocabulary tests

Correct answer: Impaired use of language in social contexts despite adequate syntax

PLI is characterized by significant difficulty using language socially and contextually, despite relatively intact structural grammar — the key distinction from SLI.

Question 8: Which assessment tool uses a standardized elicitation procedure to measure mean length of utterance (MLU) in children?

CELF-5
PPVT-5
SALT (Systematic Analysis of Language Transcripts) (Correct answer)
EVT-3

Correct answer: SALT (Systematic Analysis of Language Transcripts)

SALT is a language sample analysis tool that calculates MLU and other morphosyntactic measures from transcribed speech samples.

Question 9: Which assessment tool uses a 9-point severity scale ranging from 'very mild' to 'very severe' based on frequency, duration, and physical concomitants?

Stuttering Severity Instrument (SSI-4) (Correct answer)
Overall Assessment of the Speaker's Experience of Stuttering (OASES)
Behavior Assessment Battery (BAB)
Perceptions of Stuttering Inventory (PSI)

Correct answer: Stuttering Severity Instrument (SSI-4)

The SSI-4 combines frequency, duration of longest stutters, and physical concomitant ratings to yield a composite severity score on a 9-point scale.

Question 10: Which standardized test directly measures receptive vocabulary by having a child point to a picture that matches a spoken word?

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

Correct answer: PPVT-5

The Peabody Picture Vocabulary Test–5th Edition (PPVT-5) measures receptive vocabulary by requiring the child to select one of four pictures matching a spoken word.

Question 11: Which receptive language task is considered the MOST cognitively demanding?

Choosing between two objects
Following a two-step unrelated command (Correct answer)
Identifying a picture from a single word
Pointing to a named object

Correct answer: Following a two-step unrelated command

Following two-step unrelated commands (e.g., 'Touch your nose and then give me the ball') requires holding and sequencing two independent instructions in working memory.

Question 12: The Dynamic Temporal and Tactile Cueing (DTTC) treatment is specifically designed for:

Structural articulation errors secondary to cleft palate
Childhood Apraxia of Speech (Correct answer)
Dysarthria from upper motor neuron damage
Phonological disorders with process use

Correct answer: Childhood Apraxia of Speech

DTTC is an evidence-based motor-learning treatment developed specifically for CAS, using simultaneous production, direct imitation, and fading cues.

Question 13: A child consistently reverses pronouns (uses 'you' when meaning 'I'). This is most commonly associated with:

Specific language impairment
Phonological disorder
Autism spectrum disorder (Correct answer)
Childhood apraxia of speech

Correct answer: Autism spectrum disorder

Pronoun reversal — particularly using 'you' for 'I' — is a classic feature of expressive language in children with autism spectrum disorder.

Question 14: A speech-language pathologist will receive compensation for utilizing a specific brand of thickener in her private practice. Which ethical dilemma is present in this scenario?

Conflict of interest (Correct answer)
Fraud
Negligence
Misrepresentation

Correct answer: Conflict of interest

Explanation: Conflict of interest is defined as interference of professional practice due to personal gain.

Question 15: The demands and capacities model (Starkweather) proposes that stuttering emerges when:

Parental anxiety is transmitted to the child through operant conditioning
A child's phonological system develops faster than motor planning
Environmental and internal demands for fluency exceed the child's capacities (Correct answer)
Dopaminergic activity in the basal ganglia exceeds normal thresholds

Correct answer: Environmental and internal demands for fluency exceed the child's capacities

Starkweather's model holds that stuttering results from a mismatch between fluency demands (linguistic, motoric, emotional) and the child's current fluency capacities.

Question 16: Jimmy is a person who stutters. Which of the following age ranges correctly represents when his onset of stuttering most likely began?

2-4 years old (Correct answer)
12-15 years old
9-12 years old
4-9 years old

Correct answer: 2-4 years old

Explanation: The age of onset is typically between the years of 2-4.

Question 17: To help educators and other professionals work with the families of children with disabilities, researchers have proposed aspects of family systems and dynamics to consider. For example, one is the way family members interact on a daily basis. Which is not another one of these aspects?

Changes over time that affect family members
What resources are available to a given family
The nature and severity of the child's disability (Correct answer)
The various individual needs of family members

Correct answer: The nature and severity of the child's disability

Explanation: The nature and severity of the child's disability (b) is certainly a factor that must be considered, but it is not itself an aspect of family systems or family dynamics. Aspects of family systems and dynamics that professionals should consider to work more effectively with families of children with disabilities include (a) what resources an individual family has at its disposal, (c) the different individual needs of various members of each family, and (d) changes that occur over time and have impacts on the members of the family.

Question 18: Which statement best describes the relationship between stuttering and language formulation?

Increased linguistic complexity consistently increases stuttering frequency in school-age children and adults (Correct answer)
Stuttering is solely a motor disorder with no relationship to language processing
Stuttering occurs independent of utterance length or syntactic complexity
Simpler syntactic structures always produce more stuttering due to reduced cognitive load

Correct answer: Increased linguistic complexity consistently increases stuttering frequency in school-age children and adults

Research shows that longer, more syntactically complex utterances are associated with higher stuttering frequency, consistent with increased linguistic planning demands.

Question 19: What is true about pre-production activities that teachers can use to encourage English-language speech by ELL students?

The activities that teachers use should involve hands-on learning. (Correct answer)
Narrating students' actions will simply make them self-conscious.
It is more important that activities use speech than have meaning.
Language functions are irrelevant if students complete the lesson.

Correct answer: The activities that teachers use should involve hands-on learning.

Explanation: Experts find that narrating ELL students' actions, i.e., linguistic encoding, helps encourage them to speak English (A), that teachers should assign activities that include hands-on learning (B), and that the activities they assign should be meaningful (C). They also find that teachers should focus on which language functions the students must apply to complete a lesson, not just that they complete it (D).

Question 20: A child who produces /w/ for /r/ and /j/ for /l/ is demonstrating which phonological process, and at what age should it resolve?

Vocalization; resolves by age 7
Stopping; resolves by age 3
Gliding of liquids; resolves by age 5-6 (Correct answer)
Fronting; resolves by age 4

Correct answer: Gliding of liquids; resolves by age 5-6

Gliding of liquids (replacing /r/ and /l/ with glides /w/ or /j/) is typical but should resolve by approximately ages 5-6.

Question 21: During a comprehensive speech sound assessment, which of the following components is critical for determining if a child's errors are developmental or disordered?

Analyzing the child's productions in both single words and connected speech [1]
All of the above (Correct answer)
Administering a standardized articulation test to obtain a standard score
Conducting a hearing screening to rule out hearing loss

Correct answer: All of the above

A comprehensive assessment requires multiple components. [1] A hearing screening is crucial to rule out sensory deficits. [21] A standardized test provides normative data. [1] Analyzing speech in both single words and connected speech is essential because productions can differ between contexts, giving a fuller picture of the child's phonological system and intelligibility. [1, 6]

Question 22: A high school student with social communication disorder struggles to understand implied meanings in text messages (e.g., 'Sure. Whatever.'). This reflects impaired:

Morphosyntactic parsing
Decoding of graphemes
Interpretation of indirect speech acts and tone (Correct answer)
Phonological memory

Correct answer: Interpretation of indirect speech acts and tone

Interpreting sarcastic or indirect digital communication requires pragmatic inference — reading the implied rather than literal meaning of an utterance.

Question 23: The minimal pairs treatment approach works primarily by:

Drilling sounds in isolation repetitively
Providing auditory bombardment of target sounds
Teaching phonemic awareness skills only
Creating communicative pressure to use phonemic contrasts accurately (Correct answer)

Correct answer: Creating communicative pressure to use phonemic contrasts accurately

Minimal pairs treatment leverages communicative breakdown when phonemic contrasts are not maintained, motivating the child to produce target sounds accurately.

