Praxis Study

• Which of the following formants typically characterizes a high vowel?

  
  

  A.High-frequency second formant (F2)

  B.High-frequency first formant (F1)

  C.Low-frequency first formant (F1)

  D.Low-frequency second formant (F2)

  C.Low-frequency first formant (F1)

  
  

  The F1 is inversely associated with tongue height, such that high vowels tend to have low F1 frequencies.
• A 65-year-old patient is transferred from another facility with a diagnosis of aphasia. The patient's symptoms, however, appear more consistent with apraxia. Which of the following tasks for the patient is most appropriate when assessing verbal apraxia of speech?

  
  

  A.Repeating words of increasing length

  B.Recalling three common items

  C.Performing voluntary oral movements

  D.Following two-step commands

  A.Repeating words of increasing length

  
  

  Inability to repeat two-syllable words is a clear indicator of apraxia of speech.
• Oropharyngeal dysphagia in a child with Down syndrome is most likely caused by which of the following factors?

  
  

  A.Hypotonia

  B.Digestive problems

  C.Pneumonia

  D.Aversive feeding behaviors

  A.Hypotonia

  
  

  Hypotonia is the leading cause of swallowing disorders in children with Down syndrome.
• Which of the following recommendations to a parent of an infant with cleft lip and palate should an SLP make to best optimize feeding for adequate nutrition and appropriate growth?

  
  

  A.Providing a bottle rather than breast-feeding the infant

  B.Positioning the infant in a supine position during feeding times

  C.Allowing the infant to take as much time as needed to feed

  D.Using a bottle with a modified nipple during feedings

  D.Using a bottle with a modified nipple during feedings

  
  

  A bottle with a modified nipple allows for greater control over the quantity of liquid expressed and the pacing of feeding.
• The head lift exercise published by Shaker et al. (2002) was designed to produce which of the following changes in swallow biomechanics?

  
  

  A.Increase in laryngeal closure duration

  B.Strengthening of the base of the tongue

  C.Increase in diameter and duration of the upper esophageal sphincter (UES) opening

  D.Prolonged relaxation of the cricopharyngeal portion of the inferior constrictor muscle

  C.Increase in diameter and duration of the upper esophageal sphincter (UES) opening

  
  

  The results of Shaker et al. (2002) demonstrated a significant (p<.01p left angle bracket period zero one) increase in the opening duration of the UES.
• Which of the following sounds are typically mastered by the time a child turns 3?

  A./k/ and /g/

  B./p/ and /b/

  C./l/ and /s/

  D./ch/ and /sh/

  B./p/ and /b/

  
  

  /p/ and /b/ should be mastered by age 3 in a typically developing child
• When assessing the ability of a student with cerebral palsy to access an augmentative and alternative communication device, which of the following physical factors must be evaluated first?

  
  

  A.Upper extremity range of motion

  B.Lower extremity strength

  C.Trunk stability and control

  D.Fine motor dexterity

  C.Trunk stability and control

  
  

  Trunk stability will guide the clinician in making an appropriate recommendation for the type of device a client can access as it influences more distal movements.
• A school-based SLP wants to discharge a fifth-grade student. The student has mastered all his goals except /r/ in conversational speech. The SLP worked with the student for the entire school year, and the student is able to use /r/ accurately 75 percent of the time. However, the goal is to reach 90 percent accuracy. Because the student worked on the skill all year and still has not met the established goal, the SLP feels the student performs at his highest possible level. The SLP does not think it is in the student's best interest to continue pulling the student out of class to address the goal. The parents are upset and are questioning the SLP's decision.

  Which of the following statements from the American Speech-Language-Hearing Association (ASHA) Code of Ethics can be used to back up the SLP's decision?

  
  

  A.Individuals who hold the Certificate of Clinical Competence shall evaluate the effectiveness of services provided, technology employed, and products dispensed, and they shall provide services or dispense products only when benefit can reasonably be expected.

