Clinical Methods in Speech-Language Pathology
Chapter Exam Questions
Course Introduction
This course provides an in-depth exploration of the foundational clinical methods and procedures used in the assessment, diagnosis, and treatment of communication and swallowing disorders across the lifespan. Students will gain practical knowledge of case history collection, clinical observation, interviewing techniques, standardized and non-standardized assessments, and intervention planning. Emphasis is placed on evidence-based practice, ethical considerations, and multicultural competence. Through a combination of lectures, case studies, and hands-on experiences, students will develop essential skills for effective clinical practice in diverse speech-language pathology settings.
Recommended Textbook
Cleft Palate and Craniofacial Anomalies Effects on Speech and Resonance 3rd Edition by Ann
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2
W.
Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) Which of the following types of phonemes are considered "pressure sensitive"?
A)Fricatives, nasals, glides
B)Fricatives, nasals, plosives
C)Glides, nasals, plosive
D)Plosives, fricatives, affricates
E)Alveolars, glides, nasals
Answer: D
Q2) What separates the two plates of the palatine process of the maxilla?
A)Incisive suture lines
B)Median palatine suture
C)Transverse palatomaxillary suture lines
D)Nasal aspect of palatine suture
E)Incisive foramen
Answer: B
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3
Chapter 2: Clefts of the Lip and Palate
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Sample Questions
Q1) A bilateral complete cleft of the lip only not the alveolus) results in the complete separation of the tissue that would normally form which structure?
A)Premaxilla
B)Prolabium
C)Philtrum
D)Columella
E)Alar base
Answer: C
Q2) Which of the following can cause a wide, bell-shaped cleft palate?
A)Chromosomal disorders
B)Genetic disorders
C)Environmental teratogens
D)Inadequate folic acid
E)Mechanical interference in utero
Answer: E
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4
Chapter 3: The Genetics Evaluation and Common
Craniofacial
Syndromes
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Q1) Cleft palate rather than cleft lip) is more likely to be associated with which of the following?
A)Deformations
B)Malformations
C)Disruptions
D)Associations
E)Other congenital anomalies
Answer: B
Q2) What is failure of the brain to divide into two separate hemispheres called?
A)Hydrocephaly
B)Macrocephaly
C)Holoprosencephaly
D)Microcephaly
E)Unicephaly
Answer: C
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Chapter 4: Genetics and Patterns of Inheritance
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Sample Questions
Q1) Which of the following describes traits that manifest only when mutations are present in both copies of a gene?
A)Dominant traits
B)Recessive traits
C)Heterogeneous traits
D)Homogenous traits
E)Autosomal dominant traits
Q2) Which of the following changes in genes does not result in craniofacial anomalies?
A)Deletion of one or more nucleotides
B)Changing the regulation of gene expression
C)Insertion of one or more nucleotides
D)Polymorphism
E)Change in the function of a protein
Q3) Which of the following is not characteristic of 'X-linked inheritance'?
A)It is caused by genes on chromosome 23
B)Females are more severely affected
C)Affected males pass the gene to 100% of their daughters
D)There is no father-to-son transmission
E)Affected females can transmit the disorder to their sons
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Page 6
Chapter 5: Feeding Problems of Infantswith Clefts or
Craniofacial Anomalies
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Sample Questions
Q1) Feeding problems are most likely to occur when the infant presents with which of the following?
A)Bilateral cleft lip
B)Incomplete cleft of the soft palate
C)Complete cleft of the palate
D)Glossoptosis
E)c and d
Q2) What two items must work synchronously to be effective for normal feeding?
A)Nipple compression and rooting reflex
B)Tongue elevation and cupping of the tongue
C)Nipple compression and generation of negative pressure suction
D)A and B
E)All of the above
Q3) When feeding an infant, a general rule of thumb to follow is that the infant should be burped after how many ounces of intake?
A)1/2 ounce
B)1 ounce
C)2 ounces
D)3 ounces
E)4 ounces
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Chapter 6: Developmental Aspects:speech, Language, and Cognition
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Sample Questions
Q1) Which of the following statements is true?
A)The infant's abnormal phonological development as a result of the open palate can persist into early speech, even after the palate is repaired.
B)Many children with VPI have reduced expressive language output due to difficulty with speech production.
C)Children with a history of cleft lip only are just as likely to have speech sound errors as children with a history of cleft palate.