Question 24: A 7-year-old consistently fails to adjust speaking volume and formality when talking to adults versus peers. This reflects a deficit in:

Phonological awareness
Register shifting (communicative register) (Correct answer)
Morphological marking
Narrative macrostructure

Correct answer: Register shifting (communicative register)

Register shifting is the sociolinguistic ability to adapt language style, vocabulary, and prosody to match the social context and listener characteristics.

Question 25: Spasmodic dysphonia of the adductor type is best treated with:

Resonant voice therapy
Cricothyroid muscle exercises
Botulinum toxin injection into the thyroarytenoid muscle (Correct answer)
Voice rest and hydration

Correct answer: Botulinum toxin injection into the thyroarytenoid muscle

Botulinum toxin injected into the thyroarytenoid muscle temporarily weakens spasmodic adductor contractions, reducing the strained-strangled voice quality.

Question 26: Which of the following scenarios best represents a violation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in a speech-language pathology context?

Using a patient's full name and diagnosis in a case study presentation at a national conference without written consent. (Correct answer)
Discussing a child's progress with their parents in a private therapy room with the door closed.
Leaving a voicemail on a patient's phone that says, 'This is the speech therapy clinic calling to confirm your 10 AM appointment tomorrow.'
Faxing a patient's evaluation report to their primary care physician using a secure e-fax service.

Correct answer: Using a patient's full name and diagnosis in a case study presentation at a national conference without written consent.

Using a patient's full name and diagnosis, which are forms of Protected Health Information (PHI), in a public forum like a conference without explicit written authorization from the patient is a clear violation of the HIPAA Privacy Rule. The other options describe acceptable practices: using a secure fax for treatment purposes, discussing progress privately with authorized individuals, and leaving a minimally necessary appointment reminder are all generally permissible under HIPAA.

Question 27: An SLP supervisor in a hospital setting is asked by the administration to require their clinical fellows (CFs) to handle a caseload that exceeds their level of training and experience, compromising their ability to provide competent care. According to the ASHA Code of Ethics, the supervisor's primary ethical obligation is to:

Resign from the position to avoid the ethical conflict.
Advise the CFs to seek additional continuing education to handle the complex caseload.
Refuse to permit the CFs to provide services that exceed their competence and compromise their professional judgment. (Correct answer)
Follow the administrator's directive to meet the hospital's productivity targets.

Correct answer: Refuse to permit the CFs to provide services that exceed their competence and compromise their professional judgment.

ASHA Code of Ethics, Principle of Ethics IV, specifically addresses responsibilities for professional relationships. Rules under this principle state that individuals in supervisory roles shall not require or permit their staff to provide services that exceed their competence, education, training, and experience, or that compromise their independent professional judgment. The supervisor's ethical duty is to protect both the clients and the supervisees by refusing the directive.

Question 28: A clinician is using 'Social Thinking' (Michelle Garcia Winner) strategies with a client. These strategies primarily target:

Understanding hidden rules and social expectations (Correct answer)
Phonemic awareness for reading
Articulation accuracy in connected speech
Voice quality and resonance

Correct answer: Understanding hidden rules and social expectations

Social Thinking curriculum teaches individuals to understand unspoken social expectations, perspective-taking, and the social consequences of behavior.

Question 29: Childhood Apraxia of Speech (CAS) is characterized by which of the following triads of features?

Inconsistent errors on repeated productions, distorted coarticulation, and inappropriate prosody (Correct answer)
Hypernasality, hoarseness, and reduced loudness
Consistent substitution errors, normal prosody, and intact repetition
Weak muscles, reduced range of motion, and hyponasality

Correct answer: Inconsistent errors on repeated productions, distorted coarticulation, and inappropriate prosody

CAS is defined by inconsistent errors across repeated productions, impaired coarticulatory transitions, and inappropriate lexical or phrasal stress.

Question 30: Which best describes the loci of stuttering relative to linguistic boundaries?

Stuttering is most common on function words like 'the' and 'and'
Stuttering is evenly distributed across all syllable positions within words
Stuttering clusters at the beginning of utterances and on grammatically important words (Correct answer)
Stuttering occurs most frequently at the ends of phrases and sentences

Correct answer: Stuttering clusters at the beginning of utterances and on grammatically important words

Research shows stuttering occurs most often at utterance-initial positions and on content words, consistent with increased linguistic planning demands at those points.

Question 31: A velopharyngeal closure assessment that provides direct visualization of the velopharyngeal port during speech is:

Nasometer
Nasopharyngoscopy (Correct answer)
Electropalatography
Spirometry

Correct answer: Nasopharyngoscopy

Nasopharyngoscopy is an endoscopic procedure that allows direct visual inspection of the velopharyngeal mechanism during speech tasks.

Question 32: Which of the following speech-language pathologists is/was NOT a specialist in the field of stuttering?

Martin F. Schwartz
Daniel R. Boone (Correct answer)
George H. Shames
Charles G. Van Riper

Correct answer: Daniel R. Boone

Explanation: Daniel R. Boone (d) of the University of Arizona specializes in voice disorders and voice therapy, not stuttering. George H. Shames (a), professor emeritus of the University of Pittsburgh, was director of the university's speech clinic for 40 years and a licensed clinical psychologist, who specialized in stuttering. He developed ""Stutter-Free Speech"" and invented three biofeedback devices for stuttering. Shames was influenced by Charles G. Van Riper (b), a lifelong severe stutterer himself, who founded the speech clinic at Western Michigan State Normal School in Kalamazoo and was the first chair of the school's speech pathology and audiology department. Martin F. Schwartz (c) from NYU Medical Center was a researcher in cleft lip and cleft palate surgery who stumbled on neck constriction in stutterers in 1974. Schwartz had been using ultrasound imaging on stutterers and found they had laryngeal spasms, ultimately discovering that the physical origin of stuttering was a reflexive locking of the vocal cords. He then created the passive-inhalation airflow technique of stuttering therapy. He directs the National Center for Stuttering.

Question 33: The sensitivity of a screening test refers to its ability to:

Predict long-term treatment outcomes
Correctly identify individuals who have the disorder (Correct answer)
Measure the same construct across repeated administrations
Correctly identify individuals who do not have the disorder

Correct answer: Correctly identify individuals who have the disorder

Sensitivity is the proportion of true positives correctly identified—i.e., the test's ability to detect individuals who actually have the disorder.

Question 34: A clinician administers the CELF-5 to a 10-year-old and finds a Core Language Score of 78. How should this be interpreted?

Inconclusive due to test ceiling
Average language ability
Superior language performance
Below average; may indicate language disorder requiring further evaluation (Correct answer)

Correct answer: Below average; may indicate language disorder requiring further evaluation

A standard score of 78 falls more than 1 SD below the mean (100), placing the child in the below-average range and warranting further clinical evaluation.

Question 35: Stimulability testing in articulation assessment primarily determines:

The severity of the disorder
The child's ability to produce an error sound correctly given maximum cues (Correct answer)
Whether the child has a phonological disorder
Whether surgery is indicated

Correct answer: The child's ability to produce an error sound correctly given maximum cues

Stimulability testing assesses whether a child can produce an error sound correctly when given auditory, visual, and tactile cues from the clinician.

Question 36: Which characteristic is MOST associated with cognitive-communication disorders following traumatic brain injury?

Preserved memory with impaired phonology
Attention, memory, and executive function deficits affecting communication (Correct answer)
Difficulty with word retrieval as the isolated deficit
Fluent paraphasic speech with impaired comprehension

Correct answer: Attention, memory, and executive function deficits affecting communication

TBI-related cognitive-communication disorders primarily involve attention, memory, and executive function deficits that disrupt the individual's ability to communicate effectively in functional contexts.

Question 37: Which of the following is a primary goal of a stuttering modification approach, such as the one developed by Van Riper?

To teach a new, fluent manner of speaking by controlling rate, onset, and articulation.
To provide parents with verbal contingencies to reinforce fluent speech in their children.
To eliminate all disfluencies and achieve perfectly fluent speech.
To reduce the fear and avoidance associated with stuttering and to stutter more easily. (Correct answer)

Correct answer: To reduce the fear and avoidance associated with stuttering and to stutter more easily.