  
  

  B.Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities, and they shall treat animals involved in research in a humane manner.

  
  

  C.Individuals shall use every resource, including referral and/or interprofessional collaboration when appropriate, to ensure that quality service is provided.

  
  

  D.Individuals shall provide all clinical services and scientific activities competently.

  A.Individuals who hold the Certificate of Clinical Competence shall evaluate the effectiveness of services provided, technology employed, and products dispensed, and they shall provide services or dispense products only when benefit can reasonably be expected.

  
  

  According to ASHA, it is important that SLPs remember to provide services when a benefit can be expected. The SLP has exhausted all treatment options and a benefit for this student is no longer expected.
• Place the phonemes below in the order of typical acquisition.

  
  

  /p/

  /θ/

  /k/

  /ʒ/

  /p/, /k/, /θ/, /ʒ/

  
  

  /p/ is first because this phoneme is developed between ages 1 and 3. /k/is second because this is developed by age 3 1/2. /θ/is third because this is developed between ages 3 and 8. /ʒ/ is last because this is developed between ages 6 and 8.
• An 81-year-old female presents to a rehabilitation hospital following a severe L MCA stroke. The patient has poststroke right-sided weakness, right neglect, and suspected nonfluent aphasia. Receptive language appears to be mildly impacted. The patient has a complex medical history, including TBI following a car accident two years ago, obesity, diabetes, seizure disorder, congestive heart failure, and hypertension. Socially, the patient has lived alone for the past three years following her husband's death. Since her car accident she mainly watches TV at home and leaves her house only for dialysis. She has meals on wheels and home health aides to assist her with showering. Because of her TBI, her behavior is often variable and erratic. The highest level of education she attained was seventh grade. She stayed home to take care of her children and did not have a career.

  
  

  Which of the following medical conditions, in combination with her stroke, is likely to have the greatest impact on the patient's communication abilities?

  
  

  A.Seizure disorder

  B.Diabetes

  C. TBI

  D.Obesity

  C. TBI

  
  

  Patients with TBI are more likely to have metacognitive problems in addition to the aphasia, thus impacting their ability to improve.
• Which of the following tasks is most appropriate to include when assessing the patient's phrase length?

  
  

  A.Completing divergent naming tasks

  B.Maintaining a conversation with a known partner

  C.Responding to open-ended questions

  D.Repeating sentences of varying lengths

  C.Responding to open-ended questions

  
  

  When an SLP assesses phrase length, it is important to task the patient with open-ended questions to assess the patient's ability to spontaneously produce speech.
• Which of the following medical factors should the SLP give the most weight when determining the patient's communication prognosis?

  
  

  A.Frequency of seizures

  B.Severity of the stroke

  C.Level of obesity

  D.Severity of diabetes

  B.Severity of the stroke

  
  

  Information about the severity of the patient's stroke is necessary to estimate the patient's chance of recovery.
• Inhalation during respiration is primarily carried out through the movement of which of the following muscles or muscle groups?

  
  

  A.Diaphragm

  B.Internal intercostals

  C.External intercostals

  D.Scalenes

  A.Diaphragm

  
  

  The diaphragm is the muscle that creates the most volume in the lungs.
• An SLP receives a referral from an audiologist for a 72-year-old woman who demonstrates a moderate to severe bilateral sensorineural hearing loss preventing her from participating in social activities. Which of the following best identifies the SLP's role?