D)a and b
E)a and c
Q2) Infants associate the physical movement of sound production with auditory results through which of the following?
A)Cooing and babbling system
B)Taking turns and external stimulation
C)Tactile-kinesthetic and auditory feedback loop
D)Speech stimulation of the caregivers
E)Contrasting voiced and voiceless phonemes
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8
Chapter 7: Resonance Disorders Andvelopharyngeal
Dysfunction Vpd
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Sample Questions
Q1) Which compensatory production for velopharyngeal insufficiency is often co-articulated with /b/?
A)Pharyngeal fricative
B)Pharyngeal plosive
C)Palatal dorsal production
D)Nasal fricative
E)Glottal stop
Q2) A nasal rustle sometimes called turbulence) usually occurs due to which of the following?
A)A small velopharyngeal gap
B)A large velopharyngeal gap
C)An oronasal fistula
D)Nasal emission with a deviated septum
E)Nasal obstruction
Q3) Velopharyngeal incompetence can be due to which of the following?
A)A velar fistula
B)A thin velum
C)Velar paresis
D)Enlarged tonsils
E)Irregular adenoids
Page 9
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Chapter 8: Facial, Oral and Pharyngeal Anomalies
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Sample Questions
Q1) A child who has a maxillary retrusion is likely to have which type of occlusion?
A)Class I
B)Class II
C)Class III
D)Anterior open bite
E)Underjet
Q2) Which of the following is not used as a treatment for upper airway obstruction in children?
A)Tonsillectomy
B)Adenoidectomy
C)Tracheostomy
D)Uvulopalatopharyngoplasty
E)CPAP
Q3) What syndrome causes facial nerve paralysis?
A)Crouzon syndrome
B)Down syndrome
C)Moebius syndrome
D)Treacher Collins syndrome
E)Orofaciodigital syndrome
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Chapter 9: Dental Anomalies
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Sample Questions
Q1) Which appliance can sometimes be helpful with speech therapy for correction of palatal-dorsal productions?
A)Arch appliance
B)Quad helix appliance
C)Palatal lift
D)Rapid palatal expander
E)Speech bulb
Q2) Which of the following would be considered an obligatory distortion due to a Class III malocclusion?
A)Frontal lisp
B)Lateral lisp
C)Pharyngeal fricative
D)Glottal stop
E)Velar fricative
Q3) Which sounds are most likely to be affected by a protruding premaxilla?
A)Labiodentals
B)Interdental sounds
C)Lingual-alveolars
D)Bilabials
E)Sibilants
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Chapter 10: Psychosocial Aspects Ofcleft Lippalate and
Craniofacial Anomalies
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Sample Questions
Q1) Why is the birth of a child with a craniofacial anomaly more stressful than the birth of an unaffected baby?
A)There are many extra demands on parents because of medical appointments and feeding difficulties.
B)There are unspoken parental fears that the baby may die.
C)There is a higher incidence of psychiatric disorders among parents of affected children.
D)There is a resulting change in the parents' plans for future reproduction.
E)All of the above
Q2) Which syndrome is not typically associated with intellectual impairment relative to unaffected peers?
A)Apert's syndrome
B)Smith-Lemli-Opitz syndrome
C)Treacher Collins syndrome
D)Velocardofacial syndrome
E)Fetal alcohol syndrome
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Chapter 11: Speech and Resonance Assessment
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Sample Questions
Q1) When voiced plosives sound closer to their nasal cognates m/b, n/d, and /g), what does this suggest?
A)Phoneme-specific nasality
B)A small velopharyngeal opening
C)Compensatory productions
D)Obligatory distortions
E)Hyponasality
Q2) Surgery is never indicated for which of the following?
A)Velopharyngeal insufficiency
B)Velopharyngeal incompetence
C)Velopharyngeal mislearning
D)A symptomatic fistula
E)An occult submucous cleft
Q3) If the child demonstrates nasal emission on s/z only, what is the probable cause?
A)VPI only
B)A fistula only
C)VPI and the fistula
D)Misarticulation causing nasal emission
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13
Chapter 12: Orofacial Examination
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Sample Questions
Q1) Bilateral lip pits is indicative of what syndrome?
A)Apert syndrome
B)Beckwidth-Weidemann syndrome
C)Van der Woude syndrome
D)Treacher Collins syndrome
E)Crouzon syndrome
Q2) What are infections acquired in the hospital called?