Stuttering modification therapy aims to help individuals manage and modify moments of stuttering to reduce struggle, tension, and negative emotions. The goal is not to eliminate stuttering entirely (which is more aligned with fluency shaping), but to stutter in a more controlled, forward-moving, and less effortful way, thereby reducing fear and avoidance.

Question 38: An elderly patient scores significantly worse on speech recognition in noise compared to quiet, beyond what would be predicted by their audiogram. This pattern is most consistent with which condition?

Otosclerosis
Noise-induced hearing loss restricted to 4000 Hz
Conductive hearing loss
Age-related central auditory processing decline (Correct answer)

Correct answer: Age-related central auditory processing decline

Age-related changes in central auditory processing reduce the ability to use temporal and spectral cues in noise, causing performance worse than audiometric thresholds predict.

Question 39: In Lee Silverman Voice Treatment (LSVT LOUD), the primary target behavior is:

Coordinated inhalation timing
Slowed speech rate with precise articulation
Nasal resonance elimination
Increased vocal loudness through recalibrated sensory awareness (Correct answer)

Correct answer: Increased vocal loudness through recalibrated sensory awareness

LSVT LOUD targets increased vocal effort and loudness, leveraging recalibration of sensory feedback in hypokinetic dysarthria from Parkinson's disease.

Question 40: An SLP is leading a social skills group for adolescents with the goal of improving conversational turn-taking. Which of the following activities is the MOST direct and structured approach to facilitate practice of this skill?

Having each member complete a worksheet about the rules of a good conversation.
Giving a lecture on the social importance of not interrupting others.
Watching video clips of conversations and having the group identify examples of good and poor turn-taking.
Engaging the group in a structured conversation using a 'talking stick' to signal whose turn it is to speak. (Correct answer)

Correct answer: Engaging the group in a structured conversation using a 'talking stick' to signal whose turn it is to speak.

Using a tangible object like a 'talking stick' provides a concrete, visual, and kinesthetic cue for turn-taking. This method structures the interaction, making the abstract rule of 'taking turns' explicit and allowing for direct practice and immediate feedback within a functional, conversational context. The other options are more passive or less direct forms of intervention.

Question 41: According to Brown's Stages of Language Development, at which stage does a child typically begin using the present progressive '-ing' morpheme consistently?

Stage III (MLU 2.0–2.5)
Stage II (MLU 1.5–2.0) (Correct answer)
Stage V (MLU 3.5–4.0)
Stage I (MLU 1.0–1.5)

Correct answer: Stage II (MLU 1.5–2.0)

The present progressive '-ing' is among the first grammatical morphemes acquired, emerging in Brown's Stage II around MLU 1.5–2.0.

Question 42: A bilingual child's total vocabulary across both languages meets age expectations, but vocabulary in each language alone appears below average. This is best described as:

Conceptual vocabulary deficit
Distributed vocabulary across languages (Correct answer)
Expressive language delay
Language disorder

Correct answer: Distributed vocabulary across languages

Bilingual children distribute vocabulary across two languages; assessing each language separately may underestimate total lexical knowledge.

Question 43: Which feature BEST distinguishes transcortical motor aphasia from Broca's aphasia?

Impaired auditory comprehension
Fluent spontaneous speech
Preserved repetition ability (Correct answer)
Absence of word-finding difficulty

Correct answer: Preserved repetition ability

Transcortical motor aphasia differs from Broca's aphasia in that repetition is relatively preserved because the perisylvian language network remains intact despite supplementary motor area damage.

Question 44: A client's current AAC system is rejected because it is 'not age-appropriate.' The SLP's BEST response is to:

Discuss age-appropriateness with the client and balance it with communicative effectiveness (Correct answer)
Discontinue AAC use until a more suitable system is found
Defer entirely to family preferences about age-appropriateness
Immediately replace the system without assessing the client's view

Correct answer: Discuss age-appropriateness with the client and balance it with communicative effectiveness

The SLP should address age-appropriateness concerns collaboratively with the client while prioritizing communicative effectiveness and the client's own values.

Question 45: Executive function deficits after frontal lobe damage most commonly manifest in social communication as:

Reduced vocal loudness
Decreased speech rate
Impulsive topic changes and poor self-monitoring (Correct answer)
Loss of vocabulary

Correct answer: Impulsive topic changes and poor self-monitoring

The frontal lobes govern inhibition and self-monitoring; damage leads to impulsivity, disinhibited remarks, and poor awareness of conversational norms.

Question 46: When assessing an adult with aphasia, the Western Aphasia Battery (WAB) provides a score called the Aphasia Quotient (AQ). A score of 93.8 or above indicates:

Moderate anomic aphasia
Severe Broca's aphasia
Language within functional limits (no aphasia) (Correct answer)
Global aphasia

Correct answer: Language within functional limits (no aphasia)

An AQ of 93.8 or higher on the WAB is considered within normal limits and does not indicate the presence of aphasia.

Question 47: The term 'secondary behaviors' in stuttering refers to:

The core repetitions and prolongations that define the disorder
Language deficits that co-occur with stuttering
Learned struggle and escape behaviors that develop in response to stuttering (Correct answer)
Avoidance of specific speaking situations only

Correct answer: Learned struggle and escape behaviors that develop in response to stuttering

Secondary behaviors are learned reactions (e.g., eye blinks, head jerks, interjections) that the person who stutters develops in attempts to escape or avoid moments of stuttering.

Question 48: A 55-year-old patient presents with a unilateral vocal fold paralysis in the paramedian position. Which surgical intervention restores glottic closure most efficiently?

Arytenoidectomy
Cricotracheal resection
Type I thyroplasty (medialization) (Correct answer)
Cordectomy

Correct answer: Type I thyroplasty (medialization)

Type I thyroplasty medializes the paralyzed vocal fold by inserting an implant through a window in the thyroid cartilage, improving glottic closure.

Question 49: During AAC assessment, the feature matching process involves:

Selecting the least expensive device available
Choosing the device most commonly used in the client's school district
Matching device features to the individual's motor, cognitive, and language profile (Correct answer)
Administering a standardized language test before any device trial

Correct answer: Matching device features to the individual's motor, cognitive, and language profile

Feature matching systematically aligns the characteristics of AAC systems with the user's specific sensory, motor, cognitive, and communication needs.

Question 50: A 70-year-old client who has had a left-hemisphere stroke presents with speech that is non-fluent, telegraphic, and effortful. He primarily uses content words and omits many function words. While he shows significant frustration, he is able to follow most commands and understands yes/no questions accurately. This pattern of deficits is most consistent with a primary impairment in:

Auditory processing
Receptive language
Expressive language (Correct answer)
Pragmatic language

Correct answer: Expressive language

This clinical picture is characteristic of Broca's aphasia, which is predominantly an expressive language disorder. The core deficits are in producing fluent, grammatically correct speech, while comprehension (receptive language) remains a relative strength.

Question 51: An SLP is assessing a bilingual child who scored below average on a standardized English vocabulary test. The SLP then spends a short session teaching the child some of the missed vocabulary items using visual aids and multiple examples. The following day, the SLP re-administers the missed items, and the child shows significant improvement. This test-teach-retest method is a form of what type of assessment?

Dynamic assessment (Correct answer)
Summative assessment
Norm-referenced assessment
Criterion-referenced assessment

Correct answer: Dynamic assessment

Dynamic assessment (DA) is an approach that evaluates a client's learning potential by examining their ability to learn and apply new information following a brief period of instruction. The test-teach-retest model is a classic example of DA, contrasting with static assessments (like norm-referenced tests) which capture performance at a single point in time without intervention.

Question 52: According to the ASHA Scope of Practice in Speech-Language Pathology, which of the following activities falls within the professional roles and responsibilities of an SLP?

Performing surgical procedures on the vocal folds to remove polyps.
Prescribing medication to manage anxiety related to a fluency disorder.
Diagnosing and treating auditory processing disorders independently of an audiologist.
Counseling individuals and their families regarding the emotional and social effects of a communication disorder. (Correct answer)

Correct answer: Counseling individuals and their families regarding the emotional and social effects of a communication disorder.