  
  

  A.Training in speech reading

  B.Prescribing hearing aids

  C.Performing an auditory evaluation

  D.Using auditory integration training

  A.Training in speech reading

  
  

  Option (A) is correct. Providing speech-reading therapy is a primary role for SLPs as it enhances the overall communicative competency for the client.
• An SLP provides home practice for a patient with aphasia as part of discharge plans. The patient is approximately six-months post left-hemisphere stroke that resulted in aphasia. Verbal output has improved significantly since the stroke; however, the patient is still very concerned that written expression is moderately impaired at the single-word level. The homework assignment is to implement copy-and-recall treatment to improve written expression, which involves practicing writing target words (from photographs) and then copying those words multiple times. However, during a follow-up phone call, the SLP determines that the patient is struggling to write the assigned target words because the patient "can't think of the correct letters." Although a model is provided on the back of each target photograph, the patient wants to find a way to practice without looking at the answer. The SLP's best course of action is to suggest that the patient

  
  

  A.try anagramming the words using letter tiles to form the target word

  
  

  B.practice writing the alphabet in order multiple times before beginning the homework again

  
  

  C.use a cell phone voice-to-text application as a compensatory strategy

  
  

  D.use drawing to convey messages instead of using written expression

  A.try anagramming the words using letter tiles to form the target word

  
  

  This approach would give the client the best access to completing the homework. The letter tiles would provide a support for the client to complete the homework and are a regular part of this treatment approach.
• Which of the following instruments is often used to document stages of recovery after traumatic brain injury (TBI)?

  
  

  A.Glasgow Coma Scale

  B.Scale of Executive Function

  C.Sequenced Inventory of Communication Development

  D.Rancho Los Amigos Scales of Cognitive Function

  D.Rancho Los Amigos Scales of Cognitive Function

  
  

  The Rancho Los Amigos Scales of Cognitive Function is the only truly "scaled" instrument developed specifically for rehabilitation documentation following TBI.
• A large metropolitan school district wants to determine the prevalence of developmental stuttering among all enrolled students during the past year. Which of the following approaches is most appropriate for accomplishing the task?

  
  

  A.Dividing the total number of students who currently stutter by the total number of students who were enrolled during the past year

  
  

  B.Subtracting the total number of students who received treatment for stuttering during the past year from the total number of students who currently stutter

  
  

  C.Multiplying the total number of students who currently stutter by the total number of students enrolled during the past year

  
  

  D.Dividing the total number of newly identified students who stutter by the total number of students enrolled during the past year

  A.Dividing the total number of students who currently stutter by the total number of students who were enrolled during the past year

  
  

  The prevalence of stuttering is the percentage found by dividing the number of students who currently stutter by the number of students enrolled in school.
• An SLP uses evidence-based practice by integrating the perspectives and values of the client, patient, or caregivers into the treatment plan. Which of the following best reflects simultaneous incorporation of the host culture's perspectives and values and maintenance of the native culture's perspectives and values?

  
  

  A.Acculturation

  B.Assimilation

  C.Enculturation

  D.Ethnocentrism

  A.Acculturation

  
  

  Acculturation is the incorporation of the host culture's perspective and the native culture's perspective and values.
• The commonly used chin-down posture was initially developed to eliminate thin-liquid aspiration in people with delayed pharyngeal stage onset after having a stroke, and when its efficacy was investigated, it was found to be 50% effective. For whom is the chin-down posture ineffective at eliminating thin-liquid aspiration?

  
  

  A.People who have cricopharyngeal dysfunction

  B.People who aspirate residue from the pyriform sinuses

  C.People who have impaired lingual function

  D.People who aspirate residue from the valleculae

  B.People who aspirate residue from the pyriform sinuses

  
  

  Shanahan et al. (1993) found that 50 percent of people with stroke- and swallowing-related aspiration due to delayed onset of the pharyngeal response continued to aspirate from the pyriform sinuses using the chin-down posture. Moreover, Eisenhuber et al. (2002) found that people with a pyriform sinus residue with a height that was less than 50 percent of the pyriform sinus height aspirated significantly more than those with less or no pyriform sinus residue.
• Which of the following strategies to treat compensatory articulation errors is most appropriate for a child with hypernasality and glottal stop substitutions following surgery for velopharyngeal insufficiency?