A)Nosocomial infections
B)Acquired infections
C)Microbial infections
D)Septic infections
E)Influenzacoccal infections
Q3) Which of the following is an abnormal finding in the palate?
A)Torus palatinus
B)Median palatine raphe
C)Velar dimple
D)Zona pellucida
E)Palatal rugae
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14
Chapter 14: Nasometry
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Sample Questions
Q1) What is the advantage of using a standardized passage to gather nasometric data?
A)The passage can be read by the individual rather than repeated.
B)It is easier to administer because it is well-known by the examiner.
C)The patient's score can be compared to normative data.
D)The passage is designed to contain only certain sounds to make it easier to produce.
E)The passage can be designed to contain only oral sounds.
Q2) What should the nasalance score be for a prolonged /s/ when produced by a normal speaker?
A)0%
B)About 5%
C)About 10%
D)About 15%
E)About 20%
Q3) What does a high nasalance score indicate?
A)Nasal emission
B)Nasal rustle
C)Hypernasality
D)Hyponasality
E)Cul-de-sac resonance
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Page 15
Chapter 15: Speech Aerodynamics
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Sample Questions
Q1) Which of the following causes the rapid displacement of the vocal folds during speech?
A)Hypopharyngeal airflow
B)Subglottic air pressure
C)Vocal fold vibration
D)Decrease in air pressure
E)Phonation
Q2) Which of the following should always be considered when assessing the status of the nasal airway in children?
A)Size of the child
B)Weight of the child
C)Age of the child
D)Opening to the nasal vestibule
E)History of allergies
Q3) Which of the following cannot be determined by aerodynamic methods?
A)Timing aspects of velopharyngeal function
B)Extent of nasal emission
C)Patency of the nasal airways during breathing
D)Estimates velopharyngeal orifice size
E)Severity of hypernasality
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Chapter 16: Videofluoroscopy
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Sample Questions
Q1) Which view is done to view the lateral pharyngeal walls?
A)Lateral view
B)Frontal view
C)Base view
D)Oblique view
E)Towne's view
Q2) In comparison with nasopharyngoscopy, videofluoroscopy is superior in showing which of the following?
A)The length of the velum and the point of contact on the pharyngeal wall
B)The adenoid pad and irregularity of the surface
C)The nasal surface of the velum and evidence of a submucous cleft
D)The lateral pharyngeal wall movement and symmetry
E)The basic pattern of closure
Q3) Which view shows velar height during phonation?
A)Lateral view
B)Frontal view
C)Base view
D)Oblique view
E)Towne's view
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Page 17
Chapter 17: Nasopharyngoscopy
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Sample Questions
Q1) What is the typical diameter of a pediatric scope?
A)0.5 mm
B)1 mm
C)1.7 mm
D)2.2 mm
E)3.2 mm
Q2) Which of the following suggests the presence of a small velopharyngeal opening?
A)Bubbling of secretions
B)Irregularity of the posterior part of the velum
C)Irregular adenoid tissue
D)A small black circle
E)Visible airflow through the valve
Q3) For surgical planning, what is the most important finding through nasopharyngoscopy?
A)Size of the opening
B)Shape of the opening
C)Location of the opening
D)Timing of closure
E)Pattern of closure
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Page 18
Chapter 18: Surgical Management of Clefts and
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Sample Questions
Q1) What is a common surgical procedure for correction of velopharyngeal insufficiency?
A)Palatoplasty
B)Pharyngeal flap
C)Abbe flap
D)Palatal lift
E)Intravelar veloplasty
Q2) The earliest that a pharyngoplasty is usually done is at what age?
A)1 to 2 years
B)2 to 2½ years
C)2½ to 3 years
D)3½ to 4 years
E)5 to 6 years
Q3) With regard to the timing of cleft lip repair, the "rule of 10s" includes which of the following?
A)10 months old and 10 pounds
B)10 weeks of age and 10 pounds
C)10 grams of hemoglobin
D)b and c
E)a and b
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Chapter 19: Orthognathic Surgery for Craniofacial
Conditions
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Sample Questions
Q1) Which of the following typically causes a cant to the maxilla?