The ASHA Scope of Practice explicitly includes counseling individuals and their families regarding the emotional and social aspects of communication and swallowing disorders. SLPs provide education, guidance, and support related to the acceptance and adaptation of these disorders. Diagnosing auditory processing disorders typically involves an audiologist, prescribing medication is outside the scope of practice, and performing surgery is a medical procedure done by a physician.

Question 53: Which of the following lists the steps of the evidence-based practice process in the correct order?

Locate evidence → Generate clinical question → Evaluate evidence → Make clinical decision
Generate clinical question → Locate evidence → Make clinical decision → Evaluate evidence
Generate clinical question → Locate evidence → Evaluate evidence → Make clinical decision (Correct answer)
Make clinical decision → Generate clinical question → Evaluate evidence → Locate evidence

Correct answer: Generate clinical question → Locate evidence → Evaluate evidence → Make clinical decision

Explanation: A question must be generated to know what evidence to look for and what information to assess within the evidence. After evaluation of the evidence, a clinical decision can be made.

Question 54: An SLP recommends FM system use in the classroom for a child with hearing loss. The primary advantage of an FM system over hearing aids alone is that it:

Improves the signal-to-noise ratio by transmitting the teacher's voice directly (Correct answer)
Eliminates the need for hearing aids
Provides bone-conduction amplification
Amplifies all classroom sounds equally

Correct answer: Improves the signal-to-noise ratio by transmitting the teacher's voice directly

An FM system transmits the speaker's voice directly to the listener's receiver, dramatically improving the signal-to-noise ratio regardless of distance or background noise.

Question 55: When targeting social communication in a school-age child with language disorder, which context is MOST naturalistic and recommended?

Computer-based matching exercises
1:1 clinician-directed imitation tasks
Peer interaction during structured group activities (Correct answer)
Flashcard drills in a quiet therapy room

Correct answer: Peer interaction during structured group activities

Naturalistic peer interaction during structured group activities provides authentic social communication opportunities and promotes generalization of skills.

Question 56: Which type of aphasia is characterized by non-fluent speech, relatively preserved auditory comprehension, and impaired repetition?

Wernicke's aphasia
Broca's aphasia (Correct answer)
Anomic aphasia
Transcortical sensory aphasia

Correct answer: Broca's aphasia

Broca's aphasia presents with non-fluent, effortful speech and relatively preserved auditory comprehension, with impaired repetition due to anterior lesions.

Question 57: An SLP is writing a long-term goal for an adult client with aphasia. Which of the following goals is BEST written according to the SMART (Specific, Measurable, Achievable, Relevant, Time-bound) criteria?

The client will independently name 40 common household objects in response to clinician prompts with 80% accuracy across three consecutive sessions to improve functional communication at home by the end of the calendar year. (Correct answer)
The client will use more words during conversations with his wife within the next three months.
The client will name 30 common objects from photographs with 90% accuracy.
The client will improve his expressive language skills.

Correct answer: The client will independently name 40 common household objects in response to clinician prompts with 80% accuracy across three consecutive sessions to improve functional communication at home by the end of the calendar year.

This goal is Specific (independently name 40 common household objects), Measurable (80% accuracy across three sessions), Achievable (a reasonable target), Relevant (to improve functional communication at home), and Time-bound (by the end of the calendar year). The other options lack one or more of these critical components. Option A is not specific or measurable. Option B is missing the time-bound and relevancy components. Option D is not specific or easily measurable.

Question 58: Standardized tests with a mean of 100 and standard deviation of 15 classify a score of 70 as:

Within normal limits
Two standard deviations below the mean (Correct answer)
One standard deviation below the mean
At the 16th percentile

Correct answer: Two standard deviations below the mean

A score of 70 is 30 points below the mean of 100, which equals exactly two standard deviations below the mean (100 − 2×15 = 70).

Question 59: The Individuals with Disabilities Education Act (IDEA) provides for services for children from birth to age 21. Which part of IDEA governs services for a 4-year-old child with a diagnosed speech impairment?

Part A
Part B (Correct answer)
Part C
Part D

Correct answer: Part B

The Individuals with Disabilities Education Act (IDEA) is divided into several parts. Part C provides for early intervention services for infants and toddlers from birth to age three. Part B provides for special education and related services for children and youth ages 3 through 21. Therefore, a 4-year-old child would receive services under the provisions of IDEA Part B.

Question 60: Which federal law mandates that AAC devices and services be considered for students with disabilities in their Individualized Education Program (IEP)?

HIPAA
IDEA (Individuals with Disabilities Education Act) (Correct answer)
Section 504 of the Rehabilitation Act only
ADA Title III

Correct answer: IDEA (Individuals with Disabilities Education Act)

IDEA requires IEP teams to consider assistive technology, including AAC devices and services, for every student with a disability if they need it to receive a free appropriate public education.

Question 61: A child produces 'top' for 'stop' by deleting the initial cluster member. This is an example of:

Final consonant deletion
Assimilation
Epenthesis
Cluster reduction (Correct answer)

Correct answer: Cluster reduction

Cluster reduction involves omitting one or more consonants from a consonant cluster, simplifying it to a single consonant.

Question 62: Joint attention, the coordinated focus of two people on a shared object or event, is considered foundational for which later skill?

Fluency shaping
Phonological awareness
Language and social communication development (Correct answer)
Voice projection

Correct answer: Language and social communication development

Joint attention is a prelinguistic social-communicative skill that predicts vocabulary growth, conversational development, and social reciprocity.

Question 63: Which acoustic measure best distinguishes voiced from voiceless stop consonants?

Formant frequency
Fundamental frequency
Spectral moment
Voice Onset Time (VOT) (Correct answer)

Correct answer: Voice Onset Time (VOT)

Voice Onset Time (VOT) is the interval between the release of a stop burst and the onset of vocal fold vibration, reliably distinguishing voiced from voiceless stops.

Question 64: Which of the following best represents a 'word finding difficulty' as distinct from a vocabulary deficit?

A child has a smaller vocabulary than same-age peers
A child uses overextensions for animal names
A child knows a word but struggles to retrieve it on demand (Correct answer)
A child cannot define the word 'justice'

Correct answer: A child knows a word but struggles to retrieve it on demand

Word-finding difficulty is characterized by knowing a word (demonstrable through recognition) but failing to retrieve it for expressive use on demand.

Question 65: The term 'fluency shaping' refers to therapy approaches that:

Focus exclusively on reducing secondary behaviors through behavioral extinction
Systematically reshape the entire speech pattern to establish pervasive fluency from the ground up (Correct answer)
Teach clients to stutter more easily by modifying the moment of stuttering
Combine acceptance-based strategies with limited motor practice

Correct answer: Systematically reshape the entire speech pattern to establish pervasive fluency from the ground up

Fluency shaping approaches (e.g., Precision Fluency Shaping, Camperdown Program) rebuild speech production using targets like gentle onset, easy airflow, and slow rate to establish fluency throughout the speech system.

Question 66: According to the principles of Evidence-Based Practice (EBP) in speech-language pathology, which of the following represents the three essential components that must be integrated into clinical decision-making?

Best available external evidence, clinical expertise, and client/family values and preferences. (Correct answer)
Peer-reviewed research, district-level policies, and parent's requests.
Clinician's preference, availability of materials, and client's insurance coverage.
Standardized test results, length of therapy session, and historical treatment approaches.

Correct answer: Best available external evidence, clinical expertise, and client/family values and preferences.

The widely accepted model of EBP involves the integration of three key components: 1) the best and most current scientific evidence from research (external evidence), 2) the clinician's own professional experience and judgment (clinical expertise), and 3) the unique values, perspectives, and preferences of the client and their family.