  
  

  A.Using oral motor exercises

  B.Using a straw to elicit /s/forward slash s forward slash

  C.Using tactile cues to elicit phonemes

  D.Using negative practice

  C.Using tactile cues to elicit phonemes

  
  

  Tactile cues are used to elicit correct articulation placement.
• Which of the following neuroimaging studies specifies which artery or arteries is/are occluded in a patient with a stroke?

  
  

  A.Electroencephalography

  B.Magnetoencephalography

  C.Evoked-response potentials

  D.CT or MR angiography

  D.CT or MR angiography

  
  

  These studies will give results which specify which artery is occluded.
• Which of the following statements best indicates a screening tool with high sensitivity?

  
  

  A.The majority of the children who passed the screening were found to have a communication disorder.

  B.Many of the children who passed the screening did not have a communication disorder.

  C.All of the children who failed the screening were found to have a communication disorder.

  D.Most of the children who failed the screening did not have a communication disorder.

  C.All of the children who failed the screening were found to have a communication disorder.

  
  

  Sensitivity is the success rate in identifying all of the children who truly have a disorder.
• A 72-year-old right-handed female is evaluated following a left-hemisphere stroke. Findings reveal a moderate Broca's aphasia. Which of the following is the primary goal of intervention for the client?

  
  

  A.To improve the client's pragmatics skills and abilities

  
  

  B.To increase the client's ability to express functional comprehension abilities

  
  

  C.To improve the client's ability to express production of syntactically appropriate sentences

  
  

  D.To enable the client's ability to use a digital augmentative communication system


  C.To improve the client's ability to express production of syntactically appropriate sentences

  
  

  Improvement of expression, particularly syntax, is the most appropriate focus of treatment for Broca's aphasia.
• An SLP tries to elicit correct production of the target sound /s/. Which of the following words provides the best coarticulatory conditions to meet the SLP's goal?

  
  

  A.Spoon

  B.Sea

  C.Sob

  D.Soup

  B.Sea

  
  

  The target sound /s/and the vowel /i/that follows it both require lip spreading. The vowel /i/is high and front.
• Management of which one of the following examination observations alone will produce the best improvement in the pneumonia risk of an adult patient with chronic dysphagia?

  
  

  A.Poor oral bolus control and containment

  B.Poor oral hygiene and dependence for oral care

  C.Delayed onset of the pharyngeal stage of swallowing

  D.Impaired distension of the upper esophageal sphincter

  B.Poor oral hygiene and dependence for oral care

  
  

  Studies have identified poor oral hygiene (including presence of decayed teeth) and dependency for oral care as significant independent predictors of pneumonia in people with chronic dysphagia.
• Which of the following is a distinguishing characteristic of articulation therapy for a 2-year-old patient with a repaired cleft palate and compensatory errors?

  
  

  A.Cycling through multiple speech goals in a given session

  B.Having a play-based learning approach to address goals

  C.Focusing on carryover of speech productions

  D.Addressing speech targets with high frequency and intensity

  B.Having a play-based learning approach to address goals

  
  

  Based on the age of the child, the only appropriate treatment listed is a play-based approach. All other treatments listed are inappropriate for the age of the child.
• Early intentional communication typically emerges in the months leading up to a child's first birthday. Which of the following communicative functions typically emerges first in this period?

  
  

  A.Requesting

  B.Commenting

  C.Protesting

  D.Greeting

  C.Protesting

  
  

  Early intentional communication develops around 8 to 10 months of age, and the first function that emerges is protesting.
• An SLP plans to give Cody, an 8-year-old boy with autism spectrum disorder, tangible reinforcement in conjunction with the use of manual signs during an object labeling task. At first, reinforcement will be presented every time Cody produces a sign correctly. After several sessions, however, reinforcement will be given after every third instance of correct labeling. Which of the following choices best describes the SLP's reinforcement schedule?

