SLP Screening, Evaluation, and Diagnosis 4 — Questions and Answers
Question 1: Which diagnostic label applies when a child demonstrates persistent difficulty with word-level reading accuracy despite adequate intelligence and instruction?
- Dyslexia (Correct answer)
- Specific language impairment
- Auditory processing disorder
- Expressive language disorder
Correct answer: Dyslexia
Dyslexia is characterized by persistent difficulty with accurate and fluent word recognition and spelling, primarily reflecting a phonological processing deficit.
Question 2: A modified barium swallow study (MBSS) differs from a fiberoptic endoscopic evaluation of swallowing (FEES) in that MBSS:
- Uses fluoroscopy to view the entire swallowing sequence including the esophagus (Correct answer)
- Allows direct visualization of vocal fold adduction during swallowing
- Does not require radiation exposure
- Is performed exclusively at bedside
Correct answer: Uses fluoroscopy to view the entire swallowing sequence including the esophagus
MBSS uses videofluoroscopy with barium contrast to visualize all swallowing phases including esophageal transit, whereas FEES uses an endoscope and cannot view the oral phase or esophagus.
Question 3: When an SLP determines that a client's communication disorder significantly impacts functional daily activities, this finding relates primarily to which component of the ICF framework?
- Activity limitations (Correct answer)
- Body functions and structures
- Environmental factors
- Personal factors
Correct answer: Activity limitations
The ICF (International Classification of Functioning, Disability and Health) 'activity' component addresses limitations in executing everyday tasks, which corresponds to functional daily impact.
Question 4: Standardized tests with a mean of 100 and standard deviation of 15 classify a score of 70 as:
- Two standard deviations below the mean (Correct answer)
- One standard deviation below the mean
- At the 16th percentile
- Within normal limits
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 5: Silent aspiration during a clinical bedside swallowing evaluation is MOST likely to be missed because:
- It occurs without a cough or any overt signs of airway entry (Correct answer)
- It only occurs with thin liquids
- It requires acoustic analysis to detect
- It is visible only under laryngoscopy
Correct answer: It occurs without a cough or any overt signs of airway entry
Silent aspiration involves material entering the airway below the vocal folds without triggering a cough reflex, making it undetectable through clinical observation alone.
Question 6: A child produces /w/ in place of /r/ consistently at age 4. Based on typical developmental norms, an SLP should:
- Monitor without intervention because /r/ acquisition typically extends to age 6–8 (Correct answer)
- Begin articulation therapy immediately
- Refer for audiological evaluation
- Diagnose childhood apraxia of speech
Correct answer: Monitor without intervention because /r/ acquisition typically extends to age 6–8
The /r/ phoneme is among the latest acquired consonants, with mastery typically not expected until age 6–8; substituting /w/ for /r/ at age 4 is developmentally appropriate.
Question 7: When conducting a feeding evaluation for an infant, observation of a suckle-swallow-breathe (SSB) coordination problem is MOST associated with:
- Risk of aspiration and cardiorespiratory compromise during feeding (Correct answer)
- Delayed onset of babbling
- Sensory aversion to food textures
- Reduced jaw strength
Correct answer: Risk of aspiration and cardiorespiratory compromise during feeding
Disrupted SSB coordination can lead to material entering the airway and cause oxygen desaturation, representing a significant safety concern during infant feeding.
SLP Screening, Evaluation, and Diagnosis 4
Which diagnostic label applies when a child demonstrates persistent difficulty with word-level reading accuracy despite adequate intelligence and instruction?