Question 67: An SLP is working with a child with Autism Spectrum Disorder (ASD) on understanding that other people have thoughts, beliefs, and feelings that are different from their own. This core social-cognitive skill is known as:

Central Coherence
Executive Functioning
Joint Attention
Theory of Mind (Correct answer)

Correct answer: Theory of Mind

Theory of Mind (ToM) is the ability to attribute mental states—such as beliefs, intents, desires, and knowledge—to oneself and to others, and to understand that others have perspectives that differ from one's own. Deficits in ToM are a core characteristic of ASD and explain many of the social communication challenges observed.

Question 68: Which factor most strongly predicts NATURAL RECOVERY from childhood stuttering?

Early age of onset before 2.5 years
Presence of a family history of persistent stuttering
Female sex of the child (Correct answer)
High frequency of part-word repetitions

Correct answer: Female sex of the child

Female sex is one of the strongest predictors of natural recovery, as girls recover spontaneously at significantly higher rates than boys.

Question 69: Which standardized tool is specifically designed to screen for language disorders in school-age children?

Peabody Picture Vocabulary Test
Bayley Scales of Infant Development
Goldman-Fristoe Test of Articulation
CELF Screening Test (Correct answer)

Correct answer: CELF Screening Test

The CELF (Clinical Evaluation of Language Fundamentals) Screening Test is designed to identify school-age children at risk for language disorders.

Question 70: A child says 'gog' for 'dog,' replacing the alveolar with a velar. This phonological process is called:

Vocalization
Stopping
Backing (Correct answer)
Fronting

Correct answer: Backing

Backing is the process in which sounds produced at a more anterior place of articulation are replaced by sounds produced more posteriorly.

Question 71: An 8-year-old boy is referred for a fluency evaluation. His teacher reports that he speaks very quickly, often deletes syllables, and uses an excessive number of interjections like 'um' and 'like'. During assessment, the SLP notes that the boy's speech is often difficult to understand due to a rapid and irregular rate, but he does not exhibit sound prolongations or blocks. He also seems largely unaware of his speech difficulties. Which fluency disorder is the most likely diagnosis?

Psychogenic stuttering
Developmental stuttering
Cluttering (Correct answer)
Neurogenic stuttering

Correct answer: Cluttering

The client's symptoms, including a rapid and/or irregular speech rate, excessive 'normal' disfluencies, collapsing of syllables, and a lack of awareness, are hallmark characteristics of cluttering. Developmental stuttering typically involves core behaviors like repetitions, prolongations, and blocks, which were not reported. Neurogenic and psychogenic stuttering are acquired disorders with specific onsets related to neurological or psychological events, which are not indicated in the case history.

Question 72: When an SLP targets 'gaze behavior' in a social skills group, the PRIMARY goal is to:

Reduce nystagmus
Teach use of eye contact to signal turn-taking and attention (Correct answer)
Improve visual acuity
Train ocular motor tracking

Correct answer: Teach use of eye contact to signal turn-taking and attention

Gaze in social communication signals engagement, conversational turns, and emotional connection — the SLP targets its pragmatic function, not the visual mechanism.

Question 73: The Overall Assessment of the Speaker's Experience of Stuttering (OASES) measures:

Percentage of syllables stuttered across three speaking conditions
Phonation onset time as a physiological stuttering marker
Rate of natural recovery over a 12-month period
Multidimensional impact of stuttering on quality of life and daily functioning (Correct answer)

Correct answer: Multidimensional impact of stuttering on quality of life and daily functioning

OASES is a self-report tool that captures the broader impact of stuttering across four sections: general information, reactions, daily communication, and quality of life.

Question 74: What term describes difficulty interpreting non-literal language such as idioms, metaphors, and sarcasm, which is commonly seen in right hemisphere disorders?

Prosopagnosia
Inference failure (Correct answer)
Perseveration
Tangential language processing

Correct answer: Inference failure

Inference failure in right hemisphere damage refers to difficulty drawing conclusions beyond the literal meaning of language, including understanding idioms, implied requests, and indirect speech acts.

Question 75: A 4-year-old child consistently uses telegraphic speech (e.g., 'want cookie') and omits grammatical morphemes. Which expressive language domain is most affected?

Pragmatics
Phonology
Semantics
Morphosyntax (Correct answer)

Correct answer: Morphosyntax

Telegraphic speech with omitted grammatical morphemes reflects a deficit in morphosyntax, the rule system governing word forms and sentence structure.

Question 76: The primary goal of auditory bombardment in the Cycles Approach is to:

Test stimulability of error sounds
Provide feedback on articulatory placement
Elicit immediate correct production of target sounds
Increase the child's perceptual awareness of target phonological patterns (Correct answer)

Correct answer: Increase the child's perceptual awareness of target phonological patterns

Auditory bombardment exposes the child to amplified target words to build phonological awareness and mental representations before production is targeted.

Question 77: Pharmacotherapy for stuttering using dopamine antagonists (e.g., haloperidol) is generally considered:

Contraindicated in all people who stutter
First-line treatment producing durable fluency gains
Effective short-term but limited by side-effect profiles (Correct answer)
More effective than behavioral therapy for school-age children

Correct answer: Effective short-term but limited by side-effect profiles

Dopamine antagonists can reduce stuttering frequency but their use is limited by significant side effects, and gains often do not persist after discontinuation.

Question 78: Which texture/liquid modification in the IDDSI (International Dysphagia Diet Standardisation Initiative) framework corresponds to Level 4?

Minced and moist foods
Mildly thick liquids
Pureed foods (Correct answer)
Thin liquids

Correct answer: Pureed foods

IDDSI Level 4 corresponds to 'Pureed' foods, which are smooth, moist, and have no lumps, requiring no chewing.

Question 79: Which approach to stuttering treatment explicitly incorporates acceptance and mindfulness strategies?

Prolonged Speech therapy
Acceptance and Commitment Therapy adapted for stuttering (Correct answer)
Precision Fluency Shaping Program
SpeechEasy device training

Correct answer: Acceptance and Commitment Therapy adapted for stuttering

Acceptance and Commitment Therapy (ACT) adapted for stuttering teaches clients to accept stuttering experiences without avoidance and commit to valued communication behaviors.

Question 80: An SLP uses 'expansion' as an intervention technique. Which of the following best illustrates expansion?

Child: 'Dog run.' SLP: 'Yes, the dog is running fast!' (Correct answer)
Child: 'Dog run.' SLP: 'Dog run. Dog run.'
Child: 'Dog run.' SLP: 'What is the dog doing?'
Child: 'Dog run.' SLP: 'The dog is running. He is running away.'

Correct answer: Child: 'Dog run.' SLP: 'Yes, the dog is running fast!'

Expansion takes the child's utterance and recasts it in a more complete, grammatically correct form while preserving the child's intended meaning.

Question 81: What are school-wide positive behavioral support programs MOST characterized by?

Intensive behavioral intervention at the lowest tiers
A stringent behavior modification system at all tiers
A greater emphasis on prevention than intervention (Correct answer)
Giving positive reinforcement but never punishment

Correct answer: A greater emphasis on prevention than intervention

Explanation: Positive behavioral support programs emphasize prevention by giving all students positive reinforcement and other supports for desired behaviors. These are found to avert many behavior problems at the lower tiers, thus (A) is incorrect. Educators introduce intervention as needed in the middle tiers) and provide progressively more intensive intervention to the highest tier, thus (B) is incorrect. It is not true that such programs eschew punishment (D): This and other aversive consequences for undesirable behaviors may be introduced as well as using positive reinforcement for desirable behaviors.

Question 82: Which term describes the use of nonverbal behaviors — such as nodding, gaze, and back-channeling — to support conversational flow?

Lexical priming
Phonosemantic mapping
Suprasegmental features
Paralinguistic cues (Correct answer)

Correct answer: Paralinguistic cues

Paralinguistic cues are nonverbal communicative signals that accompany verbal messages and regulate conversational dynamics including turn-taking and listener engagement.

Question 83: In a voice evaluation, a habitual pitch that is consistently too low for a patient's anatomy may contribute to which voice disorder?

Vocal fold paralysis
Spasmodic dysphonia
Paradoxical vocal fold motion
Muscle tension dysphonia or vocal nodules (Correct answer)

Correct answer: Muscle tension dysphonia or vocal nodules

Using a habitual pitch below one's optimal frequency increases laryngeal muscle tension and vocal fold collision forces, predisposing to muscle tension dysphonia or vocal nodules.