  
  

  A.Fixed-ratio schedule followed by variable-ratio schedule

  B.Fixed-ratio schedule followed by continuous schedule

  C.Continuous-ratio schedule followed by fixed-interval schedule

  D.Continuous-ratio schedule followed by fixed-ratio schedule


  D.Continuous-ratio schedule followed by fixed-ratio schedule

  
  

  At first the desired behavior is reinforced every time it occurs followed by a fixed ratio of every third time.
• Place the examples of assessment tasks with the type of attention that is primarily being evaluated.

  
  

  Listening to a list of spoken words for a target word

  Focusing on hearing a person speaking while the television is on

  Mentally solving a complex math problem

  
  

  Sorting playing cards by color, then by number, and then by color again

  
  

  A. Alternating Attention

  B. Sustained Attention

  C. Selective Attention

  D. Working Memory

  A. Alternating Attention: Sorting playing cards by color, then by number, and then by color

  
  

  B. Sustained Attention: Focusing on hearing a person speaking while the tv is on

  
  

  C. Selective Attention: Listening to a list of spoken words for a target word

  
  

  D. Working Memory: Mentally solving a math problem
• An SLP assesses a 3-year-old child with poor intelligibility. The SLP attempts to determine whether the child has a severe phonological disorder or childhood apraxia of speech (CAS). Which TWO of the following characteristics are primarily indicative of CAS?

  
  

  A.Presenting with decreased strength and muscle coordination

  B.Displaying inconsistencies in articulation performance

  C.Making the same errors independent of length of speech utterance

  D.Speaking with a disrupted rate, rhythm, and stress of speech

  B.Displaying inconsistencies in articulation performance

  D.Speaking with a disrupted rate, rhythm, and stress of speech

  
  

  Children with CAS struggle to make consistent productions of speech sounds. Children with CAS speak with a rate, rhythm, and stress of speech that can be disrupted, and sometimes they can appear to be groping for placement.
• A 6-year-old child has difficulty producing both regular and irregular plural forms. Intervention for this problem would best target language at the level of

  
  

  A.syntax

  B.phonology

  C.morphology

  D.semantics

  C.morphology

  
  

  Regular and irregular plural forms are morphological markers.
• A patient is referred to speech therapy after a total laryngectomy. The SLP teaches the patient to speak by taking air in through the mouth, trapping it in the throat, and then releasing it. Which of the following treatments is the SLP primarily implementing with the patient?

  
  

  A.Tracheoesophageal puncture

  B.Esophageal speech

  C.Neck electrolarynx

  D.Intraoral artificial larynx

  B.Esophageal speech

  
  

  Esophageal speech focuses on using the esophagus to provide speech, and no devices are used.
• A 72-year-old male presents to a skilled nursing facility (SNF) following a complicated hospital stay. The patient is morbidly obese and has a history of COPD, depression, hypertension, diabetes, Bell's palsy, encephalopathy, and congestive heart failure. During his stay, he was not intubated but became very weak as a result of extended time in bed. In the hospital, he was placed on an NDD Level 2 diet with nectar-thick liquids due to aspiration of thin liquids and poor oral control of regular solids. The patient worked until he was 50 years old, but his health conditions led to his early retirement. Before his hospitalization, the patient did not leave his house very often, and his wife helped him with all ADLs.

  While evaluating the patient at the SNF, the SLP noticed that the patient was disoriented and confused, appeared to be hallucinating, grunted loudly when attempting to stand, and presented with aphonia. There was no indication of this condition in the patient's hospital chart, and the patient's wife stated that the patient had no trouble using his voice while in the hospital. An ENT consult stated there was no structural reason for the aphonia. Suspecting that the aphonia was of a psychogenic etiology, the SLP made a referral to the resident psychiatrist and began treatment for both the aphonia and for dysphagia.

  After a few sessions of speech therapy, the patient has made limited progress with his aphonia. The resident psychiatrist has continued to work with the patient and recommends cognitive behavioral therapy sessions and continued speech therapy.

