SLP Screening, Evaluation, and Diagnosis 5 — Questions and Answers
Question 1: In a voice evaluation, a habitual pitch that is consistently too low for a patient's anatomy may contribute to which voice disorder?
- Muscle tension dysphonia or vocal nodules (Correct answer)
- Spasmodic dysphonia
- Vocal fold paralysis
- Paradoxical vocal fold motion
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 2: The Peabody Picture Vocabulary Test (PPVT) primarily measures:
- Receptive vocabulary (Correct answer)
- Expressive syntax
- Phonological awareness
- Narrative coherence
Correct answer: Receptive vocabulary
The PPVT assesses receptive vocabulary by requiring the examinee to point to the picture that corresponds to a spoken word, with no expressive verbal response required.
Question 3: Which finding during an oral peripheral examination would be MOST concerning for a structural cause of hypernasality?
- Bifid uvula or submucous cleft palate (Correct answer)
- Tongue thrust swallowing pattern
- Reduced tongue tip elevation
- Asymmetrical smile
Correct answer: Bifid uvula or submucous cleft palate
A bifid uvula or submucous cleft palate can indicate velopharyngeal insufficiency, which allows air to escape into the nasal cavity and produces hypernasality.
Question 4: An SLP is called to evaluate a patient in the ICU who is on a ventilator with a cuffed tracheostomy tube. Before proceeding with a swallowing evaluation, the SLP must consider:
- Whether the cuff can be deflated and a Passy-Muir valve trial is appropriate (Correct answer)
- Whether the patient can ambulate to the radiology suite
- Whether the patient's hearing is intact
- Whether oral hygiene was completed within the past 12 hours
Correct answer: Whether the cuff can be deflated and a Passy-Muir valve trial is appropriate
A deflated cuff and appropriate ventilator settings are prerequisites for a tracheostomy swallowing evaluation; the Passy-Muir valve restores airflow through the upper airway necessary for safe swallowing.
Question 5: Which characteristic BEST differentiates a language disorder from a language difference in a multilingual child?
- The child demonstrates deficits in both languages, not just the second language (Correct answer)
- The child scores below average only on English standardized tests
- The child's parents report difficulty at home
- The child attends an English-immersion program
Correct answer: The child demonstrates deficits in both languages, not just the second language
A true language disorder affects a child's linguistic competence across all languages; if deficits are present only in the weaker language, the finding reflects language difference rather than disorder.
Question 6: An SLP performing a cognitive-communication evaluation after a traumatic brain injury (TBI) administers the Rancho Los Amigos Levels of Cognitive Functioning Scale. This scale is used to:
- Describe the patient's current level of cognitive recovery and behavior (Correct answer)
- Quantify expressive aphasia severity
- Screen for dysphagia risk in TBI patients
- Measure functional communication independence
Correct answer: Describe the patient's current level of cognitive recovery and behavior
The Rancho Scale categorizes cognitive-behavioral recovery after TBI into eight levels, from no response to purposeful and appropriate functioning, guiding treatment planning.
Question 7: When scoring the Arizona Articulation Proficiency Scale (Arizona-4), the SLP gives credit for a sound only when it is produced correctly in which position(s)?
- Initial, medial, and final positions as specified per phoneme scoring rules (Correct answer)
- Initial position only
- Any position in connected speech
- Final position only, as it is the most difficult
Correct answer: Initial, medial, and final positions as specified per phoneme scoring rules
The Arizona-4 scores each phoneme in the positions tested (initial, medial, and/or final depending on the phoneme) and assigns weighted values based on occurrence frequency in English.
SLP Screening, Evaluation, and Diagnosis 5
In a voice evaluation, a habitual pitch that is consistently too low for a patient's anatomy may contribute to which voice disorder?