Question 84: An SLP in a private practice receives a referral for a 7-year-old child who attends a school where the SLP also works part-time. The child's parents are seeking supplemental services outside of the school district. According to the ASHA Code of Ethics, what is the most critical first step for the SLP to take?

Refuse to see the client privately to avoid any potential conflict of interest.
Fully inform the parents of the services available within the school setting and give them the freedom to choose their provider. (Correct answer)
Inform the school administration of the intent to provide private services to the student.
Begin private therapy immediately to address the child's needs as quickly as possible.

Correct answer: Fully inform the parents of the services available within the school setting and give them the freedom to choose their provider.

According to the ASHA Code of Ethics, when a potential conflict of interest arises, such as providing private services to a client from one's primary place of employment, the professional must fully inform the persons served about all service options. This includes detailing the services available at the school versus the private practice, clarifying any associated costs, and ensuring the family has the freedom to choose without pressure. While informing the school is also recommended, the paramount responsibility is to the client's welfare and their right to make an informed decision.

Question 85: Electropalatography (EPG) provides information about:

Tongue-palate contact patterns during consonant production (Correct answer)
Vocal tract resonance frequencies
Nasal airflow during speech
Subglottal air pressure levels

Correct answer: Tongue-palate contact patterns during consonant production

EPG uses a custom palate with electrodes to record the spatial and temporal patterns of tongue contact against the hard palate during speech.

Question 86: Which resonance disorder is characterized by nasal air emission and reduced intraoral pressure during pressure-sensitive consonants?

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

Correct answer: Hypernasality with VPI

Velopharyngeal insufficiency (VPI) causes hypernasality plus audible or inaudible nasal air emission, reducing pressure for consonant production.

Question 87: Which of the following BEST describes anosognosia as observed in a patient with right hemisphere damage?

Neglect of the left visual field only
Impaired prosody in speech production
Inability to recognize familiar faces
Lack of awareness of one's own deficits (Correct answer)

Correct answer: Lack of awareness of one's own deficits

Anosognosia refers to a lack of awareness or denial of one's own neurological deficits, which is common after right hemisphere damage and can significantly impede treatment engagement.

Question 88: Which intervention approach uses video recordings of the child's own social interactions to promote self-reflection and skill development?

ReST treatment
Video self-modeling (VSM) (Correct answer)
Fast ForWord
PROMPT therapy

Correct answer: Video self-modeling (VSM)

Video self-modeling uses edited footage of the child performing target behaviors successfully to reinforce social and communicative skills through observational learning.

Question 89: The Nuffield Dyspraxia Programme (NDP3) is characterized by its use of:

Auditory bombardment without production practice
Mass practice of isolated phonemes only
Symbol-based visual supports to facilitate motor planning for CAS (Correct answer)
Phonemic contrasts and minimal pairs

Correct answer: Symbol-based visual supports to facilitate motor planning for CAS

NDP3 uses a hierarchical set of picture symbols to support sequencing and motor planning in children with CAS.

Question 90: The Speech Intelligibility Index (SII) in acoustic analysis primarily quantifies:

The proportion of speech energy audible to listeners in various frequency bands (Correct answer)
The mean fundamental frequency across an utterance
The ratio of voiced to voiceless segments
The degree of vocal roughness

Correct answer: The proportion of speech energy audible to listeners in various frequency bands

The SII measures the proportion of the long-term average speech spectrum that is audible to listeners, predicting how intelligible speech will be in given conditions.

Question 91: Which distinguishes a phonological disorder from a phonetic (articulation) disorder?

Phonetic disorders are always more severe
Phonological disorders only occur in bilingual children
Phonological disorders involve errors only on fricatives
Phonological disorders reflect impaired knowledge of the sound system; phonetic disorders reflect motor/structural production difficulty (Correct answer)

Correct answer: Phonological disorders reflect impaired knowledge of the sound system; phonetic disorders reflect motor/structural production difficulty

Phonological disorders involve deficits in the underlying rule system, while phonetic disorders involve difficulty with the physical production of sounds.

Question 92: Which assessment tool uses a continuous speech sample to calculate percentage of consonants correct (PCC)?

Structured Photographic Articulation Test (SPAT-D3)
Goldman-Fristoe Test of Articulation-3 (GFTA-3)
Clinical Assessment of Articulation and Phonology (CAAP-2)
Assessment of Phonological Processes-Revised (APP-R) (Correct answer)

Correct answer: Assessment of Phonological Processes-Revised (APP-R)

The APP-R (Hodson) analyzes spontaneous connected speech to calculate PCC and identify phonological process use.

Question 93: Thermaltactile stimulation (TTS) applied to the anterior faucial pillars is used in dysphagia intervention to target which impairment?

Reduced hyolaryngeal excursion
Delayed pharyngeal swallow onset (Correct answer)
Weak velopharyngeal closure
Reduced tongue base retraction

Correct answer: Delayed pharyngeal swallow onset

TTS uses cold stimulation (typically with a chilled laryngeal mirror) on the anterior faucial pillars to heighten sensory input and reduce the delay in pharyngeal swallow triggering.

Question 94: An SLP is conducting an AAC assessment for a 10-year-old child with athetoid cerebral palsy. The child has good vision and reliable head control but exhibits significant, uncontrolled movements in her arms and legs. Which of the following AAC access methods would be the MOST appropriate to trial first?

Joystick control
Eye-gaze technology (Correct answer)
Single-switch scanning with an auditory prompt
Direct selection via a touch screen with a keyguard

Correct answer: Eye-gaze technology

Given the client's significant and uncontrolled limb movements (athetosis), direct selection methods using the hands, such as a touch screen or joystick, would likely be inaccurate and frustrating. Single-switch scanning is a viable indirect selection method, but it can be slow. Since the client has good vision and reliable head control, eye-gaze technology provides a form of direct selection that bypasses her motor limitations, often resulting in faster and more efficient communication.

Question 95: Which test assesses both verbal and nonverbal social communication skills across multiple contexts and is normed for ages 9-adult?

TOPL-2 (Test of Pragmatic Language) (Correct answer)
CASL-2
CELF-5 Pragmatics Profile
EVT-3

Correct answer: TOPL-2 (Test of Pragmatic Language)

The TOPL-2 evaluates pragmatic language use across physical settings, audiences, and topics using picture-based scenarios, with norms from age 9 through adult.

Question 96: A child can answer 'what' and 'where' questions but fails 'why' and 'how' questions. This difficulty reflects challenges in:

Causal and procedural reasoning in language (Correct answer)
Basic referential comprehension
Phonological decoding
Narrative episode structure

Correct answer: Causal and procedural reasoning in language

'Why' and 'how' questions require causal and procedural reasoning, which are more cognitively demanding than simple referential 'what' and 'where' questions.

Question 97: Which statement about the genetics of stuttering is most accurate?

Stuttering has no heritable component and is entirely environmentally determined
Variants in genes related to lysosomal enzyme pathways have been implicated (Correct answer)
Stuttering follows a simple autosomal dominant inheritance pattern
Only monozygotic twin concordance supports a genetic contribution

Correct answer: Variants in genes related to lysosomal enzyme pathways have been implicated

Research has identified variants in GNPTAB, GNPTG, and NAGPA genes (involved in lysosomal enzyme targeting) in familial and sporadic cases of stuttering.

Question 98: Which aural rehabilitation approach specifically uses a formal needs assessment and involves the patient setting their own rehabilitation goals?

Profile of Hearing Aid Benefit (PHAB)
Client-Oriented Scale of Improvement (COSI) (Correct answer)
International Outcome Inventory for Hearing Aids (IOI-HA)
Hearing Handicap Inventory for the Elderly (HHIE)

Correct answer: Client-Oriented Scale of Improvement (COSI)

The COSI is a patient-centered outcome measure where clients nominate specific situations they want to improve, making their goals the focus of rehabilitation.