  
  

  A primary factor causing the patient's psychogenic aphonia is the presence of

  
  

  A.depression

  B.Bell's palsy

  C.COPD

  D.hallucinations

  A.depression

  
  

  Depression can lead to psychogenic disorders and given what this patient has been through, it is very likely that his depression has deepened during his hospital stay.
• Which of the following strategies can the SLP use to most effectively engage the patient in monitoring his progress?

  
  

  A.Recording their sessions for the patient to listen to later

  
  

  B.Reinforcing that the aphonia is not the patient's fault

  
  

  C.Helping the patient recognize his control over his vocal quality

  
  

  D.Asking the patient to keep a journal of why he feels he cannot use his voice

  C.Helping the patient recognize his control over his vocal quality

  
  

  Once the patient understands that he is in control and can use his voice, he will be more likely to use his voice consistently.
• Which of the following approaches is the SLP's most appropriate response to the resident psychiatrist's recommendation?

  
  

  A.Discharging the order for the new evaluation because therapy has already started

  
  

  B.Working collaboratively to further address the patient's aphonia

  
  

  C.Sending treatment recommendations to the psychiatrist

  
  

  D.Telling the patient that further speech therapy is inappropriate because of his psychological diagnosis


  B.Working collaboratively to further address the patient's aphonia

  
  

  Involving the professional who is treating the psychological piece of the disorder will hopefully lead to success for the patient.
• Which of the following is generally considered most effective and appropriate for viewing the vocal folds during phonation?

  
  

  A.Stroboscopy

  B.Endoscopy

  C.Fluoroscopy

  D.Laryngeal mirror examination

  A.Stroboscopy

  
  

  Stroboscopy is generally the most efficient and effective instrumentation for viewing the vocal folds during phonation.
• An SLP administers a language test to all kindergarten children in a particular school and finds that 40 percent fall below the tenth percentile of the normative sample. Which of the following is the most reasonable interpretation of this finding?

  
  

  A.Forty percent of the kindergarten children in the school have language disorders.

  
  

  B.The school's kindergarten population differs from the standardization population in the language skills measured.

  
  

  C.The SLP administered the test incorrectly.

  
  

  D.The standardization population is not representative of the nation as a whole.


  B.The school's kindergarten population differs from the standardization population in the language skills measured.

  
  

  If disparities exist between examinees and the norm group in terms of skills and experiences, the conclusions based on the examinees' test performance may be misleading.
• A fourth-grade student presents to a school SLP with receptive-expressive language disorder. The student has difficulty with asking "wh-" questions. Specifically, the student tends to ask only "who" and "what" questions. When probed, the student will ask "why" and "when" questions but often uses the terms incorrectly.

  When writing the annual Individualized Education Program for the student, which of the following goals is most appropriate and measurable?

  
  

  A.The student will ask six related "wh-" questions with 100% accuracy.

  
  

  B.The student will ask six related "wh-" questions with minimal cueing in two out of three tries.

  
  

  C.The student will ask six related "wh-" questions with no cueing and with 100% accuracy.

  
  

  D.The student will ask six related "wh-" questions with no cueing in one out of three tries.


  B.The student will ask six related "wh-" questions with minimal cueing in two out of three tries.

  
  

  The goal is specific, measurable, realistic, and time limited and addresses the student's specific needs.
• Which of the following is an example of a reversible passive?

  
  

  A.The balloon was broken by the pin.

  B.The kite was flown by Ben Franklin.

  C.Jared was bullied by Michael.

  D.The girl put her doll by her friend.

  C.Jared was bullied by Michael.

  
  

  In reversible passive constructions, participants can fit into either role.
• Which of the following benchmarks best aligns with current research on typical communication development for 3-year-old children?

  
  

  A.Understanding approximately 1,000 words

  B.Using irregular third-person-singular verb forms

  C.Having a mean length of utterance (MLU) in morphemes of six

  D.Producing approximately ten consonant phonemes accurately

  A.Understanding approximately 1,000 words

  
  

  Receptive vocabulary is reported at approximately 1,000 words for 3-year-old children.