A)Crouzon syndrome
B)Apert syndrome
C)Treacher Collins syndrome
D)Hemifacial microsomia
E)Stickler's syndrome
Q2) Orthognathic surgery of the maxilla cannot be performed until which of the following is well developed?
A)Maxilla
B)Maxillary sinus
C)Dentition
D)Mandible
E)Palatal arch
Q3) If an alveolar cleft is left untreated, what can be the result?
A)Loss of the permanent lateral incisor
B)Loss of the central incisor
C)Loss of the canine cuspid) tooth
D)a and b
E)a and c
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Chapter 20: Prosthetic Management
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Q1) In which situations is it most appropriate to consider the use a speech appliance?
A)When there is severe velopharyngeal insufficiency
B)When the patient has primarily obligatory speech distortions
C)When the child is not stimulable for a reduction in nasality with a change in placement
D)When surgical correction is not an option
E)When the cleft of the palate is very wide
Q2) With a palatal lift, which part of the appliance holds the velum in place?
A)Body
B)Tail
C)Mid-piece
D)Prongs
E)Bar
Q3) Which of the following is not true of reduction therapy?
A)It aims to improve velopharyngeal function.
B)The length of the lift is gradually increased.
C)It aims to stimulate movement of the velopharyngeal structures.
D)It aims to avoid surgery, or reduce the severity of the surgery.
E)The length of time wearing it is gradually decreased.
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Page 21
Chapter 21: Speech Therapy
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Sample Questions
Q1) Which of the following can be corrected with speech therapy?
A)Hypernasality due to VPI
B)Compensatory productions secondary to VPI
C)Obligatory distortions secondary to VPI
D)Nasal emission due to VPI
E)Nasal rustle due to VPI
Q2) Which of the following is true about obligatory distortions?
A)They commonly occur with structural anomalies in the vocal tract.
B)They can be corrected with speech therapy.
C)Manner is maintained, but placement is altered.
D)One type of obligatory distortion is the glottal stop.
E)They always cause nasal emission.
Q3) What speech sound should be inserted between the consonant and the vowel when trying to eliminate glottal stops?
A)/m/
B)/h/
C)/i/
D)/n/
E)/s/
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Page 22
Chapter 22: The Team Approach
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Q1) Based on ACPA recommendations, which professionals must be on a Cleft Palate Team as a very minimum?
A)Plastic surgeon, ENT, pedodontist
B)Surgeon, dental professional, speech-language pathologist
C)Plastic surgeon, ENT, speech-language pathologist
D)Plastic surgeon, oral surgeon, speech-language pathologist
E)Dental professional, orthodontist, plastic surgeon
Q2) The team's primary contact person for the family is usually which of the following?
A)Primary care physician
B)Pediatrician
C)Family doctor
D)Managing surgeon
E)Team coordinator
Q3) Most of the managed care organizations exist as which of the following?
A)For-profit corporations
B)Not-for-profit organizations
C)Third-party administrators
D)Preferred providers PPOs.
E)Government-run providers
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Page 23
Chapter 23: Cleft Care in Developing Countries
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Sample Questions
Q1) What is the primary role of the speech-language pathologist on a cleft palate surgical mission?
A)To evaluate patients for VPI
B)To determine which patients are appropriate for palate repair
C)To work with the dental professional to develop speech appliances
D)To provide speech therapy
E)To counsel the family and teach others
Q2) Which of the following statements is true?
A)The prevalence of clefts varies with ethnic background.
B)The prevalence of clefts varies with socioeconomic status.
C)The prevalence of clefts is not affected by malnutrition.
D)a and b
E)b and c
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Chapter 24: Velopharyngeal Dysfunction and Speech Disorders
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Sample Questions
Q1) What procedure is best for identifying an occult submucous cleft?
A)A visual inspection of the velum
B)Palpation of the velum
C)Videofluoroscopy
D)Nasopharyngoscopy
E)Nasometry
Q2) A patient evaluation finds that she has a combination of hyponasality and inconsistent nasal emission.Irregular adenoids are suspected as a cause.What is the best way to evaluate that?
A)Nasometry
B)Nasopharyngoscopy
C)Videofluoroscopy
D)Aerodynamic measures
E)An Intraoral examination
Q3) Nasal emission is most audible on which of the following sounds?
A)Nasal sounds
B)Voiceless consonants
C)Vowels
D)Voiced continuents
E)Voiced plosives
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