Question 99: A patient presents with hypernasal resonance following palatoplasty. Which instrumental assessment best quantifies velopharyngeal closure?

Spirometry
Nasometry (Correct answer)
Laryngoscopy
Electroglottography

Correct answer: Nasometry

Nasometry measures the ratio of nasal to total acoustic energy, directly quantifying hypernasality.

Question 100: Which intervention approach uses naturalistic teaching procedures embedded in play routines to facilitate expressive language in toddlers?

Semantic feature analysis
Phonological awareness training
Milieu teaching (Correct answer)
Drill-based structured instruction

Correct answer: Milieu teaching

Milieu teaching embeds language targets in natural interactions and play routines, using techniques like mand-model, time delay, and incidental teaching.

Question 101: A preschooler demonstrates comprehension of spatial prepositions (in, on, under) but not temporal language (before, after, first). This pattern is consistent with:

Specific receptive syntax disorder
Semantic-pragmatic disorder
Language regression
Normal developmental sequence (Correct answer)

Correct answer: Normal developmental sequence

Spatial prepositions are acquired before temporal conjunctions in typical development, so this pattern reflects normal developmental sequencing.

Question 102: A child with autism spectrum disorder uses scripted phrases from TV shows in unrelated social contexts. This behavior is called:

Perseveration
Confabulation
Jargon
Echolalia (Correct answer)

Correct answer: Echolalia

Delayed echolalia involves reproducing previously heard utterances — often from media — in contexts where they may not be communicatively appropriate.

Question 103: Which characteristic BEST distinguishes the nonfluent/agrammatic variant of PPA (nfvPPA) from the semantic variant (svPPA)?

nfvPPA features effortful agrammatic speech; svPPA features fluent speech with impaired semantic knowledge (Correct answer)
nfvPPA shows surface dyslexia; svPPA shows impaired repetition
nfvPPA has impaired single-word comprehension; svPPA has effortful speech
Both variants present identically in early stages

Correct answer: nfvPPA features effortful agrammatic speech; svPPA features fluent speech with impaired semantic knowledge

nfvPPA is characterized by effortful, agrammatic speech with relatively preserved comprehension, while svPPA presents with fluent speech but severely impaired single-word comprehension and semantic knowledge.

Question 104: A 5-year-old uses the word 'yesterday' to refer to any time in the past, including last year. This reflects immature development in which domain?

Pragmatics
Phonological representation
Narrative structure
Temporal semantics (Correct answer)

Correct answer: Temporal semantics

Imprecise use of temporal terms like 'yesterday' reflects immature temporal semantic knowledge — understanding of words that encode time relationships.

Question 105: In dysarthria, hypernasality most directly results from:

Velopharyngeal incompetence due to soft palate weakness (Correct answer)
Reduced respiratory support
Tongue tip weakness
Vocal fold hyperadduction

Correct answer: Velopharyngeal incompetence due to soft palate weakness

Hypernasality in dysarthria is caused by inadequate velopharyngeal closure due to soft palate muscle weakness, allowing excessive nasal resonance.

Question 106: Public law 99-457 encompasses:

Training family members to support the development of a child. (Correct answer)
Providing reimbursement for no more than 30 days in the hospital.
Supporting children ages 3 to 21.
Providing eligibility for special education for children in middle school.

Correct answer: Training family members to support the development of a child.

Explanation: Public law 99-457 implemented Individualized Family Service Plans (IFSP) to increase family member participation in a child’s intervention plan.

Question 107: A 65-year-old male presents with a sudden onset of disfluent speech following a left-hemisphere stroke. His speech is characterized by repetitions and prolongations on all parts of words, including function words. He does not exhibit secondary behaviors like eye blinking or facial grimacing, and his disfluency is consistent across different speaking tasks, including singing. This presentation is most characteristic of:

Developmental stuttering
Cluttering
Neurogenic stuttering (Correct answer)
Psychogenic stuttering

Correct answer: Neurogenic stuttering

Neurogenic stuttering is an acquired fluency disorder that typically appears after a neurological event, such as a stroke. Key features that differentiate it from developmental stuttering include disfluencies on all word types and in all word positions, a lack of secondary behaviors, and consistency of disfluency across tasks like singing, which often ameliorate developmental stuttering.

Question 108: In the acquisition sequence of English consonants, which sound is typically acquired latest?

/m/
/p/
/ʒ/ (as in 'measure') (Correct answer)
/n/

Correct answer: /ʒ/ (as in 'measure')

The voiced palatal fricative /ʒ/ is one of the last consonants acquired in English, typically not mastered until age 6-8 or later.

Question 109: A 10-year-old with TBI struggles to understand sarcasm and jokes. Which cognitive-communication domain is primarily impaired?

Theory of mind and pragmatic inference (Correct answer)
Working memory
Syntax comprehension
Phonological processing

Correct answer: Theory of mind and pragmatic inference

Understanding sarcasm and humor requires theory of mind — inferring the speaker's intended meaning differs from literal words — a core pragmatic skill often impaired after TBI.

Question 110: A high school student recovering from a traumatic brain injury (TBI) is struggling to complete a multi-step research paper. He can describe the assignment's goal but has difficulty breaking it into smaller tasks, managing his time, and organizing his materials. These difficulties are primarily indicative of a deficit in:

Working Memory
Executive Functioning (Correct answer)
Declarative Memory
Response Inhibition

Correct answer: Executive Functioning

Executive functions are a set of higher-level cognitive processes that manage and regulate other cognitive abilities. Key components include planning, organization, task initiation, and self-monitoring, all of which are required for a complex project like a research paper. These functions are frequently impaired following a TBI.

Question 111: A client's videostroboscopy reveals a mucosal wave that stops at the midpoint of the vocal fold on one side. This finding is most consistent with:

Reinke's edema filling the superficial layer
Functional dysphonia with incomplete closure
Vocal nodule at the vibratory margin
Scar tissue or stiffness in the superficial lamina propria (Correct answer)

Correct answer: Scar tissue or stiffness in the superficial lamina propria

A mucosal wave that is absent or stops mid-fold indicates stiffness or scarring in the superficial lamina propria, preventing normal wave propagation.

Question 112: Covert stuttering (interiorized stuttering) is characterized by:

Extensive word substitution and avoidance with few observable moments of stuttering (Correct answer)
Rapid speech rate masking the underlying fluency disorder
High frequency of overt blocks observable to listeners
Onset exclusively during adolescence or adulthood

Correct answer: Extensive word substitution and avoidance with few observable moments of stuttering

Covert stutterers substitute words, avoid situations, and hide their stuttering so effectively that observers may not detect the disorder despite significant internal struggle.

Question 113: When selecting treatment targets using the complexity approach (Gierut), which sounds are prioritized?

Sounds the child uses inconsistently
Late-developing, non-stimulable sounds from the periphery of the phonological system (Correct answer)
Early-developing sounds that are already stimulable
The most frequent sounds in the ambient language

Correct answer: Late-developing, non-stimulable sounds from the periphery of the phonological system

The complexity approach targets later-developing, non-stimulable sounds to maximize system-wide generalization across untreated sounds.

Question 114: A child can name objects when shown pictures but cannot define words or explain relationships between concepts. This pattern indicates a deficit in:

Confrontation naming
Word-finding
Phonological retrieval
Depth of lexical knowledge (Correct answer)

Correct answer: Depth of lexical knowledge

Difficulty with definitions and conceptual relationships reflects shallow depth of lexical knowledge rather than a naming or retrieval problem per se.

Question 115: Who described the Acquisition-Learning, Monitor, Natural Order, Input, and Affective Filter hypotheses?

Cummins
Swain
Gregory
Krashen (Correct answer)

Correct answer: Krashen

Explanation: Krashen. Acquisition-Learning, Monitor, Natural Order, Input, and Affective Filter hypotheses are central to Steven Krashen's highly respected theory of second language acquisition. Language Acquisition is subconscious and requires meaningful communication, while Language Learning is conscious and involves formal instruction; the Monitor is concerned with editing and correcting errors in speaking or writing; Natural Order finds there is a predictable natural order in which grammatical structures are absorbed; Input refers to the hypothesis that language is ultimately acquired and not learned, and the Affective Filter hypothesis explores ways in which positive and negative factors such as motivation, self-esteem, and anxiety help or hurt the acquisition of language.

Question 116: Which physiological parameter is primarily targeted in Precision Fluency Shaping (PFS)?

Oral motor speed and tongue placement precision
Biofeedback of subglottal air pressure
Laryngeal relaxation and gentle phonation onset (Correct answer)
Diaphragmatic breathing and abdominal support only

Correct answer: Laryngeal relaxation and gentle phonation onset

PFS focuses on gentle voice onset, reduced rate, and continuous phonation to reshape the motor program for speech, with laryngeal control as a central target.

Question 117: Which of the following best describes 'cognitive flexibility' as it relates to social communication?

Speed of lexical retrieval under time pressure
Accuracy of phoneme discrimination in noise
The ability to produce grammatically complex sentences
The capacity to shift attention and perspective during conversation (Correct answer)

Correct answer: The capacity to shift attention and perspective during conversation

Cognitive flexibility allows speakers to adjust conversational strategies, take listener perspective, and shift topic focus — all essential for adaptive social communication.

Question 118: Which of the following is true regarding core words used in augmentative and alternative (AAC) devices?

AAC devices contain only core words.
Core words are a list of developmental words.
Core words are a small number of words that make up the majority of conversation. (Correct answer)
Core words are the most important words for users to learn.

Correct answer: Core words are a small number of words that make up the majority of conversation.

Explanation: Core words can be used across many different contexts, and settings, and hold a variety of different meanings.

Question 119: The study of sentence structure and word order is called:

Morphology
Syntax (Correct answer)
Pragmatics
Semantics

Correct answer: Syntax

Explanation: Sentence structure and word order and/or their study are called syntax (a). Semantics (b) refers to the study of meaning in language. Pragmatics (c) refers to the study of how context contributes to meaning. Morphology (d) refers to the study of the structure of words.

Question 120: Cognitive load theory is relevant to social communication intervention because:

It explains why phonological errors increase under stress
It governs the frequency of disfluencies during conversation
It predicts articulation error patterns in connected speech
High cognitive load reduces available resources for social monitoring and regulation (Correct answer)

Correct answer: High cognitive load reduces available resources for social monitoring and regulation

When cognitive resources are taxed by task demands, fewer resources remain for social monitoring, pragmatic inference, and self-regulation during communication.

Question 121: The Lidcombe Program is an evidence-based treatment for early childhood stuttering. Which statement best describes the core components of this approach?

The SLP teaches the child slow, stretched speech and easy onsets in the clinic.
Parents are trained by the SLP to provide explicit verbal feedback for stuttered and stutter-free speech in the child's everyday environment.
Therapy focuses on desensitizing the child to stuttering through voluntary stuttering and disclosure. (Correct answer)
It is an indirect treatment where parents modify their own communication style to facilitate fluency.

Correct answer: Therapy focuses on desensitizing the child to stuttering through voluntary stuttering and disclosure.

The Lidcombe Program is a direct, parent-implemented behavioral treatment. The essential components involve the clinician training the parent to provide specific verbal contingencies for fluent speech (e.g., praise) and for unambiguous moments of stuttering. Parents also systematically measure the child's stuttering severity daily.

Question 122: A speech-language pathologist is designing a new treatment protocol for aphasia. To ensure the protocol is grounded in evidence-based practice (EBP), which of the following components is LEAST critical to consider during the initial design phase?

The latest peer-reviewed research articles on aphasia treatment efficacy.
The clinician's personal experience and past success with similar therapeutic techniques.
The cost-effectiveness of the materials and technology required for the protocol. (Correct answer)
The specific values, preferences, and expectations of the future clients who will receive the treatment.

Correct answer: The cost-effectiveness of the materials and technology required for the protocol.

Evidence-based practice (EBP) in speech-language pathology is defined by the integration of three key components: (1) external scientific evidence (research), (2) clinical expertise/expert opinion, and (3) client/patient/caregiver values and perspectives. While cost-effectiveness is a practical consideration for implementation, it is not a core component of the EBP framework itself. The clinician's expertise, the best available research, and client values are all fundamental to developing an evidence-based approach.

Question 123: A child with autism spectrum disorder uses rote phrases from TV shows in conversation without apparent communicative intent. This is best described as:

Immediate echolalia
Perseverative speech
Delayed echolalia (Correct answer)
Semantic jargon

Correct answer: Delayed echolalia

Delayed echolalia refers to the repetition of previously heard phrases (e.g., from media) in new contexts, often without flexible communicative intent.

Question 124: In the Darley, Aronson, and Brown (DAB) classification system, which dimension is used to characterize dysarthria types?

Lesion location only
Degree of intelligibility loss on standardized testing
Acoustic measures of fundamental frequency and jitter
Perceptual clusters of deviant speech dimensions linked to neurological site of lesion (Correct answer)

Correct answer: Perceptual clusters of deviant speech dimensions linked to neurological site of lesion

The DAB system classifies dysarthria by clusters of perceptual speech characteristics that map predictably onto neurological lesion sites.

Question 125: A child produces utterances that are grammatically correct but contextually irrelevant to the ongoing topic. This is termed:

Syntactic simplification
Tangential or off-topic responding (Correct answer)
Semantic paraphasia
Phonological regression

Correct answer: Tangential or off-topic responding

Tangential responding — producing grammatically intact but contextually off-target utterances — reflects a pragmatic breakdown in topic maintenance rather than a structural language deficit.

Question 126: An adult with traumatic brain injury has intact phonology and syntax but produces verbose, tangential discourse with poor cohesion. The primary deficit is in:

Word retrieval
Expressive morphology
Discourse-level language organization (Correct answer)
Receptive syntax

Correct answer: Discourse-level language organization

Difficulty organizing discourse coherently (staying on topic, maintaining cohesion) reflects a discourse-level expressive language deficit, common after TBI.

Question 127: In language sample analysis, which measure best reflects syntactic complexity?

Number of different words (NDW)
Mean length of utterance in morphemes (MLUm) (Correct answer)
Percentage of consonants correct (PCC)
Type-token ratio (TTR)

Correct answer: Mean length of utterance in morphemes (MLUm)

MLUm counts morphemes per utterance and is a widely used index of grammatical and syntactic complexity in children.

Question 128: Which acoustic measure is most sensitive to the degree of dysphonia severity in a voice disorder?

Cepstral peak prominence (CPP) (Correct answer)
Voice onset time (VOT)
Fundamental frequency (F0)
Formant frequencies F1 and F2

Correct answer: Cepstral peak prominence (CPP)

Cepstral peak prominence (CPP) is highly sensitive to overall dysphonia severity, reflecting the degree of periodicity and noise in the voice signal.

Question 129: A child who repeats whole words and phrases but shows no tension or avoidance is most likely exhibiting:

Normal disfluency (Correct answer)
Neurogenic stuttering
Cluttering
Covert stuttering

Correct answer: Normal disfluency

Whole-word and phrase repetitions without tension, struggle, or avoidance are characteristic of normal developmental disfluency in young children.

Question 130: A speech-language pathologist is treating a patient with hearing loss. Which of the following should the clinician always do before beginning every session?

Turn on the iPad to create a visual distraction to improve generalization
Equipment check (Correct answer)
Ling-9 sound test
Invite the patient’s siblings into the room to provide peer models

Correct answer: Equipment check

Explanation: An equipment check is crucial to having an effective session. The clinician might think the patient is not attending to sound when in reality, the patient’s hearing aids might have an old battery.

Praxis SLP Speech-Language Pathology Exam

The Praxis SLP (5331) Speech-Language Pathology Exam assesses knowledge of foundations and professional practice, speech sound production disorders, fluency disorders, voice and motor speech, receptive and expressive language, and social communication.

132

Questions

150 min

Time Limit

68%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
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